mandatory reconsideration-mental health disregard

Hello
I am struggling with my writing - it looks to me that maybe I am writing too much... I am really tired doing it. A friend of mine helping. Could you please look at my writing for preparing food. I appreciate your comments. I would also like to ask whether I should use abbreviations as HP & DM (Health Practitioner/Assessor & Decision Maker)? AND - HP copied and pasted exactly the same statements that he 'considering no diagnosed cognitive impairment low medication for mental health and moderate medication fro arthritis. Should I also copy and paste my explanation /disagreement to such statements? because it is the same as his statements are. Thank you in advance for your reading and comments. Alex

1. PREPARING FOOD
I was awarded 2 points for the Preparing food activity, descriptor 1b (2 points): ‘needs to use an aid or appliance to be able to either prepare or cook a simple meal’. I believe that the correct descriptor is 1e (4 points).
HP’s opinion, page 13: ’no consultant input for physical problem…she has diagnosed physical problems, she is on moderate pain medications, she has input from physiotherapist…MSO shows reduced movements in spine, both hips, knees and ankles WITH SIGNIFICANTLY REDUCED MUSCLE STRENGTH, THEREFORE WITH NORMAL GRIP STRENGTH in both hands, she needs sitting aids to manage task reliably and safely’. I wonder if HP had a chance to look through my PIP2 claimant file. I have been seeing Consultants Rheumatologists, Orthopaedics, Endocrinologists and other specialists; my disability was confirmed by different tests and scans and investigations. (Please see Medical Evidence enclosed with PIP2: 31 specialist’s reports, scans etc listed there).
I have no a single day without pain, which can vary in intensity, but never goes away, despite taking ten dosages of strong painkillers. During the assessment my carer has mentioned that on the day I had double the amount of my painkillers to be able to come and to manage at the interview. My pain medication is not moderate. I take Naproxen 500mg twice a day and Co-Codamol 8 tablets a day, 10 daily. For the interview I had to take double dose to be able to come and cope there well enough. I would not be able to manage without such dose. Consultant Endocrinologist warned me that this drug could make me feel drowsy, dizzy, depressed. I have these side effects and listed them in my PIP2 (p.10).

My finger joints, wrists are affected by osteoarthritis, aching most of the time. Additionally, Carpal Tunnel Syndrome (nerves compression) causes me pain, muscle wasting, numbness, pins and needles and reduced function in my thumbs, fingers (both hands) and wrists. Carpal Tunnel Syndrome also affects my right shoulder. I am in need to use wrist splints most of the days and nights provided by physiotherapists to ease a bit pain and discomfort. I often cannot grip well enough and drop items. Nerve conduction test has been done for both hands and wrists in 2017 (please medical evidence enclosed). Now, two years later this problem is getting worse and an operation is required. I have no strong grip but joints ache, pins and needles and muscle fatigue in my hands.. When I am holding a cup or cutlery for a while or a crutch, I need to release it and rest as soon as numbness/pain occurred.
Normal kitchen activities became unsafe for me: using a knife put me at risk of harm, as well as lifting and moving pans, dropping or spilling hot liquids - causing injury to myself in the past. My cousin cooks meals for me. I can help her a bit using an auto chopper for vegetables. Because of my ongoing depression I have low motivation to prepare food or to eat. On the rare occasion that I have attempted to cut a carrot with a knife, I injured my hand. During the assessment my cousin, who accompanied me wished to show to HP how badly I cut my hand and a visible mark was there but HP was not interested and had NOT MENTIONED THAT INCIDENT IN THE REPORT.
HP’s opinion, page 13: ‘considering no diagnosed cognitive impairment, low medication for mental health…eye contact…did not appear anxious… MSE shows look tired. I think that the assessor was inconsistent with his descriptions and conclusions. My cousin remembers that I have not looked at HP, no ‘eye contact’, not all his questions I could answer; that I could speak only in a slow manner and in quiet tone of voice, HP had to repeat his questions – all these things MISSING IN THE HP REPORT.
At the interview I was sitting in the armchair and looking down at my PIP2 copy placed on my lap by my cousin. In fact I COULD NOT HAVE AN EYE CONTACT: I looked at the PIP2 pages. I have not looked at the assessor; it would increase my anxiety. I cannot look in person’s eyes, face. I felt very stressed and anxious during the entire interview. I was trying to hide anxiety using deep slow breathing. I felt tired to concentrate enough and my memory was weak.
HP and consequently DM reports state that I am on ‘low dose of medication for mental health and no specialist input ’. This is not quite correct. At present I am taking daily 20mg of Escitalopram. In the past I have been on 5mg. My GP explained that 20mg is the maximum recommended dose for me considering the combination of other seven prescribed medications, my age (67) and that I have a history of the liver abnormal tests.
When I asked about increasing my dosage GP warn me of the risk that the drug may initiate intense suicidal thoughts and actions. Please see my PIP2 and Medical Evidence. Mental health practitioner also could be contacted (PIP2, p.8)
I use a perching stool to rely on handles and a backrest provides support to my fractured osteoporotic spine. When I am sitting and eating I use an easy grip cutlery with thick handles. I drink from cups with large two handles easy to grip and control a cup. I am very slow and often feel fatigued. I have given up preparing/cooking activities as the task is unsafe and overwhelming for me, my cousin cooks for me and I can help her with auto chopper. I cannot not prepare a meal safely; to an acceptable standard; within a reasonable timescale, and I would not be able to repeat the activity due to fatigue and my joints pain. I have lack of motivation and concentration – please see GP’s letter enclosed.

