PIP, DLA and AA
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When (if at all) does a Heath Care Professional read PIP2 form in its entirety?

robt1066robt1066 Member Posts: 33 Courageous
Hi, new member here. I am a retired lawyer and am trying to help my sister (along with Welfare Rights) to go through the DLA -PIP transition process. My sister has chronic depression and anxiety and has been under the care of local community mental health team for 20yrs. 

Heard good things about this forum and would like to seek member comments re the following:

We have prepared, but yet to submit, what we believe to be a relevant, honest and detailed PIP2 form including some 25 pages of additional information - mainly re how her disability effects her in respect of the 5 daily living activities that are relevant to her circumstances, a diary, a support letter from me and some relevant medical evidence, well a support letter - from her senior consultant psychiatrist, who also recommends a paper based review as he feels that a F2F assessment will distress her and potentially worsen her condition. Our welfare rights adviser has said that our submission is one of the best they have ever seen, has bespoke and good examples re how my sister is affected, and uses all the correct DWP buzzwords such as reliably, majority of the time etc etc. 

I was in contact with a DWP Case Manager last week (not the person who will in due course be assigned to my sister's case) and had a somewhat bizarre conversation re how our upcoming request for a paper based review would be handled. The Case Manager tried to be helpful, but when I asked about the screening process that would be carried out to determine whether a paper based review could be justified given the nature of our detailed submission, he gave a disturbing answer. He said that the form would be scanned, sent to Capita and a F2F assessment arranged. I remarked that he hadn't answered my question and I queried if a 'human being' would in fact immediately establish whether a F2F was even warranted given the exhaustive nature of our submission etc, He then admitted that the process is largely automated. I then asked if a Capita HP or a Case Manager would ever read our detailed submission and requests. He said yes, but only after the HP had completed their F2F assessment. I then said that this sounded unjust and that I would find it hard to believe that a HP (who I understand have only approx 1 hour to do their entire assessment) would have adequate time to comprehend some 25 pages of detailed statements re how my sister's disability affects her, and, if appropriate then amend / override the descriptor point scores which will have been robotically churned out from the PIPAT software system used in F2F assessments. So, I said to the Case Manager that I though his answer was unreasonable and that in all likelihood our detailed submission would be overlooked. He then said well if it is not read, and/or we were not happy with the assessment outcome then there's always a Mandatory Consideration. I then expressed my outrage at such an apparently unjust system. In response he said a lot of people are negative about the system, but that's simply due to scaremongers, and he said to re-assure my sister that she should not believe all the scare stories ! 

Given the above we are wondering what is the point of going to all the effort of submitting a detailed submission if it is for main part going to be ignored in the first instance. Yes it may help if an appeal were in due course necessary, but that represents such a waste of public money and will in any event distress my sister. The whole process seems to be flawed. 

Apologies for the length of this post, but members thoughts or personal experiences re the following would be appreciated:

1) When (if at all) does a HP read the PIP2 form, in particular if it contains many pages of additional (albeit relevant) information ?
2) What could be done do make sure that a) our request for a paper based review is actively considered, and b) her detailed submission is reviewed BEFORE a F2F is arranged, or starts?  Welfare Rights are somewhat intrigued by this and say they have struggled with this dilemma for years - they have suggested that I get the name of Case Manager (who will be assigned to my sister's case once PIP form is registered)  and pester them about the issue and our reasonable request. That's assuming that it will even be possible to speak directly to the appointed Case Manager. They also suggested that if there is a F2F and the HP asks their usual third question - explain your typical day - that my sister (or I who will accompany her) just simply refer he to my sister's diary whcj was submitted with the PIP form. To a large extent most of the typical F2F questions asked by HP's (e.g. Do you go to the supermarket or the local shop?) are already answered in the submission and it may be easier just to keep referring the HP to the PIP form that they should have read beforehand. 
3) My sister has no problems with mobility, but if the HP has not read her PIP form before a F2f assessment starts then why waste times asking mobility related questions !? 
4) ,,, or are we being overly cynical, and overly negative, and is the Case Manager correct to tell my sister not to believe all the scare stories. I doubt that people go on to forums such as Scope to report good PIP experiences. So are good experiences the norm and bad the exception, and therefore just a small % of claimants are being unlucky?

Replies

  • cristobalcristobal Member Posts: 966 Disability Gamechanger
    @robt1066 - my condition means that I should have had a paper based assessment, but that was ignored and I had a F2f..

    Have you read the DWP guidelines - search "DWP+ PIP+ assessment +guidelines" - and you can see what their criteria are. 

    Whether they follow them or not is another matter!!

    Good luck...
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    edited July 2019
    Hi,

    I have to admit that 25 pages is rather a lot to read, whether they will read all of that, i really don't know. When filling out PIP forms i always prefer to be more straight to the point, give a couple of real life examples of what happened the last time you attempted that activity for each descriptor that applies and leave it at that. The reason i do it this way is because very often less is more.

