Pip/Assessment

Muttleythefrog

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

Largely repeating what pete has said but OPD is overwhelming psychological distress... it is quite a high benchmark (as the number of points awarded for descriptor 11e suggest) that would leave someone unable to go on outdoor trips most of the time. In this case the assessor determined the associated mental health problems insufficient and that going out was instead largely affected by a physical disablement which would not be relevant to activity 11. In very basic terms activity 11 looks at mental/cognitive ability to plan and go on journeys outdoors while 12 looks at the physical aspect. I understand they determined 12b applied and so recognise some disablement in physical ability to mobilise.

Not sure what you mean when you say "Will this recommendation the assessor has put affect my MR when I put it in for mobility?". If you ask for a reconsideration then like for initial decision (which I believe you still await), or indeed any later appeal, evidence is evidence and the HCP's report is one piece of evidence that would be relevant to consider... it's typically the evidence the DWP Decision Makers heavily rely on while an appeal tribunal less so. Evidence remains in the process and indeed future reviews can consider previous evidence.

Hopefully soon you'll receive a decision and then you can look to putting in your MR if it reflects a lower award than you think appropriate.

Alice_Holt

If you do decide to challenge your award, I'd strongly suggest you see if your local advice charity have an experienced benefits adviser who can guide you, they might be able to:

i) Discuss in detail the points you scored, and advice on whether an increased award is a possibility given your health issues and abilities,

II) If a challenge is warranted, they could help with an MR (note that the month's deadline can be extended to an absolute 13 months time limit if good reason is given - wishing to seek advice and having to wait for an advice appt is a good reason),

iii) Most MR's result in no change, so they may be able to help with the next stage of the appeal  - a Tribunal Service hearing  

pope

Muttleythefrog said:

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

Largely repeating what pete has said but OPD is overwhelming psychological distress... it is quite a high benchmark (as the number of points awarded for descriptor 11e suggest) that would leave someone unable to go on outdoor trips most of the time. In this case the assessor determined the associated mental health problems insufficient and that going out was instead largely affected by a physical disablement which would not be relevant to activity 11. In very basic terms activity 11 looks at mental/cognitive ability to plan and go on journeys outdoors while 12 looks at the physical aspect. I understand they determined 12b applied and so recognise some disablement in physical ability to mobilise.

Not sure what you mean when you say "Will this recommendation the assessor has put affect my MR when I put it in for mobility?". If you ask for a reconsideration then like for initial decision (which I believe you still await), or indeed any later appeal, evidence is evidence and the HCP's report is one piece of evidence that would be relevant to consider... it's typically the evidence the DWP Decision Makers heavily rely on while an appeal tribunal less so. Evidence remains in the process and indeed future reviews can consider previous evidence.

Hopefully soon you'll receive a decision and then you can look to putting in your MR if it reflects a lower award than you think appropriate.

Will this recommendation the assessor has put affect my MR when I put it in for mobility.

Sorry for the above I was thinking about something else and kept on typing.


Yes there is a physical disablement have just checked my psychologists CBT report which mentions moderate depression and severe anxiety could I use this report to explain that cognitive mental ability does applies to me?

Sorry again if you feel I am asking the same question I'm just having difficulty getting my head around all of this.

Jyana

As Muttley says, the benchmark for gaining extra points in section 11 is extremely high. Very, very few people will meet the criteria for it. As an example, Rights Net have the following noted as the benchmark for OPD in section 11 for scoring above 4 points:

"‘Overwhelming psychological distress’ means distress related to an enduring mental health condition or intellectual or cognitive impairment which results in a severe anxiety state in which the symptoms are so severe that the person is unable to function. This may occur in conditions such as generalised anxiety disorder, panic disorder, dementia or agoraphobia. In cases of agoraphobia, going out provokes anxiety but may still be possible with prompting. If agoraphobia is severe and the claimant is unable to go out even with support on the majority of days, descriptor E may be more appropriate.

A claimant who is actively suicidal or who is at substantial risk of exhibiting violent behaviour and who needs ‘prompting’ not to harm themselves or others when undertaking a journey would meet this descriptor. In cases such as this, there must be good evidence that the person is a high suicide risk by, for example, a high level involvement of community mental health services, care plan approach etc. In cases of violent behaviour there must be good evidence that they are unable to control their behaviour and that being ‘prompted’ by another person reduces a substantial risk of the person committing a violent act."

As others have said, it may be wise to contact a local charity to see if they can help you with the MR before you send it off for guidance. That really is the best way to get the results for your circumstances.

