Im a PIP assessor - AMA

[pipfs]

Im a regstered nurse and have worked for PIP for a few years. I work in this role due to my personal health, i could not longer stand for 12 hours to do ward based work, i could no longer travel for the requirements of community. The jobs market when my health took a turn for nursing was limited, i had my own family to support, my options were very limited.

I do not do assessment via phone or in a clinic. That is not my role. I check claims as they come in, and will send to phone, clinic, or both where appropriate. If they are not suitable for asssessment, i will try everything i can to avoid an assessment, try to gather the evidence from health care providers, schools, social care, support contacts, appointees etc, and i write them as what is know as a paper based report. Some do end up having to go to assessment despite my efforts.

95% of claim reports i write, get awarded. Over 2/3 of reports i write get an enhanced/enhanced award. Half of the reports that i write are for 16 year old transitioning from DLA to PIP. Followed by cancers on active treatments, significant mental health, following a stroke, condition or incident where they are fully reliant on other people for their care, and cases where an attempted assessment has failed. But the transitioning cases build up the majority of my case load on an avergae week

I fully understand the frustrations and limitations of the system, i fully underand the stigma that comes from being an assessor, and how these reports can at times, be written. However the area of pip i work in is very claimant centered due to the nature of the cases we write, and i spend hours ensuring that these people, the people who cannot attend an assessment because of their health restrictions, get the support they require. It is a rewarding role.

So if anyone has any questions regarding the transistioning process, or in general, i am happy to answer where i can.

If someone has no evidence of a medical condition, what happens then?

My son was getting dla which stopped at 16 hrs still autistic , amongst other things and we got a letter recently saying that he would be eligible now based on new rules, how has that happened ? Haven’t reapplied yet

Its not about evidence of a medical condition, its about evidence of restrictions. So if we are talking about a 16 year old, letters or contact information from schools or support staff hold as much weight if not more than evidence of a disgnosis. As that information is telling us how that individiually is affected, not just a condtion that could come with a huge range of severities or connected restrictions.

If theres no evidence at all, then it would have to go to an assessment. And its all consistency based, which is much much harder as the DWP will find things to link together, even if the lived experience of the claimant is different. If an adult is solely caring for children and feeding, washing and dressing them for example, the likihood is the are capable fo doing that for themselves too. Energy levels being that once you have done it for your child, you have no energy for yourself, just isnt considered, they go off the basis of the likihood is you would be able to do so on the majprity of days if you had to.

Thank you. I wondered about how you assess young people with asd/adhd/anxiety who claim not to be able to work/go outside/do anything at all. The psychiatrist/gp can not possibly know if this is true but only relate what the patient is telling them.
A friend's dd who is 19 has been awarded PIP due to anxiety backed up by private psychiatrist (she already has UC) and friend is happy about this because even though her dd is living a "normal life" socially speaking but is too anxious to find a job she thinks she pays enough in taxes to get some back (her words). Her dd is anxious when it comes to do something she doesn't want to do- like working:) but at the same time she's going to concerts and parties all over the place so I do think it's more about laziness.

How would you judge this?

They should send you the forms for pip. If you are already registered as appointee, keep that in place, if not, apply to made made appointee prior to submitting your pip forms.

n some cases due to the amount of cases being handled, DLA is being extended to buy more time for the companies that handle claims. It could be that you fell into that and have been extended.

It could be that the DWP saw the evidence from DLA and they autmatically transferred you over as there was enough evidence to support that restrictions are in place, consistent with the conditions you reported, and they transitioned him without your cliam needing to be seen by a HCP.

If you receive a totally ridiculous claim, are you able to stop the claim immediately without the person even getting an assessment? So if for example they ticked that they were not having difficulties with most of the descriptors could you just refuse an assessment to save money?
Also why has there not been a return to home visits/ face to face assessments? in my area prior to covid they pretty much all used to be done this way. Now people are still just getting a phone call. Why ?

I used to volunteer at an advice charity and helped people with the forms and appeals. I found when reading the reports with the rejections that their words could be twisted. There was a man who admitted to playing with his grandchildren. He meant table based playing like boardgames, but the report made it sound like he was playing football with them and it was used against him. . There was a woman who was refused a taxi to get to the assessment and the fact that she was just able to struggle onto a bus was used against her.

I used to warn clients that the "chat" at the beginning was part of the assessment and to be careful what they say. One very upbeat woman told me that she was "fine with stairs", but I told her that taking ten minutes to go upstairs in her house was not "fine" and not to say that to the assessor.

You sound like you try to help people, but I did feel that some assessors tried to trip people up.

Bless you, you sound like a gem.

I have a friend who has a missing limb and she needs to resubmit claims every few years. Why do you need to prove your leg hasn't grown back, for example?

Seems silly to me but perhaps I am missing something everything?

