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Mums Net PIP Assessor's thoughts
pmlindyloo
Posts: 13,090 Forumite
Thought this might be useful for people:
October 2016 from MumsNet
Bit of background; I was a PIP Disability Assessor for a while this year, until I decided that I couldn't work within the system with a good conscience, and left. I witnessed DA's who were trying their best, mostly, to help people with their claims. They (and I) were hamstrung both by our immediate employers, and a system (whether by accident or design) that discriminated against claimants with certain conditions. In the spirit of the release of 'I, Daniel Blake', which isn't about PIP but other failures of the benefit system, I've decided to give some general advice to those looking to claim PIP.
Firstly, let's look at initially making the claim. I would say the most vital point is this; PROVIDE EVIDENCE. The way that the claim form/questionnaire is worded implies that the DWP/ATOS/CAPITA or whoever will chase letters from GPS, specialists etc to back up your claim for you. In my experience, this doesn't happen. The onus is on you to provide this information, although it would be very easy to assume the opposite. Some photocopies of a recent prescription, letters detailing diagnoses and appointment dates, and evidence of secondary care involvement (especially people with mental health conditions) provide good evidence; if you haven't provided anything, then the DA has to go mostly on that short assessment with you. You may be horribly unwell or disabled for 5 days a week, if you're having a 'good day' on the assessment however, then your claim is in trouble. Evidence, Evidence, Evidence; I can't stress that enough. Don't let the DWP have the easy option; the decision they make is heavily dependent on the report written by the health professional that assesses you. The decision maker at the DWP has no medical qualifications of any sort.
If you have disabilities that cause you to have problems getting out (especially severe MH conditions), ask for a home assessment. The way the system is, if you have a MH condition involving severe anxiety or depression, or agoraphobia; then you attend a clinic appointment, it can be used as evidence that you aren't as bad as you claim that you are. The reasoning is that you can't be that ill if you can get to a clinic appointment. It's profoundly unfair, and a large part of why I left. Once again; evidence is so important.
Don't assume that the health professional that sees you knows much about your condition. In a working and well-designed system, those with certain conditions would be given appointments with HP's with a specialism in that area. It ain't so. You could get a general or MH nurse, an Occupational Therapist, a Physio or a Paramedic. It's completely random. If you can bring along a health professional of your own, then do. I'd advise anyone against attending by themselves. That's not because I don't trust the DA's; the vast majority are good people. It's just easy to forget things, and people with severe MH problems or learning disabilities/Autism really need an advocate of some sort.
If you're asked to do a set of 12 exercises (it's called the Musculoskeletal exam, or MSK), be sensible! I had people trying to please me by trying to do these despite evident pain; tell the DA why it would be difficult for you to do it. If you cannot do it, just do what you can and explain why. Completing those ridiculous exercises at personal cost, especially pain, will count against you. Don't make stuff up to help your claim (they'll see straight through it, and assume that you're dishonest), but don't put yourself at risk of harm by doing something that you can't. The DA has to take your safety into consideration when assessing what you can and can't do. Once again, evidence is key. If you need aids or adaptations to walk, or need to wear wrist supports etc, then bring/wear them. Help the DA to help you. They normally will.
Talking of assessments, if you report any MH conditions at all, then the DA will be observing you throughout the assessment for a Mental State Examination (MSE). In my opinion, this is even more badly designed that the MSK. A HP, who may or may not have any MH experience at all, will continually assess your mood, behaviour, anxiety etc throughout the assessment. It's completely subjective. If you have a serious MH condition, if you are in pain, if you are distressed or anxious then let it show to the DA. The stiff upper lip is the worst possible approach.
We were told that those 45 minutes were key. If a consultant wrote that you couldn't do something, then you did it in that 45 minute assessment (good day or not) then the weight of evidence would be on the assessment.
My opinion, for what it's worth, is that PIP discriminates against those with learning disabilities or MH conditions. Seriously. It's appalling. If you are turned down, then PLEASE appeal. You'd be surprised how many obtain PIP through appeal; it's often through providing further evidence. Don't give the DWP the chance to deny your rightful claim in the first place; provide that evidence when you first fill in the forms.
October 2016 from MumsNet
Bit of background; I was a PIP Disability Assessor for a while this year, until I decided that I couldn't work within the system with a good conscience, and left. I witnessed DA's who were trying their best, mostly, to help people with their claims. They (and I) were hamstrung both by our immediate employers, and a system (whether by accident or design) that discriminated against claimants with certain conditions. In the spirit of the release of 'I, Daniel Blake', which isn't about PIP but other failures of the benefit system, I've decided to give some general advice to those looking to claim PIP.
