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.

PIP is for over 16, so its hard to say as his abilities aged 11-16 could significantly change. It may be worth looking into DLA in the mean time though

It is in that if you can say why it is detrimental to the claimant to be present, that assessment can go forward without them being present. That policay can be applied to most cases, as the DWP has already justified the need for an appointee. Sometimes having them there can be useful, in that the assessor seeing for themselves how restricted a person is can aid with the informal observations elements, but if an appointee feels its not in their best interests, they can do it alone.

Oh I agree that for many it would be the case (and many with an appointee would have sufficient evidence to not need F2F anyway). Sadly, it doesn’t apply to all with an appointee though and that was just my question really because I thought you were posting in general rather than just about pp’s case.

Theres a whole host of reasons why it could be telephone v clinic. If someone mentions significant anxiety, then clinic is not advised, significant phsyical restrictions clinic is removed, hearing loss, telephone removed etc. Most cases go though as any route, and then they can get allocated to either. Any route are almost always allocated by an automated system, if its a specified type only, then a person allocates them. Requesting a specific route isnt always reason enough. if you could manage a telephone assessment, the likehood hood is it would have gone through as any route, and the system allocated you to telephone.

Thanks for doing this OP, really interesting.

I have 16yr old twins, both autistic, in the process of applying for PIP. One gets MRC and LRM and the other HRV and LRM on DLA currently.

Both have been home educated since COVID so evidence is 5+ years old, although DS still has an EHCP that’s renewed every year. DS was in a special unit - DD was in mainstream but starting to seriously fail and EHCP submitted. We have reports from SALT, physio, OT, Ed Psych, paediatrician, and school for both. DS has about seven years of intensive evidence. He’s still in nappies. He won’t ever live independently and it’s doubtful for DD.

I’m so scared about the current narrative that suggests neurodivergent people are just blagging it and everyone gets a diagnosis now. My children have very real difficulties that mean they’re always going to need significant support. Neither are able to leave the house unattended, ask for something in a shop, or even shower without me sat with them.

My life completely revolves around supporting them and trying to help them gain life skills but it’s progress by millimetres. I’ve just torn my rotator cuff muscle because DS sits on my lap like a small child and wants me to swing him! It’s utterly relentless but little current proof.

My question - sorry, getting round to it now! - is how do you treat cases like this where there’s a lot of historic evidence but nothing recent other than claimant/appointee descriptions? And have you been instructed to be tougher on claims for neurodivergence?

(Worth adding that I only got around to submitting the DLA claims last year as I’m very time-poor and they were awarded on the basis of the form and historic evidence).

Thank you!

So first make sure you are appointee for both children. If you are appointee for DLA that will transition over to PIP.

Secondly, that evidence does still hold weight. I have recently done a report under very similar circumstances using EHCP from primary as there was no further educational input.

The current narritive is so harmful, as it in not applicable to cases like yours. Each claim regarding ND is taken on its own merits, as the range of restrictions is huge.Do you have any input from any services currently? Social support etc. Is there input from the LEA to support them being withdrawn from school and homeschooled? Statements from them will support current restrictions. But in all honesty, that school evidence even if aged, orginal diagnosis, what you put on an pip2 form, and if the assessor can speak to you directly, if enough for them to justify the claim.

I would encourage you to look out for calls from with held numbers, as as i said earlier, we cannot notify that we will phone, we have to just hope that an appointee answers. We also arent allowed to leave an answerphone message stating we will try and call back. I have no idea why, i really wish we could. But yours will almost certainly be attempted as a paper based if you are an appointee.

I work with people helping with their pip claims and have done so in some capacity for several years. It appalls me how things have changed. The dame conditions and restrictions that were being accepted only 5 years ago are now having to go to appeal. One man who had multiple conditions and years of evidence, was refused completely. I made him go to appeal- really fucking stressful for both of us and after 2 minutes rhe judge overturned it, said she was disgusted by the process and back paid him for the TWO YEARS it had taken.

And that is one case I've been part of
Pip assessors on the whole are despicable - and they lie. They do.

