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.

Do you ever get claims where you wonder why on earth the person has applied as it’s so obvious they won’t be entitled?

Or is it more like you can know they probably won’t be entitled but can see why they thought they would be?

I would defintely try to get an OT review, for support needed in the home. They are much more practical than phsyio. They can do home vistis, see what aids you are using and document all of that, along with your mobility difficulties and balance problems. It defininitely sounds like you have been underscored. I would try for the mandary recoonsideration but try to get a little bit more evidence first

Why is the renewal form so very different to the initial claim form, and why is it still done with paper and post, not online?
I recently had a review (the renewal form arrived 10 days after the notice of renewal and it was suggested I allow 10 days for postal return, so I only had 8 days of the 28 allowed).
I wasted one of those days getting DH to buy ink and install it into the printer to print out evidence.
The award notice was the day after the acknowledgment of receipt of my renewal form.
I highly doubt anyone even read my renewal form before rubber-stamping my renewal.

My dc is moving from dla to pip. We had to call to register and were asked is it ok for them to access the dla records to help with the award we said yes of course. We then got a letter to say there’s no record at all of dla - that they can’t access anything and definitely can’t access any award information. Is this right ? Dc is still getting dla while the pip is processing and it’s the same claim reference? They’ve told us we have to resubmit it all but I dont think I even have it as it was a 10 year award previously and they’ve said that we can’t send the information if it’s from the gp (basically the only person who could give a total overview with evidence)

also am I allowed to do the phone assessment as dc can’t speak ?

I applied in May 2025 on mental health grounds (depression, anxiety and ADHD). These conditions severely affect my functioning day to day and unless someone cooks for me I will survive on a piece of toast because I struggle to cook even a simple meal and maintain my home due to the task paralysis associated with my condition. My phone assessment was extremely thorough and the assessor was kind and supportive so I was shocked that there seemed to be a lot of contradictions in the report, for example, she put that I could cook a simple meal and seemed to think I functioned well when I explained that I struggle to go out and that my condition seriously limited my quality of life and day to day functioning. Any idea why the report would seem contradictory and why I wouldn’t have been awarded? I didn’t appeal the decision as it seemed futile but I may apply again in future.

I think my Q from earlier might have got a bit lost in the flurry of subsequent Q’s 😬 🫣

It's mad isn't it ! Some renewals are taking over a year currently ! I hate those new renewal forms ( I assist people to complete them ). I think the system is just so overwhelmed with so many people claiming. which is why renewals are taking so long. They are prioritising new claims.

Every day. Every single day, some times i feel quite sad for them, as its obvious they do have restrictions but they wont hit the thresholds. Some times its so clear that they over reporting as what they say is so inconsistent with what evidence they have sent in too. There cases where they report one consition, send evidence of one condition, they list restriction after restriction that isnt consistent at all. There other times when they list off and send in evidence of multiple conditions, and then tick no restrictions throughout. But its a case i canot keep and you know in assessment they will score 0. The whole system is frustrating. But all i can do is the best i can do in that moment, try to make sure they go to the best type of assessment for them, or add it to my queue and hope i manage to get something before i send it out. Once they go to field, they arent actively seeking more evidence at that point. But i can try to keep it for a short period and get more myself before sending it out and hope it supports enough to get awarded. There are times when my hands are tied and i have no justification for adding it to my queue, and i know im sending it out to get a 0 award.

They are transitioning to an online form now, its being trialled and rolled out. Its so much better for everyone - i get so my form completely illegible, or the scanning has messed up and it faded to the point i cant see it. So frustraiting, the online forms are infinitely better.

The review forms are done in a way that hopefully stops them going to HCP's, DWP look at form first, if it just says no changes throughout, they look at the old reports and then just re award for a number of years based on conditions reported, if you document changes it goes through to us. Its to stop reviews backlogging as much and try clear out the easier ones.

If 95% of the claim reports you write get awarded, you are clearly not the problem with the DWP. I have EDS and Post Sepsis Syndrome, I have applied for PIP twice pre-sepsis as my EDS significantly impacts my ability to function, and included evidence from work (occupational health reports/recommendations) and my GP along with significant amounts of consultant letters detailing how my EDS impacts me. Twice I was refused. Twice I appealed and went to tribunal and lost. My evidence was blatantly ignored, my information was misrepresented in the reports (detailing my medications at the wrong, lower, doses and frequency etc)

I applied a third time post-sepsis and again had to take it to a tribunal, but this time was actually awarded standard rate for both aspects. I’m now waiting for my review results, and honestly, even though nothing has changed I’m fully expecting them to try to take my PIP away from me.

