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PIP - medical assessor recommends zero points

Hi all, I have applied for PIP, have received the medical report and am waiting a decision. The nurse who I had the assessment with has recommended that I be awarded zero points for each part. In her justification to almost every element appears to be ‘she drives her automatic car daily’ so can cook a meal, wash and bathe…etc etc. I am not happy about this justification. She also writes the claim should be reviewed in 18 months as I could deteriorate in that time frame. I called the DWP today to speak with someone about this report and was told that I have to wait till a decision has been made (most likely a nil award based on the medical report) and then write in stating I’m not happy and seek a mandatory reconsideration which I’m told takes months. My claim has been outstanding since 22.01.18 as i couldn’t bring myself to fill out the form and it took me a long number of months to do and the dwp accepted it as late in Oct 18 for the exceptional reasons given.

Just looking for some advice or experiences. Does it automatically follow that the decision maker will follow the nurses’ recommendation and award nil points for each component? Is there any point in continuing to seek pip given they’re likely to award nil points so will seeking a mandatory reconsideration actually make any difference? Will it really go from nil points to 8 for an award?!

thanks.

Anon - don’t give up yet, I can’t write much tonight as I am on a plane and Wi-Fi is rubbish. Will write back tomorrow. Charlie

Don’t be put off by that report. I would imagine the decision will almost certainly follow that but i think from memory my wife’s Esa decision awarded her zero points as did the mandatory reconsideration and yet a tribunal then awarded her the higher rate!

look at the pip points system and work out what you think you should have got

It is important to remember the guidelines that each task needs to be carried out safely,reliably and repeatedly and in a timely fashion. Be honest with yourself about your capabilities and if you think you should score 8 points or more then go to mandatory,then appeal to tribunal if neccessary.read up guides from benefits and work or CAB etc or try to get help from them if you can.

Good luck

ollie

PIP is not DLA. There are different rules.

Being able to drive is viewed as having “good functionality”, so it will be hard to score high on mobility.

Did you have help with the form?

Did you include a care plan? OT or physio reports or GP letter of support??

Did your carers write a statement on how they help you with Daily Living?

If you do score zero, start preparing this kind of evidence to send in with you MR.

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i agree with ollie.

appeal and take it all the way to tribunal if neccessary.

the tribunal accepted my paperwork - the exact same paperwork that had been turned down by the DWP three times!

in my mind’s eye i see the tribunal as being superman, spiderman and other assorted super heroes!

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i agree PIP is not DLA and it really catches people out.

The main word they look at is INDEPENDANT. So how independent/dependant are you on other peoples help.

I tell people who have asked about this, that on the benefits and works web site is a PIP self help test and they should do it before they fill in their form as it will give them a good idea what they are looking for.

mobility to get full award the first question if you drive is a no brainer.

Mobility activities11.

Planning and following journeys.

11 a. Can plan and follow the route of a journey unaided. 0 points
11 b. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant. 4 points
11 c. Cannot plan the route of a journey. 8 points
11 d. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. 10 points
11 e. Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant. 10 points
11 f. Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid. 12 points

I believe they changed the parameters to enable more people with mental health issues to be considered for the award.

I would go for mandatory consideration anyway. If you use an automatic car why do you use an automatic car? Is it because of weakness etc etc.

A lot of people need to learn to do a self assessment before they fill in forms. Be honest with yourself. How much have you deteriorated, do you use aids, every little thing you have had to buy to make yourself more independent all goes to help the award.

this test has helped a lot of people to fill in their forms.

http://www.mybenefitsandwork.co.uk/pip/indexxx.php

We all know MS is a variable and changing disease. Maybe they need to change the way they add points up because one day you might be able to drive, but a few months down the line, you can barely move.

Its really hard isnt it. However i would have thought you would have got some points.

I must admit, it has been a real nightmare PIP, but what is really good about it, is people with mental health issues are getting the award and its helping them enormously. my friends uncle is in assisted living and most of his benefits went to pay for his food and care, now he gets PIP (mostly care component) and he has been able to improve his way of life. which is a good thing.

Hi Anon I’ve advised people before to use the Benefits and work website https://www.benefitsandwork.co.uk They greatly assist your application. I applied hoping for standard mobility and received standard care as well. I am capable with functionality and can drive an automatic car alone no. Problem. I suspect two main reasons the interviews go badly Firstly as applicants especially first time we feel nervous & vulnerable and this can come across as defensive Secondly the interviewers aren’t properly trained (which they should be) and don’t help to bring the evidence out. Good luck Adam

Back in the world of decent Wifi, the way I read it and how I judge PIP to work is that the benefit should provide you wtih the means to act independently, as an individual. If you need assistance from something or someone to do any activity then you are clearly not “independent”.