    Same for evidence, if you send in pages and pages of evidence, will they read it? I have no idea.

    My daughter is a great example of this face to face V paper based assessment. Her first claim was in late 2017, the form was filled in, although rather poorly by an advice agency. Lots of evidence was sent that proved beyond doubt that those descriptors applied to her. I even highlighted the most relevant parts of the evidence so that they didn't have to sit and read all of it. Verdict.... face to face assessment was needed. Successfully awarded Enhanced for both parts. No physical disabilities.

    Fast forward 12 months and i filled out the forms just like i advised above, with the examples. Kept it short and straight to the point. Sent 2 extra pieces of evidence that wasn't previously sent... verdict paper based assessment. Successfully remained on Enhanced for both parts.

    When DWP receive the forms/evidence these are sent to the health assessment providers. From here they look at the evidence and decide if a face to face assessment is needed. Mostly people do have face to face, it's very rare to have a paper based assessment. A DWP case manager has nothing to do with the claim at this point. It's nothing to do with a case manager until the assessment report has been written and returned to DWP. They then look at the assessment report and make a decision based mostly on that report.

    I don't know the full details of what happens when the file is sent to the health assessment providers because i'm not a HCP and never have been. We do have one member here on scope that was a former HCP assessor who will be able to answer that question for you, if they see this thread. I'll happily tag them for you. @ilovecats your help here would be very much appreciated, if possible please.

    Good luck.


    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • robt1066robt1066 Member Posts: 33 Courageous
    Thx for reply poppy. Yes, read the pip assessment guide. Without being cynical it reads like a procedure which though well meaning is in reality not adequately adhered to . Hopefully @ilovecats can comment. Are you allowed to PM members ? 

    Agree within reason re less is more - plan to cut it down a bit :)
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    You have to wait until you've made 25 posts before you can send a PM.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • robt1066robt1066 Member Posts: 33 Courageous
    Thx. Look forward to hearing back from you. Also wondering about measures that can be taken during a F2F to 'encourage' a HCP to look at and focus on the daily living activities which relate to a person's claim. For example my sister should score 8 points for the managing treatments activity as she spends (or is prompted, or needs prompting) 18 hrs per week on various recommended treatments. But from what i have seen re list of questions asked by a HCP the topic of 'managing treatments' seems to be overlooked  .... unless they read the PIP form !?  
  • cristobalcristobal Member Posts: 966 Disability Gamechanger
    ilovecats said:

     

    I'm happy to try to clarify any questions though before other members start telling me I am wrong or start quoting case law at me, I am only writing from my experience as a HP. There is a requirement to reasonable adjustments to be made and others could probably advise better. For example, HC rather than AC which is normally the case for unclear mental health cases...


    @ilovecats - case law is all very well but no-one at the DWP seems to have heard of it...

    Far better to tell it how it is...


  • robt1066robt1066 Member Posts: 33 Courageous
    Thank you ilovecats. Your words must be the most insightful I have come across to date. Yes, we are ignoring the activities you referred to as yes I agree they are not consistent with a claimant who suffers from depression and anxiety. Will do some more work on our submission and we would be extremely grateful for any further feedback to some other questions that we will doubtless have. 
  • weeemma88weeemma88 Member Posts: 16 Listener
    Hope you don't mind me posting this,from my experience a couple of years ago,I was put in front of an assessor to determine my physical well being for benefits,before it started,I asked,are you a nurse or qualified professional medic and have you read all my case notes from all of the medical experts that I am seeing her answer was,no,I am not a nurse or medically qualified, and no,I have not seen or read any of your medical notes,I just read off the screen questions I have to ask you and get you too do a few physical manouveres,after 20 odd years on  long term Incapacity Benefit I was cut off from that benefit from someone who had no knowledge of my hidden illness that had nothing to if I could lift an empty box.just letting you what these people are like.
  • robt1066robt1066 Member Posts: 33 Courageous
    Sorry to hear that. What would happen in such an instance if you had politely asked the assessor to read what you had put on the form, or if need be given them a copy to read there and then. If they refused I'd have been tempted to go to the front desk and complain. At the end of the day it could not have made things worse ! 
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    weeemma88 said:
    just letting you what these people are like.
    Not all HCPs are bad. I've never had a bad report and i've had 7 assessments in total, 3 for ESA and 4 for PIP. 2 of those were paper based assessments. My last ESA assessment in October last year the HCP was a nurse and she was one of the kindest and friendliest person i've met in a long time. She let me hold her arm while i walked very slowly to the assessment room, while i needed to stop several times on the way she kept telling me to take my time and there was no rush.