How is the system so weighted towards refusal, and why is there no further right of appeal after a tribunal when the assessors & tribunal panelist’s so blatantly ignored evidence and lied about information that’s in black & white?

@pipfsI did document and evidence changes and two new diagnoses but the renewal didn’t reflect any of them. I lost a lot of points because my diagnosis at the time did not explain my difficulties adequately, but not those same difficulties have diagnostic explanation this time and my points did not change.

The put of the blue call was someone attempting to do a paper based. We are able to call claimants directly, and try and get a small amount of inforation if we need it. This call should, in theory last no more than 15 minutes. If its likely to go over 15 minutes, it should be routed to a telephone assessment. We get 2.5 hours per reports. So thats read the evidence, time spent gathering evidence, writing up calls and writing the reports. If the phone call is likely to last longer, it needs to go to a full assessment. There are obviously times we go way over the 2.5 hours, however in this case the person decided they had to send you to an assessment. It wasnt to catch you out, as paper based we cannot send out appointments for calls, or even notify we are going to call. We have to blind call and hope for the best. What we can do though is say im trying to avoid a full assessment, i would like a really quick chat with you, it will take no more than 10-15 minutes, i understand this call could be hard for you, would you like me to arrange a time to call back, or are you happy to do that now?

The amount of evidence you sent, and the nature of conditions, means that policy is that paper based is attempted first. I would have kept your claim. the call means they have tried to speak the people and not managed to gether evidence, the call to yourself was the last attempt. That call being unsuccessful will not affect the outcome. It sounds like you would be entitled, i cant say for certain obviously, but based on what you say it sounds likely. If you do not get an award, i would continue with MR and tribunal in your case, as its all very consistent and meets the criteria.

As a nurse, how do you find this job? Is it as stressful as clinical nursing?

I would imagine there is a degree of moral injury but possibly no more than in clinical roles given the state of the NHS.

Hi OP, thank you for doing this it’s very helpful ! You do sound like a good one!

We are about to embark on the DLA to PIP for my son , is his ECHP enough to submit as evidence (it is a comprehensive one , and does detail his difficulties) or should we also be getting personal statements from teachers ?

Thanks so much for this. I wish the initial person calling had made that clear - they didn’t say they were trying to avoid me having a full assessment and she didn’t give me the option of calling me back in a few minutes once I’d gathered myself. It was out of the blue and really triggered my overwhelm and panic, due to what a curve ball it was. If id been told the context around it and given the option of arranging for half an hour later id have leapt at the chance, rather than waiting another 6 weeks for a 2-hour long grilling and feeling like I was being caught out in answers differing from the application form.

Because my condition (and resultant functioning) is so wildly fluctuating it made each Q incredibly difficult to answer accurately and in a way which made sense. I was being asked questions off the top of my head about the past year and I have almost no memory of most of it. The paper assessment took a lot of careful completion and I had help with it & could consult my paperwork - but the phone ax asked me all the same Q’s but relying solely on my memory. It was really stressful tbh.

Is it a bad sign if they couldn’t gain the info they asked for from my Consultant and CPN and GP? That’s a worry.

Final Q - how long (in complex MH cases like mine) does it tend to take from phone Ax to outcome? Roughly. I’m unsure whether to expect a few days or a few months. 🙏🏻

DLA evidence is trckly. I cant tell you why, but sometimes we have access to it sometimes we dont. You dont need all that evidence though. You do need to be registered as appointee, if you are your child doesnt need to be involved in the process at all for there on out. Even if you get a face to face clinic apppointment, if you are an appointee, the child does not have to attend.That appointee status grants you the full level of control. Evidence, i would get proof of any diagnosis. If you have an EHCP send in the most recent one, and other clinical specialist letter, not appointments or referrals, outcome letters. Add as much information to the application as possible, but logically. Write it all seperately first before you go to the forms. Supporting letter from schools, sen, and social care, etc all really good evidence. Supporting letter if you have OT or phsyio invilvement. Write any icidents that are a safety risk. It all depends on what conditions, but you dont need to find all the DLA evidence, you as an appointee and current evidence is enough.