Firstly, let's look at initially making the claim. I would say the most vital point is this; PROVIDE EVIDENCE. The way that the claim form/questionnaire is worded implies that the DWP/ATOS/CAPITA or whoever will chase letters from GPS, specialists etc to back up your claim for you. In my experience, this doesn't happen. The onus is on you to provide this information, although it would be very easy to assume the opposite. Some photocopies of a recent prescription, letters detailing diagnoses and appointment dates, and evidence of secondary care involvement (especially people with mental health conditions) provide good evidence; if you haven't provided anything, then the DA has to go mostly on that short assessment with you. You may be horribly unwell or disabled for 5 days a week, if you're having a 'good day' on the assessment however, then your claim is in trouble. Evidence, Evidence, Evidence; I can't stress that enough. Don't let the DWP have the easy option; the decision they make is heavily dependent on the report written by the health professional that assesses you. The decision maker at the DWP has no medical qualifications of any sort.
If you have disabilities that cause you to have problems getting out (especially severe MH conditions), ask for a home assessment. The way the system is, if you have a MH condition involving severe anxiety or depression, or agoraphobia; then you attend a clinic appointment, it can be used as evidence that you aren't as bad as you claim that you are. The reasoning is that you can't be that ill if you can get to a clinic appointment. It's profoundly unfair, and a large part of why I left. Once again; evidence is so important.
Don't assume that the health professional that sees you knows much about your condition. In a working and well-designed system, those with certain conditions would be given appointments with HP's with a specialism in that area. It ain't so. You could get a general or MH nurse, an Occupational Therapist, a Physio or a Paramedic. It's completely random. If you can bring along a health professional of your own, then do. I'd advise anyone against attending by themselves. That's not because I don't trust the DA's; the vast majority are good people. It's just easy to forget things, and people with severe MH problems or learning disabilities/Autism really need an advocate of some sort.
If you're asked to do a set of 12 exercises (it's called the Musculoskeletal exam, or MSK), be sensible! I had people trying to please me by trying to do these despite evident pain; tell the DA why it would be difficult for you to do it. If you cannot do it, just do what you can and explain why. Completing those ridiculous exercises at personal cost, especially pain, will count against you. Don't make stuff up to help your claim (they'll see straight through it, and assume that you're dishonest), but don't put yourself at risk of harm by doing something that you can't. The DA has to take your safety into consideration when assessing what you can and can't do. Once again, evidence is key. If you need aids or adaptations to walk, or need to wear wrist supports etc, then bring/wear them. Help the DA to help you. They normally will.
Talking of assessments, if you report any MH conditions at all, then the DA will be observing you throughout the assessment for a Mental State Examination (MSE). In my opinion, this is even more badly designed that the MSK. A HP, who may or may not have any MH experience at all, will continually assess your mood, behaviour, anxiety etc throughout the assessment. It's completely subjective. If you have a serious MH condition, if you are in pain, if you are distressed or anxious then let it show to the DA. The stiff upper lip is the worst possible approach.
We were told that those 45 minutes were key. If a consultant wrote that you couldn't do something, then you did it in that 45 minute assessment (good day or not) then the weight of evidence would be on the assessment.
My opinion, for what it's worth, is that PIP discriminates against those with learning disabilities or MH conditions. Seriously. It's appalling. If you are turned down, then PLEASE appeal. You'd be surprised how many obtain PIP through appeal; it's often through providing further evidence. Don't give the DWP the chance to deny your rightful claim in the first place; provide that evidence when you first fill in the forms.
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Comments
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In summary:
* Submit evidence.
* Be honest.
* Be yourself.
Anyone could have written that. I was hoping for something a little more insightful.0 -
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In summary:
* Submit evidence.
* Be honest.
* Be yourself.
Anyone could have written that. I was hoping for something a little more insightful.
Typical post from you ! Totally unhelpful as always
OP - thank you for kindly posting this on - I found it very helpful
Stuck on the carousel in Disneyland's Fantasyland
I live under a bridge in England
Been a member for ten years.
Retired in 2015 ( ill health ) Actuary for legal services.0 -
I also think it is an informative post.
The only advice I would question is the "be honest" tag. I would not condone people lying and making up illnesses, but the reality is that time and time again we hear legitimate and well documented stories that the HCP's and DA's lie ... or as a minimum are just lazy.
As the ex-DA states, it is best to make a good, well evidenced claim in the first place. If , however, you have to attend a PIP or ESA medical, then present yourself as though you are having your worst day possible, but if asked say that it is one of your best days. It is all a game and a money making exercise for the HCP's (based on piece work), so play the game.
Apologies if this appears to be overly cynical and somewhat improper, but I have recently attended a number of medical assessments and the above ruthless approach seems to work.0 -
The way the system is, if you have a MH condition involving severe anxiety or depression, or agoraphobia; then you attend a clinic appointment, it can be used as evidence that you aren't as bad as you claim that you are. The reasoning is that you can't be that ill if you can get to a clinic appointment. It's profoundly unfair, and a large part of why I left. Once again; evidence is so important.
You write this as if it tricking the claimant. Surely if a claimant puts on its form that it absolutely cannot go out of the house because of agoraphobia, but then manage to go to the clinic, surely it is the evidence that they are capable of doing it. I don't see what is unfair about reaching this conclusion.