    During the assessment i was asked some questions, which i answered the best i could. At the end of the assessment, which only lasted 15 minutes, i couldn't get up from the chair so came towards me and held out her arm for me to hold onto while i got up.

    She then opened the door and asked my to take her arm because my balance and mobility isn't good. She guided me to the door of the building and again all the way she kept telling me not to rush, she had plenty of time. She held the door open for me, where i met my daughter who was waiting in the car.

    A week later i received the assessment report which was honest and truthful all the way through. At the back of the report was her recommendations, to remain in the Support Group. 1 week later a decision was made, which of course went with the report.

    I have yet to meet a horrible HCP for any face to face assessment and have always found them, friendly and helpful.

    Do remember that we really do only ever hear the bad stories. If someone's had a decision they are happy with they have no questions to ask.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • robt1066robt1066 Member Posts: 33 Courageous
    Well said poppy123456. Good to hear and provides a sense of balance. 
  • robt1066robt1066 Member Posts: 33 Courageous
    ilovecats said:

    There is a lot of talk about 'list of questions' however there is no magical list. The longer you do it, the more you learn what questions are relevant for what sort of person / type of restriction. Every has a few old favourites. I would always start with 'Who do you live with' for the social history. For the functional history I would always lead with 'Do you like cooking' or 'Did you like cooking before you became unwell'. 
    If you for example (and you doubtless know why I ask!) had a list of question for a bi-polar sufferer who for the majority of the time is impaired by severe depression and anxiety could you kindly give an indication of what questions you would think would typically be asked, and if some of these questions were already answered on the PIP form would you bother asking them for a second time? 
  • weeemma88weeemma88 Member Posts: 16 Listener
    Hi all,and thank you Ilovecats for your reply,no,this was not for PIP it was to assess me too downgrade from Incapacity Benefit as I stated too ESA CB benefit,will catch up tomorrow as I am going off,may I end with,good luck to all that are waiting on back payments from the DWP for underpayments of ESA and goodnight too you all.😊
  • robt1066robt1066 Member Posts: 33 Courageous
    Thx again. Well my sister has been bi-polar for 20 years, but her periods of depression take up two thirds of the time. I'm aware of the variability issue, but we are looking to argue (which is true) that her low moods are what is the norm or using a buzzword is the prevalent condition 'for the majority of the time'. Her psychiatrist has written a letter confirming that is the case Hopefully such evidence will help to get around your concerning comment that bi-polar may not lend itself to a paper-based review.  To date we have not commented on her manic phases because as you say they are less relevant. 
  • robt1066robt1066 Member Posts: 33 Courageous
    Thx again. If I ask too many questions, just say. 

    What you say above is comforting. All we are trying to do is to be as straightforward and honest as possible. 

    One last question - I can unravel most of your acronyms; but what does HC stand for? 
  • Pipquestions2Pipquestions2 Member Posts: 92 Pioneering
    edited July 2019
    ilovecats said:


    With regards to mobility (A12), if you don't have any problems then tick no and leave the box blank. Do not write about anxiety in the box because it is not relevant and the HP will then have to address it by writing a negative justification. E.g. for anxiety, A5, 7, 8 & 12 are not relevant in the absence of a cognitive or learning disability. 


     A7 as in communicating? 

    My only diagnosis is severe social anxiety I've got 4 points for this descriptor. No learning disabilities or anything (at least as far as I know). Been tested for autism but they said I don't have it.

    I do think there's something more going that's not been diagnosed but I've failed the tests for everything they've thrown at me except anxiety. Perhaps the tribunal judge agreed there's more than anxiety hence awarding these points but officially it's just anxiety. 
  • TopkittenTopkitten Member Posts: 1,263 Pioneering
    This may have already been covered but imo there is no chance at all of them reading 25 pages of additional information. I would guess that they never read any of it at all most probably through lack ot time and lack of interest. I suspect that some low level person types in the answers on the forms into a computer and the assessment carried out from that. This obviously leaves people at the mercy of a typist that has no interest in it, no understanding of it and likely has to leave things out that don't fit in the computer programs 'boxes'. Having spent 25 years or more working with and programming computers and programs this is a likely explanation for a lot of the complaints I have read on here.

    Hope you have better luck than most.

    TK
    "I'm on the wrong side of heaven and the righteous side of hell" - from Wrong side of heaven by Five Finger Death Punch.
  • Pipquestions2Pipquestions2 Member Posts: 92 Pioneering
    Gonna send you a private message @ilovecats
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    As you know my daughter has anxiety, ASD and a learning disability officially diagnosed. Yet she scored no points for activity 7 and 8 despite needing support to communicate with others and support to be able to understand complex written information. She did score for activity 9C. Of course i didn't do anything about it because she had already scored 17 points for daily living.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • Pipquestions2Pipquestions2 Member Posts: 92 Pioneering
    As you know my daughter has anxiety, ASD and a learning disability officially diagnosed. Yet she scored no points for activity 7 and 8 despite needing support to communicate with others and support to be able to understand complex written information. She did score for activity 9C. Of course i didn't do anything about it because she had already scored 17 points for daily living.
    Yup

    I sent Ilovecats a brief summary of what happened, can send you it aswell if you like, though I already did a few weeks ago just maybe not in as much depth.

