An opinion of an ex Assessor

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Bit of background; I was a PIP Disability Assessor for a while this year, until I decided that I couldn't work within the system with a good conscience, and left. I witnessed DA's who were trying their best, mostly, to help people with their claims. They (and I) were hamstrung both by our immediate employers, and a system (whether by accident or design) that discriminated against claimants with certain conditions. In the spirit of the release of 'I, Daniel Blake', which isn't about PIP but other failures of the benefit system, I've decided to give some general advice to those looking to claim PIP.

Firstly, let's look at initially making the claim. I would say the most vital point is this; PROVIDE EVIDENCE. The way that the claim form/questionnaire is worded implies that the DWP/ATOS/CAPITA or whoever will chase letters from GPS, specialists etc to back up your claim for you. In my experience, this doesn't happen. The onus is on you to provide this information, although it would be very easy to assume the opposite. Some photocopies of a recent prescription, letters detailing diagnoses and appointment dates, and evidence of secondary care involvement (especially people with mental health conditions) provide good evidence; if you haven't provided anything, then the DA has to go mostly on that short assessment with you. You may be horribly unwell or disabled for 5 days a week, if you're having a 'good day' on the assessment however, then your claim is in trouble. Evidence, Evidence, Evidence; I can't stress that enough. Don't let the DWP have the easy option; the decision they make is heavily dependent on the report written by the health professional that assesses you. The decision maker at the DWP has no medical qualifications of any sort.

If you have disabilities that cause you to have problems getting out (especially severe MH conditions), ask for a home assessment. The way the system is, if you have a MH condition involving severe anxiety or depression, or agoraphobia; then you attend a clinic appointment, it can be used as evidence that you aren't as bad as you claim that you are. The reasoning is that you can't be that ill if you can get to a clinic appointment. It's profoundly unfair, and a large part of why I left. Once again; evidence is so important.

Don't assume that the health professional that sees you knows much about your condition. In a working and well-designed system, those with certain conditions would be given appointments with HP's with a specialism in that area. It ain't so. You could get a general or MH nurse, an Occupational Therapist, a Physio or a Paramedic. It's completely random. If you can bring along a health professional of your own, then do. I'd advise anyone against attending by themselves. That's not because I don't trust the DA's; the vast majority are good people. It's just easy to forget things, and people with severe MH problems or learning disabilities/Autism really need an advocate of some sort.

If you're asked to do a set of 12 exercises (it's called the Musculoskeletal exam, or MSK), be sensible! I had people trying to please me by trying to do these despite evident pain; tell the DA why it would be difficult for you to do it. If you cannot do it, just do what you can and explain why. Completing those ridiculous exercises at personal cost, especially pain, will count against you. Don't make stuff up to help your claim (they'll see straight through it, and assume that you're dishonest), but don't put yourself at risk of harm by doing something that you can't. The DA has to take your safety into consideration when assessing what you can and can't do. Once again, evidence is key. If you need aids or adaptations to walk, or need to wear wrist supports etc, then bring/wear them. Help the DA to help you. They normally will.

Talking of assessments, if you report any MH conditions at all, then the DA will be observing you throughout the assessment for a Mental State Examination (MSE). In my opinion, this is even more badly designed that the MSK. A HP, who may or may not have any MH experience at all, will continually assess your mood, behaviour, anxiety etc throughout the assessment. It's completely subjective. If you have a serious MH condition, if you are in pain, if you are distressed or anxious then let it show to the DA. The stiff upper lip is the worst possible approach.

We were told that those 45 minutes were key. If a consultant wrote that you couldn't do something, then you did it in that 45 minute assessment (good day or not) then the weight of evidence would be on the assessment.

My opinion, for what it's worth, is that PIP discriminates against those with learning disabilities or MH conditions. Seriously. It's appalling. If you are turned down, then PLEASE appeal. You'd be surprised how many obtain PIP through appeal; it's often through providing further evidence. Don't give the DWP the chance to deny your rightful claim in the first place; provide that evidence when you first fill in the forms.

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  • Posted

    Whilst I agree with the vast majority of this post, I will point out that the PIP regulations do clearly say that you are only required to send in evidence that you have and should not start hunting for it which may well incur a fee.

    The original author seems to suggest that the onus of supplying evidence is down to the claimant.

    However if you want an acceptable decision first time round AND probably not have a face to face assessment it does seem wise to do what the author says even though the regulations say otherwise. The DWP have their own version of what the rules surrounding PIP should say.

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  • Posted

    Hi les,

    Makes for interesting reading.

    My own experience of having evidence is very poor.

    Yesterday , I replied to another blog on this site con earning evidence.

    I have had about 6 mris, 2 ct scans ,X rays and electric nervous system test. I don't hold records for any of the results, just a couple of letters voicing opinions of the tests etc.

