Pip letter and assessment letter

adammh00

i got a letter to say I was refused pip. I phoned and asked for a mandatory reconsideration form. I’ve just received my assessment letter and it says to review me in 18 months like I’ve got it. Don’t understand it. Has dwp said no. I can’t phone until Tuesday just seeing if anyone else has had this 

poppy123456

The assessment report recommending to review you in 18 months is the HCPs way of saying that your conditions are not likely to change in this time, so if you start a new claim then you're likely to be refused again.

In that report pay particular attention to the dots next to the activities/descriptors and check them against the PIP descriptors to see what score was recommended. You'll very likely see that you didn't score enough to have any award because the decision maker usually goes with the report.

As you've had a decision letter saying you've been refused then the next step is indeed the MR. You can write the MR letter of request or download it from online, rather than wait to receive it from DWP.

Make sure you put where you think you should have scored those points and your reasons why. Adding a couple of real life examples of what happened the last time you attempted that activity for each descriptor that applies to you.

Avoid mentioning any lies or contradictions in the report because DWP or the Tribunal won't be interested in any of those. They will only want to know the reasons why you qualify.

adammh00

Thank you. Just before I received the refusal I found out I need surgery. Do you think that could change the decision 

poppy123456

It's unlikely because PIP is about how your conditions affect your ability to carry out daily activity based on the PIP descriptors. Usually people have surgery to improve their conditions.

sceneparade

Hi @poppy123456, 

In regards to the above post about reassessment in 18 months time, how much weight would a doctor's expertise have in their decision as to when or if reassessment is necessary? 

I recently submitted to the PIP my mandatory appeal with a detailed letter from my doctor stating how my disability affects me, and in the report my doctor says I am a safety risk to myself and others and that the condition is untreatable and incurable. She informed them of other examples such as if in the general population I would be taken advantage of (and that I have had done) and various other risks. 

it was a pretty good letter (from my perspective) because it rules out the possibility of looking for work. 

Everything she put in the report almost ticked all the criteria for the PIP assessment. 

However, would ESA work capability assessment take into account what the PIP assessors have done - i.e. rejected my claim - or will they look at the application and see that I pretty much fail most assessment criteria. 

poppy123456

@sceneparade Reviews are reviews and we are all re-assessed at these times. Most people have face to face assessments too because it's rare to have a paper based assessment.

GP letters aren't the best evidence to send because they very rarely know how your conditions affect you against the PIP descriptors. If they do know then it's because it's mostly patient lead, which means the patient has told them how they're affected. Or in some cases, even told their GP what to write and yes, i've actually heard stories of this happening.

I'm not sure why your GP sent a letter ruling out the possibility of looking for work for a PIP claim because PIP has nothing at all to do with your fitness to work. It's about how your conditions affect your ability to carry out daily activity based on the PIP descriptors. People claim PIP and work. I'm afraid that won't help.

ESA and PIP are different benefits with different criteria so it will depend on the reasons why you're claiming PIP and where you scored those points.

worried33

poppy what is leading you to assume that GP's "very rarely" know and if they know its patient led? have you carried out some kind of research into GPs or something or just assuming?  Those are some very bold claims, indicating you think GPs are dishonest people.

Given GPs are the main people dealing with day to day needs of patients, I would say they are probably the most likely to know how patients capabilities might be affected, the only people I would put above this is perhaps carers and OT's.

The question is just me trying to understand if its unpublished DWP policy to think GPs dont know what they doing and are prone to been dishonest, or if there has been some kind of study into GPs, or if its just your opinion, thanks.

poppy123456

It's common knowledge that a GP very rarely knows how your conditions affect you against the PIP descriptors. They will only ever know the basics like, what medication you take, a diagnosis, what appointments you've attended in the past etc. If they know anything more then it will be because their patient has told them, which is why a letter from a GP isn't the best evidence to send.

@ilovecats @cristobal will both agree with me here, i'm sure.

cristobal

@worried33 - I tend to agree with Poppy, but you are correct to point out that it's just opinion...

What I'm going on is the fact that GPs, as far as I know, are trained to diagnose and treat conditions not on their functional effect (which is a different specialism.) Their contract doesn't include benefit-claim work.