I am happy with my Care award of 11 points, not enough to qualify for the higher rate but I think this is correct and I am getting the right level of support. Mobility however is a different matter. I too was awarded zero points for mobility after my face to face in my home. The details/evidence I supplied never once said anything except “I am not able to walk further than 20 meters”. It was decided on initial review I could walk up to 200 meters. I put in my Mandatory Reconsideration and I supplied one additional piece of evidence. My zero points became 10 points for mobility. Still not the higher rate DLA award so I am waiting for an appeal date and time.

I totally disagree with the statement PJ makes about “functionality and being able to drive”, the purpose of PIP is to maintain our independence, not having to rely on others or other things to do the things able bodied people do without thought. I personally am unable to walk 20 meters, but I am able to drive a car. I should score 12 points, my ability to drive a car is not the question or criteria being assessed and it is this that many people appear to be pulled up on and scoring zero. The criteria being assessed has nothing at all to do with the ability to drive a car or have a job/career. I have both, I am a very busy and successful individual, I hold 2 first class degrees but I still can’t walk more than 20 meters reliably repeatedly safely at “normal” speeds.

4 Key things to include and repeat as much as possible are

  1. Reliably

  2. Repeatedly

  3. Safely

  4. At a normal rate of pace.

It is these 4 points I personally believe any evidence struggles to demonstrate clearly, and it appears to be pot luck which healthcare/decision maker you might get for your claim. This clearly impacts some people in a negative way. HPs and Decision makers are targeted to reduce numbers, it is not documented and hard to prove, but clearly this is a factor. The agenda for them is not the same as the agenda for us claimants. The DWP are trying to reduce the number of claimants, that is the overall goal which if all reports are correct they are failing badly (reports are indicating this is actually now costing more, as more people are getting higher rates).

In many cases, taking peoples higher rate DLA/PIP away makes that individual even more reliant upon others, it makes them less independent. I agree that in some cases this is probably the correct result, but in many it is not and it is this need that has to be “proved”.

The 2 mobility questions on the form are very different, the criteria asking about “planning a journey” can be used/taken in so many ways, it is far to open to bias. If you write the right things and in a certain context you could end up with many more points than others etc. My own answer, i could easily word it to get 4 points or 12 points, the fact I got zero points just pointed out to me that the whole process is flawed. The review I had back re this point didn’t make any reference to the fact I go to the same place everyday, I follow the same route every time, If i get diverted to another route I am left feeling vunerable, if at all possible I drive at times of the day and night where there are less opportunity for issues etc.

The whole mobility part is so wishy washy, how a persons independence can be judged on the back of 2 questions by 4 people that might not even have met you or fully understand your condition is an absolute joke. I don’t disagree with the purpose, it is the process which is broken, not fit for purpose.

Use the benefits web page, remember the 4 key points many of us mention, and then apply for what you need to make you as independent as the able bodied person who lives next door.

MR and then Appeal, a pain on the arse, but you will end up with the correct result is my impression.

take care

Charlie (apols for any typos)

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Hello

I sort of agree with everyone in some respects. But also disagree on some areas. The main area I think can be problematical for some people is that when you are clever, able to write and understand the rules of the benefit, you forget that the case manager (who completes the assessment of your case and provides a report for the DWP) and the decision maker (for the DWP), are not necessarily intuitive and able to make connections between individual Activities. You may find you are repeating yourself, but that might be necessary to make the CM and DM understand who you are, your disability and how it affects your daily life.

My way of doing it is to first get to know the points system. Using the Activities and Descriptors within each, try scoring yourself to see what you think you should have scored: https://www.citizensadvice.org.uk/Global/Migrated_Documents/adviceguide/pip-9-table-of-activities-descriptors-and-points.pdf You can also use the test Crazy Chick gave the link for to see how you should have scored.

Be honest, think about your worst day but don’t complete any form ‘as if it’s your worst day’ since with a fluctuating condition, chances are you’d be seen on a better day. (And thus look like you’ve either lied, or exaggerated.) As CC says, don’t forget the aids and adaptations you use.

Second, I too advise people to use https://www.benefitsandwork.co.uk/ Joining Benefits And Work costs about £20 but it’s worth it for access to their excellent guides. In addition to this, if you are fairly new to benefits, try to get some help with the Mandatory Reconsideration and Appeal (if it comes to that). Try the CAB or any other welfare rights advisor local to you.

Ollie and Charlie are absolutely correct in advising you to think about ‘safely, reliably and repeatedly in a timely fashion’, with regard to every task - you need to be able to repeat it again without a long break/rest and to do it safely.

I do agree with PJday that the ability to drive can impact on the assessors views about how you can complete other tasks. I’m not saying this is right, or fair, just that it might seem reasonable. If you’re safe to drive an unadapted (albeit automatic) car, then your hands and legs could be seen as probably working just about OK for most everyday tasks. And if that isn’t correct, then you need to make that clear both on the forms you complete and in the evidence you provide.

