Social Security Case Law

NB v Department for Communities (PIP) [2023] NICom 20

Background

The claimant made an application to renew their PIP award in February 2021, however, following the healthcare professional report the Department awarded 10 points under the mobility component, but only awarded 4 points under the daily living component (despite the claimant previously being entitled to 8 points).

During mandatory reconsideration, the Department received further advice from a healthcare professional that the nurse’s assessment was justified, and the decision remained unchanged.

An appeal was lodged in March 2022, on the basis that more points should have been awarded for daily living under activities 4, 6, and 9. The Tribunal awarded 6 points in total, and the claimant remained under the daily living threshold.

Following the statement of reasons, they applied to appeal to the Tribunal Chair, and following a refusal, to the Commissioners.

Legal Issue

The main grounds for appeal concerned;

• The decision making process of the Department, in particular the apparent lack of knowledge of the previous Tribunal award by the healthcare professional who conducted the at home assessment in 2021;
• Too little reliance on the evidence of the Trainee Cognitive Behaviour Therapist;
• The Tribunal’s reasons showed it took into account the appellant’s care of her young child, despite that child being born just a day prior to the Departmental decision, and the legal provisions whether such a matter can be permitted as it did not obtain at the date of the decision.
• The reasoning as to the appellant’s motivation to care for herself was much influenced by her perceived abilities to care for her child, and, accordingly, the decision was flawed.

The appeal was supported by the decision maker and both parties agreed in principle on some, not all, of the arguments.

Decision

The Commissioner cautioned in favour of a better format for the statement of reasons, summarising that the Tribunal needed to provide adequate explanation for its decisions, in particular when a Tribunal has decided not to renew a previous award they should outline their reasoning for doing so.

The Commissioner went to consider a final point in more detail – the consideration of evidence under article 13(8)(b) of the Social Security (NI) Order 1998. This article directs the Tribunal not to take into account circumstances that did not exist at the date of the decision under appeal. However, the Commissioner stated that a Tribunal may take later evidence into account to shed light on what position was likely to have been at the relevant time, which is the statutory period prior to the decision, as outlined in BmcD v DSD (DLA) [2011] NI Com 175; [2013] AACR 29.

The Commission also noted that the medical evidence in conjunction should have led the Tribunal to a more curious line of investigations before making a decision on the benefit.

After examining the evidence, the Commissioner held that the appellant suffers from debilitating mental health problems, including anxiety, depression and specific phobias that have been ongoing since childhood. The Commissioner held that a holistic reading of the medical evidence provided strong support for the existence of difficulties both inside and outside the house. Thus, the standard rate was awarded by the Commissioner for the daily living component of PIP, alongside the agreed rate of mobility.

You can read the Commissioners full decision ‘here’.