Personally I can't think of a time when my GP has ever commented on how my condition affected me - possibly when he/she has written a sick note for work?

I asked my GP and was told that if I tell her what she wanted me to write she would if she had time.

sceneparade

But then what is the point of the assessment if they are making a decision in which they don't WANT you to have any money to save the DWP money?

If what is written above is correct, then it doesn't matter what any expert writes because it is the assessor who just turns around and says 'nope, I will be rejecting this person's claim just because I can'. I have submitted evidence from at least three psychiatrists and 2 psychologists, and for what? Nothing. For example, the doctor could write medical expertise letter prior to the PIP or ESA assessment, which you submit in with the application, and then you turn up and meet the criteria and then they just decide that actually they don't want you to have PIP just to reduce the cost to the DWP. 

I can understand why so many claims are rejected - because it isn't based on any medical expertise but the opinion of an unqualified assessor who's sole purpose is to reject an application for PIP or ESA. That is why the success rate at tribunal is so high - because the Judges base their decisions on medical evidence, not the opinion of someone unqualified. How would a judge feel if their opinion was also overruled about the law? Its the same principle. 

And what does the CAB do any different anyway? Just a re-wording in a more legal way about how your disability affects you, based on the reports you have submitted. Again from doctors. 

cristobal

@sceneparade - as I suggested aboveI think a lot depends on what the 'medical evidence' says.

I don't think that anyone doubts the skill and expertise that GPs but when they are writing up their notes etc they are concentrating on diagnosis and treatment. In your case it sounds like you doctor has examined you specifically to evidence the PIP descriptors which I imagine is really valuable evidence if he/she has done this for all of them.

I was fortunate to be examined by an OH consultant prior to being medically retired from my job. He was not concerned about diagnosis at all - but spent over an hour examining me, watching me carrying out basic tasks etc. His report was really valuable and, since he is a specialist in this field, effectively beyond dispute...

I wonder if the best advice might be simply to read through what you GP writes, if they are prepared to write a report for you, and see whether it just repeats what you have just told them? 
Alternatively you could see an OH consultant privately...

sceneparade

@cristobal

My evidence states I was a safety risk to myself and others, that I have and would be taken advantage of if allowed out by myself. That I need constant supervision when taking medication for safety reasons. That I cut my thumb off when attempting to cook food by myself (I showed the assessor evidence of it) because of my inability to cook food, and because I often wonder away and leave the gas on which has burnt pots and nearly caused fires. It mentioned extreme anxiety and an inability to communicate with others. There was a lot the report said that would easily pass the criteria. Based on the safety reasons alone I would have scored very highly. 

Not everyone has the opportunity or financial resources to pay for an occupational therapist. At the end of the day, most people are rejected because it is bias. Take the example of someone with schizophrenia who is in the middle of psychosis. They could be feeling persecuted and being very aggressive because of it, and clearly in no position to work. Yet the assessor would say 'well he can walk, he can read and he is able to communicate with me, so I shall reject him'. Then they apply for a job and the employer would say you aren't fit to work, so we can't offer you a job (which I have actually heard to be true). Where is the fairness in that?

If I go to the CAB, how would they help? What do they do that would argue my case successfully? 

cristobal

If I go to the CAB, how would they help? What do they do that would argue my case successfully? 

@sceneparade - I wouldn't advise going to the CAB. My personal opinion is that the don't do anything that you can't do yourself.

If your GP has examined you and found that you are not safe to cook, are unable to communicate with others and need help with medication etc and has reported this then you will obviously score points for them. Personally if this is what your doctor has written then I can't see how anyone can disagree. An obvious question which might be asked is that if you GP is reporting that you are unsafe then what is he/she suggesting is done about this? Do they suggest any aids/ adaptations etc as you might be able to use this as well??

Hopefully everything will be sorted out at the MR

Good luck anyway

poppy123456

It doesn't cost anything to have an needs assessment done by an occupational therapist, this is free from the NHS.

https://www.nhs.uk/conditions/social-care-and-support-guide/help-from-social-services-and-charities/getting-a-needs-assessment/

This thread is about PIP and PIP isn't about not being able to work, that's what ESA is about and you're confusing the two.