No not necessarily a bad sign, it could be that some is a bit conflicting and they just wanted clarification from yourself. GP information is usually the one to throw it off, as they complete the forms we send but its so generic as they are filling out so many, it can conflict. It could be just a case of you needing to confirm what a CPN had said. Its hard to say for sure, but if there is even a small inconsitency we havent addressed, DWP fail it, send it back to us, and then we have to send it out anyway.

The outcome i honestly dont know, i believe currently its 6-8 weeks in my area, but that could be different in other areas, sorry.

My son is due to transfer to PIP this year when he turns 16
He currently gets HRC and HRM under severe mental impairment rules hes severely autistic with severe learning disabilities and completely non verbal i dont anticipate the rates changing on transfer as he cant do anything by himself and cant travel anywhere independently or plan a journey
He goes to a special school and has loads of professionals involved so evidence is no problem
But im just wondering how much to send in ?
His EHCP is very detailed and clearly outlines his needs ,would that be enough ?

EHCPs are worth their weight in gold. But supporting statements from teachers are very very good too. If you are able to get them, absolutely send both. But i wouldnt worry if you cant, a full EHCP is more than enough.

Yes that EHCP on its own is enough. As with the previous poster, supporting evidence from schools helps, on headed paper only. Plus a simple GP print out that fully states any diagnosis. Make sure you are appointee and then that paper based should be completed. Appointee cases, the vast majority of the time, a paper based is attemptied prior to assessment.

I'm so grateful you are opening up this AMA, OP.
I am just about to start the process of applying to transition from DLA to PIP for my child, and have noticed I'm finding it very hard to begin the process; the years of caring, advocacy and leading on securing the right provision have been exhausting, and, as it is becoming increasingly clear that DC will not be able to live independently, I find that I'm sort of flinching at the prospect of another 'push' for resources. You sound so sensible and reasonable, I'm placemarking to reference if I start to feel like it's getting to me.
Thank you.

Not RTFT- but considering applying for this role myself- do you enjoy it? And do you work for a private company? I’ve heard mixed reviews of companies- any you recommend? Thanks x

Its stressfull in a different way. Targets, timing, managing call and case loads, i work fully remotely and have to self manage my entire day, every day, no meds, washes, beds, ward round, notes, meds etc kind of structure. Having spend 15 years clinical, it was completely new territory to me. But elements carry over, esp the area im in, its so person foccused, i spend a lot of time talking the other HCPs, its the not taking everything at face value, under reporting is common, just cos a person says that their pain is 3/10 doesnt mean that pain is a 3/10. Your clinical knowledge is so important to find the inconsistencies and then justify why restritions are clinically likely. Its very diffierent, but rewarding in a different way.

I cannot comment individually on your case or outcome, and i wish i could say this was uncommon but it isnt. I have a lot of cases come across my queue where i read a previous report and im like wtaf. I dont know how they can justify not giving an award.

What i can tell you do is reapply, limit the evidence you are sending to only what your restrictions are now. Get the proof of diagnosis and evidence around what you currently need support with. They will be able to see your old stuff, but newly dated evidence holds more weight. They cannot see the outcome of tribunals etc, that evidence is not available to us. All we can see is your older pip2 forms, older reports, and everything you have submitted. Be super factual in you application. "I cannot cook safely due to a significant risk of harm due to XYand Z. I have included letter from Mr Y dated xx/xx/xxxx which shows i am a risk of falls, poor grip, limb restrictions," however it affects you. Forms where people have multiple conditions its helpfull 2 seperate it a bit into different paragraphs and say X affects this, Y affects that. The likelihood is you will still go to assessment, but if its very clear, vbery consistent, and you only include evidence thats supports what you are saying, it can help you progress

I really enjoy it. Initially its very hard, learning to work to targets, learning to write in a certain way, the initial auditiing process is brutal and makes you feel like you will never be able to do it, i trained with 11 others and only 3 lasted the first year. But sticking through that and you get more autonomy is worth it. Now i cant imagine going back to clinical even if my own health allowed me to. I work for one of the big companies yes.