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What is the difference between these two 'personal action' LCWRA descriptors?

Rumbler303

Hello there,

Activity 13: Difficulty with planning, organisation, problem solving, prioritising, or switching tasks without needing help from somebody else

Descriptors:
(a) Cannot, due to impaired mental function, reliably initiate or complete at least 2 sequential personal actions.
15 Points
(b) Cannot, due to impaired mental function, reliably initiate or complete at least 2 personal actions for the majority of the time.

Does anyone have examples of what this means? Does (a) also mean majority of the time? Am I missing something here between the two? I don't get it?

Thanks.

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anisty

I think that (a) would apply to someone with significant learning difficulty that could not sequence steps of a task together.

For example some people cannot dress themselves as they are unable to sequence what to do first, second, third etc to get that task started, done in order to completion.

It could also apply to someone with dementia or perhsps OCD (if a person felt an overwheming need to stroke all creases from a top before putting it on maybe)

My son scored on 1b. He isn't as severe at that but he does struggle with task initiation and sequencing.

Just tonight was an example of him being unable to take his own shoe off because he had a pack of biscuits in his hand. He just repeatedly tried to remove the shoe - far longer than you would expect until i told him to put the biscuits down.

He is good once he learns the steps of a task but they take a while to teach and he doesn't generalise his learning. He can make a packet of supernoodles but that doesn't mean he can boil rice. When he makes his noodles he follows the taught steps. If the pan fell off the stove, he would not think to pick it up. I would need to sort that and he would need to start over again.

Rumbler303

Hello @anisty thanks for the reply. So is one to do with completing a task from start to finish in a logical manner then? That being A.

Then B is…. yeah I’m still finding it hard to see the difference. I can see one is to do with “sequential,” and one isn’t. I can see that now.

Is there a better example of B?

anisty

To be honest @Rumbler303 I am no expert on this and hope someone else will be along to clarify.

I think (a) means that a person cannot perform 2 sequential actions at all.

I think (b) means a person can do a sequence sometimes but not reliably every time (DWP use 50% as time)

I think they are both describing the same thing. Whenever you do any task in your day - whether that be take a bite of food or drive a car - the brain needs to go through certain processes.

I am not a medical expert either so this is a basic layman's description from school level biology.

The brain has the thought (task initiation)
Dopamine (chemical in brain) goes to nerves to signal the correct muscles to move limbs in correct order and sequence to do 1st step of task.
Dopamine switches of and signal goes to brain to say complete.
Initiate 2nd step. Dopamine release - signal - repeat.

So - thinking about what happens in the brain of someone with adhd. They are intelligent. They want a drink.

Brain signals thirst. Dopamine fires. Muscles fire. They go to kitchen. They notice letter on kitchen counter. More dopamine releases. They pick up the letter and leave the kitchen, never having had the drink. They got distracted as Dopamine misfires in adhd and releases at the wrong times so the brain does not get the message that they have finished step 1.

They saw the letter and that instantly became more rewarding.

But, had they not been distracted, they would have had that drink.

Does that make any sense at all?

Rumbler303

It does, there is a caveat to that and from what I see (a) has sequential and (b) doesn't, but I would say that the difference between (a) and (b) is that you cannot do anything, at all, 100% of the time when compared to (b) which is for the 'majority of the time', I could be wrong though… perhaps someone else can clarify as well? Thanks, confusing though.

Also just to add but that letter example happens ALL THE TIME with me 😂. Highly frustrating.

Rumbler303

I suppose actually on that, if that particular example happens all the time, then I'd qualify? Still, hopefully someone can perhaps go into what (a) and (b) means further though, thanks.

Rumbler303

I dunno why that example happens all the time, other times my brain is fine but literally for that type of stuff, happens EVERY time because of my ADHD. I do think I qualify for it @anisty ?

anisty

You might do. You won't know til you apply - have you applied yet?

anisty

After a bit of a dig round online, i'm none the wiser!

To my mind, if you can't complete 2 personal actions in any order, that is more severe than not being able to complete sequentially but that scores fewer points.

Personal actions does suggest self care like showering, teeth brushing etc but what use are they in a work place?!

I wonder if it means just not being able to do a workplace task start to finish🤔

I'd say in your case @Rumbler303 - is your profile mixed adhd and autism? - if your reports refer to processing difficulties and task initiation (check your ADOS report) you will qualify.

With your adhd, i'm not sure - does your medication not work? I'm not as knowledgable about adhd as autism but i am aware very severe adhd can be unmanageable and leads to very dangerous behaviour. If your meds work though, you might want to focus on your autism report (if your adhd report highlights difficulties with sequencing though, by all means refer to it and include it of course)

As for life long - hmmm - not sure as i said before adhd and autism, function can improve. I think lifelong will be reserved for progressive illnesses or brain injuries, paralysis. The sorts of things that limit function so severely and permanantly that there is no chance whatsover that improvements could happen.

