YM v Secretary of State for Work and Pensions (PIP Tribunal procedure and practice - statements of reasons)

Factual and Procedural Background

The Plaintiff, born in 1992, had been receiving Disability Living Allowance (DLA) virtually since birth, including the higher rate of the mobility component and the middle rate of the care component. Due to transitional regulations, the Plaintiff was required to claim Personal Independence Payment (PIP). The Plaintiff’s PIP claim form indicated needs across all daily living descriptors and mobility restrictions to less than 20 metres.

On 17 March 2016, the decision awarded 6 points for daily living and 0 points for mobility. Upon appeal to the First-tier Tribunal (FtT), the Plaintiff was awarded only 4 points, with the FtT finding the Plaintiff not a reliable witness and overstating the effect of her illnesses.

The Plaintiff appealed, arguing that the FtT failed to provide a reasonable explanation for departing from prior DLA decisions that had awarded benefits for her disabilities. The Plaintiff contended that the FtT’s disbelief in her testimony conflicted with the longstanding DLA awards.

The Upper Tribunal Judge Ward allowed the appeal, finding the FtT had erred on a point of law. The decision of the FtT was set aside and the case was remitted for rehearing before a differently constituted tribunal, with specific directions regarding the assessment of evidence and reasoning.

Legal Issues Presented

1. Whether the FtT erred in law by failing to call for and consider relevant DLA evidence that had been omitted by the Department for Work and Pensions (DWP).
2. Whether the FtT erred by not providing sufficient reasons under the principle established in R(M)1/96 explaining why it departed from previous DLA awards when making no PIP award.
3. Whether the FtT erred by removing points previously awarded for washing and bathing without explanation.
4. Whether the FtT erred by failing to consider awarding points for managing toilet needs or incontinence despite some evidence suggesting such needs.
5. Whether the FtT properly addressed the Plaintiff’s reported non-epileptic seizures and their impact on relevant PIP activities.

Arguments of the Parties

Appellant's Arguments

• The Plaintiff argued that the FtT failed to explain why it departed from the Plaintiff’s longstanding DLA awards, thereby failing to meet the duty to give adequate reasons.
• The Plaintiff contended that the FtT’s finding that she overstated her disabilities was inconsistent with the DWP’s prior recognition of those disabilities for 23 years.
• The Plaintiff implicitly challenged the omission of consideration of certain daily living activities, such as washing, bathing, and managing toilet needs.

Respondent's Arguments

• The representative of the Secretary of State submitted that the FtT had sufficient evidence and that the omitted DLA evidence dated from 2010 and was of limited value.
• It was argued that the duty under R(M)1/96 to explain reasons for differing decisions applies only where the previous award was also a PIP award, not where the award was under a different benefit such as DLA.
• The FtT’s failure to award points for washing and bathing was not material as it would not have met the threshold for benefit.
• The FtT did not err in failing to consider managing toilet needs in detail due to lack of explicit challenge and the evidence as a whole.
• The FtT’s treatment of the Plaintiff’s reported non-epileptic seizures was unclear and this omission was significant.

Table of Precedents Cited

Court's Reasoning and Analysis

The court acknowledged that both parties agreed the FtT’s decision involved an error on a point of law, obviating the need for detailed factual or evidential analysis. The primary legal focus was whether the FtT was required to explain why its PIP decision departed from prior DLA awards, given the different criteria between the benefits.

The court emphasized that while the law change from DLA to PIP means the two benefits have different criteria, it is insufficient to dismiss prior awards without analysis. The tribunal must consider whether there is a genuine inconsistency and, if so, provide adequate reasons to address the claimant’s perception of unfairness, consistent with the duty under R(M)1/96.

The court reviewed the relevant legal standards for mobility and daily living components under both DLA and PIP, noting differences in descriptors and scoring. It highlighted that certain prior awards under DLA could reasonably be material to the PIP assessment and that failure to address this adequately could amount to an error of law.

The court further noted the importance of addressing the claimant’s reported non-epileptic seizures, which could materially affect the assessment of relevant activities.

Given these considerations, the court found that the FtT’s decision was legally flawed for failing to provide adequate reasoning and for not properly considering relevant evidence and issues raised.

Accordingly, the court set aside the FtT’s decision and directed a full rehearing before a differently constituted tribunal, with instructions to apply the legal principles outlined.

Holding and Implications

The court’s final decision was to ALLOW THE APPEAL and set aside the First-tier Tribunal’s decision dated 9 June 2016.

The case was referred back to the First-tier Tribunal (Social Entitlement Chamber) for a complete rehearing before a differently constituted tribunal. The rehearing must comply with the legal principles set out, including the duty to provide adequate reasons when a PIP decision departs from a prior DLA award, consideration of all relevant evidence, and appropriate treatment of reported medical conditions such as non-epileptic seizures.

No new precedent was established beyond clarifying the application of existing principles regarding adequate reasons and the treatment of prior awards in the context of benefit transfers from DLA to PIP. The decision’s direct effect is to ensure the claimant receives a properly reasoned reconsideration of her entitlement consistent with applicable law.