    Do I ask my GP, or each separate hospital involved, 6 and counting.

    Mike.

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    • Posted

      Hi I would say that the written reports you have regarding these tests are exactly what you need to send in with your claim, every consultant I have seen in the past 10 years has cc me in when informing my Dr of the outcome of tests and consultations.

      The main reason being is that I suffer with health anxiety and need to know exactly what's going on to he'll me cope.

      I think its a normal occurrence now for every one to get these copies, also it cost 5p per photo copy to send them off, I did not have to chase any one for my paperwork, also I have just sat and read my pip form through and I found it quite clear that you are needed to send in what ever evidence you have, I do not think that the DWP have the time or inclination to source our medical records.

      I'm not even sure they would have the right to access them?

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    • Posted

      This is something that has always foxed me too. What I used to do was get copies of my GP medical records – updated every two years (when the DLA/ESA/IIDB) re-assessments came round. I generally found something of use that I could send in. But, this incurred a fee of upwards of £70 a time.

      I have to admit that the evidence I sent in never seemed to suit the DWP as after the regular face to face assessments (I always had these) the DWP sought to prefer what the assessor had said instead of what my evidence suggested.

      As an example my consultant at the Spinal Unit after having been tested me with MRI, CT and a treadmill wrote a report to the GP that it was most unlikely that I could walk beyond 50 metres (this was about 7 years ago). I sent this in to the DWP for the DLA re-assessment. The assessor gave his opinion that I walked long distances twice a day when I took my dog out for a walk. The DWP took that to be more reliable evidence even though I had never owned or walked a dog.

      That was just one example of what the many assessors wrote over the years. Each time the result was the same – the refusal by the DWP to re-award my HRM & MRC – it went down to nil.

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    • Posted

      When you sign your application form for PIP you are giving the DWP permission to access your medical records from any contacts you name on the form.  In practice they very rarely do.  This was supposed to be an objective and fair assessment, applied even handedly so that everyone had the same experience.  In practice it is subjective, unfair, screens out high levels of genuine need and in a lot of cases the outcome becomes a case of your word against that of the assessor.    Les's post giving the assessors' point of view confirms a lot of what I already privately thought or had first hand experience of.  There is very little medical evidence acceptable to the DWP outside of the assessment report.  This is because in the vast majority of cases your or consultant won't be able to provide medical evidence specific to the activities being assessed - simply because they don't have any opportunity to observe you in those situations.  Therefore the DWP can comfortably dismiss most 'supporting' evidence as irrelevant because it doesn't speak directly to what's being assessed.

       I am helping a lady at the moment who suffers from Spina Bifida. She is profoundly physically disabled and we did everything asked of us by the DWP - most of which appears in the post from the ex assessor.  The application form contained relevant and specific detail as to how her condition affected the activities assessed.  Medical evidence from her GP and other professionals, including secondary care agencies was sent with the claim.  She had a home assessment with a seemingly empathetic assessor (a nurse)  who agreed one thing at the face to face and then went away and wrote something completely different on the report. Result - significant reduction in support, regardless of need.  The reconsideration request was specific to the points in dispute and medical evidence was obtained which clearly and specifically supported what she was saying.  The reconsideration was refused and the DWP decision maker stuck to the report provided by the assessor - in effect dismissing the opinion of a doctor who has known and treated this lady for fifteen years,  in favour of that of a nurse who saw her for 45 minutes.  How is this a fair and objective assessment ?  It reinforces what I have said all along.  It is NOT about support, it is about saving money and disabled people are getting a raw deal at the sharp end of a system which is not fit for purpose.  I don't see any evidence to support the assertion made by the ex assessor that the people involved will help you if you are honest.  This lady WAS honest and had the evidence to prove it, and she was still refused, and will now have the trauma of going to a tribunal to try to get a fair decision.

      Disabled people have been abandoned by an uncaring government to a system where they are assessed by ill equipped and inappropriately qualified medics, and then their benefit awards are decided by office workers with no medical training, who have never clapped eyes on them and who, in the main, are too scared to do their job properly and consider ALL evidence provided.  Instead they just rubber stamp whatever the assessor says - and as far as I am concerned the reconsideration process is just a stumbling block thrown in the way of claimants in the hope that it will discourage them from going to tribunal.  I don't know of one single case where a decision has been overturned at reconsideration - the DWP in the main try to force claimants to go to tribunal because they know a lot won't and for every one who doesn't, there is a benefit saving.   The disabled have no effective voice with which to change the system and the general public don't want to know because they've been brainwashed into believing 'all cripples are scroungers'!!  It's only when Mr Joe Public walks under a bus and becomes disabled himself that he finds out what it's all about - but it's too late because the rug of support has already been pulled from under us, and with our complete agreement !!  The measure of any decent society is how it cares for it's most vulnerable, including the sick, the disabled and the elderly.  Well Britain is failing miserably in every category.  It makes me ashamed to be British.  Sorry. Rant over.

