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PIP increased on review but not backdated ?

MJK
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Chesterfield Citizens Advice

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Hi - I am a bit taken aback to find that although my Client has been awarded a higher amount of PIP, now enhanced both elements,  following our submission of a review form in March the increase is not being backdated to March.  The decision letter dated 27/11/2020 states the increased award is payable from 27/11/2020. 
Is this correct - it is detrimental to the Client if he misses out on benefit because it took the DWP 8 months to review his claim (administrative delay).  Your thoughts welcomed

Daphne
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Unless they have a reason to say that the changes in her circumstances meant she only met the criteria applied from 27/11/20, then they should be paid from date notified of change of circs - see part 2 of schedule 1 of the D&A Regs - https://www.legislation.gov.uk/uksi/2013/381/schedule/1

bristol_1
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WRAMAS Bristol City Council

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Hello, I’m wondering if I’m seeing things right, as to whether there could be scope for my client’s increased PIP award to start from an earlier date?

My client had an existing award of PIP SRDL. DWP commenced a ‘planned intervention’ i.e. award review by sending a PIPAR dated 11/11/2019, he returned this on 09/12/19 and sent medical evidence returned 19/03/20. An assessment date was given on 23/10/20, but after an hour no-one had called and my client went to the loo (has urinary frequency) only to miss the assessor calling him (1 hour late). A further assessment was booked for 22/01/21 and an award decision was made 15/02/21 awarding SRDL and adding 2 (d) 10 points for SRM, but only from the date of the decision (15/02/2021), stating “I cannot increase your award from earlier as you did not tell us within the 13 month limit”.

This appears to be referring to Para 15 of Schedule 1, Part 2 & Reg 36 of The UC, PIP, JSA & ESA (Decisions and Appeals) Regs 2013; but the award letter makes no reference to what the change was - if we are saying the change was worsened mobility, the client did report this early on by the evidence he wrote on his PIPAR back in 2019, to summarise: ‘I can only walk about 4 bus lengths before I stop, using my stick at all times’.

I don’t see why they can’t use Para 18 of Schedule 1, Part 2:
‘18.  Where the superseding decision is advantageous to the claimant and is made on the Secretary of State’s own initiative, the decision takes effect from the date on which the Secretary of State commenced action with a view to supersession.’
Or indeed rely on Para 15, but use the date of notification of the change, if they think the change occurred more than 13 months before the PIPAR was completed.

This would give scope for the increased award to start from an earlier date - any thoughts?

Elliot Kent
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Shelter

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The first question is - is the supersession attributable to a change of circumstances? If so, then reg 23 and the earlier grounds for supersession may be raised. If the answer is “no” then you are left with just reg 26 and the decision taking effect on the date of the decision.

Then if the supersession is attributable to a change of circumstances, the question is when it was notified to DWP.
(1) If the change was notified in advance, on the date of the change or within a month thereafter, the decision operates from the date the change resulted in an increased entitlement to PIP.
(2) If the change was notified more than one month but less than 13 months after it occurred and the time for reporting the change is extended, the decision operates from the date the change resulted in an increased entitlement to PIP.
(3) If the change was notified more than 13 months after it occurred - or if the time for a late reporting of the change is not extended - then the decision operates from the date the change was reported.

In your case, the decision maker has immediately gone wrong because they have concluded that as this is a case in the third category, the decision takes effect from the date of the decision rather than the date the change was reported. So there immediately appears to be grounds for challenge there even accepting the position is as the decision maker describes (which of course you aren’t obliged to).

You ask if it is possible to in any case argue that the effective date of the supersession can be the date that the DWP instigates the review process on the basis of para 18. I think this is arguable although I am sceptical about it. I am not sure that it is right to say that the review is action with a view to a supersession when the process is nominally ‘neutral’ as to whether a superseding decision will occur. 

 

bristol_1
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Superb breakdown, thank you Elliott. I think from the wording DWP must be treating it as a change of circs and I can’t see they’ve got this anywhere near right. I will go for an MR on the effective date of the decision.

The bit about him missing the 1st assessment phone call was just in case there is any merit in throwing in a complaint about AP practice/delay in assessing PIP claims but as there appears to be a recourse based on the Regs I will go via that.