Edit to add source

Spoonie_Turtle

EDIT: Thinking about it a little more, all of the following comes with the caveat that it might be best to get some personalised help e.g. from the CAB who can actually talk to you, find out the effects your mental health has on theoretically going out, and advise you based on that.


There is also the possibility that if you can do journeys as long as you are accompanied (and can't without) you could score a different descriptor https://pipinfo.net/activities/planning-and-following-journeys

Have a look at the explanation of descriptors here, and see if you feel your anxiety might reach the threshold for any of those: https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-2-the-assessment-criteria#mobility-activities

If you feel that you reach one of the activity 11 descriptors then it is worth challenging - remember you only need to score 8 points in total across the two activities to get the mobility component.  But it is a high threshold so it's entirely possible you may not qualify, depending on what exactly your health issues are.


ESA has different criteria but if you were awarded that on the basis of mental health, that could lend weight … looking through your previous threads it looks like they awarded it to you based on "Initiating and completing personal action (which means planning, organisation, problem solving, prioritising or switching tasks)." - more experienced/knowledgeable forumites, would that indicate likely difficulty planning and following a journey (reliably/safely/etc.) by oneself?

Muttleythefrog

pope said:

Muttleythefrog said:

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

Largely repeating what pete has said but OPD is overwhelming psychological distress... it is quite a high benchmark (as the number of points awarded for descriptor 11e suggest) that would leave someone unable to go on outdoor trips most of the time. In this case the assessor determined the associated mental health problems insufficient and that going out was instead largely affected by a physical disablement which would not be relevant to activity 11. In very basic terms activity 11 looks at mental/cognitive ability to plan and go on journeys outdoors while 12 looks at the physical aspect. I understand they determined 12b applied and so recognise some disablement in physical ability to mobilise.

Not sure what you mean when you say "Will this recommendation the assessor has put affect my MR when I put it in for mobility?". If you ask for a reconsideration then like for initial decision (which I believe you still await), or indeed any later appeal, evidence is evidence and the HCP's report is one piece of evidence that would be relevant to consider... it's typically the evidence the DWP Decision Makers heavily rely on while an appeal tribunal less so. Evidence remains in the process and indeed future reviews can consider previous evidence.

Hopefully soon you'll receive a decision and then you can look to putting in your MR if it reflects a lower award than you think appropriate.

Will this recommendation the assessor has put affect my MR when I put it in for mobility.

Sorry for the above I was thinking about something else and kept on typing.


Yes there is a physical disablement have just checked my psychologists CBT report which mentions moderate depression and severe anxiety could I use this report to explain that cognitive mental ability does applies to me?

Sorry again if you feel I am asking the same question I'm just having difficulty getting my head around all of this.

When/if you put in a MR then you are asking them to re-make a decision (that is for Daily Living and Mobility) on entitlement (a different decision maker takes the evidence available and any new submitted like when you ask for reconsideration and makes a new decision that replaces the original) - usually the decision is the same as original not least because the DWP Decision Makers rely heavily on the report they commission from the assessment company and that will be same. Putting in a MR will not erase the recommendations in the report or the report as evidence.. nor will an appeal at an independent tribunal if you ended up needing one.... indeed nor will any future reassessments although the DWP will tend to default to a new report as their primary evidence. But such reports are just one piece of evidence... and appeal tribunals are much better than the DWP at looking at all the evidence and finding where approximate truth lies.

The other questions well dealt with by others.... and some may be right that when you get decision it may be worth seeking support to help make a MR. It really does help to understand how the criteria is applied and therefore how your difficulties may translate to getting additional (or higher) scoring descriptors considered appropriate. 

peteuk

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

The other thing to look at is HOC - history of condition.  I had a really good tool (wish I kept it) which was first, second and third line meds.  So if your anxiety is controlled by first line meds then although it might be diagnosed as servere, it can be discounted in mobility.   Equally i would say “had had” is in the past tense so not attending CBT at present.

Think about what it takes to go out ignoring the physical.  What do you need to leave the house? When do you leave the house ( GP appointment, weekly shopping ect).   

Muttleythefrog

peteuk said:

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

The other thing to look at is HOC - history of condition.  I had a really good tool (wish I kept it) which was first, second and third line meds.  So if your anxiety is controlled by first line meds then although it might be diagnosed as servere, it can be discounted in mobility.   Equally i would say “had had” is in the past tense so not attending CBT at present.

Think about what it takes to go out ignoring the physical.  What do you need to leave the house? When do you leave the house ( GP appointment, weekly shopping ect).   