Indeed, it is, but as you've said, is it what is left to go by when there is lack of concrete evidence. What do you suggest is being used?A HP, who may or may not have any MH experience at all, will continually assess your mood, behaviour, anxiety etc throughout the assessment. It's completely subjective.
Ie. Mrs X claims to be agoraphobic which is so severe, she can't live her house. She has care and mobility needs as a result. Although severe, she hasn't seen any medical professional for years. She write a very long application, citing how she can't go out, how she gets panic attacks if the door bell goes, how she endured a painful tooth abscess because she wouldn't go to the dentist etc...
There are two possibilities: the claimant is totally honest and wrote it exactly as it is. They haven't been out of the house for years and couldn't even face going to their GP. Or.... they could be desperate to remain on PIP because their husband claim CA and if she lost her claim, they would be in big financial trouble losing DLA, their husband having to look for work, and they have therefore seriously exaggerated their claim (as indeed although they don't like going out much they do manage to when it involves doing something pleasurable).
So what do you then? Accept everything a claimant will say at face value? Do you genuinely believe that the vast majority of people will be totally honest, even when the consequences of being so will be significantly unpleasant? Do you say that unless they have access regular clinical support that can provide a reliable assessment of the person MH condition (rather than a one off 10 mns appointment just the week before the assessment), they can't claim anything? Or do you accept that you have to settle for some sort of compromise and decide that the MSE is the least of two evils?
So many people happy to criticise the current system, so few coming up with a better alternative that will mean that benefits are distributed to those who will use PIP to pay towards means to making living with their disability easier which they couldn't afford otherwise rather than those who see PIP as a mean to an alternative or additional disposable income (or even if some cases savings).0 -
Can I just make it absolutely clear that this is a post from someone on Mums Net, not me!!!!!!!!!!!!!0
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You write this as if it tricking the claimant. Surely if a claimant puts on its form that it absolutely cannot go out of the house because of agoraphobia, but then manage to go to the clinic, surely it is the evidence that they are capable of doing it. I don't see what is unfair about reaching this conclusion.
Indeed, it is, but as you've said, is it what is left to go by when there is lack of concrete evidence. What do you suggest is being used?
Ie. Mrs X claims to be agoraphobic which is so severe, she can't live her house. She has care and mobility needs as a result. Although severe, she hasn't seen any medical professional for years. She write a very long application, citing how she can't go out, how she gets panic attacks if the door bell goes, how she endured a painful tooth abscess because she wouldn't go to the dentist etc...
There are two possibilities: the claimant is totally honest and wrote it exactly as it is. They haven't been out of the house for years and couldn't even face going to their GP. Or.... they could be desperate to remain on PIP because their husband claim CA and if she lost her claim, they would be in big financial trouble losing DLA, their husband having to look for work, and they have therefore seriously exaggerated their claim (as indeed although they don't like going out much they do manage to when it involves doing something pleasurable).
So what do you then? Accept everything a claimant will say at face value? Do you genuinely believe that the vast majority of people will be totally honest, even when the consequences of being so will be significantly unpleasant? Do you say that unless they have access regular clinical support that can provide a reliable assessment of the person MH condition (rather than a one off 10 mns appointment just the week before the assessment), they can't claim anything? Or do you accept that you have to settle for some sort of compromise and decide that the MSE is the least of two evils?
So many people happy to criticise the current system, so few coming up with a better alternative that will mean that benefits are distributed to those who will use PIP to pay towards means to making living with their disability easier which they couldn't afford otherwise rather than those who see PIP as a mean to an alternative or additional disposable income (or even if some cases savings).
Why do you hate people with mental health problems, the hatred in most of your posts show this.
Best thing to do is get on with your life and live it to the full.
And to top it all we now have MissB back :eek:0 -
wellynever wrote: »Why do you hate people with mental health problems, the hatred in most of your posts show this.
Best thing to do is get on with your life and live it to the full.
And to top it all we now have MissB back :eek:
She never left.Unless I say otherwise 'you' means the general you not you specifically.0 -
Why do you hate people with mental health problems, the hatred in most of your posts show this.
Maybe because I worked for years with people suffering from MH problems severe enough to require 24 hour care. I have therefore learned there are suffers who are seriously disabled by MH, who couldn't possibly work despite a desperation to do some having no choice but to give up a rewarding career, and those who see fit to use MH as a ticket to easy income.
So you are very wrong to assume that I hate people suffering from MH illnesses. Those suffering from debilitating schizophrenia, severe depression, unmanageable bipolar disorders all have my full support and benefits should be available to them whilst being medically supported to learn to cope with their illness. I do have an issue (not hate though) with the growing number of those suffering from selective anxiety, depression and the rest, ie. those who are fine to carry on with the fun things in life, but are somehow much too ill to get on with the things we don't like to do, but have to because it's life. As said in the OP though, symptoms, presentation, and impact of these illnesses are all very subjective, it is very difficult to distinguish between the genuine and those who play it up when you only have a few minutes to get to know them.0 -
By the way Wellynever, I find your site very helpful.0
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