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PIP was 2nd claim with new conditions but from 15 April 2025 new 3rd claim as advised.

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  • tifo
    tifo Posts: 2,107 Forumite
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    edited 11 April at 4:15PM
    peteuk said:

    When it comes to Activity 9 - the catch all is as follows

    Where, as a result of past intervention, the claimant is now able to engage with other people satisfactorily and without further help, then the claimant does not need support for face to face engagement.

    So if your husband takes you appointments - like I do with my wife, as support she doesnt need it, just a nicety- are you able to discuss things with the health care professional?  If you are then all other evidence is irrelevant.  It clearly states you dont need support.   THis is why you really need to read and understand the activities. 

    I had a report sent back to me because the claimant spoke to the women at the check out in the suppermarket. They didnt like using self service counters. 


    "So if your husband takes you appointments".

    Wife. I'm male. But it's ok as you'd not know from the thread.

    "I had a report sent back to me because the claimant spoke to the women at the check out in the suppermarket. They didnt like using self service counters".

    I'm the same but it's because i don't want to touch the self serve terminal. I'd rather pay by card and put the shopping in the trolley (both of which i've already touched) rather than touch the self serve terminal or use cash which has been handled by many people.

    "THis is why you really need to read and understand the activities".

    I understand what you say, the only thing i didn't get was your comment about how having a driving license affects everything on PIP. Lots of people on PIP have a driving licence (and need it for their motability car) and some people have a driving license but never drive. I drive only when needed but not for pure leisure.
  • peteuk
    peteuk Posts: 1,986 Forumite
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    tifo said:
    peteuk said:

    When it comes to Activity 9 - the catch all is as follows

    Where, as a result of past intervention, the claimant is now able to engage with other people satisfactorily and without further help, then the claimant does not need support for face to face engagement.

    So if your husband takes you appointments - like I do with my wife, as support she doesnt need it, just a nicety- are you able to discuss things with the health care professional?  If you are then all other evidence is irrelevant.  It clearly states you dont need support.   THis is why you really need to read and understand the activities. 

    I had a report sent back to me because the claimant spoke to the women at the check out in the suppermarket. They didnt like using self service counters. 


    "So if your husband takes you appointments".

    Wife. I'm male. But it's ok as you'd not know from the thread.

    "I had a report sent back to me because the claimant spoke to the women at the check out in the suppermarket. They didnt like using self service counters".

    I'm the same but it's because i don't want to touch the self serve terminal. I'd rather pay by card and put the shopping in the trolley (both of which i've already touched) rather than touch the self serve terminal or use cash which has been handled by many people.

    "THis is why you really need to read and understand the activities".

    I understand what you say, the only thing i didn't get was your comment about how having a driving license affects everything on PIP. Lots of people on PIP have a driving licence (and need it for their motability car) and some people have a driving license but never drive. I drive only when needed but not for pure leisure.
    To hold and maintain a drivers licence you need to be able to see 25 meters in front of you.  If a claimant says Im blind cant see more than 10 meters, then the question is have you been advised to surender your licence.  The evidence of still holding a licence is greater than the claimant saying they can only see 10 meters.   If this backed up with opticians reports, opthamology etc...if it is then the balance swings back. 

    Just because you say something doesnt mean its going to be taken as true.  

    You suffer with OCD - which I get youve put up with and havent mentioned it to a doctor.  So the fact that there is no diaagnosis, no specialist input, no medication etc etc.  Means on balance your OCD doesnt hit the threashold for PIP.  I had to write that alot in many PIP assessments, I get it (hence I left) its frustrating...


    Proud to have dealt with our debts
    Starting debt 2005 £65.7K.
    Current debt ZERO.
    DEBT FREE
  • Muttleythefrog
    Muttleythefrog Posts: 20,412 Forumite
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    edited 11 April at 5:35PM
    tifo said:
    I've had the reply from maximus for my 'complaint'.

    It starts with "As part of my investigation, I have arranged for a Client Relations Medical Advisor (CRMA) to complete a review of your complaint alongside the report. The CRMA is a senior clinician, who works alongside the Client Relations Team. This review is carried out from a clinical perspective and is intended to identify any potential issues of quality, detail, consistency and medical justification with any such issues being reported directly to the Department for Work and Pensions (DWP)".