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    • Posted

      ….and people lambast me for not taking the DWP to a Tribunal and/or not keep on putting repeat claims until an award is made!

      As you know I have lost all faith in the system and those that operate it. There is only so much that one can cope with.

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    • Posted

      Les.  I contacted this lady on Mumsnet as they have a private messaging system.  I asked her about my friend whose assessor was in complete agreement with her, about her inability to complete one activity during the assessment, and then went away and wrote do,thing completely different which drastically reduced the point score and left her one point short of the enhanced care rate.  I was astonished at her reply. Basically, the main reason for her resignation was that before any of the assessors reports are submitted to the DWP an 'audit team' scrutinises them and where they feel the assessor has been too generous the report is handed back for the assessor to rewrite and lower the points.  She says this happens on a regular basis, but I note that she doesn't say which provider she worked for. Her advice is that my friend's orginal report was probably subject to this process and this is the reason there was no mention of the original conversation and there appears to have been sudden change of mind.  She confirmed that the 'audit teams have no part in the actual assessments and have never seen the claimants for whom they require the points score to be 'revised' and therefore have no knowledge of their actual ability. She didn't clarify whether these auditors have any medical expertise or whether the DWP are aware that this goes on, as this happens before the reports are submitted to the DWP.  If the DWP ARE aware of it, it goes some way towards explaining why they are so reluctant to change any of their decisions at the reconsideration request stage.

      If this is true, then it's easy to identify a pattern here.  The assessor sees the claimant and writes the report.  The audit team gets the score lowered, the report goes to DWP and the assessment provider has fulfilled their responsibility.  The DWP render a decision based on the report giving a lower rate of benefit.  The claimant asks for a reconsideration and is refused - benefit is saved and the DWP have fulfilled their responsibility.  It is left to an independent tribunal to render a fair decision, as they answer to no one.  The tribunal are picking up the slack from everyone else, as the DWP and assessment providers seemingly couldn't care less if the decision is fair or not. Pretty soon even the tribunals won't get to render a fair decision because the DWP are currently training up 86 presenting officers to try to stop the tribunals overturning as many decisions.  The tax payer and the disabled people caught up in this farce are the losers - and no one seems to have a voice with which to complain. 'Great' Britain.  More tea vicar ?

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    • Posted

      Thanks Pam

      ?A very enlightning review.

      ?Yes I was aware of this secondary 'audit team'. From what I was told a while ago it was set up on instructions from the DWP in order to make sure that what the assessor had written was robust and evidence backed. It is staffed by the assessing company but there is a direct link from the DWP decision maker to them.This was supposed to be for the DM to ask questions of them to ensure the accuracy of the report.

      ?I am amazed that their brief is to try and reduce the points wherever possible - but this does not surprise me. Originally this 'audit' team was staffed by the DWP and ATOS for ESA claims that were at the Tribunal stage. Many ESA claims were awarded just days before the hearing when this team got involved in reviewing the cases. It was originally created to try to solve the ESA appeal backlogs that the Tribunals were suffering.

      ?It now seems to have gone full circle and brought PIP into the mix.

      ?In a way there is nothing wrong with having an 'audit' team which should be there to ensure that the quality of the assessors' reports are the best that they can be before the DWP get them. To find that they are now manipulating them is going in the wrong direction.

      ?Maybe the answer is to simply ignore what a DM decides beit at the initial stage or the MR stage - everyone who thinks that their award/decision is wrong MUST appeal to the Tribunal. To not do so is playing into the hands of the government. That was my experience - every decison was wrong and every one was eventually changed just days before the hearing (DLA, ESA & IIDB).

      ?And yes I am aware of these new prosecuting officers. Have you seen the job description? There is very little difference bewteen them and the American version - Assistant DA's.

      Coming up against them for some is going to be trouble. And many PIP claimants will now decide not to appeal in the light of these 'heavyweights'.

      ?And finally did you read that the DWP are pushing hard for their appeal cases to be the first to go digital? They are pushing that the oral hearings are done away with (as early as next year). In future all appeals will be dealt with by a single judge on written submissions and written evidence only. There may be some cases, just a few that SKYPE could also be used or the Judge may telephone the claimant.

      ?If you read the job description for these 'prosecutors' emphasis is placed on writing submissions.

