Health Professional's justification contradicts descriptors

DanaScully

Hi All

I'm a new member here. 

I had my telephone PIP assessment around a month ago and requested a copy of the Health Professional's report. When I received the report I was confused as she includes a lot of what I told her in the justification but the box ticked for each descriptor doesn't match up. This is the case for nearly every descriptor. I have had my decision letter through today which states I have not been awarded any points (quelle surprise!). 

For example:

Managing therapy or monitoring a health condition

HP's descriptor choice: 
a: Either -
i) Does not receive medication or therapy or need to monitor a health condition; or
ii) can manage medication or therapy or monitor a health condition unaided
(No points) 

HP's justification for descriptor choice:
'CQ (?) reports cognitive dysfunction and forgets to take her medication. Her partner fills a dosette box for her weekly and prompts her with medication. FH (functional history) reports that she needs prompting with medication due to her memory problem and that her partner arranges this into a dosette box for her weekly and prompts her daily. There is no cognitive restriction reports in the HOC (history of conditions) or FME (?). IOs (informal observations) report that despite today being a bad day she attended assessment unsupported and needed no prompts. She has no specialist input and has not been referred to memory services, SOH (social and occupational history) report suggests that she works full time and that on one day a week she also works from home which would suggest good cognitive ability. It is likely that she can manage her medication unaided safely, to an acceptable standard and repeatedly on the majority of days.'

Unfortunately HP has not been entirely truthful in her report. My partner was at work so I had no choice but to attend alone. On my original form and during the assessment I told her I really struggle with cognitive ability due to my ME and the brain fog I experience. I also told her that I experience anxiety and panic and my partner has to regularly remind me to use the techniques I learnt in CBT. 

It's so disturbing that this lady who lulled me into a false sense of security has essentially said she believes I am lying throughout the report. How can I evidence that my partner has to help me with my meds and therapy unless she comes and sits in my living room and watches us for a week?!

Although I was expecting the nil point decision, I'm still very upset as my conditions and how they affect me mean I should be entitled to an award. I am going to request MR and use the template letter on the advicenow website, but can anyone offer any guidance or advice on how I can push back on her lying? I did record the assessment but unfortunately it didn't capture her voice, only mine. I'm in the middle of typing it up so that I can spot anything she has claimed I have said I could do which I can't. 

Thank you.  

DanaScully

Also I am thinking of writing to my MP to make him aware of how I have been dealt with so far and my experience. Any thoughts or comments on this would be very welcome.

quinq

So in the one you quoted anyway, what she's saying is "DanaScully says she can't do this thing without help. I think she can do it without help" I imagine the others are similar?

Also, did you record the assessment yourself?

Cressida

@DanaScully this is what I found online about 'therapy'. When I applied for PIP I assumed I would be awarded points in this area as my son has to administer my injections but that was not the case. 

In relation to Personal Independence Payment (PIP), “therapy” means therapy to be undertaken at home which is prescribed or recommended by a registered doctor, nurse, pharmacist or health professional regulated by the Health Professions Council, but does not include taking or applying, or otherwise receiving or administering, medication (whether orally, topically or by any other means) or any action which falls within the definition of “monitor a health condition”.

Not sure if this is helpful at all but good luck with your mandatory. Try not to concentrate on the lies but to point out where you should have received the points and why. 

DanaScully

quinq said:

So in the one you quoted anyway, what she's saying is "DanaScully says she can't do this thing without help. I think she can do it without help" I imagine the others are similar?

Also, did you record the assessment yourself?

Yes, pretty much. In each one she writes down what I've reported, including where I've said I need help from my partner or use an aid, and then ends each of the descriptors with, 'It is likely that she can do (activity) safely, to an acceptable standard and repeatedly on the majority of days.' 

I did record the assessment but as I mentioned in my original post, the recording only captured my voice and not the HPs. 

DanaScully

Cressida said:

@DanaScully this is what I found online about 'therapy'. When I applied for PIP I assumed I would be awarded points in this area as my son has to administer my injections but that was not the case. 