In 2024 I had a brain stem stroke which initial gave me double vision and I had to start using a walking stick , a shower stool and a perching stool in the kitchen .
I can no longer do housework like clean Windows , hang out washing , open jars , or tins or put trays of food in the oven .
I don't have double vision now but still cannot do those things as I have been left with balance problems and spacial awareness as I lose balance when I look up and also into long distance .
I cannot go out alone , I have no independence , I can't work , I can't drive as it makes me feel sick with movement and even being a passenger gives me these symptoms and spacially I feel we are travelling too fast and about to crash so I fear travelling .
Sorry for that long list ! I just wanted to give you an idea of the impact on my life.
I am on pip , but was awarded just standard living and no mobility .
Why would that be ?

It depends on the evidece. Being able to go to a concert doesnt necessairly mean they can then do everything. If the only time they are able to leave the house one day a week, then the majority of days they cant, and would be entitled to an award.

Anxiety alone is a hard one, there has to be really strong evidece, lots of input from mental health services, high dose medications, evidence of that support to be awarded. A letter from a GP stating initial dose of a medication is not enough to support anxiety. A referral letter to talking therapies or CBT isnt enought to support. Referral letter in general hold absolutely no weight. Which is why most anxiety only cases do not get awarded from assessors.

If this came across my case load, i would attempt a suitability call to the claimant, to see if they would have support for a telephone assessment only. I wouldnt send them to a clinic, but i also wouldnt keep it.

I think the assessors have a very hard job. I have a long background of Nursing but now work as a benefits advisor and no way would I want to be an assessor. I'm frequently baffled by some of the awards given or not given. I think it must be very hard to accurately assess without a good insight into their lives and a phone assessment is never going to accurately capture everything because people get nervous/ clam up etc. medical evidence that people have available to send is often not the best either.
I just don't understand how some people are so easily awarded and others not. I have one very vulnerable client who has been waiting since July for an assessment. We sent huge amounts of excellent evidence from all kinds of health professionals and yet he still waits trying to survive on a pittance.

No, unfortunately not. We have argued for this for a while. We have to send to an assessment, as there is the risk of a person under reporting as much as over reporting. There are times when we can send back to the DWP and say this claim has no evidence, we cant send to an assessment, theres no contacts, no GP, no services,etc and say we cannot complete this. But however much i know they are never going to get an award, i have to send to assessment.

Clinic is now being enocuraged again. They are prefering we send people especially with phsyical restrictions such as back pain etc to a clinic where they can be seen.Home visits is before my time. But home visitis now isnt an option on our screen, people request them, and in some cases they are granted, but not often. Most people are going to be either to have a phone or clinic assessment, if not, chances are a paper based can be written. We have a type of paper based whereby we have a little bit of evidence, the cliamant cannot be assessed, and we then write based on the most clinically likely outcome. These are not very common though.

How much evidence of your mobility problems did you send ? you could have asked for a mandatory reconsideration if you felt the award was unfair although of course that can put your existing award at risk.

You sound like one of life’s good ones, OP. Thank you.

I’m an HCP too, and with an LTC so I really do identify.

My LTC is bipolar disorder 1. Also have diagnoses of PTSD, and the recent 6 months in bed self-neglecting with BPAD1 has led to MSK issues and skin issues. I’ve had a long hx of v severe eps, am on 2 different mood stabilisers including lithium & lamotrigine plus AD’s / benzos / sleepers etc. I’ve had hosp IP stays and stints under the HBTT this past year. I was v ill for the first half of 2025 with hypomania, then housebound for 6 months with severe depression / suicidality. I permanently struggle with memory, cognition, fatigue, reduced motivation, need help ordering and remembering meds etc, have to pace my activity levels & avoid stress. Even so, when well I work 4 days a week in NHS (no other option) - I fear this will stand against me in my PIP claim. When unwell I’m either dysregulated, reckless, engaged in dangerous sexual activity, unable to focus etc OR bed-bound, no self-care, unable to leave house or drive.

My professionals whilst in the crisis house urged me to apply for PIP in Oct which I did. With 42 pages of clinic letters from consultants etc. I got a phone call out of the blue in Jan from a nurse “just asking me a couple of questions”. It really threw me (I was struggling to speak & communicate at the time). I tried my best but ended up breaking down in tears, so she said she’d book me in for a pre-arranged call instead, which I finally had on Friday just gone. I assumed it’d be “just a couple of questions” again, but it was a full-on interview lasting 2 hours, where I was asked all the details that I’d already extensively put on my written application.

I suppose my questions are:

• what was behind the out-of-the-blue call with a couple of Q’s? Was this to catch me out if I was in a shopping centre or at work, whilst claiming to be housebound?
• why might the brief call have been rearranged for a full-scale 2hr ax?
• might you be able to take a stab at whether I might qualify / be awarded something without having to drag it to a tribunal?

I’m desperate to be awarded something as I’m a single parent, paying the mortgage alone, working an NHS part time wage and gone to half-pay due to the amount of sick leave I’ve needed, and regularly am unable to shop / cook / drive / care for self or the kids, so I’ve had to spend extra on pre-prepped meal, shopping deliveries and taxis.