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  • Posted

    thanks for that information hun Ive got copd and sent in ct scan results showing I've got collapsed right lung and in report it states I've got severe copd and severe back pain low moods aniexty depression I did refuse some of exercises as I couldn't of done them due.to slip disc on my spinal cord which is written in evidence my daughter does most of my cares and answered most of the questions and stated to him because I was such a independent woman I can't face the fact that I can't do the tings I use to do but the only thing I think she's done wrong and I think it was just slip of the tongue he asked how long could I stand for she said 10 min but I can't without being in agony but my mobility is my back but more my breathing by walking not standing pain and breathing is mainly when I'm mobil but is that enough for them to knock me back he did seem really nice and listen to my daughter how my illnesses effect my day to day ablitly he shook my hand when he left and Said I hope everything turns out ok is that a God sign or bad sign also I rang the other day they said my claim was with case manager what's the difference with case manager and decsion maker got me worried now thanks for your information hun good to let others know xx

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    • Posted

      I used to feel like that – not being able to do what you used to do. Eventually you find ways around your difficulties so that any disruption is mitigated.

      I thought that only the claimant can answer the questions hence why I never saw the point of taking my wife in with me – she always stayed in the waiting room ready to take me home afterwards.

      As for having an assessor that was friendly, understanding or even courteous – I never had one of that ilk in all of my 18 face to face assessments. As far as I am concerned I treat them as ‘them and us’. They are not my friend nor are they there to help or sympathise, they are simply there to try their best to find ways to discredit both what I say and what I have put on the claim form. Their dismissive attitude is matched by mine. I have spent more years than I can remember dealing with these types and have years of experience in dealing with part time/unqualified investigators.

      I believe that as long as you tell it as it is – the bad and the good, explaining what difficulties you had and how you have managed to overcome most if not all of them. Some people concentrate on only the ‘can’t do this, can’t do that’ without explaining how you can find ways around most things.

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    • Posted

      Yeah I was quite surprised myself that he let my daughter doing the talking as my son has adhd aspergus and severe depression and when he had his assessment few yrs back he has trouble making eye contact and talking to strangers but would she listen to me no should wouldn't she wanted to hear it from luke which clamped up she was actually very rude I was very surprised when they continue his pip my partner helps my daughter but his a plasterer and I hate having to rely on him he works hard all day and I hate the fact that some days I'm just into much pain and can't help it's horrible when you go to a independent person to have ppl having to help me thasks for replying will let you know my outcome it's such a horrible waiting game x

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  • Posted

    Very helpful post Les.  See my earlier reply (or rant, whichever way you want to look at it) to AlexandriaGizmo below. 
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  • Posted

    Hi les,

    Yes you have eventually been ground down. I hope your assessors are proud of themselves.

    Do you qualify for anything???

    Regards,

    Mike

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    • Posted

      Mike - I can tell you he didn't and doesn't, having applied for attendance allowance recently and turned down yet again.  It doesn't make any sense, and completely disproves what the ex assessor says about assessors wanting to help if they can.  This hasn't been my experience - quite the opposite in fact - see my last post regarding a friend with Spina Bifida.

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  • Posted

    Hi les,

    Are our records that are held by the dwp available to be released under freedom of information act.

    After all they are of national importance, as they help keep the nation's budget balanced,I don't think

    . It would be interesting to see all the documentation that they keep on us and may explain the ludicrous decisions made.

    Mike.

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    • Posted

      The DWP are very skilled in side stepping any requests under the freedom of information rules. The most common reason is that they are currently compiling statistics of their own on that particular subject and don't want to compromise their position.  Releasing private individuals records into the public domain would also, I think, contravene the data protection act as it would be classed as sensitive information. 

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    • Posted

      I doubt that anybody at the DWP will care.

      They just see the fact that the savings achieved by me losing the opportunity to transfer to PIP and refusing the Attendance Allowance claim is all that they are concerned about. The savings they have made out of me on an annual basis is over £13,400. Over the next ten years that would amount to £134,000!

      I would also mention that because of being in hospital in 2004 for an extended period and then years of trying to cope with life I missed the opportunity to appeal against a decision to refuse me IIDB on renewal. By the time I got round to being able to deal with my own affairs in 2011, I proved that the 2004 was wrong. The DWP whilst acknowledging the wrong decision and revising it they refused to make any payment for those 7 years simply because I did not make a valid appeal in the time given (being in hospital and lacking the ability to deal with anything in the years following didn’t count for anything) That’s another £20,000+ that I added to the Treasury coffers.

      I still qualify to make another Attendance Allowance claim next September. Qualifying to make the claim is one thing, qualifying for an award is a totally different matter. I just couldn’t cope with the form filling, chasing up-to-date evidence and worst of all having another face to face assessment and a letter of rejection thrown at me.

      I for one would not be happy if any of my records held by any government department became public.

      Whilst life is now a lot more settled without the constant re-assessing of DLA/PIP, the financial Impact is giving grave concern to us.

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