PIP - Diagnostic Evidence v Daily Functionality Abilities

Kittylees53

Hi Everyone

My first time on here as a writer but I’ve read lots of your queries and information over the past months and found everything very helpful and supportive. However I now have a query myself. It is a little read (sorry).

My History for reference: I received PIP for several years (5ish) for diagnosed Coronary Heart Disease, High Blood Pressure, Anxiety, Stress and Depression. I had a mandatory review in December 2023 and was awarded Enhanced daily Living (again). In January 2024 I was diagnosed with a large hernia in my chest cavity, gastric polyps, GORD, SIgmoid Diverticular Disease. I take a lot of medication for these conditions (20+ tablets every day). My medication for anxiety has increased to the maximum amount. I have had 3 heart attacks and see my GP monthly and am under two consultants at hospital in the coronary unit (current awaiting surgery appointment 22 October ) and gastronomy.

I reported a change of circumstances to let the DWP know about my additional health conditions, and when reviewed in June I was given 0 points for everything and lost my PIP. I was in total shock. I nose-dived into a deep depression as it affected my finances so much (I was made homeless 5 years ago after COVID and still get anxiety about bailiffs knocking on the door).

I didn’t appeal as I missed the month deadline due to my health and didn’t realise I could have appealed up to 13 month after the decision.

In August was asked to attend a UC Health Assessment (face to face) and I was awarded LCWRA (I know this isn’t related to PIP but I was encouraged to reapply for PIP by the UC assessor and my GP as neither could understand why I was denied PIP.

I reapplied in August, this time I wrote how all my conditions affected me and that I had an unpaid carer who assisted me on a daily basis with all my physical tasks (dressing, bathing, cooking, shopping etc) and that I could only go out with another person as I’d had two falls/faints (resulting in broken bones) while out alone. I had my assessment last monday (14 October) and requested my report as soon as available.

I has arrived today. The recommendation is 0 on every point. The assessor has said that I have said one thing but my medical history says another (she refers constantly to previous UC Health Assessment report dated 03/2023 - nine months before my new conditions - and not to my most recent UC Health Assessment in August 2024 where I was awarded LCWRA). I’m quite distressed again and don’t understand. I have the medical evidence for the conditions (documented GP and Consultant reports etc) and I have given lengthily details of how my condition(s) affects me.

I know this is just the assessors report and not the DWP final decisions but the decision in my August report agreed with the assessor. I will await the decision letter and I will do a MR if I’m denied … but any advice in the meantime would be welcome. I’m sorry for such a long post 😞

poppy123456

If you're refused again I'd advise you to challenge the decision this time by first requesting the MR. When you reapply constantly using the same or similar evidence you previously used it can see constant refusals. The best way forward is to challenge the decision.

You should put the request in writing stating where and why you think you should have scored those points. When you filled out the form if you didn't give a couple of real world examples of exactly what happened the last time you attempted each descriptor that applies to you then you should do that.

Include detailed information such as where you were, what exactly happened, did anyone see it and what the consequences were.

The most likely outcome of the MR will be the decision doesn't change. If that happened you can appeal to the Tribunal, if you either appear in person or have a telephone/video hearing then the success rate is about 70%.

If you need further advice at anytime please do come back.

Kittylees53

Thank you Poppy

I understand the resubmitted evidence again statement (I read that in some of your other posts too) as in this instance it was a totally new claim again I felt I needed to cover everything.

I am keeping a full diary now including my stats on Blood Pressure, Heart Rate, Temperature and Oxygen levels (my GP said this would be good for my cardiology appointment too). This tells what I was doing previously, during etc etc and also includes any incidents during my day.

My nurse is providing me with my latest Annual Coronary Heart Review report (Completed in September 2024) which confirms my condition has gotten worse in the previous 12 months and my doctor is written an overview of the past year, also summarising how my conditions has deteriorated and the impact this has had on my daily life.

I’ve also requested, and am due, a copy of the latest LCWRA report to include in my evidence, as when compared to the previous report (the one the assessor referred to in my PIP Assessment) it will also indicate that my condition has deteriorated (and that they have moved me from LCW to LCWRA) …. I appreciate these two should not be connected but it’s the PIP assessor who has referred to it in the latest PIP report, not myself.

I will definitely ask for a MR if PIP is denied and will go to tribunal as I appreciate that not many ‘win’ at this stage. And as you say, focus on what I can prove, rather than what I disagree or argue with on the PIP Assessment report.

Is it worth me sending this evidence in now before I have my final PIP decision ? Would the DWP even look at any further evidence at this stage? What’s your advice?

many thanks …. Xx