Personal Independence Payment Question Re When No Face to Face Should Be Required

Mandy53

Hi Everyone, firstly i am new to the forum and would like to introduce myself and say hello. I came across an old post on MSE from 2016 while searching for information regarding when no face to face should be required for personal independence payment application and have enclosed the information below. I suffer from severe COPD (combination of Brochieastatis, Eosonophillia, Asthma ,previous Aspergillosis and am prescribed a nebuliser machine by the hospital and nebules by my GP and 3 inhalers,steroids and anti biotics for recurring chest infections on advice from my respiratory consultant. I also have a chronic spinal and joints condition,thrombotic tendency and have had DVT,P.E.. and clot in my arm, urinary problems and problems with my throat/voice :the latter 2 are being investigated by hospital consultants.I get lots of medications including warfarin for life. I applied for PIP as my health has exacerbated and i now have a carer and get direct payments to pay for the carer who was on the council register.I am dependent on my carer as can no longer perform day to day tasks and my mobility is very restricted. I sent reports from my respiratory consultant including the deterioration in my lung capacity/spirometric readings over the years ,letter from my social worker and many other letters confirming my treatments,appointments medications,how my disabilities affect me etc along with the PIP form. I received a phone call on Friday less than 2 weeks since DWP received my PIP form,etc and the woman asked if i could attend a face to face that afternoon and i told her i couldn,t. On the form i stipulated i would need a nebuliser at the face to face as well as other things such as accessible toilet and i was told to contact their customer services after an appointment was made at their assessment centre. I don,t know who it was who phoned as she didn,t say who she was though i think it was the assessment people as got a text from them afterwards?. On phoning their customer service i was told that they have no medical equipment at all in their assessment centres and that someone had made a mistake asking me to attend a centre as my need for a nebulisrer was mentioned in the form backed up by a medical report and that they would get back to me to arrange a home visit. I didn,t think i would need to have a face to face at all as my severe COPD alone is included as a condition which should not normally require a face to face as outlined in the assessment guidelines(below) and just wondered if i can challenge having a face to face and if so how i go about this? I live approximately 60 miles from the assessment centre and would need a taxi to get there and back:i was told that i would be reimbursed the taxi fares but it would take up to 14 days for them to send a cheque as they do not reimburse the costs at the assessment centre however as say, they are arranging a home visit instead. I contacted Welfare Rights to ask about the face to face assessment guidelines but they just said they knew nothing about any "exemptions" and that everyone had to have a face to face? I would be grateful for any advice and include the post/assessment guidelines i found regarding when someone should not require a face to face.
From the PIP Assessment Guidance

Cases that should not require a face-to-face consultation
2.5.10. In certain circumstances it should be possible to provide advice at a
paper based review. Although each case should be determined
individually, The following types of cases should not normally require
a face-to-face consultation:
• The claimant questionnaire indicates a low level of disability, the
information is consistent, medically reasonable and there is
nothing to suggest under-reporting.
• The health condition(s) is associated with a low level of
functional impairment, there is nothing to suggest underreporting
and the claimed level of function is not supported by
further evidence. For example:
o Claimant with asthma who uses salbutamol PRN, no
preventer medication, under GP care only, no hospital
admissions. Even if they claim a high level of functional
impairment this is medically improbable. A face-to-face
consultation would not add much useful additional
information, bearing in mind that clinical examination is likely
to be unremarkable.
30
• The claimant questionnaire indicates a high level of disability, the
information is consistent, medically reasonable and there is nothing
to suggest over-reporting
• The health condition(s) is severe and associated with a high level of
functional impairment which is consistently claimed. Examples
might include:
o Claimants with cardiorespiratory conditions such as severe
Chronic Obstructive Pulmonary Disease (COPD) or those
awaiting a transplant.
o Claimants with severe musculoskeletal conditions such as
poorly controlled rheumatoid arthritis or severe osteoarthritis
awaiting major joint surgery.
o Claimants with severe neurological conditions such as motor
neurone disease, dementia, Parkinson’s disease, a stroke
resulting in a significant impact on the claimant’s functional
ability - for example, those left with lasting neurological
deficit such as left sided hemi paresis (the inability to move
the left side of the body), etc.
• Any case where there is sufficient detailed, consistent and
medically reasonable information on function.

So you can see that you do not have to have a face to face before a PIP decision is made.

You still have the right to appeal.

Mandy53

Sorry my post is so long as i was trying to keep it as brief as i could and didn,t realise i,d written so much

pmlindyloo

Whilst it is true that not all PIP claimants need a face to face assessment it is also true that the majority do.

Your quoted points are from the PIP Assessment guide and like your welfare adviser I am not aware of any exceptions that are legally binding.

You have been offered a home assessment so that is good.

Personally I do not think that you can appeal this.

The most that you can hope for is that before a home assessment takes place (which is often some time, their not having sufficient numbers of assessors to complete these) someone will look at your claim in detail and decide that it can be done on a paper based basis.

Having said that it is probably to your advantage that you have a face to face so that they can award you the correct level of PIP which may not happen on a paper based decision.

Despite your medical evidence this often does not relate to your daily living and mobility needs in detail which is basically what PIP is all about and not about your condition. Plus, it is totally possible that whoever is looking at your application and evidence has no idea of how the condition impacts on your life despite your detailed information.

The system is seriously flawed but it is what it is and I'm afraid you have to 'go with it'.

