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.

Lovely to see an intelligent, thoughtful woman doing such a difficult job. 🙏

PP asked about RRMS and the fact we have relapses then wake up “fucked” and you said to take the “worst day” - and at the same time over 50% of days.

This is really confusing for me tbh. I have days/weeks/months where I’m totally borked - yesterday I felt “normal” (ha!) and today I’m still waiting to find out. 😉

Anyway, my question is - this is a fairly recent diagnosis and I’m due to see my neurologist within the next fortnight - at which point I’ll find out if a) I get to keep my license and b) what meds I’ll get. I currently get PIP for MH/autism - and I’m in Scotland. Do you think I should submit a “revised claim” to PIP or should I jump ship and try for SDP instead? I feel terribly in limbo and have no idea what to do for the best. I should add, due to my geographical location it’s all been paper-based to date.

I get PIP on a two year review. I had the review paperwork through in June and it’s still outstanding. Is there a really long backlog still? It’s really affecting my condition not knowing

I have a question.

When they ask for review paperwork do you keep your current award until it's complete?

If it's changed so you keep previous or new award until reconsideration and/or appeal.

Interested in this also.

And whether if your award continuation is denied following a PIP reassessment, you have to repay the award amount from when you submitted the review paperwork to the review decision.

The family member mentioned upthread has been waiting about 22 weeks and is terrified if their award isn't continued, they'll have to repay all payments from that 22 week (or more) period?

@Galactico

To the poster who said there were inconsistencies - let me know what these are?

Ok I will bite and without having to go any further back;

As for not reading the evidence, I can only speak for myself but reading the evidence often means I’m working 30-60 minutes before I’m paid to do so, trying to get ahead; read the evidence/previous outcomes etc.

As an assessor why are you reading previous evidence or previous outcomes and who sends you all of this information and is it copies of claims, previous assessments and evidence or a summary? The assessor is there to carry out an independent assessment, we are told repeatedly that the assessor does not access other records and that previous assessments are irrelevant. How can it be independent if you spend 60 minutes reading up on this person?

The Decision Maker is the person who has all of the evidence, are you suggesting that the assessor does too?

Which part of the country uses NHS staff to assess? Atos etc have contracted work out to the NHS and NHS staff have moved to an assessment role. Is your role different? Do the NHS provide this service independently of any contractor and if so which guidance do they use?

@DarkKarmaIlama I do tell people what I do, but I appreciate why someone wouldn’t (as evidenced throughout this thread). I haven’t really had any bad reactions, I think I place a lot of focus on the knowledge that I do my best and never look to cheat or fabricate anything to someone’s detriment. Do people not say to your sister “oh, where do you work?”? Wondering how she tackles that one.

@saraclara I noticed you commented a few times with a bit of reasoning, thank you. I appreciate that.

@itsgettingweird and @monsteramunch Your current award carries on as normal until a decision is made on a review. If someone does lose their award, they don’t pay back any money that the got between the period of filling the review application and being interviewed.

Similarly, if you make a first application and wait, your subsequent award will be backdated to the application date, so often people end up with a lump sum in their first payment.

@BadShepherd For people like yourself, it should be looked at on a wider scale. Instead of good days/bad days, they should consider the last six months or so. How many good weeks have you had? How many relapses? How long do they last? On your “good” weeks, are you functioning like a person without RRMS, or are you still affected partially?

This part of the assessment is often when I ask the most questions. It can be tedious for the person because it must feel like I’m drilling into every second of their day, but the reality is that some conditions are ok until lunchtime, bad until dinner, a bit better before bed then at it’s worst between 4-6am.

As for your new diagnosis, I think I’d probably wait to see neurology and find out if you can keep your licence, what meds you’ll take (if any), any ongoing input from neurology etc. These are questions your interviewer will want to know about, so it’d help you to have the definitive answers.

I’m not really sure on SDP, maybe Citizens Advice could help? Sorry, I wouldn’t want to give you any info that may be wrong.

Why is it difficult for my Multiple sclerosis patients to get disability binefits unless they are in a wheelchair, am stressed having to write supporting letters, so unfair for most of them

We have access to all previous correspondence between a claimant and the DWP. Sometimes these go back years (hence the additional work I do before my working day starts). We get the old applications and any supporting evidence, a copy of the assessment report and any reply the claimant sends afterwards. Appeals, letters from Citizen’s Advice, handwritten letters from family.

They’re sent to the DWP and presumably scanned into the system by a DWP employee so we can see it all.

Reading the previous outcomes is helpful. Maybe someone was waiting on an operation, mental health input etc so seeing this means I can follow this up with them.

I’m not sure what the DM gets access too. What I’ve written above is what I get to see.

Regarding NHS staff, I think they’re used throughout various areas of the UK to do this job.
My role hasn’t changed, no. The DWP have a contract with the health boards and this is renewed periodically (I think it’s been done twice in my service time). My employer is the NHS, my wages come from the NHS and the guidance we use comes from the DWP directly.

This is one of the most frustrating parts of my job, actually. I don’t know who at the DWP complies the guidance and policies but I definitely feel like I sometimes work with one hand tied behind my back. They overrule us a lot and I often wonder if the claimant gets their zero award result and thinks it was me who decided this. The reality is that the decision is out of our hands.

@Babyroobs It shouldn't really matter what your diagnosis is because PIP is assessed only on the PIP descriptors and whether you can do those things safely, repeatedly, reliably.

It shouldn't matter, in fact you don't even need a diagnosis, but in practice it does matter, if the assessor does not have knowledge of a rare or complex condition how can they assess whether the claimants needs are consistent with that condition?