I panic every time I read your posts....lol.... as it alerts us to just how unscientific and flawed assessments can be. I am pleased you tend to take the matters in good spirit and any criticisms from me should be considered generic of a poor system rather than of yourself who I imagine simply followed training and guidance given.

Anxiety and depression medications are notoriously ineffective for many (not for our cat recently though who was given one to prevent him starving to death.. 'it gives cats the munchies' the vet said as I tried using the Pheromones cat spray to cool me down)... I imagine many only take them to pacify those treating them or are holding on for some beneficial effect. I was on such meds.. different ones tried in ever increasing doses.. to the tune of 'we just need to find the right one and get you 'topped up' to the dose needed' until I stopped things stone dead due to severe side effects. So receiving relevant medication may not at all shed light on anything other than the activity relating to ability to take medication/manage condition. As for CBT... whether it was effective who knows. Important though in this case if relevant that if drugs and therapy are not having the impact desired that this is clarified and their disablements detailed.

I would though ask your opinion on the use of the word "likely" in "Therefore 11a likely".... do you think the assessor was not able to be more certain because the claimant has probably expressed their inability to not go out due to leg injury and so it was hard to measure the underlying mental health disablements due to lack of recent experiences... or would you suggest it was just possibly their usual phraseology for descriptor recommendation (perhaps the rest of the report would clarify on that). It's possible in the assessment the HCP didn't explore (the Op will be able to establish due to recording being available) as you suggest the Op does (and as I would suggest when describing their problems in any MR/appeal).. by getting them to exclude the physical problems and then go through how they would plan and action a trip out and what happens... .

The HCP states "Anxiety described in this assessment does not meet the threshold of OPD" and I wonder what the Op thinks about this.... anxiety is probably hard to measure over a phone (especially if wondering how bad it might be on a trip out!)... I'm not a medical professional but I do suffer severe anxiety and I'm not sure me describing it is the best way to measure it for a particular activity (and not beyond what already I would have said in the assessment form)... I have face to face assessment reports which offer good insight because they were able to better observe some of the symptoms like discolouration, disorientation, aggression, inability to cope and trembling caused by having tried to perform the activity. It leads me to next paragraph..

Worth adding.... and well spotted Spoonie... the claimant in this case has also very recently been subject to a WCA and been allocated to Support Group based on their inability to perform 2 sequential personal actions.... I do indeed wonder if this evidence could be useful as it implies a severe level of functional disability due to (I assume!) their mental health problems. As Spoonie cautions... the assessments for PIP and ESA/U-C are quite different in criteria but I have certainly used assessment reports interchangeably where I felt it supported my arguments at reassessments and they have been used by assessors to justify or aid advice. Someone would have to look at the WCA report to see if it could be helpful or a risk (it includes a prognosis as example that may not help).

It points again perhaps to the Op here needing some assistance from a 3rd party advisor because a MR construction might need a bit of skill and solid understanding of how the activities are assessed.

peteuk

Muttleythefrog said:

I panic every time I read your posts....lol.... as it alerts us to just how unscientific and flawed assessments can be. I am pleased you tend to take the matters in good spirit and any criticisms from me should be considered generic of a poor system rather than of yourself who I imagine simply followed training and guidance given.

I dont post to cause alarm or distress, and thankfully I see most of the criticisms are pointed at the system.  You are totally correct the system is poor and open to interpretation.  I can only provide an insight into the training and workings of a Pip assessor in 2021.  I havent kept up to date as such (other than reading the info you can read on the web) and I have no contact with my former colleagues.   The system is massively flawed, hence I left. 

I hope people like yourself @Muttleythefrog can see what angle I try to put across, I totally understand when the situation is personal to the Op they may not fully see where I come from. I share peoples frustration at the assessment process and the hoops people jump through to get what they justifiably deserve.  

pope

Muttleythefrog said:

peteuk said:

pope said:

I have just seen on one of the pages assessor has put. 

Justification For Descriptor 11 and 12

Recommendation and evidence used to support 

Although he reports anxiety affects 11, HOC shows he has relevant medication and is under the care of the GP and has had several sessions of CBT, He reports he doesn't leave the house because of his leg fracture which is not considered in this assessment, also he will get anxious and upset about the closure of a journey either familiar or not. Anxiety described in this assessment does not meet the threshold of OPD, no cognitive impairment was reported in this assessment. Therefore 11a likely.


What does OPD mean? Will this recommendation the assessor has put affect my MR when I put it in for mobility?

