PIP Query regarding inaccuracies and use of walking aids

gone · December 2017

Hi guys.

I received my PIP award a few days ago and am looking for some help.

I was awarded Enhanced Daily Living and Standard Mobility. I am also in the Support Group of ESA.

My ESA was awarded based on the descriptor which talks about not being able to start and finish tasks as it takes me a long time to finish tasks and I need to be prompted a lot to do them for various reasons. Nothing else was looked at in my ESA WCA because I guess she decided she didn't need to. I was awarded ESA a few months ago now.

So with that knowledge I applied to PIP back in late August (could be wrong about that, my sense of time isn't great). I have both mental and physical issues, but it seems to me that where the HCP decided I could just use aids, assistance or supervision to mitigate my physical issues she didn't take into account my mental health issues citing that I couldn't need prompting as I'd never been in hospital/sectioned for it and because I'm apparently not under a MH team (but I am under a MH team and I explained this to her). The problem is that if I had assistance cutting up my food like she said I needed, I still wouldn't eat without encouragement/prompting. She also stated that I was of average weight when I am actually underweight due to a mix of MH issues and physical issues (the whole MSE was a farce honestly, reading it made me angry). Anyway, the same with supervision for washing, if I didn't have prompting I wouldn't get into the shower to be able to wash in the first place (also a mix of MH and physical issues causing problems in this area). With dressing she said I could use aids, but again, without prompting I wouldn't get dressed anyway, most days I don't, so aids are irrelevant (MH and physical health related again).

Curiously, for things like complex budgeting decisions, engaging with people face to face, and planning journeys she's awarded me points because of my MH conditions, it's like she's decided sometimes my MH issues are severe enough and other times they're not (when she can get away with giving lower points).

Essentially, I am concerned that because I've gotten an ESA award for basically needing prompting to do basic things like washing, dressing, eating, etc. and because it's an accurate representation of my difficulties that this inaccurate PIP report will be used against me in the future when I have to reapply for ESA and I won't have a leg to stand on because they take a HCP's word as gospel.

She's also said I can cook with assistance when I can't and I don't cook at all because of pain and fatigue. I can hardly stand up most days to get downstairs let alone cook.

Additionally, she said I walked unaided when I was wearing a knee brace (I am unable to use rollators/canes to mitigate my physical issues with walking because of shoulder/elbow/wrist/hand problems). Wouldn't a knee brace be classed as an aid due to it improving my physical ability to walk? She did say I was wearing a knee "support" - it's a bit more substantial than a support given that it has two metal hinges in it, but anyway. I can't walk unaided for more than about 40-ish meters, not without walking into walls/falling over/being unstable/etc. I am unsure if my mobility award is correct. Also I have been looking into getting a wheelchair due to how limited my mobility is, especially when I am outside, I don't know if that affects anything.

Basically, my questions are: would discrepancies in the PIP report affect my ESA award (/what should I do about this?)? And, do knee braces count as aids as they improve my ability to walk (should I ask for a mandatory reconsideration?)?

BenefitsTrainingCo · December 2017

gone,

I don't think you need to worry about your ESA award for now. In fact if anything, I'd think about things the other way around - how could use your ESA evidence & decision to show the PIP report is wrong and you should get an enhanced mobility component.

You could consider asking for a mandatory reconsideration. It's hard to tell from what you've said whether you should get 12 points for mobility. The fact that you're wondering whether you need to get a wheelchair shows that you have difficulties, but remember that many of the PIP descriptors in mobility activity two say 'aided or unaided'. An aid or appliance is anything which improves, provides or replaces a function, so I do think knee braces are aids, but does that help you get more points? I think you would have to look in detail at activity two and decide what applies to you, because I'm not sure how far you can walk with the knee braces. You could try using the PIP self-test to see if you should have got 12 points.

It also sounds as if in the daily living component the assessor has disregarded/refused to believe your need for prompting. It isn't just about whether you can physically do things, as you know. And if you can't stand up to cook, you may need more than just prompting for that activity - perhaps it should be four points for assistance. On the other hand, you have got enhanced daily living - you can't get any more points there, and unfortunately you are not going to get a statement from the DWP or the assessment company correcting the report, although you could complain (and I think that would be a good idea).

If you do ask for an mandatory reconsideration, bear in mind that it's possible for things to get worse not better. Unfortunately most MR requests result in no change (although we've recently been told the targets used in MRs have been dropped, so that might improve), but sometimes people lose points which I absolutely wouldn't want to happen to you.

