I assess disability claims - AMA

[Galactico]

Just as the title says!

I know the public feeling towards assessors isn’t always good. I’ve been doing the job for about 7 years, let me give you some insight into the “other” side.

Have you experienced any blatantly false claims?

or those that may not “tick the boxes” but definitely need help?

how do you deal with that?

Are you told to try and deduct points wherever possible?

Is there an assumption that people will appeal?

Hi
My 15 year old receive DLA - she is worried she won’t get PIP - what do we need to know in order to reflect her needs appropriately on the PIP application later on this year?

Yep, these happen. The vast majority of people are genuine though, I think. In all honesty, the money people get isn’t great (especially not these days with everything costing so much). There are some people who give information then contradict themselves later in the conversation.

People underreporting their difficulties are far more common. “Oh I just manage” is something I hear a lot. It’s all about asking questions - getting to the finer details to see that they are perhaps coping but with great difficulty.
I just try to ask those questions sensitively as I don’t want to offend anyone.

Do you deal with mental health assessments and, if so, are you qualified in this area?

Never. This is one of the biggest misconceptions of the role. There are absolutely zero incentives or benefits to me for deducting points. Everyone is seen on their own merit.

I think that around 80% of appeals are successful, so I imagine people do appeal very often. We deal with what’s in front of us - if someone has submitted zero evidence of any treatment/surgery/diagnosis, it can be really hard to award the benefit because we don’t have access to NHS medical records. At appeal stage, they’re able to gather any of that information and present their case much more thoroughly.

I was asked how much I weigh during my recent telephone assessment and was asked what I was doing about it, this was after she discovered that I was in a wheelchair and can only stand for about 15 seconds before falling. Is this standard for assessors or did I get a really bad one?

Gather evidence. GP notes, doctors letters, specialist nurse letters, repeat prescriptions, anything from school (care plans etc). Submit them all.

She’ll be assessed on 12 areas of function. Some she may be fine with, others she may struggle. Take your time filling in the application and be honest.

What is her condition? If she has one by which you think she’ll struggle to express her difficulties, ask the DWP to assign you as her appointee. It means you can speak on her behalf.

Why do some assessors lie and falsify information? At my husbands last assessment the assessor stated that he was able to lift heavyish objects, write using a pen and undo a bottle, complete lies.

I do, yes. Mental health conditions are probably even more common than physical ones.

Everyone who does my job is medically qualified (doctor, nurse, physiotherapist, occupational therapist) and has undergone further training through the job itself.

If there’s anything that comes up which we’re not 100% sure of, we have colleagues available for second opinions, just like you’d get in other medical settings.

It depends. Were you claiming for a condition in relation to your weight? If someone reports an eating disorder (be that anorexia or overeating), asking their weight/height is a relevant question. It gives us a bit of insight (especially over the phone where we can’t see you) into how bad your restrictions are likely to be.

Of course, it should be done sensitively and with a bit of compassion.

What made you choose this job rather than the medical jobs you are qualified for?

I've never had an issue with claiming it's always been so straight forward but I would like to know how you decide the length of award! My sons got severe learning difficulties and severe autism and can't do anything for himself at age 18. He's also none verbal but he only ever gets a two year award,while other people I know with high functioning children get 10 years!

If 80% of appeals are successful, do you not think there is something wrong with the process

People are denied funds whilst waiting for an appeal, and they fond the appeals process incredibly stressful, in an area of the population that has higher than average stresses in their life already

Do you not think the system could be improved?

I was very happy with the way I was assessed and my outcome

I honestly don’t know.

There are absolute no incentives - financial or otherwise - for an assessor to play down someone’s disability or to falsify anything. I can truly say I have never exaggerated, downplayed or fabricated any part of any report.

I know it does happen though. We are always able to see any previous assessment results and sometimes you read it and can’t understand why the assessor has written certain things.

Did your husband appeal?

My cousin has received DLA since childhood for asthma he’s never been hospitalised doesn’t use an inhaler and for some reason has never been transferred over to PIP . He brags about this to anyone who will listen . How come people like him who manipulate the system manage to get away with this but I know loads of people with life limiting conditions who have had to go to the appeal stage .

Thank you - yes I already received the letter asking if she will need appointee and that is gonna be me.
Her conditions are ASD, ARFID, OCD, Anxiety, depression - so all ‘invisible’ - we are still on the waiting list for medication but plenty of support from CAMHS, GP, peadiatricians, social worker and special school.

Do people ever claim with a thyroid disorder?

I worked in general medical jobs before this. I left due to family reasons (I have a six year old) and the predictability of the role/hours etc. When my child was very young, it really helped to not do shifts.

I miss it a lot though.

Do you have so many targets to meet? I looked into doing this once and read reviews of people that work there (also a nurses’ husband I work is in management for a company) stating they were very much on a timeline and often had work send back making them change it! 🙈

2 years sounds short based on what you’re describing.

The length of award comes from the likelihood for change. For example, someone with arthritis of the knee but scheduled for a knee replacement MAY improve, so we’d ask to see them back post-surgery for another assessment. On the other side, someone who’s entitled to maximum benefits and has vascular dementia will not improve, so they would never be reassessed.

Does your son get the maximum award of the benefit? If he doesn’t, I’d imagine they’re giving a 2 year award to check if things have worsened for him. The assessor does have to give an explanation for the length of award, you could request the report to see that.

I have FND but work part time and haven't made an application because I manage but know me child have to support my care. Would it be worth applying?

Absolutely. I don’t deal with any appeals but I can imagine how stressful they are.

There are many ways I think the system could improve. For example, I’d love to make it mandatory that the claimant’s GP is asked to comment on their diagnosis/medications etc. Having that information at hand would be great in ensuring that the right people get the right benefits.

Of course, it’s unreasonable and completely unrealistic to expect this of GPs. Maybe allowing us access to live medical records would help bridge that gap.

Excellent. Photocopy any and all letters from
them. In my experience, social workers/schools and CAMHS etc are happy to provide details for a benefits claim. Sometimes I have upwards of 100 letters to read for one person. It’s definitely worth sending it all in.