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Hi I have osteoarthritis in both thumb joints and in both shoulders and have had a trapeziectomy to my left hand and steroid injections in my right. I have also been diagnosed with moderate stage Chronic Obstructive Pulmonary Disease and Osteopenia and have a long history of Depression and Anxiety. I have been declined PIP on 2 occasions now after being awarded zero points. I wish to appeal and welcome advice on what to incluse in an appeal letter. Thank you