As for ESA, it is more likely that they will reassess you than use the PIP evidence to change your award. If you're in the support group, then if you are assessed again, you should be told whether that's the last time (that is, whether you are expected to improve or not, and if not, you shouldn't have to face reassessment after the next one). But I don't think you need to worry about this for now - ESA reassessments are pretty random (but too frequent) - I'd be surprised of one was prompted by your PIP report..

I'd definitely concentrate on getting the PIP decision changed if you want to go for the enhanced mobility component. Bear in mind the risk of losing what you have (at tribunal stage, you would hopefully get it back if that happens, but even that isn't guaranteed, and tribunals too can reduce awards). Another way of challenging the PIP evidence would be to complain about the assessment and keep a record of that complaint. Even if you leave the PIP award as it is, that would help to show that you didn't agree with the assessment if it is ever used as evidence in another context.

Will

gone · December 2017

Thanks for your reply, Will!

Unfortunately, my physical disability was never even looked at in my ESA WCA (the nurse conceded that she didn't feel comfortable assessing me when I asked her at the end of it as she didn't know enough about it - probably because she'd never heard of it). She purely looked at one activity (the starting/finishing tasks one) and put me straight into SG, due to all the prompting I require to do basically everything or I just do things to slowly/not at all.

I currently get 4 points for needing prompting for journeys and 4 points being "able" to walk between 50 and 200m aided or unaided, although she only saw me walk with an altered gait at a slow pace for about 25m (according to the report). I can't really walk without the braces as I get so unstable I just stumble about/fall over, though I only really wear them out of the house (I don't go out often, less than twice a week on average because of MH stuff) as the metal makes my knees bruise up (it's predominantly my right knee that causes trouble but I wear them on both, depending on what has been happening injury wise) - bruising is common in my condition but it still hurts nonetheless. I mostly just don't walk or go downstairs when I'm in the house, this mitigates some issues, but I'm still in pain, etc. regardless. I got 17 for Daily Living.

Yeah, the wheelchair has been a recent thing I've started to have to really think about due to how limited I now am, although I have had issues for about 2 years now mobility wise. I know it'll be difficult to get an electric wheelchair on the NHS though, so I'm probably going to fund my own (somehow). But I can't self-propel a manual because of the power issues in my arms/hands and also instability/pain. Would it be a good idea to then put in a change of circumstances if I get the wheelchair?

Who would I complain to? Would it be ATOS or the DWP? Someone else? I have thought about informing the DWP about the fact I am under a MH team and am on a waiting list for therapy (a long one as well). If she had read the letter correctly she would've seen that people only with severe issues are referred to this MH team from the access team in my area, it's not my fault it has a long waiting list and I feel annoyed that I've been penalised for it. She basically said that my MH issues can't be that severe even though they're more debilitating than my physical ones!

I am mostly told I'm too complex for the NHS and they generally don't know what to do with me MH wise. They also caused some of my issues so I struggle massively with engaging, particularly with the teams in my area. This was to the point where my old CPN didn't know what to do with me as she was the only person I'd engage with somewhat, but I only had her briefly. She even said to me she didn't feel like I was safe in the community because of how suicidal I was back then but she also knew being in IP wouldn't help due to aforementioned issues. Anyway, I don't know whether or not that'd mean I'd be expected to improve in the DWP's eyes though, probably would be expected to improve because it's fun to poke people who are already struggling with life I guess, I dunno. Just feels wrong to me.

BenefitsTrainingCo · December 2017

Hello gone

It is a difficult decision. As your PIP decision was made a short time ago, as Will posted you are within time to request a Mandatory reconsideration, that is ask PIP to look again at their decision. The alternative is to ask that PIP look again at the decision later on as your circumstances have changed. A change in circumstances is generally in regard to health deteriorating or improving. It sounds in your case the change maybe in regard to you being able to save for and purchase a wheelchair rather than a deterioration in health, although such a purchase may indicate a change in health.

For both the Mandatory reconsideration and a possible change of circumstances request, as Will posted there is the risk of losing what you have.

Will put a link to the PIP descriptors, and it maybe worth seeing if 4 points is the correct award especially for the descriptor: moving around. A lot of emphasis is placed on the distance a person can walk (aided or unaided), though walking distance to an acceptable standard should be considered and as such any distance completed when in pain may be disregarded.

When making a complaint about your medical you will need to make a complaint to ATOS, I have put a link to a leaflet on the complaint procedure.

https://www.mypipassessment.co.uk/media/1734/ias-complaints-leaflet-a5-updated.pdf

. Maria

PIP Query regarding inaccuracies and use of walking aids

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