To think medical evidence is the key to PIP / ESA

[LovelyBath77]

Just this really. It seems to be having gone through it all, that if you have good medical letters etc from consultants and things like a care plan and prescription copies, it makes it all so much easier and there is less for them to argue with.

LovelyBath77 how do you go about asking your GP for a care plan?

It takes weeks for an app with my GP. I've had to wait a few weeks to see her as the steroid usage has started affecting my back. Well it's been affecting it since last summer but I did that British thing of ignoring it and hoping it'll go away. What does a care plan involve?

In my experience I would say you are more likely to get your PIP/ ESA if you have professional help with the forms. If you live in an area where advocates can attend the assessment with you that will also help.

I agree that unfortunately it can depend on who the assessor is. Some will just not look at medical evidence or letters.

If the assessor lies in their report then your fucked in your apeal too

Not true, I'm afraid. I was a benefit advisor for 2 years and won many appeals where the assessment report had been untrue/inaccurate.

When you appeal, you can introduce additional evidence that rebuts stuff in the report, the tribunal will form their own conclusions based on the evidence and on the answers that you give at the hearing.

Imo, what you put on the forms is the most important thing. Giving a very full account of why you can't do things, and linking them back to your medical conditions (eg that your depression means you don't have the motivation to cook for yourself unless someone encourages you to do it) is essential.

It's always best to get advice from a benefit specialist with the forms, if you can't access CAB or similar then get the advice pack from Benefits and Work before you do the forms.

A lot of medical evidence is only really helpful in confirming a diagnosis, and doesn't really address how the health problem affects what you can do. Things like care plans or OT reports are better in this respect.

Awaywiththepixies
You would have been better of saying that your mum picks the kids up from school for you as your not able to
You really do have to think how they the assessor interprets what you have wrote down

You see it on here all the time how people assume stuff without seeing the full picture

"My neighbour has a mobilty car and says she is disabled but I see her at the shops ,school at the pub . How can she be disabled if she can do Xyz

Well that's exactly how an assessor looks at it . If you contradict what you have put on the form when answering the questions you will fail

If you can take your kids to school , you can plan a journey , have no anxiety problems or mobility problems .Thats how they look at it

People try to throw in lots of evidence & medical reports about the illness they have and assume that's what they want
It's not about your illness
It's about how your illness affects your ability to do stuff hence the descriptors and you meeting them
It's why if you have a slipped disc, bad back , carpel tunnel syndrome chronic pain but then you walk in ,using crutches holding a handbag and are well dressed looking presentable you will 99 percent fail

CTS is problems with hands so using crutches or holding a handbag is a negative for this . .
Walking when you have slipped disc , bad back and looking presentable is negative

I'm sorry but time and again people are referring to state of dress. They really fail you if you are clean?! If my brother ever gets called in again I will tell mum not to remind him to wash or put on clean pants for the week leading up to it. tbh my mum said the accessor appeared really flustered and unsure of herself - brother was not having a good day and was ranting about public transport. You would think they would employ people who have experience of learning difficulties and autism.

MrsPear, dd (ASC and EDS) was seen by a physictherapist who knew nothing about either condition. Whilst I don't normally expect a physiotherapist to be an ASC expert, I would expect at least a basic working knowledge of EDS, but apparently not.
Oh, and both my PiP assessments commented on my state of dress.

They do, Mrs Pear! I always advised clients to go looking scruffy and not to put make-up on before their assessment.

Other things that can go against you: making eye contact, looking calm and relaxed, shaking hands, picking your handbag up from the floor, being "well enough" to go on your own etc. They observe you in the waiting room as well, so no looking calm while you wait!

In fairness to the assessors, they are often "instructed" to amend their reports by their managers. The best case of lying I've ever come across was following a home assessment, where the report said the applicant went upstairs without difficulty. The applicant lived in a bungalow with a ramp to the front door, so the assessor must have brought a staircase with her.

The tribunal struggled to keep straight faces at that one.

MrsPear
I would advise your brother / mum
to not wash for a week ( no social awareness of hygiene , can't physically do it )
Wear old smelly clothes with some spilled food , rips on them

Wear crocs or slip on shoes ( means he can't dress properly)

Not to shave / brush hair ( Can't use his hands properly or no social awareness )
To eat garlic two night before and the day of the assement
Rub some garlic in clothes

Dirty nails & hands Lack of washing / not able to wash
going in clean , presented , well dressed , all of this is seen that you are aware of social norms , that you can dress and present yourself correctly therefore you are aware and able to understand basic skills of life . Also implies no mental health problems .leaning difficulties or austisum

That you can dress & wash & look presentable points to no problems with manual dexterity with hands and that you are mobile .

