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Can anyone tell me what happens at physical examination?

Hello The examination will be carried out by an assessor trained on carrying out the assessment. If you have enough medical evidence to show an assessment will cause pain, discomfort, then you are able to refuse. An exam will look at upper/lower limb function including power / grip and finger pinch. They could be handling paper/ bags / cups / plates. They could test shoulder/ neck movement. As well as physically assessing, you will be watched as to how you manage things.

My examination took place at home, it was all over and done with in about 40 minutes, most of it was questions on how the MS affects you, then at the end it was a very short physical examination.

If I recall correctly I was asked to grip the ladies fingers as hard as possible, then asked to stand up and go onto my tip toes, that was it !

No walking, or trying to go upstairs, nothing over the top.

It really does help if you have paperwork from consultants ect backing up your claim .

Just be calm and tell the truth how MS really does affect you.

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I calmly stressed out of the prospect of the assessment, no need to have as the nurse I saw was extremely nice and reassuring. The examination was at a centre but much the same as jactac.

I have a habit of playing down how MS effects me, in this situation it is important to tell it how it really is, in hindsight I regret that I didn’t lay it on thicker.

You will be notified after your assessment that they have all the information required and that there is NO NEED for you to contact the powers that be, however after twelve weeks of watching what came through the letter box, I broke and thankfully called. Yes they had all my details and I been successful in my application but for some unknown reason I’d been filed away. The lady who I spoke to was very apologetic, helpful and resolved to sort me out straight away, which she is doing.

I recommend, that you don’t stress out about the assessment but you do keep check on further progress.

X.

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Hi there, for PIP applications, the physical assessment (not a medical examination) is only a small percentage of the whole thing. As others’ have said, the assessor is with you for around an hour. You’re given lots of notice plus useful info for you and/or your carer to prepare for the assessment. Loulla is spot on to chase after 12 weeks, files do get misplaced and she did the right thing by NOT laying it on. Over exaggeration will be spotted in a one to one. The asessors look at details, if you use arms for leveraage to get up from a chair or bed, if your eyes flicker. My assessor could clearly see my ppms physical issues, asked me to sqeeze his fingers, to turn my head from left to right whilst sitting, stand up to put my right foot ankle directly in front of my left foot toes so they touched. I received full rate for care & mobility fixed for a minimum of 10 years. I wish you every success and hope you don’t worry about something we have no control ove (easy said, I know). Chrissie x

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i went in to mine in my wheelchair with my care worker, and the assessor said ah Mrs… I have lots of good evidence about how your MS affects you from your neurologist and your doctor and you wont be here long. I was there 30 minutes some of which was just chatting. I got enhanced in both. I think i was lucky as i had great back up by my medical team so i didn’t have an examination.

The assessors aren’t daft are they C.Chick. My assessment was similar to yours but a home visit which surprised me. I think it was you who advised me to send plenty of evidence with the paper application (ppms). It certainly helped as, like my earlier post said, I received both parts on full rate (enhanced) and it won’t be reviewed for at least 10 years. Evidence is deffo important.

Chrissie x

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I had only limited evidence as I hadn’t seen a neurologist for about three years, having been discharged by him because “I can’t do anything for you” My assessor was an Occupational Therapist, so had some knowledge of MS. I attended a clinic not far from home. Went in my wheelchair but took my crutches. I had to squeeze her fingers, and walk about five or six steps. She stopped me having seen enough. While sitting I was asked to place my heel on the top of the opposite foot then draw it up towards the knee (both legs) I can’t raise either leg from the hip so couldn’t do that. Like others have said the physical exam is only a small part of the assessment. Take someone with you for moral support and to remind you of anything you may forget to mention. I got enhanced rate for both. Initially for only three years, but now ongoing after completing a form sent out by the DWP about two years after it was granted.

hi chrissie yes evidence is so essential. My friend was upset her husband didnt get it and when i saw what they did i couldlnt believe it, there was no evidence of hardly anything. It really is important, i am so glad you did ok, and yes mine is 10 year review. I use my money to pay for care worker. xxxx

Eeeeeeek, I have my physical assesment on Tuesday morning! Thankfully this will be at home, but I am so used to trying to hide my symptoms, I might shoot myself in the foot. I am trying to act as I am when I am at my worst to try and drill it in to me. Wish me luck! Moira

I don’t have any supporting proof. I see my MS nurse once a year and she always says how well I look! Also my GPs is group practice, I never. see the same Doctor twice and usually the nurse. When I last went for a sick note she asked me what she should write (MS flare up), I have asked for an appointment regarding a PIP claim the receptionist said they would reply when asked (by DWP I think) by looking at my medical conditions on file.I said the doctor could look at me to see how I am and it is not enough to say I have MS but how I cope day to day. She said I could pay £25 for a “to who it may concern letter” if I told them what to put. I don’t know what to put !! Don’t know what to do about this. I have RRMS and am have chronic pain am on about 20 tablets a day and can function. I only have help from my partner and son.

Oooh Moira, please don’t even try to act anything. Your diagnosis is confirmed so that takes you into a set route.

You will shoot yourself in the foot if you act or over emphasise symptoms. eg If you stand up from sitting, the assessor looks at the way your head leans, which way your hands face, if you use anything for leverage, where your shoulders go, which way you move out, what your eyes do.

I stood up from my chair and the assessor leant forward without touching me, he talked to guide me to sit down without falling. When I said I often but not always fall when I turn. He explained why and what my brain was doing versus my bodys natural movement. Equilibrium, cerebellum et al. I was awarded full enhanced mobility & care for at least 10 years. Yet I’d stood & walked as normal (but not normal for someone healthily without MS). Only an experienced person would see the struggle of argument between my brain and my body.