My cousin clearly stated to the health professional that I fail to eat at all if she does not prompt me and remind me to eat. HP HAS NOT RECORDED it in the report. my cousin’s letter enclosed. HP noted that ‘MSE shows look tired’ (p.13). In fact I was so exhausted during the interview that when it was over I had fainted in the car park. When I came around my cousin and the passer-by helped me to get into the car. Please see my cousin’s letter enclosed.

Thank you, Gordon - it is great support when somebody can give such helpful comments - I can't thank you enough...
In my PIP claim I put that I can't cook at all. This is true as my cousin cook for me for the last two years. If she is not around, usually I do not eat - too tired, no motivation, etc.
Reading your reply I SUDDENLY realised that I need now to highlight my MENTAL issues more rather than physical - mental ones HP ignored in order to give me standard not enhanced rate (as I had with DLA).
I remember that I shouldn't critisise HP or DM for my own sake . but how to lightly indicate that HP was not in a position to comment on my diagnosis or dose of medication. I have no specialist-psychiatrist input. My antidepressants, sleeping pills prescribed by GP. I take them for 19 yrs. I made a draft based on the B&W Guide's . Could you please indicate your opinion. I am not using any more 'incompetent', 'non-professional' etc regarding HP-physiotherapist. But somehow I would like to indicate that he was not in a position to put in doubt medical doctors opinion and there was a court case on similar problem. I highly appreciate your comments.

GENERAL POINTS ABOUT THE EVIDENCE/report
I suffer from depression with anxiety and panic attacks since about 2000. It affects my mind and my body. I have 8 medications on my regular prescriptions, which are 17 tablets and capsules daily. These prescriptions were re-adjusted by doctors over the years to help my health problems. All medications have their side effects including increase my level of depression, anxiety, dizziness etc. Please see p.10, PIP2.
I disagree with the decision because my mental health problems were completely disregarded by HP and DM. Throughout the Report the assessor copied and pasted exactly the same statements on my mental health: 'considering no diagnosed cognitive impairment, low medication for mental health etc.'. Also his observations were not accurate but supporting his assumptions on my mental health. Copied and pasted same paragraphs on pages 13,14,15,16,18,19, 20, 21 and 24 significantly reduced the scores on all these activities. HP was a physiotherapist, who called into question medical doctor’s opinion on my mental health diagnosis and dosage of antidepressants, painkillers, sleeping tablets. PH ignored all the signs of my mental health during his half an hour of interview. I was extremely fatigued and only once HP mentioned that I was tired. I have a weak memory and my helper was keeping at the interview my PIP2 copy as a prompt for me for answering HP’s questions. I was struggling with anxiety during my assessment taking deep slow breathing – he preferred not noticing it. I cannot have an eye contact with him or other people - it is part of my mental problem – HP reported I had.
I would like to ask for looking again at mental issues statements in the Report when making the final decision. I hope my explanations and medical evidence enclosed with PIP2 and with this letter, would be sufficient to consider enhanced premiums for daily living and mobility.
I belief that doctor’s evidence of many years on my mental treatments and my disagreements in some sections of the Report should be taken into account.
HP was not a qualified medical doctor or a mental health practitioner. I wonder if his interpretation of doctor’s diagnosis and prescriptions on my mental health can be relied on.
A friend of mine spoke on my behalf with Citizen Advice and was told that there was a precedent setting court case (CE/3883/2012), where the Judge stated: ‘where...the disability analyst is a physiotherapist and the problems s/he is dealing with are mental health problems the opinion of the physiotherapist as to the conclusions to be drawn have no probative value whatsoever. This is because the physiotherapist has no professional expertise in mental health matters’.