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Change of circumstances whilst waiting for PIP renewal to be processed by DWP

  • Onceuponatime6789
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6 months 3 weeks ago #290562 by Onceuponatime6789
Hi everyone,

I was awarded higher rate care and higher rate mobility for PIP and my first renewal was due October 2023. I submitted the renewal form on time and included a form from my GP in which she said I still needed help with all areas (the letter template suggested on this website) and a letter from my Community Mental Health Nurse along the same lines.

I haven´t had any response from the DWP except they have my form and there´s a delay in processing. They´ve extended my award to cover this period and continue to pay me.

However, a couple of months ago I started to see a private practitioner who a) believes I was misdiagnosed and b) provided new treatment that has significantly reduced the amount of help I need at least at the moment, though it´s early days.

I would like to know what will happen if I submit a change of circumstances reducing my claim to help with mobility only or even ending my claim completely, depending how recovery goes. Would they attempt to reclaim all payments since my renewal date (or earlier) or would they respect that this change has happened only recently (as is the truth)? How would I prove this either way? I´m very anxious and would like to know the worst that could happen.

Thanks so much

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6 months 3 weeks ago #290571 by LL26
Hi Onceuponatime6789,
Firstly it good to hear that your health has improved.
OK, the law is clear that you need to report a change if circumstances (here health improvement) that could affect your benefit.
However, there are two things you need to consider.
1. Be absolutely sure that your condition has truly improved. I am aware of people who get different medication and think everything is improving but a little later realise that thus may not be the case, or there are troublesome side effects etc (which I hope isn't the case for you.) Speak to your medics to clarify this point if you need to.
2. Just because your health has improved, it doesn't mean you necessarily lose points/ benefit. A good example of this is you can score 4 points for being able to walk 50-200m. If you could only walk 60m, and now walk 180m this is a vast improvement mathematically, but you would still fall within the 4 points range.
Similarly, consider the effect of pain, (acceptable standard)safety, repetition and reasonable time. Of your pain levels have decreased from 10/10 to 8/10 it is still likely you should get points, as you have sufficient pain to be 'unacceptable'.
Have a re-read of the guides and match your new condition to the descriptors. Also if you had enhanced rate daily living with say 16 points and the health improvements amount to only 2 less points you still qualify for enhanced rate.

So, if you are certain your health has improved and your level of benefit needs to be reduced, then you must contact DWP ASAP - don't wait until your assessment. (Per point 1 above, I think there must be a grace period after a new treatment and the certainty of improvement. I can't advise you exactly how long this is, as it will depend on your own circumstances, but given your post this is clearly something that you believe may have happened.) Hence phone up DWP, and make sure they note that you have improved, this information will then be made available at the review and forthcoming assessment.
You will no doubt be asked when did your health improve. Say 'from today', or say a previous date as appropriate.
Normally DWP allow a month to report a change. You can say you have had a different medication etc which seems to be working etc. You said you have had the medication for 2 months, and hence the worse possible scenario is to receive an overpayment for 2 months. However given what I have explained above I do not think that DWP have a strong argument to say that you should have reported the change earlier, and hence on thus basis there should be not be any overpayment
if you report the change shortly.
If you delay in reporting a definite change that you are aware of, that would lead to a reduced award, then yes you risk creating an overpayment, and more important, you would be committing fraud.
One can never be sure what DWP will actually do. I have seen instances where a decision removing benefit has been made following a poor assessment report. DWP have then attempted to remove benefit from the previous renewal date, many months previously. In order to remove/reduce benefit (called a supersession) there has to be evidence of an actual change, and as part of that decision DWP need to prove the effective date of the change in order for the supersession to be legally valid. If the effective date is incorrect you would have a right of appeal, and you can use thus to argue against any such overpayment, if it was to arise.
To recap, if you are sure you have improved, then report ASAP to avoid the likelihood of overpayment.

I hope this helps.
LL26

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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