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Hi, my name is winterson6023! Need some advice regarding PIP Claim.

winterson6023

I appreciate I’m a little early here. I applied for PIP due to a prolapsed disc post surgery with nerve damage to my leg and foot with severe reduction in mobility and functionality. I’m fortunate that due to this happening via a RTA I had a injury claim and a top Neurosurgeon did a private full legal document detailing my injuries and restrictions for a potential court case so had excellent evidence.

I had my assessment and I’m awaiting a DM decision. I got a copy of my assessment and the HP awarded me 8 points for care and 12 points for mobility.

That would me. Low care element enhanced mobility. I appreciate this is a good start and the DM is likely to award as the assessor has advised. My question is the following.

The mobility element states I can stand and walk more than 1m but no more than 20 hence 12 points. I provided evidence that my knees are very weak and give way without warning and provided evidence via a neurosurgeon report as detailed above and A&E records and Ambulance records detailing two falls were my legs have way causing injury.

So the HP awarded me 12 points and agreed with my claims etc. But when it comes to care she states I can do the following despite being unable to walk far stand for long and knees that will give way without warning. Also need catheter for bladder and bowel incontenence about 60% of the time. She agreed with all this in report. However.

1. Can make own food and cook with aids. 2 points.

2. Can dress himself with use of aids. 2 points

3. Can get in and out bath with aids. 2 points.

4. Can use toilet etc with use of aids 2 points.

I disagree with the above because.

1. I can cook for very short periods but reluctant to cook and don’t because of the risk leg wil give way and cause me to drop hot scalding kettle pot etc. I also cannot use things above or below waist as restricted back and leg.

2. I cannot wash dress put socks on etc without help below hips. Cannot bend. I accept there are aids to do this but is that really reasonable as it will not take away from the dangers of my leg giving way.

3. Getting in and out bath. Yes aids could assist but no aid can take away from fact I’d need to put all my weight on one leg and again the risk of my leg giving way as described.

4. Toilet I can again get on and off toilet with an Aid BUT I contend CE is difficult with it without an aid. Most importantly I wear a catheter which has a bag that’s attached to just below my knees. I’m unable to attach it there remove it empty it etc and need someone to do this. The HP states agreed I need and use it but this can be overcome with an aid! I know if no aid that can do this and this one single part being changed from Aids can assist to complete 2 points to needs assistance for toolet needs including incontenance of either bowel or bladder 6 points would award an additional 4 points so 8 to 12 meaning high care element.

My question is.

1. Is it risky to ask for a MR when if I’m awarded low care high mobility for sake of £30 a week as could lower whole award?

2. Do the DM generally award what the HP recommends?

3. If I’m awarded I will get an award letter and back dated £ to start of claim as well as being told what date my next payment of 4 weeks £ will be paid and then every 4 weeks there after. If I do an MR id of received my back dated £ but will my future PIP payments stop until MR completed or carry on and any adjustment done once resolved.

Thank you in advance

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poppy123456

HI,

You haven't yet had the decision. Whilst they mostly go with the report, they don't always and it has been known for them to go against the report.

To answer your questions in order..

1/ preparing food.... If they think you can reasonably use an aid, even if you don't then you will score 2 points. Moving pots/pans/plates and kettles etc around the kitchen is not considered as part of this activity. Not cooking because of X is not going to help you score more points here.

2/ washing/bathing and dressing/undressing.... 2 points is awarded for needing to use an aid but you would still get 2 points for needing assistance to wash/dress below the waste. So no further points here.

3/ getting in and out of the bath is part of washing/bathing. to score points for descriptor 4E you would need to prove why an aid can't reasonably be used. Again, not doing an activity because of X is not going to score you any extra points. You can only also score points once per activity.

Where a claimant chooses not to use an aid or appliance which he or she could reasonably be expected to use which would enable them to carry out the activity without prompting, supervision or assistance, descriptor B will be appropriate.

4/ managing toilet needs. This activity considers a claimant’s ability to get on and off the toilet, to manage evacuation of the bladder and/or bowel and to clean them self afterwards. This means that if you need to use an aid to get on and off the toilet but you can manage to clean yourself afterwards then you won't score 6 points here and the 2 points for using an aid would be correct.

In my opinion based on what you've said here, a further 1 point maybe possible if you can prove you can't reasonably use the aid for washing/bathing but this won't be enough to get you a higher award.

winterson6023

Surely point 4 is 6 points as it says.

5e. Needs assistance to be able to manage incontinence of either bladder or bowel. (6 points).

I can’t teach below hips so cannot clean myself properly although they say I can with an aid. But I cannot use an aid by myself as a catheter is attached to below knee and I can’t fix in place take off or empty it.

Would 6 points not apply?

chiarieds

Hi @winterson6023 - & welcome to the community. As mentioned above, you need to wait for your decision letter, as you seem to appreciate. If the decision you feel is inappropriate as far as the daily living activities go, you can ask for a MR. Another DM will however look at your whole award again. Currently the chance of a change in an award is about 50% (but I gather this is decreasing), so most stay the same, altho an increase can occur. The chances of your award decreasing are however rare, so this is possibly worth pursuing.

I agree with Poppy on the points you've raised, apart from perhaps the last about your toilet needs. So, just to be sure, altho PIP is about the help you need even if you don't receive this, does someone actually assist you in emptying your catheter?

winterson6023

yes as I said I only wear it about 60% of the time. But when I do I cannot reach down to attach detach or empty it. The assessor has accepted I cannot reach down in her assessment overview also. This is why I expected the 6 points on that part. As you say I need to await award. Been told 1-4 weeks but new claims are likely 1-3 weeks I’m 2 weeks into it so won’t be long.

chiarieds

Hopefully not too long, tho here on the forum we usually hear that a decision letter following an assessment can take an average of 8 weeks. So, someone does actually help you empty your catheter the majority of the time? How do you manage without the help, as you say you only wear it about 60% of the time?

winterson6023

Not sure what your asking or how to answer tbh. I always have help thankfully so there’s never an issue there. If your asking how I cope without using a catheter it’s hard to explain but…. I had a damaged sciatic nerve which is reduced in diameter by 50%. In effect most of the time we’ll practically all the time I have the feeling I’m desperate to empty my bladder. After 2 years of this condition and understanding and taking into account what I’ve drank as well as the last time I emptied bladder means I can have some room for not requiring it. However the issue occurs when I’m out with my family and don’t know when next toilet opportunity will arise etc. If it makes sense the point when you feel like your desperate for toilet and may not even make it I get that feeling every few mins. The hour or two after I’ve been I know I can ignore and 99% of the time I’m correct. This however only applies at home. When I’m out or at work it’s not possible or I would not risk chancing it by not using my portable catheter. Hope that makes sense.

chiarieds

Sorry, my queries were not meant to be invasive. With PIP it is how you are the majority of the time, which was why I was asking. You need to consider this.....I don't know how long you're at work, or how often you use a portable catheter, but if someone doesn't help you emtpy this the majority of the time at home/work/out with your family then I can't see an increase in points that may be awarded either. I just hoped to clarify this point.

poppy123456

Do you use the catheter at work? If so how many hours do you work?

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