Where Charlie says he disagrees with PJday, because PIP is supposed to allow disabled people some ‘independence’, that’s true. However, when claiming benefits you need to think the way a benefits assessor might. They look at each Activity and tick boxes, if you’ve not explained why you are able to do X but not Y, then they may consider that ability to do X means you are also able to do Y. Rationality needs to some extent to be parked some distance away from you with regard to benefits. Being smart and able to work with complexity does not mean the assessor can do the same.

I also disagree that the system is designed to reduce numbers on benefit. It is true that often people are refused benefit following assessment of their claim (partly due to the complexity of the benefit and the difficulty of explaining exactly how your MS affects you), but many, many people are awarded benefit at MR stage, and more still at Appeal. There are also plenty of people who are granted maximum benefit for both components for the maximum period of time ‘on the papers’ with no personal assessment being needed (both PJday and myself fall into this category).

I take the view that when you complete a benefit claim form, you have to answer each question as if you and the assessor are on the same side. Your job is to show the assessor exactly how you live and how you fit into their Activities. They don’t know you, so you have to take them by the hand (figuratively) and explain everything. If your right foot behaves well enough to drive an automatic car, but your left is useless, then explain that. If your hands are ok to drive, but you throw food all over yourself when trying to eat, then explain that. If you’re not capable of putting on your socks independently tell them that.

Then you need to supply evidence of everything you’ve said. And highlight which piece of evidence applies to each Activity / question (include a separate sheet of paper explaining what evidence you’ve provided and where this fits in the ‘picture of you’).

Best of luck. I hope the DWP decision maker can see that the assessment doesn’t reflect what you’ve written on the claim and provided evidence for. But if you are turned down completely, then definitely apply for Mandatory Reconsideration. You have one month in order to do this from the date of the decision letter. You might find as the clock starts ticking the minute you’ve asked for MR, that you are as well getting further evidence ASAP rather than phoning on the day you receive the letter. You should be able to get supporting letters from your MS nurse and anyone else you see from the NHS (physiotherapist, bowel and bladder nurse, OT, anyone else you see regularly). You may also have copies of relevant letters from your neurologist and/or other medical professionals. You can even provide letters from your partner, friends or anyone else who helps you with personal care.

Sue

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RE: Charlie’s “I totally disagree with the statement PJ makes about “functionality and being able to drive”, the purpose of PIP is to maintain our independence, not having to rely on others or other things to do the things able bodied people do without thought.”

I have taken this from the House of Commons Committee meeting where Capita stated:

"Being able to drive is viewed as having good functionality".

Capita also stated: "Those who fail to provide evidence will be seen."

Sue and I were not seen, because we provided the right kind of relevant evidence to support our applications.

It can be done. But of course we are both SPMS and a little older.

There is of course ‘Access to work’ for those still in employment:

Examples of what may be funded

  • Specialist software, such as screen readers
  • A support worker, such as a driver or job coach
  • Adapted equipment, such as chairs and desks
  • Taxi journeys to and from work if you can’t use public transport

Hi all. I work full time but having read all of above, am I right in thinking that I can claim some sort of benefit?

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Hello,

I would just like to say I had my appointment with my specialist nurse today and she is fantastic. I told her that I have put in for pip and have she heard anything, she said they normally contact -----who have all your details . I miss heard what she said who they where . I think it depends on who you see. I really want to just say is keep going and don’t give up. It’s your right fight for it. xxxx Anyway very sleepy got to go. Good luck.xxxx

Hi all, thanks for your replies. I will certainly take them on all on board when sending in evidence in support of the MR. The examiner has missed vital parts out and makes comments inconsistent with tests. For example she states that when I wash my hair I have to take breaks as my arms will get sore and need a rest before continuing. She writes that although this may take me double the time i eventually manage it so no points. She also writes that the days after my plegridy injections are bad but aren’t the majority of my days so zero points but what I actually said was the days after the injections were worse than normal not that the rest of the days were fine.

I work full time but would like to cut down as it’s exhausting. AuntyM it’s certainly worth applying for if you don’t mind the hoops they make you jump thro.

Thanks everyone. Will keep you posted over next few weeks. x

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Excellent post again Sue.

you wrote. I take the view that when you complete a benefit claim form, you have to answer each question as if you and the assessor are on the same side. Your job is to show the assessor exactly how you live and how you fit into their Activities. They don’t know you, so you have to take them by the hand (figuratively) and explain everything. If your right foot behaves well enough to drive an automatic car, but your left is useless, then explain that. If your hands are ok to drive, but you throw food all over yourself when trying to eat, then explain that. If you’re not capable of putting on your socks independently tell them that.

This is the main point.

A civil servant goes to work in the morning and has to trawl through mounds of applications. They have no idea who the recipient is, and will have a point scoring system i would think a template on computer to work with.