    Ilovecats said he would have given 9D rather than 7C, but I wouldn't really say I fit into 9D either lol
  • worried33worried33 Member Posts: 399 Pioneering
    ilovecats said:

    Also, from my understanding, on the rare occasions where odd scores have been given at tribunal (1F for epilepsy was given to me as a caselaw example on a different thread), this tends to have little impact on future assessments because this would have been awarded in unusual/exceptional circumstances and the majority of epileptics fit the 1C/1E descriptors.

    Far better to get the application correct and nail the assessment than to worry about MR/Tribunal/Case law etc in advance. 
    I appreciate your insight.

    My issue with this approach is I have always considered it unfair.

    Condition X must mean Y, but sometimes people may have condition X and dont fit into Y and then its a struggle to convince people of that, also what happens if you have no diagnosis, such a system that heavily relies on diagnosis to award a descriptors against non diagnosis heavily.

    For this reason I would say face to face assessments are a good thing, as in theory this should reduce the tendancy to rely on diagnosis to award descriptors but what I dont know if is during face to face does diagnosis get disregarded (and they just look at symptons + evidence) or is diagnosis still heavily leaned upon.

    There was/is a former ESA claimant who got a job at maximus, on her blog she reported she was going to push for claims to be solely 100% decided by diagnosis which scared the hell out of me, her reasoning was anyone without diagnosis cannot be that ill and it would kill all the fraud,  but to me categorising people only by their diagnosis has always been wrong.  You can have two different people with condition X who may lead entirely different lives because (a) they may be affected by it in different ways and (b) they getting different treatments/support.  For that reason automatically awarding descriptors is wrong as well I feel, as someone might have a condition that is seen as typically causing significant disabilities, but are actually only mildly affected then finding themselves with maximum descriptors.

    Assessing people on their health always seems to be a shot in the dark, it took me 5 visits to a knee consultant to get my knee problems recognised, basically they needed to see me on one of my worst days to accept the problem, and that want even a benefit assessment.  I have never been one to deliberately exaggerate pain etc. tho and that may have been part of my problem in struggling to get diagnosis for things.  So when medical professionals see me face to face whether its for a benefit assessment or hospital appointment, how they see me is the true picture.  Ultimately it means they never see me at my worst, because at my worst I wouldnt be able to get to the appointment.
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    PIP isn't about a diagnosis, it's how those conditions affect your ability to carry out daily activity based on the PIP descriptors. Lots of people successfully claim PIP that don't have a diagnosis and my daughter was one of those. Enhanced for both parts on her first claim and this was before she had a diagnosis.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • robt1066robt1066 Member Posts: 33 Courageous
    Agree poppy. 
  • robt1066robt1066 Member Posts: 33 Courageous
    @poppy123456 said ... "You have to wait until you've made 25 posts before you can send a PM.",  I now have made 25 posts. If I want to make a PM how do you go about doing so? 
  • buzzerbuzzer Member Posts: 107 Pioneering
    @robt1066 click your name and get to your profile, under the list of posts, discussions, etc there is a link to inbox, click this and you will see a new message button 

    Try & be kind to one another even if we may have different views. 

  • robt1066robt1066 Member Posts: 33 Courageous
    OK, thx @buzzer . I will send you one to see if it works. 
  • sheZZasheZZa Member Posts: 232 Pioneering
    @ilovecats
    a friend of mine had her f2f with the same assessor as me about 9 months apart.  The assessor treated us both in the same rude, aggressive manner.   She certainly didn’t read any evidence that we both sent in. We both have a disability that the assessor admitted she’d never heard of let alone knew anything about. I have three other debilitating illnesses that she doesn’t have but our reports were virtually identical. We certainly do not believe that it was not a tick box exercise. She applied for a mr and was successful and I am just starting the process.
  • sheZZasheZZa Member Posts: 232 Pioneering
    @ilovecats
    the ha wrote that we both looked well nourished. She’s overweight and I’m average. I thought people shouldn’t judge by appearances. We were both examined and could manage all the exercises when neither of us could and neither of us were tested. As far as I’m concerned one form fits all and nothing is tailored to the individual. 
  • Adrian_ScopeAdrian_Scope Testing team Posts: 7,924

    Scope community team

    robt1066 said:
    OK, thx @buzzer . I will send you one to see if it works. 
    Did you manage to get it sorted @robt1066?
    Senior Community Partner
    Scope

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