    Then:

    "Obsessive compulsive disorder (OCD) - You explained the report does not reflect how your OCD and anxiety affects you daily. The CRMA has advised the questionnaire received nor the available medical evidence reports an OCD diagnosis or restrictions. The history of conditions also does not list this as a reported condition. Therefore, it is not possible for the reviewing CRMA to clarify around any potential restrictions caused by this condition".

    So saying that because OCD wasn't in the PIP form or a diagnosis on my GP record it could not be taken into account.

    I might be wrong but i thought since it's a part of the assessment it would be taken into account, and we spent around 20 mins talking about it about how it affects me going out and interacting with people.

    "Engaging with others -  You explained the HP has downplayed how your conditions affect your ability to engage with others. The history of conditions shows no mental health medications, and your mental health is currently managed by your GP. There is currently no medical evidence which would support an alternative descriptor in relation to your reliability to engage most days".

    This is for the anxiety though depression has been on my GP record since beginning of 2019. I'd said that it's a big assumption going from accompanied hospital visits to being able to engage with people outside as a reason that this activity can be carried out reliably.

    "Driving ability - You explained you feel as you are able to drive, the HP has assumed you can carry out all daily activities. The CRMA has advised that no one piece of medical evidence gathered within a consultation report, would be used to support descriptor advice".

    I'd said that they used being able to drive as a reason to say I can carry out all activities reliably and it's used in most descriptors.

    It finishes with:

    "Quality of the report - The outcome of the CRMA’s review is that the information and advice contained within the report is medically reasonable and appropriately justified. The HP has completed all recommended actions as per Maximus' professional guidelines and the DWP criteria, to produce a report to the required standards which is based on the current information we have available".

    Which i'd expected them to say. Then they've referred me to an MR.
    Just quickly going through this... I've never seen a complaint response so interesting to see elements.

    On the OCD they effectively say exactly what I've said to you... and which poses risk to your further challenging of this decision.... you have no basis at the 11th hour to claim the OCD related problems so they discounted them... hence my question to you... have you already damaged your MR and appeal or set them on a course to be difficult to argue. You say "So saying that because OCD wasn't in the PIP form or a diagnosis on my GP record it could not be taken into account" - essentially yes.... the OCD appeared from nowhere (as far as the evidence shows) so they have little basis to consider it...the only evidence came from you but then you never raised it in the application... you have no documented/presented medical history of such and they would expect a condition leading to serious disablement to have such. A new application with medical supportive paperwork and explanation as to how it disables you relevant to activities is what should be put in place. The assessor is not there to conduct a medical exam and diagnose your health problems and the assessment is not a place for you to start self diagnosing conditions. In the end all they had was you diagnosing a condition and claiming disablements regarding such... they're left wondering why you never mentioned it before or sought medical help before... and that's before you get to the question of what relevant disablements are applicable or explained by you.

    On engaging with others you would need to take them through the mechanics of how you are disabled.. the benchmarks are high.. so anxiety generically described may be insufficient... but at the end of the day you need to make a case for which descriptor applies. Their extrapolations can be wild but they also seem to give impression of lack of evidence and facts to help them. 

    On driving ability and daily living activities... they point to the idea not one single fact or piece of evidence will be used for descriptor choice. My suspicion is that they relied on more than driving licence/driving ability to make descriptor choices but if you're saying they didn't in the report then I would have to accept maybe they did not. There are some activities I would have thought it reasonable assumption a claimant who drives would automatically fail to score points on in the absence of competing narratives to explain disablement.

    Like I say it is up to you how you pursue further... but I remain worried this claim has a dark cloud over it due to your evidence irregularities and the lack of evidence to support the new reported condition... if you raise your OCD related problems with the person at Shelter who helps you with an MR.. how will they deal with that.
    "Do not attribute to conspiracy what can adequately be explained by incompetence" - rogerblack
  • peteuk
    peteuk Posts: 1,986 Forumite
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    edited 11 April at 5:35PM
    Not to trivialise disabilities but @tifo I will simplfy this hopefully youll understand. THESE ARE EXMPLES FROM THE TOP OF MY HEAD TO POINT OUT THE DIFFERENCES. 

    Take two people with arthritis of the hands/fingers.  One is mild one is server. 

    The mild may get something written like...

    "Claimant states they have arthritis of the fingers/hands, is under the care of the gp and simple analgesia has been prescribed.  Claimant is still driving, demonstrating that the grip and hand strength is sufficent to hold a steering wheel/ gearstick.  Although claimant struggles with pans when the condition flares, this is only three times a year and is for on average,2 weeks at a time. Overall the condition does not affect them for the majority of the time and therefore the claimant can carry ou the activity unaided." 