I said i struggle to put my socks on, and showed them a photo of me actually using my SOX aid to get my socks on. Every aid i have i took photos off and explained why i used them and what for. I have a host of stuff.

I might feel ok first thing, but by the time i am up and about i loose balance, and drop stuff and my life becomes a nightmare. so whoever had my forms could see everything i had to use. I even included my mobility scooter and had a photo of lucy on the seat, and said the dog was my aid as she got me up and out lol…

what we say they want it mirrored.

I do think my having a care plan by the social services also helped me, as they actually came out saw me and assessed my needs, and this was good positive proof for the assessor as they felt comfortable reading it and what it said matched my form.

Its easy to get a care plan. I rang adult social services for Direct Payments and they did it.

I say it again, i think PIP is much better then DLA as more people with mental health issues are receiving it. They need help too.

some of the questions are directed at people with mental health issues not necessarily with physical disease. The ruling was the best thing ever, as i know personally several people now who get PIP and they can afford a mentor to go out with and other aids to help them have a better life.

What was the High Court ruling against PIP?

Personal Independence Payments for a mental health condition is assessed in two components:

  • Daily living component (how your mental health affects your daily life) and,
  • Mobility component (how your mental health affects your ability to travel and make journeys).

Regulations introduced by the Government in March 2017 meant people unable to travel independently on the grounds of psychological distress - rather than other conditions - were not entitled to the enhanced mobility rate of the benefit.

In December 2017, the High Court ruling declared that this policy had been “blatantly discriminatory” against people with mental health conditions and was unlawful because there had not been any consultation on the issue.

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It’s a rare case where the PIP assessor write for information from MS nurses, or indeed, anyone else. The information you provide them with is what they use to assess your claim. And if you don’t provide evidence, then they won’t look for it.

Also, see Crazy Chicks post earlier - you can provide photos as evidence. I included photos with my claim form. Maybe not quite as many as CC, but certainly photos of my wetroom, showing shower chair and loads of grab bars around the loo and the shower. And a photo of my bedroom, showing bed rail and frame that I can use to get stable when my OH is helping me dress.

Sue

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My advice centre called the assessors the silent assasins as no matter how you try to explain to them - the report will come back - although has problems - is able to function on most days - its tough to get through but my resummission got enhanced mobility and standard care

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Lessons learnt Welfare Trends Report 2019

PIP assessments are not “objective medical assessments” … "in reality that is not feasible"

"To draw on the expertise of DWP’s medical advisers involved in the testing and the development of the new assessment criteria, rather than being solely reliant on analysts. This could have highlighted the necessarily subjective nature of the assessment, which was billed in the June 2010 Budget as the introduction of an “objective medical assessment” when in reality that is not feasible." (p.121)

See here:

I’ve recently had a PIP reassessment and the outcome was that they definitely used the fact that I drive NOT to award me above the standard rate. The case manager actually wrote in her findings that if I can take control of car I can use everyday items such as tin openers, hold cutlery, pour boiling water into a cup, dress and undress without issue, ect ect. She also found that I should be able to tie shoe laces, do up small buttons, use zips and fasteners, pull on a pair of socks ect ect, all because I can sit in a car and turn a bloody steering wheel… I’m trying to remember when the last time was that I had to undo buttons and zips to get into my car, then use a tin opener to start the bloody thing. I actually thought that the assessment I had at home went very well, but obviously the people who read the reports have different ideas. I did actually explain that my wife or son usually do the driving for me but on the VERY ODD occasion that I feel I can drive I will push myself and give it a go. Clearly telling the truth can open a can of worms with these people. Just a day in my shoes would make them have a complete re-think. My advice is to watch out for trick questions. Question : Do you own a mobile phone ? Answer : Yes Question: Do you use it to send TXT’s Answer : Yes Outcome : If you own a mobile phone and can operate it to send TXT’s, then you simply CANNOT have issues with grip or dexterity ! Question : Do you drive Answer : Yes Question : Every day Answer : No Question : 3 or 4 times a week ? Answer : No, probably once, maybe twice sometimes ? Outcome: This MS thing is all in your mind, if you can drive, even once, there’s no way you can’t do up buttons, tie laces, pick up tiny tablets from their packets, climb stairs or get in and out of the bath. You can sit down turn a steering wheel and operate large buttons in your car so you’re cured from MS, now get out there and get on with life, you silly man.

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Jactac i know your post is pretty serious stuff, but you did make me chuckle. I might get my friend who is a cartoonist to do a drawing of someone using a can open to start their car lol.

It is ridiculous, but they have written everything in such a way your beaten before you start. However, i know people who drive and have been awarded so again is it a post code LOTTERY.

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The assessors seem to use the Expanded Disability Status Scale (EDSS).

How do you score?