Why would you be taken advantage of if you went out alone? What happened the last time you went out alone? This is what you need to tell them and give real life examples.  Just telling them that you would be taken advantage of isn't enough.

The same for needing constant supervision when taking medication. Why do you need this, what happened the last time you didn't have supervision?

kami24

If you have a great GP who knows you very well then it might help but they are very brief in my experience and simply send the medical report and records already done and some are lazy or overworked so don't have time. My GP is awful i moved so have a new surgery and its worse old one much better they vary alot

sceneparade

@cristobal - my doctor said in the report that it was a neurological condition (ASD) and it was an inability to socially communicate with others, and that because I don't understand social skills or nuances. She said it is untreatable and incurable and would require lifetime treatment. She added that she has known me since I was 11, so about 25 years. 

@poppy123456 - The doctor stated I am a risk to myself. She gave an example where I was on on my iPad game when out with relatives, and whilst they were paying bills in the post office someone asked if they could have a go and that because I can't read or understand others they took it and fled with the iPad and hence was taken advantage of. She did give other good examples too. My doctor also described a few times where I over medicated and had to be taken to hospital, hence I need supervision at all times. She also said that because of the nature of the condition, I find it hard to regulate emotions and sometimes can get angry and lash out impulsively, which finds relationships difficult. It is all part of the ASD. 

cristobal

@sceneparade - your GP seems to have spent some time helping you with this and it's really good that they have been so accommodating.

Can I point out a couple of things which I think might help?

When your doctor says that you are a risk to yourself is he/she linking this with 'Engaging with people face to face' as this refers to behaviour which would result in 'substantial risk of harm to the claimant or another person'?

If so I personally don't think that the iPad example is a good one as there is no 'harm'..

Also your GP say that you 'sometimes lash out' - this doesn't sound like it happens for the majority of the time - has she/he specified anywhere how frequent this actually is?

Good luck - I hope that you find this helpful 

sceneparade

@cristobal - Sorry, I should have elaborated. 

In her report she said I was a risk to both myself and others. For example, the nature of the condition is that because you can't reason emotionally, you lash out aggressively to people you feel are frustrating you, or you then hurt yourself by banging your head against the wall, or picking cuts or scrapes, or self harm through medication and blades. There was also evidence of being referred to a psychiatric hospital as a result of self harm. This was caused by relating to others. 

In regards to the iPad incident. She said that it led to an emotional breakdown and depression that lasted weeks and affected my ability to do anything, including self-harm. There is documented reports from psychiatrists of 'lashing out' which states it has alienated others and that relationships are extremely difficult. She stated that - collectively - there is. no cure for it, which infers a-lot of the time. 

And thanks, I have found everyones advice very insightful and helpful. I realise that there is enough evidence to not be as concerned about an appeal or going to the tribunal, as I feel a. bit more confident.

cristobal

@sceneparade - I'm glad you found it helpful...

Your GP sounds to have been very thorough - hopefully you should get a better result at MR, or tribunal ...

sceneparade

@ilovecats

But if you self-harm around others, or act out aggressively - as demonstrated by commitment to a psychiatric unit - how can they expect you to still work, albeit with support. The nature of ASD is that they will not tolerate people unfamiliar to them. They will react strongly against anyone they do not trust. My nephew is the same. He would have a serious breakdown if his mum wasn't with him 24/7. He is her life-support. In addition, if they believe I need support at work, that would cost the employer a lot of money in funding a support worker to work alongside me, which they would never entertain. Furthermore, employing a support worker to prevent myself from being vulnerable wouldn't help with anxiety in relating to others in general. Even without being taken advantage of, I have evidence backed by the doctor that states relationships in themselves lead to anxiety, depression and even stated this had led to psychosis-NOS on a number of cases. 

Does anyone know the difference(s) between the support group and the work-related group? For example, constant face-to-face meetings at the job centre, training courses, weekly payments received etc. 

kami24

Work related one is where you have to go and see the work coach every 2 weeks (ridiculous!) i hope i am not put into that group because I have bpd and autism so I don't like travelling on my own on buses especially and to see strangers who judge you. I am currently waiting for them to tell me which group they have put me in as i was on jobseekers previous to this and i am staying on esa she said but its up to the dwp or something what group they put you in so tense about that now.