This results in 0 or very little points certainly not enough for an award

It's human nature to want to present yourself in the best light possible unfortunately with PIP /ESA looking good is not in your best interest

A friend was refused in part because she had nail polish on her toes
This was seen as she could bend down , use her hands , sit still , concentrate and paint them .
This was despite the fact that she told them her niece did it as she was training to be a beauty therapist . So like to practice on her

LakieLady it was true for me. I spoke in my assessment about my SIs, burst out crying when telling her about that, also burst out crying when I was explaining that the kids have to come and give me a goodnight kiss downstairs most evenings as I cant do the stairs at the end of the day.

Her statement of "Pixies was laughing and joking throughout the assessment" was only challenged (and subsequently ignored by them) by me.

The best case of lying I've ever come across was following a home assessment, where the report said the applicant went upstairs without difficulty. The applicant lived in a bungalow with a ramp to the front door, so the assessor must have brought a staircase with her.

OMG! That's outrageous! There should be consequences for them when they blatantly lie like that.

Yes MrsPear . "well nourished" is also used for = 'Claimant is fat so cant possibly struggle with nutrition'. N.B we'll just ignore the evidence of the meds 'Tom' is on, those ones where the main side effect is = weight gain.

Well, with me the GP suggested the care plan after my surgical consultant said any further treatment would only be in a life threatening situation. So she did one which is about emergency admissions to hospital to support me as I also have Mh condition as well. If you google you can find the version she used. if you put things like care plan GP emergency admissions template. She had it on the computer. then I also have a care plan from the MH recovery service which is more based on MH. So we put the MH stuff - things like advance directives on the new care plan. My husband is the named carer in my care plan. It's linked into NHS 111 as well due to the condition needing hospital treatment at times. there s a sheet I did with the surgeons as well which is then in my hospital notes, and I included the letter from the consultants about the care plan etc in my PIP notes.

The only home visit I had they said things like I looked tired and tense and was sat at the kitchen table when they arrived, and small things like that so they so pick up on small things - I didn't cry or anything though. They said I failed a memory test but I don't remember this - although maybe my memory is the problem, not sure. They also referred to the observations in my psychiatrist reports which said things like my self care was reasonable and eye contact, but i had obvious symptoms of psychosis. So maybe they realised things are not always simple, in some cases. I was very honest and told them I go to the shops and gym for example. and use the computer. but that I use a swipe card and go to the back of the class...which was all there in the report.

She did say some odd things though- like she kept telling DP that this didn't depend on our savings or earnings, almost reassuring him about this, and on the way out told us that she 'was;t trying to catch me out, she could see from the start I was genuine, and they need to check as some people who apply have been wrongly advised to'. I just kind of looked shocked and my husband let her out. But the report was genuine.

On the subject of the air varnish, I had my hair in a bun. and the assessor asked if I could raise my hands above my head, which I said yes, of course (have nothing wrong with my arms). I think it was a test perhaps so to see if I could do my hair or not. Not sure, but have heard that this is something they do.

I agree that there should be penalties, Awaywiththepixies.

I think that it ATOS/Crapita/Maximus etc were made to bear the cost of successful appeals, their reports would be a lot more accurate.

A welfare rights expert made such a suggestion to a senior DWP bod. He was told that it wouldn't work, because the DWP make the decisions, not the assessment agency, so it would lead to big, costly disputes between the DWP and the contractors.

The last time I heard figures, 40% of ESA appeals succeeded, rising to over 60% when a benefit specialist was involved. Given that a lot of decisions go unchallenged, I wouldn't be surprised if 2/3 of claimants were wrongly denied ESA.

I heard over 60% of PIP appeals are successful too.

You can have all the paperwork in the world but if your assessor is a lying cunt then you are screwed.

I have major spine problems. I've had god knows how many MRI's, injections, two major surgeries and have been under the spinal team for 5 years. I also have PTSD, anxiety and depression. I take medication for both things. My GP file must be huge.

I had a medical for PIP over a year ago. Got enhanced mobility and standard care. Absolutely zero problems at all.

Then my ESA renewal came up. Bear in mind I don't even get any money due to DP's income (but it pays my NI stamp) I was a bit taken aback to find the assessors report bore no resemblance to my actual assessment.