In relation to Personal Independence Payment (PIP), “therapy” means therapy to be undertaken at home which is prescribed or recommended by a registered doctor, nurse, pharmacist or health professional regulated by the Health Professions Council, but does not include taking or applying, or otherwise receiving or administering, medication (whether orally, topically or by any other means) or any action which falls within the definition of “monitor a health condition”.

Not sure if this is helpful at all but good luck with your mandatory. Try not to concentrate on the lies but to point out where you should have received the points and why. 

Thank you, this is helpful. I did also mention to the HP that my partner has to help me monitor my health condition as she often recognises signs that I don't that indicate I am doing too much and may face a flare up, so she will remind me to slow down and reduce my activity, however HP hasn't mentioned this.

quinq

DanaScully said:

quinq said:

So in the one you quoted anyway, what she's saying is "DanaScully says she can't do this thing without help. I think she can do it without help" I imagine the others are similar?

Also, did you record the assessment yourself?

Yes, pretty much. In each one she writes down what I've reported, including where I've said I need help from my partner or use an aid, and then ends each of the descriptors with, 'It is likely that she can do (activity) safely, to an acceptable standard and repeatedly on the majority of days.' 

I did record the assessment but as I mentioned in my original post, the recording only captured my voice and not the HPs. 

horrible, im so sorry!

i think you'll want to collect as much evidence as you can that you can't do the specific things for the MR - including any help you get to do the things she's used as reasoning 

what i meant was, did they know you were recording?

DanaScully

quinq said:

DanaScully said:

quinq said:

So in the one you quoted anyway, what she's saying is "DanaScully says she can't do this thing without help. I think she can do it without help" I imagine the others are similar?

Also, did you record the assessment yourself?

Yes, pretty much. In each one she writes down what I've reported, including where I've said I need help from my partner or use an aid, and then ends each of the descriptors with, 'It is likely that she can do (activity) safely, to an acceptable standard and repeatedly on the majority of days.' 

I did record the assessment but as I mentioned in my original post, the recording only captured my voice and not the HPs. 

horrible, im so sorry!

i think you'll want to collect as much evidence as you can that you can't do the specific things for the MR - including any help you get to do the things she's used as reasoning 

what i meant was, did they know you were recording?

Thank you. I know how corrupt the system is but it's totally different when it's you they're telling the lies about. I have been discharged from various outpatient departments so I think I will get back in touch and ask if they will write something to support me that I can include with the MR.

My phone automatically records calls so it wasn't a conscious and deliberate recording, and as she didn't specifically ask if I was recording or stipulate that I couldn't, I didn't feel the need to disclose.  

mikehughescq

It’s useful to remember a couple of key things about HCP assessments.

1 - it’s not their role to simply repeat what you say. If it were then what would be the point of having them in the process? They have formed an opinion on your functional impairment and it’s different to yours. There are always reasons for that.

2 - whilst the HCP assessment is pre-eminent in the things considered by a decision maker most people make the mistake of making the HCP report the focus of any subsequent challenge. They react to that rather than asking how come the HCP was able to come to that conclusion. 

Instead of accusing them of lies or corruption look at it from their perspective and build your case from there. 

So, 4 issues to address if we take your above example.

• No prompts
• No specialist input 
• No memory referral 
• You work 

Most reasonable people would say that balanced against an assertion that you need prompting to use a dosette daily at minimum you would need to explain why each of the 4 things above are misleading. The question you then need to ask is what was your evidence on those 4 things? 

Did you, for example, explain about why you needed no prompts on the day or why you appeared that way to them but in fact had multiple coping mechanisms and tenon sets in different forms?

Did you explain why you currently have no specialist input? Have you exhausted it? Refused it and so on?

If the need for prompting for meds is a memory thing then why indeed has there not been a referral to a memory clinic? Or has there but you didn’t say?

What have you said about work? Do you have reasonable adjustments under the Equality Act? 

