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DLA reconsideration

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Hi Im Rachel and this is my first post although I often read posts and have taken a lot of advice from them.

 

First a bit about my condition:

 

I suffer from chronic pelvic pain caused a potential multitude of gynaecological conditions although none of these can be officially confirmed without surgery and I have 2 blood conditions that make surgery a very high risk, for example the last surgery I had caused a pulmonary embolism . this condition makes putting any pressure on my right side painful and thus I struggle with walking I use a stick but that only helps a little. I cannot bend at all and don’t even get me started on managing stairs. On a bad day which is the majority of days I cannot even sit up without assistance, I have to be carried by very loving and amazing husband which is difficult when he’s working (someone’s got the pay the bills hey) I also suffer from depression and social anxiety almost going on agoraphobia, and dyspraxia , oh and a eating disorder(emotional binge eating)

 

I put a DLA claim and a visit from one of those lovely ATOS DRS he is a local GP so I had already heard bad things about him, but thought id give him a chance anyway sure enough a week after the rejection letter came, seems he has focused on my mental health and barley touched on my physical issues the problem I think with this is that my GP doesn’t take them seriously, for five years I’ve been begging for counselling my consultant has written several times requesting psychotherapy but the answer I get is there’s no money for that! I feel like asking for a refund on my taxes!!!:mad: I spoke to someone from the welfare rights and they told me if you’re not under a psychologist they will assume your mental health problems aren’t serious – is this true?:? If it is I feel a bit gyped

 

So I asked for a reconsideration and have now got to send in supporting information, what I’ve done is for every point on the refusal letter written a paragraph explaining why it is incorrect. I also keep a symptom diary and I’ve included copies of exerts and typed up exerts(because I doubt they would be able to read them) showing the frequency and severity. Is this the right way to go about this and do I need to be getting supporting letters from consultant or GP or that only at the appeal stage which I have accepted is prob going to have to happen.

 

Any advice would be much appreciated and sorry for the super long post.

 

Thanks

rachel


The whole world is made of faith, trust and pixie dust :p

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what I’ve done is for every point on the refusal letter written a paragraph explaining why it is incorrect. I also keep a symptom diary and I’ve included copies of exerts and typed up exerts(because I doubt they would be able to read them) showing the frequency and severity.

 

YES - that is the best manner of doing it. Also point out anywhere that they contradict themselves. When you are talking about the symptoms, make sure you focus on what help you need as a result of the symptoms.

 

The most common mistake people make with DLA claims is telling them all about their symptoms, rather than what needs arise from those symptoms. DLA is awarded based on the amount of help a person needs with their care and/or mobility, not the illness or symptoms in itself.

 

do I need to be getting supporting letters from consultant or GP or that only at the appeal stage which I have accepted is prob going to have to happen.

 

Thanks

rachel

 

Do it just now - but the letters must relate to how your condition was at the time the decision was made, i.e they cannot include any new ailments even if you have deteriorated; that would be disregarded as a reconsideration and appeal only deals with the condition from the date you claimed to the date of the decision. If there is going to be a delay in you getting the letters you need, send the reconsideration request but make mention in your covering letter requesting reconsideration that further supporting evidence from your own medical professionals will be forwarded in due course to support your case.

 

You can of course wait till appeal stage but personally I wouldn't. I'd send all information you can get now. I got DLA decision revised on reconsideration (for my child) without the need for a tribunal.

 

Also have a look at the examples in the DLA guides (I will post below) and think how that can apply to your own situation. It's hard for them to argue when the information is taken directly from their own guides. There is also significant case law you can use to win your case. Again, I'll post links at the end.

 

Think about your day, and write about it. From the moment you get up to the following morning. How do you get out of bed, wash, bathe/shower, dress, eat, get out and about etc - the whole day and the night too if you need night time care. When you really sit down and think about it, you may find that you have missed out vital information on the claim form. Sometimes there are things that we just "do" and because it is how we manage, we don't stop to think that this is actually something that we wouldn't do that particular way or with that kind of help, if the condition wasn't present.

 

Chapter 61 AA and DLA

 

Disability handbook

DLA A-Z

 

Sources of Evidence

 

Common medical tests

 

Case law digest - DLA and AA

Search for jugdments

 

Hope this is helpful.


My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

 

 

Please do not seek, offer or produce advice on a consumer issue via private message; it is against

forum rules to advise via private message, therefore pm's requesting private advice will not receive a response.

(exceptions for prior authorisation)

 

 

 

 

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Thanks Erika:)

 

I will have a look at those, i will get on to my consultants and GP but i do worry about the amount of time this may take i don't think i will get it within the time scale especially as i am not seeing my new pain specialist until October, my consultant was unhappy with the last one i saw, but at least i know they will be ready for an appeal in necessary.

 

Thanks Again

Rachel.


The whole world is made of faith, trust and pixie dust :p

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Hi,

I recently put into appeal my DLA decision after having reconsideration and still being refused, I included a lot or what I thought was a lot of information to the dwp this included

 

• Comments on each point they raised in the original refusal as to why I disagreed and what my needs were

• Detailed itinerary of a bad day and an average day, stating how often each occur

• A statement from my husband who cares for me

• Exerts from diary specifying occasions where something major had occurred such as a fall or panic attack, need for emergency medication

• Photographic evidence of occasions of self harming

 

I called and requested a written statement of reasons and what they have sent me is a reiteration of the refusal letter with no further information and the requirements for eligibility

 

Is this right if so what is point of this is doesn’t offer me any helpful information?