Im sorry this is so long - I feel a bit cheeky using you to ask these questions of 😟. I think it’s really good of you to do an AMA. X

I agree, that seems very silly. But it would depend on if they are only claiming for the limb, of if they have other conditions too. For example if they claim the limb but they also have restrictions around mental health, then a reassessment would be required, or they have another phsyical condition alongside. Reassessment based on that alone seems uneccessary. And as assessors we can recommened a review period, but it often gets ignored. I have had claimas where a previous assessment has recommened no review, then 5 years later is back in my case load. Makes no sense to us either. Thats all the DWP and non HCPS's making decisions.

I agree with the previous poster, you need to request a mandatory reconsieration. You also need supporting evidence for your balance issues. Have you seen an occupational therapist? If not ask for a refferal via your GP. If you have ask the OT to complete a letter of support, factual based, on headed paper, stating what aids you use, how far you can mobilise, and restrictions with daily tasks, and risks of falls etc. An OT report is so so valuable when assessing the kind of restrictions you have.

If someone fills out the form very badly but has strong evidence which shows they cant do things they didnt mention or didnt explain the impact well, would they get an assessment or an award.

Depending on area, theres a few reasons he is waiting.

Theres been some new IT systems, some cases were added to the old system, staff moved to a new system, old cases need pulling over. Its a nightmare for cliamants as it feels likel their case is lost, its not, its just in the wrong place.

It could be in someone paper based queue. Some of these cases sit there for a long time. Best practice is they are written wothin 5 weeks of being held for paper based, that isnt always possible. If they havent managed to get evidence, they than have to request to write it as a best interests report.

Too much evidence can also hold things up, sometimes without meaning to, two specialists can contradict each other, and then its trying to seek clarification over which is stronger. As i mentioned previously, some evidence hold more weight, for example, with mobility, an OT report is better than a GP report in 90% of cases and we can write that into a report, but if we have 2 pieces that contradict each other, but both from good sources, it can be a nightmare to justify which is right.

Alot of times people just send in everything, which isnt always the best choice.

Despite your great write-up of yourself, I've a feeling you'll still get flamed at some point OP.

All the previous 'I'm a PIP assessor AMA' have ended this way.

Not your fault of course, just the sheer frustration of claimants I guess.

Under reporting is super super common. Especially with cancer cases. If the evidence is telling me a restriction is there, im writing a report based on the evidence not what they are telling me. For example, All to often they write they can eat and drink ok. And they are thinking of the phsyical action of lifting fork to mouth, but actually, they are eating a teaspoons worth, and without another person they wouldnt even eat that. They are on anti emetics, supplements, mouth sores etc. What they have reported isnt accurate. the evidence is telling me another story, so i score for prompting.

I’m a type 1 diabetic, I have multiple hypos a day and usually at night which render me unable to do anything for about 30 minutes every time it happens. Once treated, I’m ok. I’ve had a look at the PIP forms and they don’t seem to accommodate this kind of answer as they assume the incapacitation is permanent or not. Just wondering if it’s even worth making an application.

I expect it, i understand the stigma, i had the same opinion prior to doing my job. I feel i got super lucky working in the role within pip assessing that i do though, and it is much much less common than the field clinic/telephone assessment. Its a slightly different perspective of the job. I dont think the possinbility of having a report written without needing an assessment is super common knowledge. And if it helps even a couple of people with the process. espicially transitioning and pip being a completely new area for them, i can handle a bit of flaming.

I recently completed 5.5 months of neurological physio . It ended because he felt he had gone as far as he can with me , so basically in around about way , go away and get on with it .
No real evidence to submit other than them looking at medical history as initial appointment made via the telephone then face to face appointments made ongoing .

This is really good to read. I do a lot of PIP forms for cancer patients and fill the managing treatments section with all chemo side effects they are suffering, details of neutropenic sepsis risk, management of Picc lines and needing to be careful not to get the Picc line wet, sore mouth, checking their temperature for signs of infection etc. The people I've assisted have generally had good awards which is so helpful when they are paying out so many additional costs.

It depends on the level of support you need. For example, does it stop you from being able to bathe or shower alone? Cook alone? Walk alone? Do you become confused or disorientated? Its not so much the condition, its the level of additional support you need because of that condition that they are looking at. Its a super difficult one to have evidence for. I would look for support from your diabetic nurse (specialists who you have regular contact are really good strong evidence), have a support contact whohelps you write a letter with their contact number and consent to contact them directly can help too. But the diabetic nurses specialist being able to say "playingvideogames has multiple hypos a day, during a hypo which lasts 30 minutes she experience symptoms of x y and z her family member/friend needs to support every day with 1 2 3, she cannot cook, shower, walk, make a journey unsupervised as his she becomes confused, disorentated, she is at risk of falls and harm to herself". That kind of evidence would be something no one could argue against, from a source where the evidence is really weighted.