Can I challenge PIP medical assessment report before decision?

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amandadv

Hi everyone,

I've just joined the community for what I guess is a pretty common reason - problems and worries with claiming PIP!

I have relapsing-remitting multiple sclerosis. It got bad enough that after relapsing on disease-modifying treatment I was switched to a highly aggressive immunosuppressive treatment. After my second round in January last year, I relapsed again. The fatigue and pain are so bad when I push myself that I very reluctantly had to give up work last autumn. I successfully claimed Employment and Support Allowance and was put in the Support Group. You could have knocked me over with a feather! I was so shocked and happy when I got that letter.

I finally brought myself to claim PIP because I struggle on a daily basis with cooking, showering and mobility. I was given a home assessment even though I did not request one. The assessor was pleasant and listened to me. However, I've requested a copy of his report and it contains a number of areas that worry me or are just plain misinterpretations of what I can manage to do repeatedly, reliably and safely without being in significant pain. For example, at a number of points in the report the assessor states that I did not appear fatigued or tired, and that I 'looked well'.What I'd like to know is whether I can challenge this or make a submission pointing out where it is not what I said *before* the decision.

For those interested, here is more detail about some of the problems with his report. If you just want to answer my question without reading all the details then stop here. :-)

Thank you so much in advance for any advice,
Amanda

Despite stating clearly at the start of the report that I have two good days a week, which are the days I can manage activity, he then fails to take account of this in the scoring section. I can't cook or shower more than 50% of the time, meaning that I need help to do things like cook a meal otherwise I eat toast or yoghurt. That's a maximum of twice a week I can cook. He's rated me as 'needs to use an aid or appliance' which only scores two points. He said that although I report restrictions caused by fatigue I did not appear fatigued or tired, and that I 'was not in pain on exertion'. I'm assuming this is from the very short physical exam. As if that is the same as standing, or even sitting, and preparing a meal! He says the fact I could tolerate sitting for 60 minutes and have normal grip shows my ability to use aids or appliances to prepare and cook a simple meal. I very clearly told him that I can manage this activity on a good day, of which I have a maximum of two per week, and ONLY if I haven't done other activities like showering or walking. This is the same for the washing and bathing descriptor.

He disregards aids I use such as my pill organisers, which I need because otherwise I forget if I have taken my medication and because it is too tiring for me to sort out my numerous pills every morning and evening. He states that although I report I am forgetful so I use a pill box, I have intact cognition with good general memory and concentration, so I can manage my condition unaided and score no points. The fact that I need a perching stool to empty my bowels at all, or without causing haemorrhoids is also disregarded.

It leaves out important things I said, such as that the recovery time if I push myself to e.g. walk too far can be days or weeks. He's put one or two days. I said that when I cook, I have to space out preparation throughout the day (meaning I don't fulfil the 'reasonable time' test). He doesn't mention this. He's said that although I report balance problems, I remained balanced during the assessment.

If the decision-maker follows his recommendations on points, I would score:
Preparing food - 2 points
Washing and bathing - 2 points
Moving around - 8 points

That means I wouldn't get the daily living component at all, but would get mobility at the lower rate. I would quibble a bit with his mobility assessment, but will take it as it meets the points criteria. Daily living is where I really struggle, probably more than mobility! If I score myself against the criteria, I think I should get 16-20 points in that section. That's a BIG difference!
Preparing food - 8 (but I'd settle for 4)
Managing condition - 1
Washing and bathing - 3 
Managing toilet needs - 2
Engaging with other people - 4
Making budgeting decisions - 2

cristobal

@amandadv - I’ve only had one assessment, and I know that there are others who post on here with more experience of what goes on.

In my experience trying to get the assessor, through whichever company they work for, to correct their report is almost impossible. There seem to be two reasons for this:-

Firstly, they don't want to amend anything so the response I got was either that the assessor “can’t remember” or that the assessment report is not intended to be a “verbatim record”, both of which are hard to challenge.

Secondly, a lot of the assessment is a matter of opinion.

The assessor’s opinion is that your memory/ cognition is sufficient that you don’t need a pill box, and don’t have problems budgeting; you disagree but, in the absence of good evidence to the contrary they will go with the assessor’s opinion.[I formed the impression that unless your GP has referred you for specialist help with cognition you almost certainly score 0, but I may be wrong]

I’d be inclined to ask for a mandatory reconsideration.

Set out where you think you should have scored points, and give examples of what you can’t do, and how you manage or what aids you use. Keeping a diary may help as well.

Good luck…