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.

That seems very odd. If anyone was going to make a fraudulent claim it would be the parent not the 16yo so taking the parents
word as strong evidence seems mad.

Also the form I filled in said you can only be an appointee if the person lacks mental capacity or is severely disabled so I wouldn't qualify. The government website says the same thing.

It also says the DWP will arrange to visit the claimant to check if they really do need an appointee. It doesn't sound as if you can just decide to do it to make things easier.

https://www.gov.uk/become-appointee-for-someone-claiming-benefits

You absolutely can be an appointee for a 16 year old. The DWP accepts that that they require additional support as managing a condition at that ages is difficult, whether its phsyical, mental, ND etc. They accept that 16 year olds need more support than an adult claiming. Its about making the process easier for the child, and allowing someone to advocate for them.

The evidence from an appointee is strong, BUT, its alongside medical and social evidence. Just popping up on a claim an as anppointee without anything else is not enough, but if you have evidence of disgnosis, evidence of restrictions and evidence of support, a quick call to an appointee to get a bit of clarification and confirmation is then weighting the evidence enough to fully support the decriptors, it becomes equal to other evidence. Its espeically helpful when evidence is a bit dated. If i had evidence from 6 years ago without an appointee, its going to full assessment. If i had evidence from 5 year ago, with an appointee, i can keep it and use an appointees statements to support current restrictions. I can write:

Claimant reports XYZ with restrictions of ABC.
Evidence confirms conditions as reported in the questionnaire. Evidence supports/suggests restrictions of ABC.
Telephone call with appointee indicates 123. This is consistent with evidence and clinically likely.
Therefore, what ever descriptor is chosen.

A summary like that for a report is really strong, and the DWP cannot argue against it.

Fraud cases are not common, and that is not the first thing consisdered, its not even the 10th thing considered. It doesnt come in to it at all.

But to support a young person claimain, and the make the process as easy for them as possible, and support them as a parent, i would advise anyone in that situation to apply for appointeeship, and 99% of the time when we are talking about a young person under 18, the DWP will grant that appointeeship.

Thats my advise, you dont have to take it, you can obviously support your child without being an appointee, but if that is the case, anything that you say in assessment is not then considered as evidence.

And just to clarify your original question, taking appointeeship out of the question, whether it is paperbased or not would really depend on the condition and how the evidence supports, and the person reviewing the claim.

If the evidence you have factually reports that his condition is from birth, lifelong, unlikely to significantly change, he will need this support for the rest of his life, then yes, it could potentialy avoid assessment. It depends how clear the evidence you have is. If its a condition that could progress, or is variable and has good days/bad days, then he may need an assessment as that evidence would not be enough to support current restrictions.

It can also depend on the person reviewing the claim. I would, even non-appointee cases, attempt to contact any medical professionals or school/college support workers etc documented for more up to date evidence if its a 16 year old and contacts are available, just because i hate sending them to assessment im prepared to keep it in my queue for a week or 2 in the hope i can write it and fully support it. No contacts and not very strong evidence it would have to go out. However, some would read and immedicately send to assessment if its a phsyical condition and there is no risk connected to assessment. So it also becomes a little bit pot luck, as theres no reason to attempt paperbased if they are capable of attending an assessment.

Thank you, that's very very reassuring. It's hard trying to evidence PIP descriptors for a dependent child! It's a big change from DLA where you have to prove that they need more care than an average child of the same age (which my son without doubt does) to PIP where the qualifying criteria are very different. I hope very much that my son can leave home and live independently but part of his condition is a bit of a developmental delay so he is more like an 11-12 yr old with independent living skills at the moment! Maybe by 18 he will be where you'd expect a 14-15 yr old to be 🙏

Hi OP. Great thread. Just wondering if PIPS has a quota of claims that they can pass? So many per year and no more.. If so do they need to choose who they give it to carefully because of this?

No, that is a complete myth. Along with the £80 bonus for every failed assessment that crops up on social media from time to time. Targets are based on number of reports completed, not on awards. There are targets to increase the amount of people having clinic based assessments rather than phone to complete more accurate assessments too, but again, not connected to what they are awarded.

However, im speaking from an assessor perspective. We write a recommendation only, we are not the decsion makers Its something like 97% of cases get the award recommended by the HCP at assessment, but its not guaranteed. The non-HCP decision markers at DWP may have some target i am unaware of.

How come i with physical progressive disability gets the lower rate daily living and a car while someone my husband works with with has mental health and ADHD gets the higher rate and a car?

I just did the transition from DLA to PIP for DD1 and got awarded enhanced/enhanced. She has 4 or 5 conditions, most are lifelong but one we hope will improve (mental health related) as she's having therapy. I answered the form honestly at the time but I'm worried about being accused of doing it fraudulently. E.g. if she couldn't go out without support but in a year's time she can sometimes. What's the advice in these circumstances? I think she got a 3 year award. Do people generally just wait for the next review? I'm also aware that she could improve and then go downhill again so I don't want to jump the gun either IYSWIM.

Because MH descriptor = a higher score than aids if that is what you were currently assessed as needing. I dont agree with that, but that is how they are scored. However, MH and anxiety is extreemely unlikley to score high enough for mobility scheme, chances are they have reported a secondary condition along side to be awarded that too.

Wait till your review in most cases. Stability with a mental health condition can take a long time, which is why the award is often a minimum of 2 years before the review, so there is time to undergo treatments, and ensure that there is no change.

Just done my sons PIP renewal - turnaround was about 4 weeks, renewed for next 6 years. Grateful that the process has been so smooth

I have never applied for PIP as I assume I wouldn’t meet the threshold. I am autistic, have ADHD and Ulcerative Colitis. My energy levels are so low. I have to work full-time but as a result I am constantly really exhausted and overwhelmed. Outside of work I cannot keep up with household stuff and life admin. This weekend no housework (or anything) will get done as I feel ill with my UC, but even without a flare up of this, my ongoing fatigue is just miserable. I can’t afford a cleaner. I’m assuming I would be one of the people fooling themselves by applying?

I have a family member who receives PIP for how colitis affects them.

PIP doesn’t get awarded on your diagnoses, it’s awarded on how your symptoms affect your daily life and how they stop you from doing things independently and safely.

It’s worth applying!

Its always worth applying if you have conditions that effect you on the majority of days. Its hard to say for specific conditions as everyone has different levels of restrictions even with the same diagnosis, but if you look up the descriptors, and feel you have restrictions in the specific activities on the majprity of days, absolutely apply.