Mental health. PIP vs attempting to better myself

[Piparellah]

I'll try my best to articulate this correctly

I've been on ESA for years. My mental health is shot. I have terrible anxiety, depressions and OCD like intrusive thoughts.
I'm agoraphobic
I don't leave the house without a chaperone (my youngest child is 14 so either one of my kids or my husband)

I feel scared even putting the bins out.

I can't walk my dogs as I feel like they're going to get run over or just die if there's not someone with me etc...

My financial situation has got alot worse so months ago I applied for PIP.

I'm currently on medication and have had CBT therapy. I'm awaiting taking therapy.

But I've been doing alot of work on my own.

I've lost a lot of weight and want to be healthier.

There have been times over the last 2 weeks where I've wanted to go for a walk round the park or try to go to the local shop to buy a drink or something.

But I've stopped myself every single time because I feel like if I have my assessment for PIP soon and tell them I can go for a walk alone or go to the shop alone they won't award it.

I absolutely cannot work right now but I want to get better but I feel like I can't even try some very small things to push myself as I will then be seen as well enough to work.

Does that make sense?

And I don't want to lie to my assessor so I'm just staying how I've been for years even though there's a growing part of me that wants to try and leave the house alone.

But if I do that I won't be able to get the PIP I need to relieve some of the stress

You absolutely can do these things and be eligible for pip. Some people work and claim pip.
The test is what you can do on the majority of days.

I know but it's notoriously hard to get PIP for Mental health reasons alone. I have no physical issues

You are allowed to leave your house, and claim PIP. You are not under house arrest. Just answer the questions you are asked at the assessment.

It’s really hard and I think a lot of people feel the same. There should be a way for people to improve and still get it for 6months as I’ve seen a few people on support groups worth the same, they think they can get a tiny bit better but without the extra support they then wouldn’t be able to pay for the extra therapy and be in a worse state 6months later.

That's not true. The majority of PIP claims are for mental health issues.

https://www.benefitsandwork.co.uk

I work in this area. Many, many people claim pip for mental health reasons. You absolutely aren’t expected to stay at home.

Yes, assessors can twist things, but they can do that even if you go nowhere. And even the worst assessor won’t expect you to stay indoors and not try to help yourself.

You tell the truth about how often you’re able to leave the house, and what support you need to do so. And what prevents you from leaving the house the rest of the time.

@WaitingForMojo love your user name!!

PIP is awarded based on how you are the majority of the time, so if you can go out alone once a week but not the rest of the time you may still score points based on that descriptor. The mobility component is only half of PIP, so it's perfectly reasonable you could get a mobility award but not daily living if you are fine doing the daily living activities - washing, dressing yourself etc

I'm not. I stay in my pyjamas all day. I have to be reminded to shower/wash. I don't brush my teeth for days.

I don't eat regularly.

I'm a mess
I want to change but it's so scary and I just don't have the energy

All those things suggest very strongly that you're entitled to PIP.

They should cover how you are most of the time. So if you say you have more bad days than good days you’ll be fine.
If you can’t go out most days or if you have to have someone with you to go anywhere that’s fine. Just have your medical evidence submitted to back up what you say.

You’re very unlikely to get it for medication/CBT alone. Do you see a psychiatrist?

This isn’t true. It will help if you have evidence from a psychiatrist and CMHT involvement but there are many reasons why people may not, and it shouldn’t impact eligibility.

I say shouldn’t, because it can be used, but that is unlawful and should be overturned if it went to appeal.

No.

I've avoided dealing with people. It's extremely stressful. It took me years to get the courage up for CBT.

And I'm now on aa waiting list for tlaking therapy.

I'm on 40mg citalopram and propranolol for anxiety attacks.

It isn’t unlawful to be refused PIP on the basis of a lack of specialist input. In fact that’s the basis on which many applications are denied. Please don’t spread misinformation. If you’re going to retaliate and say that you aren’t then please provide us with evidence of this ‘unlawfulness’

I think people often feel in the dilemma you are in OP. PIP assessors frequently use the slightest thing to decide you can therefore manage everything else. Despite so many mumsnetters saying correctly that you can work and claim PIP reality is that assessors are looking to turn you down not help you get the benefit.
I have frequently heard of assessments that say for example that if someone went to university ( albeit many years ago) they clearly have no cognitive problems. Similarly if someone has a pet then they can obviously look after themselves. 2 + 2 often equals 5 in PIP land.
As regards you wanting to get better there seems no room in PIP for this. You are either so badly disabled that you qualify or if you are venturing out at all as you would like then you must be fine.
In theory yes you should be able to have it understood that you are only trying limited ways to improve but in practice you may find it used against you.
I would wait till after your assessment and then try and if you get better and sustain this then you can inform the DWP that your health has improved.

I don’t want to derail the thread but just for you, the main case I use when arguing this point is MM v SSWP (ESA) [2018] UKUT 446 (AAC).

