When you should not need a face to face assessment for PIP

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I was looking at the assessors handbook this afternoon and came across this:

Cases that should not require a face-to-face consultation

2.5.10. In certain circumstances it should be possible to provide advice at a paper based review. Although each case should be determined individually, the following types of cases should not normally require a face-to-face consultation:

• The health condition(s) is severe and associated with a high level of functional impairment which is consistently claimed. Examples might include:

Claimants with severe neurological conditions such as – dementia.

 Not now claiming PIP so I have no idea if this actually happens, but for DLA  would the same have applied?

The reason I ask and laugh at the instructions is that I had to have a full face to face assessment for DLA in 2012/13 and one of my confirmed diagnosis is Dementia. I went to the CMHTOP for a memory test, then to have a CT brain scan at the request of my GP - it came back as vascular dementia. 

Seems that the assessors over stepped their mark with me!

Anybody else had this happen to them? What should happen rarely actually happens?

 

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  • Posted

    I too read somewhere that people with certain conditions should not be asked to attend assessments some, in my case should have come under "refer to seek Drs advice" or something on those lines but that was a guideline for DLA, perhaps it no longer applies to PIP?

    Who Knows?

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    • Posted

      Hi & thanks

      Yes, that extract came out of the PIP handbook so was wondering if it applied for DLA as well.

      You are right there. There was a list for DLA which was also a joke. Under the that list amongst many other things that I qualified under - I should not have been called for assessment if I was prescribed Morphine. Seems the DWP ignore anything that doesn't fit in with what they want to do.

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  • Posted

    there is always exception to the rule. its the advanced stages of dementa they are refairing to. theres different stages to dementia and like other illnesses, theres also illnesse that can only be assessed by a dr. also regardless of ones condition, if your medical reports from the medical staff who are involved in your care back up what you are saying, then you shouldn't need to go for a face to face assessment, like everything else there is exception to the rule. (this is my experience of esa for which i am in the support group) i did have to go for an face to face with DLA, and i can only emagine i'll have to go for a face to face for PIP.  
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    • Posted

      Hi David

       My interpretation is very much along the same lines as yourself. The handbook is guide and there are no absolute rules which stop a face to face assessments

      When this Government started welfare reform in 2010 the biggest compliant was benefit recipients could be handed up to £10000pa tax free without any real checks as most DLA/ESA claims relied on self-assessment.

       They (the Government) saw it as reasonable to make periodical checks on claimants and this continues to be popular amongst the electoral population. Problems DO exist with ATOS interpretation of conditions and of course those who are undiagnosed fall into a nightmare no man’s land.

       Whilst we (the sick/disabled) have rights to extra help we must also accept we have a wider responsibility to the tax payer to undergo these periodical checks. Provided checks and balances remain in place that is reasonable.

       My personal belief is the checks are already starting to prove to be expensive and time consuming and more paper based decisions will be made. This is my own personal opinion but I believe after 2/3 face to face assessments most claimants will be dealt with via paper decisions alone in the future.

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    • Posted

      In my case the only paper based decision that I have ever had was when they down graded my DLA from High Mobility/Middle Care to Low Mobility only in 2004.I have had a total of seven face to face assessments for the Industrial Injuries Benefit (1996, 1998, 2000, 2002, 2004, 2011 and 2013), five for DLA (1995, 1998, 2000, 2002 and 2012) and two for ESA (2010 and 2012).

      Given that history, that is the reason that I decided against moving over to PIP - just couldn't face the same for the years that I have left. 

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  • Posted

    I had what I thought was good information from my GP and Consultants and I included it as evidence when I applied for PIP. My condition is rare and comes under several strains of rheumatological disorders. The problem with PIP is not with the condition you suffer but how the condition affects you personally and how you manage your daily tasks.

