Advice about an MR for Mobility

Hi Margaret

I'm sorry that you have not been awarded what you were hoping for. Have you got a copy of the PA4 - Assessor's report? If you haven't then you should ring the DWP and ask for a copy.

You can fill out a form or write a letter about the Mandatory Reconsideration. If you have a look at the Guide to PIP Appeals. which explains putting in for an MR - and the choices you have benefitsandwork.co.uk/guides-for-claimants/pip (Scroll down the page to find the right guide).

You ask whether an assessor can dismiss a hospital doctor's diagnosis. I would like to say 'no,' but in truth, assessors do it all the time. I suspect that the assessor didn't even know what cauda equine syndrome is (especially as it is rare) —and unless your assessor was a consultant rheumatologist or consultant neurologist (which I'm sure they weren't), they don't have the experience or skills to dismiss what the A&E doctor said.

I have no idea what your expected walking speed is supposed to be and I don't think it's particularly helpful to try and even quote one. From what you've said you have proof from the doctor that you have problems getting out of a chair. That means you have problems from the moment you try and stand. You have unreliable balance issues, you are in pain etc etc You are at a risk of falling and you have proof. So you cannot walk safely, or reliably and the fact that your balance is so unreliable - it's obvious that you will not work as quickly as someone who doesn't have the same condition. Speed for me doesn't come into it, and I wouldn't try and argue that. I think in your MR, you should say that the assessor was unaware of the severity of the symptoms experienced by someone with cauda equine syndrome (which is a rare form of stenosis) along with the other issues and how debilitating this is for you being able to move around your house or venture outside.

Have a look at the Guide and then come back and ask if you have any further questions. You only have one month from the date on the decision letter to get your response in.

BIS

Hi Margaret,

To add further explanation to what BIS has said.

Here is an extract from a recent post I wrote.

Regulation 4(2A) PIP Regs 2013 provides that all PIP descriptor activities have to be completed
• safely
• repeatedly
• to an acceptable standard
• within a reasonable time
This is the so called 'reliability' criteria - all 4 must apply- if you fail to meet even just one of the four this indicates you can't do that descriptor and may need help, an aid or actually can not do the task
Safely - is there a substantial risk that harm might occur? So, if you have epilepsy, and a fit could occur causing danger then this indicates eg supervision for bathing- it doesn't matter whether the likelihood of the fit is infrequent; clearly a fit in the bath could have very serious consequences. Safety issues could comprise dropping knives, or hot pans/food whilst cooking or eating, but could also include leaving the cooker on, and running the risk of fire etc. Falls indicate safety issues, not hearing traffic coming could indicate the need for supervision if out walking.

Acceptable standard is not defined but kind of means the level of completion expected by others. Leaving large messes whilst cooking, or constantly spilling food off the plate or food probably isn't acceptable. Only being able to hear half the words being said is unlikely to be acceptable. Putting on clothes upside down or back to front with buttons not aligned with the button holes is unlikely to be acceptable.
In addition, significant amounts of pain will also be 'unacceptable".

Reasonable time- this is defined as no more than twice that of non disabled person. If you take too long again this shows a need for an aid or physical help.
Some of these criteria overlap- if you are too slow then this probably isn't acceptable. Leaving slip hazards in kitchen could be both unsafe and unacceptable.
Finally consider repetition, tasks need to be done as many times a day as reasonable. The repetition rate will vary across the descriptors.You might wish to cook 3 times a day. Toilet needs with incontinence might need to be managed 10 or more times per day. With journeys and walking this could be 6 or 7 times per day. Bearing in mind the journey could be by car or public transport, but inevitably will involve at least a few short steps to the car and into the nearby building. It would not be unreasonable for someone to take kids to school, go to supermarket, need to go and get new shoes, walk back to car via card shop. Go home.Write card and go to post box. Pick up the kids. Visit mother in evening. None of these journeys or small amounts of walking would be unreasonable, and perhaps one of two more might be required. Communication could however be required 24/7.

You need to be able to do all the required repeats acceptably safely and within the appropriate time for each descriptor. If you fail to repeat except for a trivial time eg 5 mins of the day you can't communicate you can achieve points in accordance with the level of disability under the relevant descriptor.

A descriptor will be met if you can't achieve any/all of the 4 criteria for the majority of days. This means that if you have a better day every so often, that won't preclude points/award of PIP.

Fatigue could also comprise non acceptable standard. It is easy to consider each descriptor task in isolation. Think about the descriptors holistically.
So...if I asked you, do you cook? - if you told me yes, but only when I don't go walking, and it's not the day I have a bath. This would suggest you can't repeat all the activities across the day. Likewise if fatigue, pain breathlessness increase in blood pressure, etc makes activities too slow, this might indicate a problem with repetition as well as being unacceptable standard, and perhaps not safe.

To answer your specific query.
In terms of mobility, it seems to me that you may have a very strong argument to say that you can not walk at all.

Descriptor 2e says
Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided.
12 points.

2f says
Cannot, either aided or unaided - (i) stand; or (ii) move more than 1 metre. 12 points

Your post suggests an outright maximum of around 6m. But PIP is not about how far can you actually go. As explained above, safety, repetition etc must be fulfilled. Since you have falls, often within a very short distance of a chair, and struggle to get out of the chair this suggests you might be able to argue 2f it appears that you can not achieve this descriptor safely, in a reasonable time. (You may not do this acceptably or repeatedly either - but you only need to fail one criteria to fulfil the 'can not' in the descriptor.

I doubt very much that the walking speed you describe will allow you to conduct any walking within a reasonable time either.

I suggest that you write a letter with a paragraph or two setting out your health issues, and background to these eg if you had an accident, when this happened etc. Detail any surgery.
Then write a paragraph about flaws in the report.
Get a scrap of paper first and list the major issues with the report. Formulate these into 4 or 5 bullet points and give examples. Write these in the letter.
You can then go through each descriptor and if you agree with the points says so. Or, if not explain at what level can you perform activity within each descriptor set. (Bear in mind the 4 criteria.) Give examples. You can have a more specific critism of the assessment report here. Also explain why DWP is wrong.
Include and refer to any medical evidence, send more in if you have this.
You haven't mentioned if this is a first claim, (or move from DLA,) or renewal. If either of the latter then thus us a supersession case and DWP would have to show an actual change if circumstances has occurred.
Finally, and crucially very important. Given that you maybe nearing pension age, if you do not send in an MR letter now you will not be able to attain enhanced rate mobility, as you can't 'upgrade' your mobility award after state pension age, unless you are awaiting the outcome of MR/tribunal appeal already started. You can always upgrade standard daily living if your health deteriorates sufficiently.
Whilst you specifically mention about mobility, you may also wish to consider whether you should have been awarded enhanced daily living rate too. Pain, slow speed, safety etc apply equally to daily living tasks.

Your MR letter should be sent within 1 month if the decision letter. However, time can be extended if you have reasonable cause and can show this. I'll health, family crisis etc could all comprise such reasonable excuse.
Make sure all pages have your name and NI number clearly marked.

I hope this helps.
Good luck.
LL26

Hi Margaret

I despair at the idiocy of some of their assumptions. The way you have described it here is exactly what you should tell them on your MR. I would say something along the lines of "The assessor has said a, b, c, but they have missed several of the key symptoms of my diagnosis, XYZ, which means that I am prone to falling every time I stand etc, etc... I previously explained this on my PIP form.

And yes, these problems do restrict your ability to cook.

BIS