[34-[35]
34 The claimant’s representative comments
“A current lack of treatment is not by itself [a reason] including the appellant did not meet the qualifying criteria. … The appellant had had the conditions and symptoms for many years. It may be that management by the GP was currently considered the most appropriate by the appellant’s own health care professional, other treatments and interventions having taken place over [preceding] years. The tribunal made no findings about prior treatments and interventions the appellant had undergone. … The tribunal should have put those concerns to the appellant and considered an adjournment to seek further evidence to address this issue.
35 I broadly agree with those observations. However, I do not agree that the tribunal should have put its concerns to the appellant. The claimant is not medically qualified and therefore lacked the knowledge to respond to any concerns the Tribunal may have had on this point. It is difficult to see how she could have commented other than to suggest that the treatment she received was a matter for her GP’s professional judgment which she was not in a position to second-guess.
Judge Poynter goes on to hold at [40]-[45]
40 But medicine is a broad church. As is recognised in other areas of the law, there is a wide spectrum of reasonable medical opinion and practice. And anyone who has ever sat as a judge or disability-qualified member in the Social Entitlement Chamber will probably be able to provide examples of medical members who hold widely differing views about the issues that commonly arise in appeals. Moreover, it is not unknown for professional people to believe that their own views and practices are more universally held and followed than is in fact the case.
41 Furthermore, particularly in relation to prescribing, treatment is an art as well as a science. Or, at least, it is a matter of professional judgment that can be heavily influenced by the individual doctor’s own experience.
42 To take the current case as an example, the Tribunal’s medical member may well be correct to believe that, across the population as a whole, talking therapies are effective to improve the type of anxiety and loss of confidence that are described in paragraph 34 of the statement. But the professional experience of the claimant’s GP may be atypical. It may be that, for whatever reason, the results achieved by his patients from talking therapies in the past were disappointing and that he is therefore less inclined to refer his patients to such therapies than would otherwise be the case.
Alternatively, he may be aware of circumstances that are not known to the Tribunal, but which suggest to him that the claimant would not benefit from such therapies.
43 Finally, although I do not suggest that it is so in this case, some claimants will simply have a GP who is not very good at his or her job.
44 Assuming a normal distribution of medical excellence, a large proportion of the population will have a GP who is below average. That is not a reflection on the medical profession. It is also true by definition of most, if not all, fields of human activity. Not everyone can be above average.
45 There is therefore a real risk that drawing inferences about function from treatment will in some cases lead the Tribunal to conclude that claimants do not suffer from the loss of function they describe because they are not being correctly treated for it.
I think the “1st line” argument is pretty meaningless when viewed in the light of the general observation in the British National Formulary on the efficacy of anti depressants
“There is little to choose between the different classes of antidepressant drugs in terms of efficacy, so choice should be based on the individual patient’s requirements, including the presence of concomitant disease, existing therapy, suicide risk, and previous response to antidepressant therapy.”
Some of your counter arguments may well depend on the circumstances of your client, and I recently had a case that is a good example. The DM had argued (on the recommendation of the HCP) that my client was fit for work and that ESA Reg 35 would not apply because my client “is not on medication” and is “under the care of his GP”.
I countered with:
“I will discuss the Respondent’s position regarding Regulation 35 further, but I will at this point address the HCP’s contention (p53 of the bundle) that there is no risk at least in part because my client “is not on medication” and is “under the care of his GP”

The guidelines for assessors are also clear on the issue of claimants being denied because they are not taking medication.

https://www.gov.uk/government/publications/personal-independence-payment-assessment-guide-for-assessment-providers/pip-assessment-guide-part-1-the-assessment-process held that - :
‘1.6.36 when considering mental health medication HPs should remember that not all claimants with a mental health condition will be on medication or receiving therapy. Severity of a mental health condition does not necessarily correspond with the type or dosage of medication that the claimant is receiving. There are a number of reasons why a claimant may be unable or choose not to take mental health medication, for example, but not limited to:
• poor compliance due to the nature of mental health condition
• side effects or difficulty tolerating medication
• lack of efficacy
• preference for psychological therapy instead of medication
• complicating factors, for example excessive alcohol consumption
Therefore absence of medication does not automatically mean that the health condition is not severe. However, HPs should consider the type and context of certain medications, for example use of depot antipsychotic injections in psychotic disorders.
HPs should also take into account that some medications are used to treat different conditions, for example some antidepressants are also licenced to treat anxiety. HPs must also consider the use of other treatments such as psychological therapies’.

Re the specialist input, it is indeed the basis on which assessors deny claims, but that is likely to be overturned at tribunal as it isn’t supported by legal precedent.

That goes for a lot of the reasons given in the assessors’ reports.

I know people who go out to work everyday and can still claim PIP. Don't make yourself be a prisoner who can't leave the house. Try to go a little way everyday even if only down the road and back. I'm not sure why you think your dogs will die though.🤷

I am agoraphobic and get PIP. I can do the occasional short dog walk and pick the kids up from school every so often by myself. Anything slightly further or longer and I need someone with me. The key to the getting out question is whether or not you can go out as often as you need, for as long as you need and if this gives you overwhelming psychological distress. For example, my daughter needed taking to school and picking up from school a total of 10 times a week. I could manage this at most 2 days, so 4 trips. This would cause all the horrible anxiety symptoms. The other 6 times I would be completely unable to do this. Therefore, I couldn't do this as often as I needed, it would cause huge distress and I would either literally run to the school/home or I would freeze and be unable to move further up the road.
If you explain it using these examples, you start to realise that doing things to try and help yourself is not something to worry about when it comes to your entitlement.
I do get how you feel though. On very, very few occasions I have actually been able to enjoy a 20min walk with the dog, and at these times I think 'what if someone saw me and didn't understand what I'm like the other 99.99% of the time?'
Sorry, I've rambled. Please do keep trying to get out, I wish you so much luck with this.

Because I have OCD and intrusive thoughts that if I'm solely responsible for them when out if the house I won't be able to protect them and they will die.

I know it's not logical but that's kinda how being mentally ill works 🤷‍♀️

Try going out without your dogs.

Then I just think I'm going to get run over or stabbed or somehow end up missing and mu kids will never see me again.

Or someone will think I'm a shoplifter and call the police on me. Or there will be a terror attack. Or a major natural disaster and I won't be able to get home.

It's exhausting.