Good luck with it all.

w06

There is a large range of functional impairment associated with having severe COPD, from walking around with a bit of difficulty to bedbound, although they can award without face to face this is the exception and not the norm.

If you need a nebuliser at the venue then you would have to provide it, and presumably you'd need it on the journey there too and so likewise would need to provide it.

Just to forewarn you my assessment was very fair and on the basis of being wheelchair and housebound as a result of COPD I would have only scored standard rate care - a have enhanced rate but the points that got that were for other disabilities as well.

nannytone_2

also be aware that it is likely than a large percentage of any PIP daily living award will need to be paid to youe LA in return for the care you receive.

my LA take 70%

Mandy53

Thanks pmlindloo for your input and advice which is much appreciated . It probably would be better for an assessor to see me to see the effects my health conditions have on my mobility and day to day living tasks although i thought it would be a doctor who would examine and interview me rather than an assessor who has no experience or knowledge of my health conditions particularly the Aspergillosis as i know that even some nurses i,ve seen at hospital don,t even know what that illness is nor it,s long term effects and the damage it has left to my lung. My most recent blood test showed my Aspergillus count is raised significantly again and it can come back anytime. I understand the system is flawed and it needs reviewed.

Mandy53

I had a financial inspector from the council come out to check my bank account to establish if i needed to make a contribution towards the costs of my care and the direct payments .She checked my bank account balance and i don,.t have to make any contributions as am well,well below their threshold amount for making contributions .She said that someone is allowed to have a limit of £16,000 before they have to contribute to their care costs /direct payments. I am in Scotland so don,t know if it is different for the rest of the UK?

GlasweJen

Nurses only spend 3 years at uni and most of that time is on ward placements. Their medical knowledge isn't always great, particularly when it comes to rare illnesses.

As an example, just last night I visited NHS out of hours GP. Despite being a heart recipient and therefore at huge risk of my infection running rampant and out of control the nurse there left me for 2 hours in a busy waiting room and then proceeded to listen to my chest by placing a stethoscope over the top of my pacemaker. When I said "are you actually hearing anything" she assured me that yes she was before toddling off to get a doctor.

The doctor was most concerned about this clicking noise that my lungs were apparently making before laughing when I said "well yes but she was listening to a lump of platinum".

We won't talk about the blatant errors on my DWP medical reports, "the claimant was happy and relaxed" well Valium will do that to you, "the claimaint had normal vision when she closed one eye" yes that's how double vision works dear.

I'm looking forward to reading the newest one.

Mandy53

Yes,i am aware that there is a large range of functional impairment with COPD and it can sometime be much worse than other times especially when i have a chest infection which i,m getting every few weeks now and leaves me completely incapacitated. I have a chronic spinal condition, neck,/joint and nerve damage due to spinal surgery and urinary and throat/voice problems. I receive DLA high mobility and low care which was granted for these conditions and DLA was never reviewed for the COPD which is a combination of Brochieatatis ,Eosonophilla ,Aspergillosis and Asthma as well as the DVT, P.E. and clot in my arm which all happened later after i was awarded DLA for the conditions relating to my spine,joints and nerve damage only. If i was even awarded the standard rate for care then that would be more than the low rate care i get just now so i,d be grateful to even get the standard rate care.
As for the nebuliser machine, i can,t carry it as it is too big and too heavy to carry and can,t even get it to the hospital to be serviced hence i requested one at the centre . The centre is over 60 miles from me ,i don,t drive anymore and would have needed to get a taxi which would cost over £100(each way) and i just don,t have that amount of money upfront and the centre cannot reimburse straight away.

Ames

Mandy53 wrote: »

Yes,i am aware that there is a large range of functional impairment with COPD and it can sometime be much worse than other times especially when i have a chest infection which i,m getting every few weeks now and leaves me completely incapacitated. I have a chronic spinal condition, neck,/joint and nerve damage due to spinal surgery and urinary and throat/voice problems. I receive DLA high mobility and low care which was granted for these conditions and DLA was never reviewed for the COPD which is a combination of Brochieatatis ,Eosonophilla ,Aspergillosis and Asthma as well as the DVT, P.E. and clot in my arm which all happened later after i was awarded DLA for the conditions relating to my spine,joints and nerve damage only. If i was even awarded the standard rate for care then that would be more than the low rate care i get just now so i,d be grateful to even get the standard rate care.
As for the nebuliser machine, i can,t carry it as it is too big and too heavy to carry and can,t even get it to the hospital to be serviced hence i requested one at the centre . The centre is over 60 miles from me ,i don,t drive anymore and would have needed to get a taxi which would cost over £100(each way) and i just don,t have that amount of money upfront and the centre cannot reimburse straight away.

You can ask for the venue to be changed to one near to you. You have to make sure that it's for a time and date you know you can get there as you're only allowed to make one change.

You do know that PIP replaces DLA, you can't get both? And that PIP is harder to get than DLA. It's not clear from your posts whether your PIP application is the DWP naturally moving you across or if you've put in an application yourself. If it's the latter then you might be better asking for a supercession of your DLA on the grounds that your condition has worsened.

cantcope

If they've offered a home visit i don't see an issue anymore as you'll have everything you need there and they will see how you condition affects you daily better in your home environment than they'd be able to at a centre.

Just for information, i was offered a centre miles away but when i called them up to see if it could be changed they moved it to one a mile away. the computer just spits out the next available appointment regardless of whether its close.