    Where as someone with server arthrits in the hands and finger may have something along the lines. 
    "Claimant notes they struggle with grip, their consultant letters notes they have lost all fine pincer grip and hand strength/grip is at 25% of normal range, the letter additional notes the fingers continue to be swollen and painful and despite being on maximum medication, which has little to no effect on a regualar basis.  Claimant notes the use of larger handles on their pans helps, so therefore the use of aids is considered sufficent for the client to carry out this activity."

    (Its been a few years since I wrote an actual report so yes its cack but it gets the point across) 

    Do both claimants have arthritis, yes certainly.  But PIP isnt a medical exam, its about what a person can/cann't do due to their conditions. 
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  • born_again
    born_again Posts: 20,377 Forumite
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    Something that just clicked on a previous post. 

    https://forums.moneysavingexpert.com/discussion/comment/81312302/#Comment_81312302

    When you got this assessment appointment. You said you wanted it to be a face to face rather than phone. Which I think can now be back in their offices, rather than at your home.
    So given you are saying you can't mix with people & OCD added in at the last second, would be like throwing the baby out with the bath water. (sorry to be so blunt)

    Given a phone interview negates meeting other people & going to a area used by other people.
    Life in the slow lane
  • HillStreetBlues
    HillStreetBlues Posts: 6,053 Forumite
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    Something that just clicked on a previous post. 

    https://forums.moneysavingexpert.com/discussion/comment/81312302/#Comment_81312302

    When you got this assessment appointment. You said you wanted it to be a face to face rather than phone. Which I think can now be back in their offices, rather than at your home.
    So given you are saying you can't mix with people & OCD added in at the last second, would be like throwing the baby out with the bath water. (sorry to be so blunt)

    Given a phone interview negates meeting other people & going to a area used by other people.
    That would depend.
    When I have an assessment I want it to be face to face, lot easier for me to have a call, but I want them to see how hard it is.
    Let's Be Careful Out There
  • tifo
    tifo Posts: 2,107 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    peteuk said:
     
    To hold and maintain a drivers licence you need to be able to see 25 meters in front of you.  If a claimant says Im blind cant see more than 10 meters, then the question is have you been advised to surender your licence.  The evidence of still holding a licence is greater than the claimant saying they can only see 10 meters.   If this backed up with opticians reports, opthamology etc...if it is then the balance swings back. 

    Just because you say something doesnt mean its going to be taken as true.  

    You suffer with OCD - which I get youve put up with and havent mentioned it to a doctor.  So the fact that there is no diaagnosis, no specialist input, no medication etc etc.  Means on balance your OCD doesnt hit the threashold for PIP.  I had to write that alot in many PIP assessments, I get it (hence I left) its frustrating...
    I understand what you say about driving license, and it comes from your experiences, what I don't understand and which seems to be said here and in the report is why someone with a driving license has to drive all the time or a medical professional has to tell them to surrender it. Why can't I not drive when I'm not able to and only drive when I can which is what I say? Thus I still don't understand how those on PIP have a driving license and especially those with a motability car need it to drive. I may be naive in this but I just don't get it.

    My eye condition is in my blind eye and vision is good in my other eye, any pains etc are in the affected eye and related headaches/migraines etc. My gout is in my feet and knees, the osteoarthritis is in my knee. My anxiety is in my head as is my OCD. I don't need to be able to mix with people to be able to drive, I'm on my own in the safety of my car. I prefer being alone than with others. On the times I'm not able to drive safely I don't. Thus I don't understand why I cannot drive when I can. Putting aside majority/minority of days why can't I drive for, say, 4 months of the year altogether (which is what I probably do anyway) or 7 months of the year?

    I hope you understand what I'm saying above.

    Regarding OCD and anxiety, I'll go see my GP and there will be a record as well as medication, the conditions are quiet disabling for me and I've been coping. I'm not doing this for another PIP claim but correcting a mistake. Like I said, I only mentioned OCD because it came up in the assessment. I already wrote about being anxious etc and about mixing with people in the previous PIP claim in 2001 and the MR and tribunal. I now realise it was discounted because of no medical record but at that time I saw it as part of my depression which was diagnosed and to me anxiety was a part of that. So it's only OCD which is the 'new condition' for PIP though anxiety needs it's own record.

    Again I hope you can understand what I mean above.