    The rule book is vague and really out of touch with a disabled person's needs, you need to fit into the boxes and if not, you get a lesser award or none at all

    I didn't have to go for an assessment for ESA if I remember but I have a feeling that I may be asked to do so in the near future. I have amongst other things a peg tube which under present rules of ESA exempts me for now - But for how long?

    I don't think there will be many people who will escape going to a face to face. I struggled to get there, struggled at the consultation and boy I struggled when I got home. I shan't be doing that again. Any further assessments will have to be done at home or else I will lose what I have for sure

     

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    • Posted

      Hi Sweety

       

      Firstly, I admire your grit and determination and obviously I don't know your full history.

      However, I have to make some comments on your replies.

      The whole idea of DLA/PIP when it was first introduced was to help with the extra cost of disability due to the extent of how your condition affected you. Many individuals make the classic mistake of believing that a diagnosis is an automatic pass to the benefit.

      The system used is not perfect but there are many claimants who receive DLA/PIP who have no qualms with it because it works for them. I don’t mean the so called ‘cheats’ I refer to those who have adapted homes or equipment due to their disability and therefore score well using the system.

      I think your problem (based on the little I know) is your condition rather than the system. Rheumatologically cover a huge area and affects a large part of the population. The condition itself can range from a small irritant to complete disablement.

      Recently I heard of someone who had been diagnosed with arthritis in her hands and wanted to claim PIP. Fair enough but she worked as a full time cleaner so it is hard to see how she would ever score enough points for personal care.

      I know that having arthritis and claiming PIP is very difficult because so many people have the condition and get by perfectly well, although there are obviously severe cases which rightly receive the extra help.

      When you send reports from consultants/GP’s all they do is confirm your condition, they don’t confirm how the condition affects you. Accessing an Occupational Therapist is real challenge these days so actually having a face to face is a good opportunity to show the Health Care professional how your condition affects you.

      Providing the assessment is done fairly and your evidence is consistent then there should be nothing to worry about. I do sympathise with those who are boarder line but unfortunately the line has to be drawn somewhere. Personally if I were you I would concentrate a little less on the fairness of the system (it’s not going to change!) and instead concentrate on the strength of your argument and link them to the descriptors.

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    • Posted

      Thanks, I tested myself for PIP and came out with 4 points for Care!!!

      If I can't convince myself that I tick enough boxes and gain enough points I couldn't see the DWP doing any better.

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    • Posted

      That is on the assumption that the assessor is honest and relates the report to what they are told and not to their view on how they think you are. They don't live with you yet many reports read that the claimant is a compulsive liar and is attempting to claim benefits by way of deception.
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    • Posted

      Les

      Law of averages states there will be bad assessors at some point and that is why checks and balances are so vital.

      However, there are hundreds of thousands of claimants who receive PIP without any problems whatsoever using the points scoring system. Of course that system doesn't help some people like yourself and if it were changed then it would affect others in a similar way.

      Disability charities had a huge input to the PIP process and the devising of the point scoring process. It appears they looking towards the most vulnerable hence the heavy reliance on aids/equipment/help/prompting.

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    • Posted

      Les if you can only score 4 points on care then obviously you don't qualify for the benefit.

      That could be because your too honest or hard on yourself or alternatively that is the situation which could only be helped by exaggeration.

      Either way you seemed to have made your mind up to let your claim lapse when transferred to PIP.

      BTW what was your condition again?

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    • Posted

      You have to be hard on yourself - the same way that ATOS and the DWP are. There is no point in deceiving yourself.

      From the top:

      Early stagesVascular Dementia

      Frontal Lobe damage

      Chronic Pancreatiis

      Spinal injuries to the neck (too much rugby when young) and lower back (seriously injured after a horse riding accident)

      Type 1 Diabetes (uncontrolled) - (regular hypos)

      High Colesterol

      Periperal Arterial Disease to both legs

      All of those affect me

      On top of that there is a whole host of other side effects 

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    • Posted

      oops forgot - PTSD for which I receive Industrial Injuries Benefit.
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    • Posted

      There is little doubt that the system needed reforming and to be honest I don't know how they would have done that without employing outside help!