Though of course if you are nearing retiring age, that could make a difference with what they decide.

I don't really know how it works to be honest.

anisty

I have found the official guidance from DWP for this descriptor.

I had to screenshot as it was too tricky to copy and paste.

Screenshot_20250328-165722_Drive.jpg

anisty

Right i have had a read and i wasn't too far off the mark with my thoughts.

It looks like DWP do mean toothbrushing but, at some stage, someone has gone to tribunal and the judge has pointed out that toothbrushing does not demonstrate cognitive function at all!

Because toothbrushing is a habit. If you have been brushing your own teeth twice a day for 30 years, chances are you could still do that in active psychosis (proven by myself; i had severe psychosis in hospital but could still brush my own teeth) or with severe mental impairment, depression etc.

So it looks like the judge has given a different example and that is getting dressed. If someone else chooses your clothes and you merely put them on, that is habit and doesn't count for this task.

If you can choose your own clothes appropriate to the weather, recognise they are clean, put them on correctly, that is demonstrating you can pass this question.

** by pass i mean you would not score points**

If you know you should shower BEFORE getting dressed - you'd not score here.

Another example given, can you open a tin of soup, put it in a pan and then set the pan on the stove all in the right order?

And i was on the right lines with who might not be able to do these things

Those in active psychosis.
OCD where claimant gets stuck in ritual mid task
Learning disability
Adhd severe enough to disrupt task completion
Depression severe enough to hinder task initiation
Dementia, confusion.

It does say scoring in this area is reserved for those with the severest disabilities.

Hope that helps clear this one up a bit!

anisty

https://www.gov.uk/government/publications/work-capability-assessment-handbook-for-healthcare-professionals

Here's the handbook i got this from - you can read what they mean for all descriptors here and if you need a hand interpreting anything, happy to (try to!!) help.

Rumbler303

I do have comorbid ASD and ADHD, but I've never wanted to take meds and have always tried to manage it using software and reminders mostly, as much as I can.

It seems these two descriptors are really involved though, and I'm afraid to say when it comes to a lot of text I'm finding that hard to process @anisty , can you please give a short summary of what it is they're looking for, for both? I'm merely curious as I think my assessment report does indicate (a) but I can't tell you 100%. I have been awarded LCWRA though, but I'm not sure which criteria I have met.

Rumbler303

I mean I am re-reading again, and again, and I've read a lot here and there the past afternoon, so is it basically you get (a) if you mix up steps due to ADHD, is that it? But is that for the majority of the time, or always (meaning literally always; I don't think so though)?

Is (b) essentially you can do 2 steps and complete a task but you won't do it in the right order? Where-as with (a) you can't finish the task at all? Gosh this is pretty confusing! Sorry.

Rumbler303

I definitely get (a) I think: you need to complete a task in a logical order, basically? No idea about (b) though still.

Rumbler303

Sorry, cannot complete a task in a logical order. I think (b) is if you can complete a task in a non-logical order. I think…

Rumbler303

I think (a) also has majority of the time too.

anisty

I think they're the same thing

a) is if you can't do the task at all and you can see how that might apply to someone with a profound learning disability.

b) if you can do a task sometimes but not others. So - to take the soup example and autism.

Initiation is a feature of autism. To do this task unprompted, i think you would need to recognise hunger yourself (and many autistic people have no drive to eat at all)

You would need to realise the time of day (soup not great breakfast choice)

You would need to find the soup in the cupboard

Open it

Select pan

Pop on stove

Light stove

Heat soup

Pour soup into suitable dish.

Replace pan

Select spoon.

Eat.

So - the descriptor is saying you only need to do 2 steps in order. It does seem a bit silly.

I think people more likely to score in this would be people with adhd, early dementia, maybe autism, maybe ocd, maybe schizophrenia - where the intelligence is there but the brain gets distracted, confused or "stuck" sometimes.

Depression even - sometimes someone with depression might not get this task started, or abandon it part way through. Other times, they might go start to finish.

Are you sure you scored in this category? Maybe it was another descriptor. You only need 15 points in one category to get LCWRA.

That's great you have got it!

anisty

Ps i asked for my son's UC50 report via his journal. You could get yours to see what they said.

Rumbler303

Right okay, so (a) is you can't finish the task at all (not even 1 or 2 of them)? (b) is if you can do at least 2 tasks even though you might not finish it? I've read the report, it is difficult to see what I've been awarded, I've asked the DWP but no clarification yet on what criteria I have.

Rumbler303

(b) bearing in mind is 2 tasks, in order, but not necessarily completing it? For the majority of the tim?