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Worst day

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1 month 2 weeks ago #295036 by Mich3769
Worst day was created by Mich3769
Hi

I completed my pip on my worst day and now I am worried I will be seen as fraudulent. I recently received my award but want to correct this to give a clear picture….. how do I do this ???

I do have written evidence from professionals but want to push myself to get better and not stay in worst scenario….

Advice appreciated please.

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1 month 2 weeks ago #295041 by LL26
Replied by LL26 on topic Worst day
Hi Mich3769,
You get descriptor points for showing that you can't complete the activity 'reliably ' for the majority of days.
'Reliably' is the shorthand for 4 criteria - all of which must be met.
•Safety - is there a risk of substantial harm?
• Reasonable time- not more than twice that if non disabled
•Acceptable standard- what normally is expected. Additionally if you get significant pain fatigue, breathlessness this indicates not acceptable
standard.
•Repeatedly ie as many times as reasonably required throughout the whole day.
Consider the above, and re-read the members guides concerning each descriptor as appropriate. Remember that help needs to be reasonably required, you don't need to prove you actually have help.
Think about how you do the activities, if you don't perform them safely, timely etc then this indicates you either need aid/help or possibly can not do.
Be brutally honest, and ask eg partner or friend to do the same analysis.
Compare this with what DWP says. If they are the same then you are on the correct level of benefit.
If your scores are somewhat less but overall the award is correct eg you score 9 points and DWP score 11, this won't make a difference either.
If your worse case disability is for more the majority of days then that level of points will be correct. However if you still have less disability on other days, still comprising a descriptor score, you can aggregate the scores. If you can show eg across 1 week or 1 month that you have a descriptor scoring disability for at least the majority of days that gives different scores, your correct score is the one that will apply for the most of the time. If 2 or more scores in one descriptor apply equally for at least the majority of days , then the highest value applies. (Regulation 7 PIP Regs 2013)
Obviously if your newly calculated scores are much less than DWP and you are not entitled to benefit or benefit at that level, you should write to DWP immediately. Explain that you got confused about filling out the form, you used the worst case scenario as that's what you believed to be correct.
The likelihood is that DWP may well remove all benefit, unless you can successfully argue only some descriptors were exaggerated.
Dwp may claim you were therefore wrongly paid, thus creating an overpayment. It is also possible that DWP may state you made a fraudulent claim.
Thus you need to be very careful about saying your claim form was wrong.
You have said you have evidence from professionals. If this supports your claim then don't worry.
I'm wondering if you are overthinking about this.
Disabled people, especially those with anxiety issues often tend to undervalue their disabilities. Regulation 7 might have been used.
If your health is sufficiently poor that you are entitled to benefit then you are entitled! There may well be others with more disability or indeed somewhat less who also qualify. There are many disabilities at various levels that will correctly provide benefit.
Don't worry about this. Think just about yourself.
If your health actually improves then you can write to DWP and explain you are better. DWP can then review your claim accordingly.
If your health doesn't improve, and you are entitled to the level of benefit DWP provides then use the money to help provide some comforts for yourself.
I hope this helps.
LL26

Nothing on this board constitutes legal advice - always consult a professional about specific problems
The following user(s) said Thank You: Mich3769

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1 month 2 weeks ago #295046 by LL26
Replied by LL26 on topic Worst day
Hi Mich3769,
You get descriptor points for showing that you can't complete the activity 'reliably ' for the majority of days.
'Reliably' is the shorthand for 4 criteria - all of which must be met.
•Safety - is there a risk of substantial harm?
• Reasonable time- not more than twice that if non disabled
•Acceptable standard- what normally is expected. Additionally if you get significant pain fatigue, breathlessness this indicates not acceptable
standard.
•Repeatedly ie as many times as reasonably required throughout the whole day.
Consider the above, and re-read the members guides concerning each descriptor as appropriate. Remember that help needs to be reasonably required, you don't need to prove you actually have help.
Think about how you do the activities, if you don't perform them safely, timely etc then this indicates you either need aid/help or possibly can not do.
Be brutally honest, and ask eg partner or friend to do the same analysis.
Compare this with what DWP says. If they are the same then you are on the correct level of benefit.
If your scores are somewhat less but overall the award is correct eg you score 9 points and DWP score 11, this won't make a difference either.
If your worse case disability is for more the majority of days then that level of points will be correct. However if you still have less disability on other days, still comprising a descriptor score, you can aggregate the scores. If you can show eg across 1 week or 1 month that you have a descriptor scoring disability for at least the majority of days that gives different scores, your correct score is the one that will apply for the most of the time. If 2 or more scores in one descriptor apply equally for at least the majority of days , then the highest value applies. (Regulation 7 PIP Regs 2013)
Obviously if your newly calculated scores are much less than DWP and you are not entitled to benefit or benefit at that level, you should write to DWP immediately. Explain that you got confused about filling out the form, you used the worst case scenario as that's what you believed to be correct.
The likelihood is that DWP may well remove all benefit, unless you can successfully argue only some descriptors were exaggerated.
Dwp may claim you were therefore wrongly paid, thus creating an overpayment. It is also possible that DWP may state you made a fraudulent claim.
Thus you need to be very careful about saying your claim form was wrong.
You have said you have evidence from professionals. If this supports your claim then don't worry.
I'm wondering if you are overthinking about this.
Disabled people, especially those with anxiety issues often tend to undervalue their disabilities. Regulation 7 might have been used.
If your health is sufficiently poor that you are entitled to benefit then you are entitled! There may well be others with more disability or indeed somewhat less who also qualify. There are many disabilities at various levels that will correctly provide benefit.
Don't worry about this. Think just about yourself.
If your health actually improves then you can write to DWP and explain you are better. DWP can then review your claim accordingly.
If your health doesn't improve, and you are entitled to the level of benefit DWP provides then use the money to help provide some comforts for yourself.
I hope this helps.
LL26

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

Please Log in or Create an account to join the conversation.

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