PIP, DLA and AA
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GP Evidence for PIP MR

MK70MK70 Member Posts: 4 Listener
Hi 
I had a face-to-face PIP assessment early December and was given no points at all for both daily living needs and mobility needs, obviously followed by the decision not to award PIP.

I then wrote to my GP asking for assistance with evidence to appeal and my GP has contacted me to ask what evidence is required.  I have read through lots of different forums and information and am really struggling to know what to tell my GP now.  I understand that I cannot advise my GP what he needs to state on any correspondence, so what is the best way to go about this please?

I suffer with an extremely rare genetic condition called HLRCC which causes me severe pain, particularly on my right arm with lesions covering the forearm and upper arm, but this is now developing across my back, on my upper leg, left arm and scalp.  Incidentally, I consider myself to have a very high pain threshold (gave birth twice with only small amount of Entonox, have dental fillings without anaesthetic etc) but the pain associated with this condition is unbearable, like having a knife cutting through the skin of the affected area which regularly brings me to tears and is so severe that I have to stop whatever I am doing until the pain subsides - this happens several times during every day.

My pain is triggered by both temperature fluctuations and stress.  It was relatively recent that I related the pain with stress but made the link after waking in pain following a nightmare. It only takes a small amount of stress, worry or temperature change to trigger pain which I understand would be difficult to see within a face-to-face assessment lasting around 30 minutes, held indoors and with me wearing a feather down jacket.  I avoid going out on social activities with work colleagues as the pain in moving from place to place would be too much/too embarrassing and have had periods of time off sick from work due to the pain.  Additionally, I work for the NHS, was a shift worker but was advised by Occ Health not to continue working night shifts, my shifts were reduced from 12 to 10hrs and I am the only employee to be given long sleeved uniform.  I take nifedipine and amitriptyline twice daily, my central heating costs are high and I sleep with an electric blanket on all night due to the need for warmth, I need to buy warm clothing such as down jackets etc.

I have submitted a MR appeal which included a letter my husband wrote detailing how my condition affects me on a daily basis but I advised that I had not yet received the GP report. 

I am sorry for the long winded post but is it worth my GP submitting any further evidence? The report stated that 'other than your painful skin lesions you have no physical restrictions' and 'it is reasonable to assume that temperature changes within your home would be minimal suggesting minimal functional impact and a low level of restrictions'. 'You said that you have difficulty moving around, however you have no lower limb restrictions. You were observed to walk at a normal pace and gait'.  I have to take the medication now in order to function at all, otherwise I would spend all of my time sat by either the fire or radiators within my house which is what I did for a whole month late 2018 whilst trying to find effective medications. 
 Thanks in advance!

Replies

  • wilkowilko Member Posts: 2,399 Disability Gamechanger
    Hello and welcome, sorry for being blunt with my answer. When you applied for PIP did you read the descriptors and how they apply to you in relation to your daily living activities and mobility issues. Your GP will not know how each of the PIP descriptors effects you on a daily basis but only knows your health conditions, medication and diagnosis. PIP is not awarded on a diagnosis or disability or the medication you are prescribed but on your abilities or inability to preform attempt the PIP descriptors safely and repeatability and in a timely manner for 50% of your daily life over a 12 month period. 
  • MK70MK70 Member Posts: 4 Listener
    Hi thank you for your reply. A lot of the info given in my post was for background into my condition, not meaning that I believe I should be awarded PIP due to my condition/medication. I am asking for advice regarding any input from my GP. If it is not regarded as useful I'm wondering why there are so many mentions of supporting evidence from HCPs/GPs?
  • chiariedschiarieds Community Co-Production Group Posts: 10,163 Disability Gamechanger
    Hi @MK70 - Welcome to the community. I'm sorry to read about your very painful genetic disorder & also your unsuccessful PIP claim. I can identify with having dental fillings without anaesthesia, as I found it didn't help; it turns out with my type of genetic order local anaesthetics just don't work! Many here also find that stress (& other triggers) undoubtedly increases pain,
    As far as PIP goes, the letter from your husband detailing how your condition affects you sounds good. This is the important thing about PIP; it's about how your disability affects you rather than 'just' your diagnosis.
    I am unsure if you're thinking about asking your GP for help with your MR, or if this goes to a tribunal. Sadly the success rate of MRs is low, with most having to go to a tribunal, & the waiting lists for these are about 1 year.
    Will your GP know how your condition affects your daily living or mobility? Probably not, but, if they are willing to be supportive, they might write about the lesions they've seen, & the severity of them. Other than that, they really can't describe anything about your 'functionality.'
    For future reference, I would suggest taking the time to look at this lengthy link about the PIP descriptors, which it's worth trying to understand.
    For any problematic descriptor, it's worth illustrating with a couple of examples as to how that affected you (at the time of your assessment).
    If the work you do contradicts part of your PIP claim, this may go against you, altho you can work & claim PIP.
    I hope this may help, & others with more knowledge may reply. Please do let us know how you're doing, & if the community can help support you in any way. Do write here any time.



  • woodbinewoodbine Community Co-Production Group Posts: 5,058 Disability Gamechanger
    The DWP doesn't really take much notice of GP's i'm sorry to say, if they did they wouldn't need ATOS etc as has been said already PIP is about how your condition affects your care and or mobility needs and that's what you need to concentrate on, also for an MR you need to tell them (nicely) where you think you should have scored points but didn't. If you have to go to appeal I would suggest you get some help, from CAB or welfare rights or similar.
    good luck
    I will now only offer benefits advice on PIP, and specific benefits advice for other people with Epilepsy. 
  • Alice_HoltAlice_Holt Member Posts: 46 Courageous
    edited March 2020
    Linking to the descriptors will be key to your MR:
     https://www.benefitsandwork.co.uk/personal-independence-payment-pip/pip-points-system

    As, I think, will reliability, the link chiarieds has provided has a section on that ( Section 2.2).

    If you take twice as long to do an activity as others without the illness - then you shouldn't be counted as being able to do it.

    If pain stops you doing an activity at any point on the day (other than momentarily) then that is likely to mean you can't do it reliably (i.e as and when required).

    8 points are necessary for an award. Possibly look at dressing, bathing, maybe preparing and cooking food for Daily Living.
    Do you require help with any therapy / medical interventions at home prescribed by a medical practitioner? If so, Activity 3 may apply.
    Possibly toileting - sorry to be so direct - do you need an aid to clean yourself afterwards?

    PIP is very prescribed -  it only looks at the listed activities - it does not look at wider care needs.  You are going to have to fit around these descriptors, and for some conditions that can be difficult.  But the reliability rules will help you.

    I would write the MR around the descriptors that apply (getting you to 8 points) fully explaining why you can't do the activity reliably - specific examples will make things clearer, include (as suggested) a letter from family / friends expanding on the daily difficulties and help you need with these activities.  Then, since the condition is so little known, a letter from your GP / specialist explaining the severity, extent, and frequency of the pain may well be helpful. The 3 combined will help build your case.

    As said, it is very likely the MR will be rejected and you will need to go to tribunal. This explains the process:
    https://www.advicenow.org.uk/guides/how-win-pip-appeal

    Benefits & Work has a good appeal guide (and more info on reliability), but membership is c.£20 a year to access their guides. You may consider this worth it. if a local advice agency can't help you with the appeal. 

     

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