She had asked me how often I go out. I said that if I need to go to the GP then I will drive there (5 mins) but mainly I manage everything online and have repeat prescriptions set up etc. Report said I am out driving every day.

She asked me what I do each day. I said that I get DD up and come down to have a cuppa that DP has made for me before he leaves for work and then get DD off to school (she walks herself). I then often have to go back to bed while pain meds kick in. She said that I often choose to have a duvet day. That phrase gave me the utter rage.

I was denied ESA and I put in an appeal. I tore her report to shreds, said I was fucking offended with the term Duvet Day in relation to a chronic illness which prevents me going further than the bathroom on some days and I was put back in the WRAG group.

So yes, you can have all the paperwork but ultimately if the assessor is having a shit day or has a target to meet then you will find yourself with a battle on your hands. Always take someone with you to an assessment.

I'm about to apply for ESA after being on long term sick from work where my sick pay has now run out and this thread has made me feel even more anxious about applying for it. I have a toddler who I am the main carer for and I'm sure this will get used against me as I seem clearly able

The person making the decision has to look at all of the evidence but they often don't which is why the case is often won at appeal as the panel have to consider all of the evidence and give reasons for rejecting or accepting it, so it is always worth sending it in.

It is also the quality of the evidence, a generic letter is not going to add much. Also the level of disability has to be consistent with the diagnosis, prognosis and list of medication.

The DWP frequently rely on the assessment alone and some of those are of such poor quality that they bear no resemblance to the actual person being examined.

Often it is having representation that makes the difference, someone to complete the form or write an appeal. However government cuts has also reduced access to the professional help available as organisations do not have funding for staff.

Yes it depends a lot on the quality of evidence, I'm always careful to be frank and specific about my difficulties and not be afraid to exhibit them when having consultations as this all gets put into the paperwork so it counts as useful evidence. If you hide your difficulties with your doctor then their letters are going to reflect that, I am always keeping things in mind how things will appear on letters and paperwork when I go to consultations. I've never had a face to face assessment so I don't know much about that side of things. Everyone at our CMHT has a care plan and mine is very detailed so I included that, plus information about my hospital admissions and OT sessions. Most of my evidence is not just about a diagnosis but also how my condition affects me, so maybe that's why it was more useful compared to others.

I struggle with caring for my dc and getting them to school due to my disabilities and I put in letters from social services and my consultant about that. My dc were missing school because I couldn't get them in until SS sorted out a taxi and escort so I sent in the letters about that. I often don't wash for weeks and am smelly and unkempt when I go to appointments, so that is all documented as well. No point being ashamed of it or trying to hide it when it shows to the decision makers the impact of your disabilities.

She had asked me how often I go out. I said that if I need to go to the GP then I will drive there (5 mins) but mainly I manage everything online and have repeat prescriptions set up etc. Report said I am out driving every day.

Yes. It's a bit like when they ask you to if you do your shopping. Many people will only use the corner shop. But if your corner shop happens to be a local Tesco express that probably has about three aisles, they'll put 'does weekly shopping at tescos'. our tescos is huge, that huge my Dad can't actually go in and around it without getting either an angina attack or a just a copd flare up if he's lucky. But if you just read that off the bat you'd assume that they go to the huge one with many issues to navigate so = no problem.

imsodizzy I have 2 DCs, 11yo DD who helps me out a lot and 8yo DS who has ASD. I had my reassessment in January and I got placed in the WRAG group. (was previously in the Support Group). Not all assessors are satans siblings are awful.

Thankyou for your advice LovelyBath77

The cost of appeals should be what the media is focussing on. I went with a relative - how much does it cost to have a Dr, a legal expert and a welfare rights person, all independent, sitting in a room all day making decisions? How much does it cost when there is 15 rooms, all staffed like that, doing that 5 days a week?

Sometimes even when they accept someone has the condition as described they don't award. Dd's narcolepsy was described as "predictably unpredictable" which meant, apparently, she should be able to keep herself safe because she should know she is unpredictable. The tribunal judge hit the roof at that one.

I've also known them fail narcoleptic's on the "plan and follow a journey" on the basis they can plan a journey. One lady, who pointed out she could plan many journeys but had no hope of safely making any of them, win at tribunal, but the dwp appear to be using her as a test case. They are saying you need to be unable to plan and follow, the fact she can plan means she doesn't meet the criteria.