 

I also wrote to my consultant and saw my GP about getting supporting letters although they are both happy to support my claim they have both said they can do so if the dwp write to them and request this, my consultant has not been contacted. My GP was but it was at a time when my GP was off sick so it was done by one of the other partners who does not know me in fact they have not seen me for over 3 years I remember because it was very first time I went when my problems began. I haven’t seen the report but I feel that is very generic with no insight into my personal circumstances as this GP is not very patient orientated id goes as far as to say they are rude, obnoxious and insensitive.

 

Is there anything else I can do I really don’t know what I can possibly put into the appeal that I haven’t already done, I feel really stuck now.

 

Any suggestions would be much appreciated

 

Thanks

Rach


The whole world is made of faith, trust and pixie dust :p

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Hi

 

I am still doing my appeal and when I have carefully read the decline letters from my original application and my reconsideration they both totally disagree with each other. For my reconsideration I sent in quite substantial additional information. However I can’t get medical information as they will only issue it to the DWP so I admit that it was about lacking in that department. But even with this additional information the DM has stated I need no help at all, where as the first acknowledged I had some needs but not sufficient enough to qualify.

For example

 

DM 1 can walk up to 99m

DM2 can walk over 100m

 

DM1 Need help for comfort and reassurance

DM2 Does not ……….

 

DM1 need some help with personal care

DM 2 Need no help……………………….

 

And it goes on like that for most points.

 

I wonder if it would be valid out or a useful angle to point out that these disagreements show some potential discrepancies in the way the original information has been understood as the only evidence the DM had to evidence this disagreement was my additional information. I am quite sure did not prove any further capabilities.

 

Does anyone understand what I’m saying, I’m finding it difficult to explain and does any on e have any opinions or advise please.

 

Thanks

Rach


The whole world is made of faith, trust and pixie dust :p

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I understand completely what you are saying.

 

The DM on reconsideration is entitled to reach their own conclusion on the matter and disagree with the first DM, which is afterall the point of a reconsideration. For example, if they were to change the decision in your favour, they would have to disagree with the original DM in order to do that.

 

It is better if you can find contradictions in the decisions of the same person, because this demonatrates a lack of consistency in their measuring of the evidence.

 

However in view of the additional information which further demonstrates your needs as opposed to capability I'd say that the vast discrepancies between the two DM's determinations would raise a serious doubt in respect of consideration of all of the evidence, and boy I'd encourage you to use that. Along the lines of:

 

The original DM felt I had some needs arising from a, b or c. This decision was based on (insert what it was based on - the original decision letter should say what that was). On requesting reconsideration, I presented to DWP additional evidence from (insert name of medical professional for example) which further supports that I have these needs, but in addition have xyz needs. This evidence demontrates that the needs I have in respect of (personal care/mobility etc - insert as applicable) are to a greater extent than originally accepted by the DM in the initial decision.

 

In spite of this, the DM on reconsideration appears to have completely disregarded both the original evidence which was initially accepted to demonstrate a need for abc and the additional evidence presented which further supports my needs in respect of abc and xyz, in reaching a determination that I have no needs whatsoever. The two seperate determinations made on behalf of the Secretery of State contradict each other almost in their entirity.

 

Obviously tailor it to your own needs, but it gives you an idea of what to write.

 

In respect of the medical report, you will get this once DWP make their submission to the Tribunal Service; they send a copy of their schedule of evidence to you. However you can ask DWP to provide you with a copy to enable you to gather your own evidence to challenge the decision. Don't delay in getting the appeal in though - you can write your submission to the tribunal at a later date, but you can't be late in getting in your appeal or it may not be accepted.


My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

 

 

Please do not seek, offer or produce advice on a consumer issue via private message; it is against

forum rules to advise via private message, therefore pm's requesting private advice will not receive a response.

(exceptions for prior authorisation)

 

 

 

 

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Thanks Erika, that is really helpful, i have until the 19th to get my appeal in but i hope to have it posted by the end of this week to make sure it gets there in time.

 

thanks again

rach


The whole world is made of faith, trust and pixie dust :p

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Best wishes, Rachael. Just another word of advise - you may want to ask for assistance from Welfare Rights again, particularly with the submission. They may be able to help you from completing the GL24 to a tribunal hearing but funding is being drastically cut for Welfare Rights, so if they are not able to help with everything, try and see if they can at least help with the submission as that it the most important part, though it's a long way off yet.


My advice is based on my opinion, my experience and my education. I do not profess to be an expert in any given field. If requested, I will provide a link where possible to relevant legislation or guidance, so that advice provided can be confirmed and I do encourage others to follow those links for their own peace of mind. Sometimes my advice is not what people necesserily want to hear, but I will advise on facts as I know them - although it may not be what a person wants to hear it helps to know where you stand. Advice on the internet should never be a substitute for advice from your own legal professional with full knowledge of your individual case.

 

 

Please do not seek, offer or produce advice on a consumer issue via private message; it is against

forum rules to advise via private message, therefore pm's requesting private advice will not receive a response.

(exceptions for prior authorisation)

 

 

 

 

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