I wish i could disagree with you, but i cant. I see an awful lot of claims where previous reports have been all A and i cannot fathom how they got to that, which i then have to send to assessment as i cant justify the paper based, and i know it will go all A again.I dont know if its that the criteria in field is different, i cant imagine it is, or that they just gain more information, worded in certain ways,to be able to negate evidence, but the awards are much, much more brutal than the area i work. The area i complete reports is very much the evidence is gospel, if it is telling there is a restriction, then it exists, and we award based on that. I feel that doesnt cross over.

I agree the system is unfair, i agree it seems like they lie on reports and i dont know how they get away with it.

But the same as on the wards, where there are crap HCP's who appear that they have lost all compassion and care for patients, but there are some who genuinely do care and do everything in their power to advocate, for anyone in their care, the same does apply to PIP. Some of us genuinely do want the best outcome for every claim. I only get to keep and write the a minority of cases i come across, but for those few, i do my absolute best to ensure the DWP cannot argue with my evidence, and they get awarded.

I'm sorry. You do seem one of the good uns!!! I've just had so many bad ones with my patients and it so frustrating!

Can I just clarify, are you saying that EVERY claim has to be assessed even if it's clearly not going to be successful?

So my stepdaughter is 16, predicted high GCSEs, has multiple hobbies which she excels in, currently trying to get a PT job, works out most days and is very fit and healthy, is easily able to take care of herself, cook elaborate dishes, travel around the country on public transport, etc. All in all, I'd say she's a "normal" 16 yo but actually she's functioning at a higher level than the average 16 yo and I'm not sure how she fits it all in. Lots of friends, active social life, big plans for the future.

She has ADHD and got DLA because she did need extra support when she was younger, but this hasn't been necessary for some time now, beyond the help she gets in exams with extra time and movement breaks and her ADHD medication.

She's now applied for PIP and based on that fact she isn't eligible for any points I assumed she'd just get it rejected. Are you saying that she'll have to be assessed in a clinic?

How do i go about completing the best possible application for my husband who suffers terribly with his mental health and has for the last 30 years severely restricting his ability to work?

Why has she applied for PIP?

Yes, it would have to go to an assessment if she applies. If the pip forms are generated and she doesnt fill them out, she would still be invited to an assessment. If there were multiple attempts and assessments that we bookedf and she ddid not attend, then it would be sent back to the DWP, who would decide whether we needed to write a report based on DLA evidence only,, or if the PIP claim is withdrawn. But if that PIP application is generated, she would be reffered for an assessment, if is she wrote on an application she has no restrictions, or didnt submit it at all.

If she feels like she wouldnt be awarded, or no longer requires support, if they generate the pip claim, call up and ask for it to be withdrawn. Otherwise it will go to assessment.

Goodness knows- I think it's her Mum's idea. I did try to tell her that she can't possibly be eligible and also gently asked if she thought it would be fair to get it when some people who are significantly disabled and really struggling with life don't.

She said, "I have ADHD so I need more money to pay for days out to theme parks and stuff because people with ADHD get bored more easily." (I also have ADHD and consider getting bored to be my responsibility to pay for!)

And then she was cross with me for being an evil stepmother and suggesting she didn't need £350 a month or whatever it is for theme park tickets. 🙄Also, with or without PIP she's not hard done by, she goes on holiday usually 3 or more times a year (once or twice with us and the same with her Mum) we take her on load of days out and if she wants anything she only has to ask- we spent £400 on her birthday present last year and her Mum spends even more, took her to Lapland (the Finland one) for Christmas- this is not a kid short of fun experiences.

Keep it factual. Cooking - low mood, low motivation, risk of self harm. Needs prompting to cook daily or he wouldnt do it, needs supervision due to the risk of harm, needs support to complete this activity teh majority of days. Do try to guess a percentage or number of days, just say majority. This would count for activities 3 (meds) 4 (washing) 6 (dressing) 9 (engaging with others) 10 (finances) and 11 (making a journey)

2 eating, even if he misses meals, he is unlikley to score here, eating is repeated prompting thoughout a meal, not just to start the activity. 5 toileting he wont score, 7&8 speaking and reading, motivation, low mood, etc do not come under these activities, so just put no restrictions, these activities are about senses, sight. hearing loss, cognition, developmental delays etc, he will not score for these, so focus answers in the other activities. 12 mobility he wont scrore so also tick no restrictions. Only fill out areas of the form that are relevent and he is likely to be awarded in.