      The disability charities did have an input into the new rules, you are correct but the 20 metre rule has been challenged, in court and failed, twice I think? Anyhow the inclusion of "Safely Reliably and in a Timely Manner was eventually included after pressure from disability organisations. It's this phrase that is vague and can be widely interpretated - you may be able to walk or move 20 metres but it depends in what manner you do it

      I don't rely on my condition's name to qualify me for PIP - I don't have Athiritis either, except for the odd few squeaks and grinds of a middle aged woman. I've always been awkward so I have a complex connective tissue condition that affects me in numerous ways that do qualify me for PIP and fit the decriptors - not made to fit I might add. The fact it comes under a Rheumatological condition is that it affects Muscoskeletal and vascular movement - I need not go on as I am in fear of listing everything internally and out

      I went to tribunal and was awarded enhanced rate mobility in less than 15 mins. They didn't get it right at assessment and that's what's wrong the the system. If I was a one off I'd agree that the system is fine but I'm not

      My doctors were great in sending good information about my mobility - not the condition and how I came to use a peg tube for nutrition. I can't thank them enough for their support

      I'd much rather be at work and not have this illness. I was a tax payer, a hefty one at that and my family are also in very demanding jobs, also paying tax , I so wish I could join them and I wish there was a cure? Then again on the news last night there was encouraging revelations about stem cell research for MS - maybe that ill work for me in the future. I certainly hope so

      All the best

       

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    • Posted

      Les

      You have my sympathy with Chronic Pancreatitis and Type 1 Diabetes as I'm a fellow suffer.

      If you are experiencing hypos, then there is a definite care need as a medical condition needs to be monitored and/or assistance. You have vascular dementia and what amounts to brain damage (Frontal Lobe damage stroke?) and this could in theory be contributing towards your poor control of diabetes (forgetting to eat/check blood sugar levels)

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    • Posted

      Many thanks

      To be honest, our home is very much akin to the 'blind leading the blind'.

      I manage as best I can with the control of the Diabetes as my wife has her own difficulties. She does not have the ability or capability to monitor or assist me. The levels range from 2.4 in a morning to a max in the evening of about 26. In between those times I feel that I am chasing the levels but never getting it right - hence the regular hypos in the morning and at some point during the day.I don't see it that I can't cope moreso I could do better.

      The dementia obviously gives me problems with short term memory difficulties. I get over this by making notes throughout the day on my IPad which I carry round with me.I do have difficulties recognising shapes etc and have very little ability left when trying to concentrate.

      Brain damage was caused by trauma having had some idiot crack the back of my head with a baseball bat when I was trying to disarm his mate who was pointing a 9mm pistol at me (armed robbery). i discharged myself from A&E before they could get me into a head scan (I wanted to go home).

      The main problem which was eventually diagnosed years later as brain damage is the complete change of personality and temperment. I cope and with an understanding wife, I get through each day with little problem.

      Using those and the problems with Mobility and spinal injuries, and being pessimistic when testing myself for PIP (which is what ATOS/DWP would do) I cannot find anymore than 4 points for care. My main problem there is that I do not and have any form of relationship with my GP (as I only attend when I am forced to) Also I am a regular at walking away from hospitals and not attending consultant appointments when I should. Hence there is little proof/evidence of what I have said.

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    • Posted

      Thanks again Les for more insight.

      Gosh your life is a difficult one I can see your problem. The blood sugar readings are frightening TBH but on the plus side they do provide evidence in the form of your blood sugar monitor readings!

      From what I understand (and many misunderstand) is DLA/PIP there only needs to be a 'need' for the care, it does-not necessarily means the care has 'been provided'

      In your case there is a need (dangerously fluctuating blood sugar). The fact that you can't get help from your wife is irrelevant.

      Also using an iPad to prompt yourself during the day would certainly fall into the use of an aid under mental health.

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