Now, I’m not interested in the answers to these specific things but you should be. The HCP report will not feature much if you were to pursue this to an appeal hearing. There, the focus will be on what the evidence is which shows you qualify rather than what the HCP did wrong. The HCP report when read in this way tells you every gap in your evidence which you need to address in order to succeed. You note that you are your own best evidence here i.e. the evidence needed to plug the above 4 gaps is not medical evidence. It’s evidence from you, anecdotal evidence. 

You’ll appreciate I’m playing devils advocate here but you’ve 2 choices with a HCP report. Waste energy ripping it apart and making all sorts of accusations that further down the line a tribunal won’t care less about, or, using the clear information they’ve given you to improve your evidence to make your case irrefutable. 

Jankins

Get help from Citizens Advice.  I did for old ESA and PIP, had the same as you, assessor for ESA said  I can travel on public transport on my own TOTALLY UNTRUE.  Then had a very rude woman come into my own, moaning about the sun through the window, and got turned down for PIP.  Won both tribunals so bear with it.  Get as much medical evidence as you can too.  If you are successful, which I'm sure you will be, they will back date PIP and carers allowance to the date you applied for it.

Good luck! 

DanaScully

mikehughescq said:

It’s useful to remember a couple of key things about HCP assessments.

1 - it’s not their role to simply repeat what you say. If it were then what would be the point of having them in the process? They have formed an opinion on your functional impairment and it’s different to yours. There are always reasons for that.

2 - whilst the HCP assessment is pre-eminent in the things considered by a decision maker most people make the mistake of making the HCP report the focus of any subsequent challenge. They react to that rather than asking how come the HCP was able to come to that conclusion. 

Instead of accusing them of lies or corruption look at it from their perspective and build your case from there. 

So, 4 issues to address if we take your above example.

• No prompts
• No specialist input 
• No memory referral 
• You work 

Most reasonable people would say that balanced against an assertion that you need prompting to use a dosette daily at minimum you would need to explain why each of the 4 things above are misleading. The question you then need to ask is what was your evidence on those 4 things? 

Did you, for example, explain about why you needed no prompts on the day or why you appeared that way to them but in fact had multiple coping mechanisms and tenon sets in different forms?

Did you explain why you currently have no specialist input? Have you exhausted it? Refused it and so on?

If the need for prompting for meds is a memory thing then why indeed has there not been a referral to a memory clinic? Or has there but you didn’t say?

What have you said about work? Do you have reasonable adjustments under the Equality Act? 

Now, I’m not interested in the answers to these specific things but you should be. The HCP report will not feature much if you were to pursue this to an appeal hearing. There, the focus will be on what the evidence is which shows you qualify rather than what the HCP did wrong. The HCP report when read in this way tells you every gap in your evidence which you need to address in order to succeed. You note that you are your own best evidence here i.e. the evidence needed to plug the above 4 gaps is not medical evidence. It’s evidence from you, anecdotal evidence. 

You’ll appreciate I’m playing devils advocate here but you’ve 2 choices with a HCP report. Waste energy ripping it apart and making all sorts of accusations that further down the line a tribunal won’t care less about, or, using the clear information they’ve given you to improve your evidence to make your case irrefutable. 

Thanks for your reply, I appreciate you taking the time to make this post. It's really useful and has helped me to look at the report from another aspect which will hopefully be to my advantage in my appeal.

DanaScully

Jankins said:

Get help from Citizens Advice.  I did for old ESA and PIP, had the same as you, assessor for ESA said  I can travel on public transport on my own TOTALLY UNTRUE.  Then had a very rude woman come into my own, moaning about the sun through the window, and got turned down for PIP.  Won both tribunals so bear with it.  Get as much medical evidence as you can too.  If you are successful, which I'm sure you will be, they will back date PIP and carers allowance to the date you applied for it.

Good luck! 

Thank you. I'll get in touch with CAB to request support. Well done on winning your tribunals!