As for things being sent back to you to change, this is true. The reports are audited regularly and we’ll be asked to change something. It is a huge bugbear of everyone who does the job. We might say ABC then we’re told to change it to DEF. We aren’t allowed to say no.

I'm curious about what sort of things you are asked/told to change - please could you give a couple of examples?

Yeah. Each section of the report has choices that we select. Can do it independently, needs an aid, needs prompted etc. Each choice corresponds with a number of points which are then added to decide whether someone meets the minimum criteria.

They’ll ask us to change these. They may feel that even though we’ve recommended someone needs help, they don’t.

Unfortunately we have no contact with these people and there’s no way to plead our side of things. It does make you wonder at times why they don’t just do the assessments themselves.

I applied for pip for my adult autistic son recently, as his appointee. I wrote honestly and had some evidence to support.

I was really pleasantly surprised that the process was fine; DS was awarded high rate for both for 4 years with just a quick call from a very pleasant lady to check how independently he can travel.

We may well have been lucky but our experience was very positive.

I'm an OT and if my professional clinical judgement was that a person's functional ability in activity A was X, how would acquiescing to a non-clinical decision maker forcing me to change it to Y align with my code of practice? Surely I couldn't comply with either RCOT or HCPC standards in these situations? I'm not bashing you, OP, and I know you're a nurse, I just don't understand how an OT specifically can do this job and remain compliant with our registration requirements. I say this as someone who has considered doing this job myself in the past but decided it wasn't appropriate for me to be involved in something like that.

@Galactico please respond to my comment as I would really like to know if it's ever worth me
trying to apply for it. Thanks

Another one here with a very positive experience recently of a PIP assessor.

I sent in tons of information and reports about my son's autism and anxiety and the phone assessor was clearly helping me by asking questions about how independent he is to enable them to make the high award for mobility.

Not all assessors are out to get you.

You could definitely apply. It’s important to remember that it’s a functional assessment, so the conditions themselves are one thing but it’s how they affect you that matters most.

It’s completely understandable RE the continence issues that you wouldn’t want to do things. If you also have OA in your knees and hips, are you struggling with walking, bending etc?

There’s absolutely no harm in requesting an application. Are you on any medications for your conditions? Any use of things like continence products?

Thank you for your answers re MS and its unpredictability. 🙏

I have another question though. If I “update” my PIP claim to include the MS, does this mean my current claim is paused until reassessment or does it continue to trundle along?

FWIW - and I understand this won’t be applicable to all cases - friends who’ve been refused and blamed “terrible assessors” didn’t have the understanding of how to answer the descriptors - eg instead of detailing daily struggles, simply wrote bipolar or fibro for the first question and left it at that. It’s a shame the assessments can’t be done F2F with a health professional such as yourself rather than these daft questions which seem to trip up so many. Some people have a talent for forms and some don’t.

Op you admit to changing the reports, knowing that person on the other end is going to lose or fail their reward. You're basically paid a shitload of money for lying.
We all know why the dwp don't do the assessments themselves or rely on medical professionals themselves. They use you people to add weight and "reason" for their decision. You can't pretend you don't know this.

Of course I know what their position is. If something has to be changed in a report, it’s made clear (from my end) that it is being changed at the request of DWP.

There have been instances where colleagues have refused to change something. Do you know what happens? Someone changes it for you.

The system doesn’t work well. That’ll never change with the UK government though. They won’t care.

FWIW, I’m not paid “a shitload of money”. Suppose it depends on what you class as a shitload.

Morph22010- she needs help in school, allowances for her behaviour (teachers ignore her violent rocking/ tics / she's allowed her headphones in class- including listening music because it reduces her disruptive behaviour. She is allowed to leave class and go to the senco room when overwhelmed. She is allowed to go to senco during all breaks as the crowds overwhelm. She leaves class ten minutes early to get lunch as she can't handle the hall when full. She doesn't get penalised for being late as she gets lost between lessons if the "right" child isn't in - ie whoever she's learnt to follow to the next class. Many of the NT kids complain that she has such privileges. ) but as she doesn't have 121 or an iep the dla feel she's is perfectly functional in school. She's academically able. But that's only because of the amount of allowances she has in place. And round and round and round.

Shame they don't use 'a bit of reasoning' when assessing the claims eh instead of condemning people with complex hard disabilities to feeling like absolute criminals.

This. I'd be ashamed to take even a penny for lying re the Reports of disabled people to save my paymasters some £. There are real people worried sick because of what you do. Then, after they have the (rigged) 'decision' they are desperate.

@Galactico

i think my sister gets paid a lot for the amount of work that she does. Must be in the 40-50k bracket. She does a lot of assessments but saves time by hardly reading the notes. 100 percent isn’t working full time but on paper she is. If you did the job properly it would exhaust you that’s why a lot of people suffer burnout and leave. They essentially have too much empathy and integrity for the role.

PIP only looks at what you can do or have difficulties doing in relation to the PIP descriptors. So can you wash and dress yourself, cook a simple meal, communicate, budget, manage medications and therapies, mobilise etc. Can you do these things reliably, to an adequate standard as often as necessary ? these are the things you score points on. It's not about a diagnosis but purely about ow your illness affects you in relation to everyday living and mobility.

It’s not lying though. My position is that I feel X, they disagree and want me to put Y.

Perhaps I didn’t mention, but when they ask something to be changed, it’s not in the sense of “Person A said they had difficulty walking, change that to show they have no problems so we can deduct points”.

They have guidelines and procedures that they follow (and whether those guidelines are moral is a different thread) and they justify it that way. The standard of function you need to have in order to be functioning adequately isn’t very high.

I think often the HCP has a bit more compassion and when the faceless DWP person looks at it, they’re harsher in their judgements. Ultimately though, they’re acting within those set guidelines.