I carry out PIP assessments - AMA

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The disclaimer:

I changed my name for this.

I can’t tell you why your claim was declined, or if you’ll be accepted with a particular condition.

I can’t comment on individual claims or look you up on the system on Monday.

I won’t bother with any “how do you sleep at night?” comments as they’re just inflammatory.

I’ve done the job for around 8 years, so covered the job in pre and post-pandemic times. Work full time, 9-5 and I’m a nurse by profession.

My part of the job is the actual consultation.

Ask away!

Are you actively told to downplay peoples symptoms so they get rejected and have to appeal?

Do you assess according to a set of criteria? If so, where do they come from and do you think they are fair?

My son who has autism, dyslexia, dyscalculia, dyspraxia and OCD but no physical disability was assessed by an occupational therapist who awarded 0 points whatsoever (reversed on appeal). Is it normal to assess someone for a condition that you have no understanding of?

No, never. We’re actually advised that if we feel stuck between two choices (eg - that they’re independent or they need aids to do something) to always go with the higher option.

How long does it take from submitting the form to getting/not getting the award?

Do you think PIP is a better system than DLA? Why/why not?

Does the decision maker agree with your report most of the time?

The guidance re: mobility states that people qualify if they cannot do something consistently, to a certain level, and at least half a fast as someone able bodied. How is this assessed? And why is no mention of these things made in the initial assessment even if they were stated by the claimant?
Is the standard everywhere to just reject the claim so it has to go to reconsideration and then appeal?

Does someone else (eg a manager) look over and edit or change your report, or do you feel confident it's your actual assessment that forms the decision? If that makes sense.

There are no concrete criteria. It’s a holistic approach that looks at the entire person, their conditions and likely restrictions.

With that said, if you have someone saying they have severe arthritis in their hands but they’re driving a manual car 5 days a week, that doesn’t bode well.

Some of the decisions I’ve seen made aren’t fair no. If a mother claims for depression but has a child aged 5 or so and she makes their dinner and baths them, she will be deemed to be motivated enough to also look after herself.

I think that’s unfair as we all know that a mother will give all of their energy to the kids while neglecting themselves.

Do many people claim for fibromyalgia/ low mood? And If so are they likely to be successful?

I think it might be more about the way people write about their condition? I applied for pip on behalf of my autistic son and he was awarded high care and mobility for 4 years with just a quick phone call to check what sort of journeys he would be able to make independently (none, without having been shown first). I didn't write about the worst day as if it is every day which is advice I often see, I just described the impact of his huge social anxiety on his life.

I don't know if I was lucky or if his needs really are exceptional compared to most applicants, but it was really straightforward - much more so than LCWRA application.

How many people do you think are gaming the system as %?

How can I evidence that I still need to dress and shower my almost 16 year old due to their severe mental health issues (OCD), ASD and suspected ADHD.

I once timed her with lots of prompts to see how long it took her to get dressed by herself...3 hours it took. How can I evidence that please?

I get basic mobility pip cos I can sort of get around the house. But when it comes to leaving the house I cannot walk for long periods of time without resting. It causes me so much pain. I was still rejected for higher mobility because I can bathe myself (once my husband has helped me in and out of the bath), could cook if I had to, (but it would be something I would sit down to chop, place in oven and sit down again) and put on my trousers without help.

It’s so difficult. I cannot afford a mobility scooter or even a self propelled wheelchair. I literally have to wait till dh can take me out and get shop wheelchairs. It sucks. It’s not your fault OP I know that. Just venting

Btw he does have very high needs. He is mid 20s and I still have to run his bath, ensure he eats a range of food, buy his clothes for him, order for him in restaurants etc. so we are not gaming the system.

The time taken varies massively. I’ve had claimants tell me it took a few weeks, others wait months. I’m not sure if there’s a correlation between complexity of a case and time taken to get a decision but the waiting times must cause so much anxiety.

I never dealt with DLA so I’m not sure about that one.

Theres a middle person between myself and the decision maker. A selection of my reports go to the middle man (sort of like an auditor) who then agree or disagree with me, before it’s allowed to go to the decision maker.

I never know if the DM has agreed or not, but from the ones who go to the middle man, they often disagree (see reply to another poster regarding a mother with depression). They’re far harsher than myself and my colleagues are, but we can’t overrule them.

Quite honestly, yes.

It’s never a case of mental health goes to a MH practitioner, physical cases go to physiotherapists…there’s no allocation system. I really wish there was as it would help claimants get someone who “gets” their reported issues.

Can an application's acceptance depend on the individual assessor and their views/opinions or is it a black and white 'tick box' type process? I work in social housing and a customer (who in my opinion 100% qualifies for p.i.p) has just had their application rejected which was a real shock as even their g.p thinks they should have it. They're going to appeal the decision but to me it seems some people who are really in need don't seem to qualify and others who maybe aren't as in need (again just in my personal opinion) do qualify.

I just wrote it. "I have to turn on the shower and encourage Mary in. Once in the shower I have to wash her hair and soap her body and she then rinsed herself. I have to support her by picking out her clothing and helping her out on each item. If I do not fo this, Mary would never have a shower and this would obviously lead to health and hygiene issues. Mary herself does not perceive this as a priority because of her social understanding differences as a result of her autism. If I do not help her dress, she is capable of dressing but becomes so distracted and is so slow that this can take a very long time; when timed recently it took her 3 hours to get dressed from me giving her her clothes. This is because of her poor focus and planning abilities as a result of her autism."

I have an extremely rare condition - there's 2 of us in the UK currently. It is listed in the decision makers guide with a note that suggests you discuss with the departments medical services provider-as necessary.

I would be amazed if they would know anything about the condition or how it effects someone on a day to basis as I've yet to meet a doctor or consultant or anyone else with medical knowledge who has seen another case.

How do you decide if the information given tallies with a condition that you have no knowledge of or way of finding out?

Assessing mobility is very hard, particularly when most claims are done via video call or phone call. You have to look at the whole picture - what they’re telling you, if it is consistent with their diagnosis, if their medications indicate severe restriction. We also look at their life itself - working, driving, hobbies etc.

No, there’s absolutely no standard practice to reject anyone and send them to appeal, certainly not where I work.

Managers don’t look at it but a certain % goes to be reviewed by an outside company. You never meet, speak to or contact this person but they decide whether you’re correct in your decision or not.

If they decide there’s a change to be made, it happens. We can’t appeal it. It’s one of the biggest flaws of the system - that a person who has had no contact with the claimant can overrule me like that.

Do you find it emotionally taxing? My DD had an amazing assessor who conducted the interview with me over the phone (after someone from DWP had visited to meet my D and I to allow me to be the nominated person). I got a bit emotional on the phone explaining what an average day was like, and the assessor was really supportive explaining they were the parent of an autie child too. I wondered afterward how she did these calls all day/every day and then unplugged to focus on her own child/home life.

What are your thoughts on severe spinal stenosis? Is it frowned upon when people don’t have the surgery that has been offered (fear etc)
Also, how is driving comparable to opening a jar ( the pressure and shape is a very different activity surely)

God, yes. They’re two of the most common conditions I come across.

Success depends on your own individual case, so I’m not sure of the overall success rate with those conditions.

What qualifications do you have and do you feel that you make decisions on things that are outside your scope of knowledge?