Thanks 

The other thing to look at is HOC - history of condition.  I had a really good tool (wish I kept it) which was first, second and third line meds.  So if your anxiety is controlled by first line meds then although it might be diagnosed as servere, it can be discounted in mobility.   Equally i would say “had had” is in the past tense so not attending CBT at present.

Think about what it takes to go out ignoring the physical.  What do you need to leave the house? When do you leave the house ( GP appointment, weekly shopping ect).   

I panic every time I read your posts....lol.... as it alerts us to just how unscientific and flawed assessments can be. I am pleased you tend to take the matters in good spirit and any criticisms from me should be considered generic of a poor system rather than of yourself who I imagine simply followed training and guidance given.

Anxiety and depression medications are notoriously ineffective for many (not for our cat recently though who was given one to prevent him starving to death.. 'it gives cats the munchies' the vet said as I tried using the Pheromones cat spray to cool me down)... I imagine many only take them to pacify those treating them or are holding on for some beneficial effect. I was on such meds.. different ones tried in ever increasing doses.. to the tune of 'we just need to find the right one and get you 'topped up' to the dose needed' until I stopped things stone dead due to severe side effects. So receiving relevant medication may not at all shed light on anything other than the activity relating to ability to take medication/manage condition. As for CBT... whether it was effective who knows. Important though in this case if relevant that if drugs and therapy are not having the impact desired that this is clarified and their disablements detailed.

I would though ask your opinion on the use of the word "likely" in "Therefore 11a likely".... do you think the assessor was not able to be more certain because the claimant has probably expressed their inability to not go out due to leg injury and so it was hard to measure the underlying mental health disablements due to lack of recent experiences... or would you suggest it was just possibly their usual phraseology for descriptor recommendation (perhaps the rest of the report would clarify on that). It's possible in the assessment the HCP didn't explore (the Op will be able to establish due to recording being available) as you suggest the Op does (and as I would suggest when describing their problems in any MR/appeal).. by getting them to exclude the physical problems and then go through how they would plan and action a trip out and what happens... .

The HCP states "Anxiety described in this assessment does not meet the threshold of OPD" and I wonder what the Op thinks about this.... anxiety is probably hard to measure over a phone (especially if wondering how bad it might be on a trip out!)... I'm not a medical professional but I do suffer severe anxiety and I'm not sure me describing it is the best way to measure it for a particular activity (and not beyond what already I would have said in the assessment form)... I have face to face assessment reports which offer good insight because they were able to better observe some of the symptoms like discolouration, disorientation, aggression, inability to cope and trembling caused by having tried to perform the activity. It leads me to next paragraph..

Worth adding.... and well spotted Spoonie... the claimant in this case has also very recently been subject to a WCA and been allocated to Support Group based on their inability to perform 2 sequential personal actions.... I do indeed wonder if this evidence could be useful as it implies a severe level of functional disability due to (I assume!) their mental health problems. As Spoonie cautions... the assessments for PIP and ESA/U-C are quite different in criteria but I have certainly used assessment reports interchangeably where I felt it supported my arguments at reassessments and they have been used by assessors to justify or aid advice. Someone would have to look at the WCA report to see if it could be helpful or a risk (it includes a prognosis as example that may not help).

It points again perhaps to the Op here needing some assistance from a 3rd party advisor because a MR construction might need a bit of skill and solid understanding of how the activities are assessed.

Assessor How many days in a week do you leave the house? The only time I leave the house is to go to hospital appointments.

Assessor why don't you leave the house? Because ofmy leg and also because of my mental health I feel anxious.

Assessor In a space of 1 week how many days do you go out? I don't go out the only time I do go out is for appointments and that's with my partner.

Assessor Does your partner drive you to appointments? Yes

Assessor In a space of 1 month have you only gone to appointments or have you gone elsewhere? I have not been anywhere else other than my appointments I stay at home as its really distressing for me when I think about going out.

Assessor How do you feel before leaving the house
? I don't feel like going out as the thought of it makes me frightened my partner encourages me.

Assessor How do you feel when your out of the house? I pannick and and feel the worse going to happen.

Assessor If you were in a journey and the road was closed maybe because of road construction if you was driving or not driving in a car could you find your way around it? No because I will get anxious confused and get terrified.

I have now gone back to the recorded pip assessment and listened in to it. And above are the questions the assessor asked I feel the assessor has gone through the descriptor element off activity 11 thoroughly to understand my situation. But i don't think he has taken all the information on board to give points.