Include evidence from Gp, any other mental healths support he recives, include evidence of medications and therapies. You can also write a supporting statement yourself about the level of daily support you need to give. Have him ask them to record yourself as an additional support contact, with your phone number included.

No one in their right mind would give her pip- what a cheek!

Hi Op thank you for this.
Just had my PIP assessment and have been so poorly since with the stress and anxiety, I have also been in hospital this week, however I have little evidence and I get bounced from GP - Physio etc back to GP, get refused by specialists everytime, will this go against me, this has been happening for over 5 years to the point my mobility and abilty to go out has stopped.?
The consultant I saw in the hospital this week has said I need x,y,z and referal to pain clinic but GP are saying their hands are tied, I
I am so worried that lack of evidence except me being constantly at GP and having other diagnoisis will go against me.

It shouldnt go against you. But as above, assessment dont always go as expected, and they can use inconsistenices against you unfairly. Should this happen, i encourage you to go for an MR and tribunal if needed.

In the meantime, if you dont already have support from the physio you saw previously, try and get a supporting letter. If you havent seen an OT, try and get a referral, or it its an option for you, get a private assessment. I cannot stress how good OT support is with mobility and phyical restrictions. There assessment reports are such good evidence. Physios and GP, whilst good at diagnosis, and treatments, generally dont report how exactly this restriction is affecting you on a day - day basis, and what aids support you, and what aids could support you that you dont have. If you are going to MR, this is the type of evidnece that can change the award. As it is so hard for anyone to dispute.

If only one thing comes from this AMA, i genuinely hope its more people requesting OT input, as in so many cases, that would be the evidence needed to change from an all A report, to getting an award for adults with physical restrictions. OT is so under utilised, and they are so so good.

That's what I was thinking, I thought it would just be rejected. If there's a whole assessment then it will turn into a big drama. They won't ask us will they? I don't want to be responsible for her not getting it but I also can't in good conscience support her getting it.

@pipfs 2 separate queries

DS1 was transitioned from DLA to PIP with a pepper based assessment (they spoke to his OT and psychologist) at 16. He is now 25. I am his appointee and also have PA for finances and health. His first review I never heard back after completing the form before his next review was due. I submitted the form and heard nothing until I was told his award had been extended to February 2025. They have now informed me his award is extended to February 2026. As he is on a three year resubmission cycle this will take us to to the due date of the next review. We seem to be stuck in a never ending review cycle. His needs are more acute. What is going on?

I have just completed DS2’s review forms. They are different to review forms I have completed previously. They no longer ask if the condition has changed but ask what aids he needs, if he needs prompting and how often and when the needs began and why. He also transitioned from DLA to PIP and had a phone assessment with me present as appointee. Have the review forms changed?

My ds’s PIP is coming up for renewal this year. He gets higher rate and I am his appointee. Do they take into account previous awards when deciding what happens next?

Is he on enh/enh? If he is I wouldnt do anything. If he is in standard you can contact them and request a review and forms as his needs have increased and his award may have changed. If he is already on enh/enh i would just let the cycle run as the award cant change.

There are two different types of reviews forms. One is more indepth. One basically asks you to confirm no changes

Yes. They look at previous awards and new evidence when reviewing. If u complete the forms and say no changes, provide evidence to support that, and are still his appointee the likelihood is he wont be assessed they will just renew the claim

I'm on ADP rather than pip, but it's the same process. I only half arsee filled out the first half then never bothered with the rest as it was just really embarrassing and traumatic going through everything I've lost. I was actually hoping not to hear back from them as I couldn't face an assessment again after bawling my way through my lcwra but my gp clearly went all out and must've been brutal.

How common is this?

You and I work at opposite ends of the system. I spend 80% of my working hours working on PIP and Child DLA appeals to support clients. Your stated award rate as an, I'm assuming, individual decision maker, is very different to the combined results I see. Hence so much time in tribunals.