    In fact I've been meaning to speak with my GP for anxiety since last year January 2024 when my partner was diagnosed with MADD and the medication changed to fluoxetine tablets. She's been on depression tablets for many years. She got 0 points on her first PIP claim in summer of last year and didn't pursue it further.

    At that time I thought I suffer from most of and more than the symptoms she described.

    But, that's just me and my delays where I don't do things until the last moment. Had I don't it last year (and I had no intention of doing another PIP claim then) I'd be in a better position now.

  • tifo
    tifo Posts: 2,107 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    Just quickly going through this... I've never seen a complaint response so interesting to see elements.

    On the OCD they effectively say exactly what I've said to you... and which poses risk to your further challenging of this decision.... you have no basis at the 11th hour to claim the OCD related problems so they discounted them... hence my question to you... have you already damaged your MR and appeal or set them on a course to be difficult to argue. You say "So saying that because OCD wasn't in the PIP form or a diagnosis on my GP record it could not be taken into account" - essentially yes.... the OCD appeared from nowhere (as far as the evidence shows) so they have little basis to consider it...the only evidence came from you but then you never raised it in the application... you have no documented/presented medical history of such and they would expect a condition leading to serious disablement to have such. A new application with medical supportive paperwork and explanation as to how it disables you relevant to activities is what should be put in place. The assessor is not there to conduct a medical exam and diagnose your health problems and the assessment is not a place for you to start self diagnosing conditions. In the end all they had was you diagnosing a condition and claiming disablements regarding such... they're left wondering why you never mentioned it before or sought medical help before... and that's before you get to the question of what relevant disablements are applicable or explained by you.

    On engaging with others you would need to take them through the mechanics of how you are disabled.. the benchmarks are high.. so anxiety generically described may be insufficient... but at the end of the day you need to make a case for which descriptor applies. Their extrapolations can be wild but they also seem to give impression of lack of evidence and facts to help them. 

    On driving ability and daily living activities... they point to the idea not one single fact or piece of evidence will be used for descriptor choice. My suspicion is that they relied on more than driving licence/driving ability to make descriptor choices but if you're saying they didn't in the report then I would have to accept maybe they did not. There are some activities I would have thought it reasonable assumption a claimant who drives would automatically fail to score points on in the absence of competing narratives to explain disablement.

    Like I say it is up to you how you pursue further... but I remain worried this claim has a dark cloud over it due to your evidence irregularities and the lack of evidence to support the new reported condition... if you raise your OCD related problems with the person at Shelter who helps you with an MR.. how will they deal with that.
    "Just quickly going through this... I've never seen a complaint response so interesting to see elements".

    What do you mean?

    "
    but I remain worried this claim has a dark cloud over it due to your evidence irregularities and the lack of evidence to support the new reported condition".

    Hence the advise is to make a new claim. But I don't want them to think I'm doing it only because this one failed and not because I've made mistakes in this claim. They will of course refer to the previous 2 claims.
  • tifo
    tifo Posts: 2,107 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    Something that just clicked on a previous post. 

    https://forums.moneysavingexpert.com/discussion/comment/81312302/#Comment_81312302

    When you got this assessment appointment. You said you wanted it to be a face to face rather than phone. Which I think can now be back in their offices, rather than at your home.
    So given you are saying you can't mix with people & OCD added in at the last second, would be like throwing the baby out with the bath water. (sorry to be so blunt)

    Given a phone interview negates meeting other people & going to a area used by other people.
    That would depend.
    When I have an assessment I want it to be face to face, lot easier for me to have a call, but I want them to see how hard it is.
    I was thinking the same. I thought I can get my points across better face to face than telephone.
  • tifo
    tifo Posts: 2,107 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    born_again said:I see 
    Something that just clicked on a previous post. 

    https://forums.moneysavingexpert.com/discussion/comment/81312302/#Comment_81312302

    When you got this assessment appointment. You said you wanted it to be a face to face rather than phone. Which I think can now be back in their offices, rather than at your home.
    So given you are saying you can't mix with people & OCD added in at the last second, would be like throwing the baby out with the bath water. (sorry to be so blunt)

    Given a phone interview negates meeting other people & going to a area used by other people.
    I see it the same as a GP or hospital appointment. I'm not 'mixing' with people because I don't have to interact with them. I'm just sitting there for an appointment. I can wash my hands and wipe down my clothes when I'm done.

    Seeing a medical specialist doesn't mean my conditions have suddenly got better and I can run a marathon or become the star of a party.
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