The assessors are experienced people and will detect lying. They ask the same question with totally different words ages after, you won’t notice if you lie, over egg or act.

Some have and they’re being caught. I’m sure there’ll always be thieves but you are not in that category Moira x. You have a correct and undeniable condition that is damaging your brain, body and, as yet, incurable.I

Now, it’s bad enough you have MS but no reason at all why you will be awarded the correct amount. I wish you well and …

HAPPY NEW YEAR xx

Just take the self PIP test. Print out your answers and get your GP to

write them out in a letter.

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

Remember - PIP cash is not about the actual illness - but about proving how much help you need from others for Daily Living and Getting Around. The PIP form is about functionality - a social care needs analysis.

For example driving a car is an example of good functionality. If you can still drive you might find you score low points for PIP.

Three important recent documents for PIP are:

1) An up-to-date Care/Management Plan from your MS Nurse, or GP

2) A GP letter [mine cost £12] outlining how your symptoms affect your daily life - how much care you get from others with washing, dressing, cooking, driving etc.,.

3) Signed statements from carers on how they help you everyday. (can be paid or unpaid informal carers/helpers) NB. (Get these carers registered with your GP)

I provided this kind of social care evidence and did not need a face-to-face appointment because my letters from my GP and care plan were written in the last 15 days. So very up-to-date. So do your own assessment - get your NHS professionals to help you. Manage them.

What is your NHS paper trail like?

For example:

  • How much social care evidence will you supply?

  • Are your carers registered with your GP?

  • Have you had help from Adult Social Care?

  • Do you have a Care Plan via your MS Nurse or GP?

  • Will your informal or paid carers supply signed statements on how they help you with washing, dressing, cooking driving, pushing you in a wheelchair etc.,?

  • Will your GP supply a letter of support for PIP? [mine cost £13] - okay yours is £25. Worth it.

  • Any letters/reports from your OT, physio or NHS Wheelchair Services, or Community Rehab Team??

  • Do you have a history of falls documented? Mention this in the GP’s letter.

  • Do you have rails, ramps, and a bath lift at home?

  • Do you have a wheelchair or walking aids?

Get all these things written up in the GP’s letter or Care/management Plan.

Fay

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Oops, I meant no reason at all why you will not be awarded PIP. Sorry for missing it!

Fays post is fabulous and helpful. Great points & links. Good luck Moira, let us know how you get on. I think it takes around 8 weeks to receive the decision letter.

Chris xx

My PIP process took 12 weeks.

Hi Anon, I am like you but even worse as I don’t have an MS nurse even.

All consultants discharged me years ago…same reason, can’t do anything for you. Even my Rheumatologist discharged me saying the same.

My GP handles all my issues and when I have a relapse he gives me steroids often over the phone so I am dreading when I have to go from DLA to pip.

Like many on here I always try to play down my troubles.

What is a care plan? Doesn’t look like I’ll get it. Am near to giving up now.

Hi Anon, never give up.

Just learn how to make the most of the NHS services that are there for you. Our taxes pay for them.

Prepare for your care plan appointment:

  • Just makes notes on your PIP self test results and note down what extra care/help you need or aids etc.,.
  • A Care or Management Plan is in the Care Act. Because you have a long term condition you have a right to a Care Plan. PIP is linked to them. They go together - like a passport to PIP.

It is designed to help folk with long-term conditions like MS. My one includes my health, rehab, physio and meds and social care needs and includes stuff like: Fay …

  • needs grab rails, and a bath lift.
  • needs some physio and help with falls management, and a referral to the Community Rehab Team
  • needs a powerchair and ramps.
  • needs help with pain management.
  • has help with washing dressing and cooking.
  • can no longer drive due to symptoms.

"A written care plan will include:

who is involved in your health care

treatments and therapies

details of anything else you need to stay in good health

Everyone involved in treating you, including doctors, nurses, therapists, and sometimes social workers, should work with you to follow the plan.

These care plans can be particularly useful if you’re finding the care you receive from the NHS are disjointed or confusing.

If you do not have a care plan, but feel you would benefit from one, ask your GP, MS nurse or therapist."

Book a 30 min appointment with your GP or MS Nurse - they are free.

Fay

More info here:

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Hello Anon,

As PJday (Fay) mentions “never give up” and by same token don’t feel you need to ‘play up’ or ‘play down’ any symptoms to impress an Assessor.

Effectively the Assessor & assessment are not there to catch you out, but (as a representative of DWP) to confirm & see visually what they already know ← this is their responsibility and “duty of care” to DWP.

Keeping it simple, remember you gave permission to see your medical records in applying for PIP.

Therefore an Assessor has already seen ‘data & fact’ of:

  • Neurologist’s medical diagnosis of your condition ← so verified & beyond question!!!
  • GP’s medical records of your ongoing condition ← so verified & beyond question!!!
  • List of any meds taken now or in the past as your condition changes over time (supplied through GP’s medical records) ← so verified & beyond question!!!

The final item to complete the package as it were, is a ‘care plan’ mentioned by Fay if you feel your condition needs it at present.

The Assessor does however need to see you as not all symptoms are recognisable through paperwork (example: any speech difficulties and their severity)

Happy New Year

kayjaypee60

Barriers to providing additional medical evidence. “35% of assessors request a GP Factual Reports for further evidence. But less than 10% of GPs sent back the reports, only 3% of their evidence would be relevant to the functions aspect of the PIP assessment.” https://community.mssociety.org.uk/forums/everyday-living/pip-and-esa-assessments So there is a problem with confirming medical evidence. This is why I argue that people should see their GP themselves and get either a Care Plan or letter confirming their dx and social care needs related to the PIP questions.