PIP rejected because of home medical assessment

Hi All,

I've been a member for a number of years, and the guides have been invaluable in helping me tackle the benefit forms. This is the first time I've felt completely lost and I'm really hoping that someone out there can help me with some advice for my MR for my PIP decision, I'm really not sure if i am doing it correctly or not?!!

Last week I received the decision and was shocked that i didn't score enough points to get the benefit at all.

I've already rung the DWP, asked for the MR and the copy of my medical assessment report (which i received on the weekend).

It is full of inaccuracies and assumptions made by the HP. So i am really struggling to write the MR letter without challenging her opinions as they were so incorrect.

Here is what I've picked up as the main problems:

* Throughout the report in each of the descriptors she has concluded that because my examinations were normal and my limbs showed no signs of wasting that therefore either an aid is appropriate or i can manage unaided.

* She has also throughout each descriptor decided there was a inconsistency with my reported pattern. When she asked I told her i was having an ‘average day’ on the day of the assessment and this did not fit into what she was assuming was my ‘general pattern’, given what I had described to her as an ‘example weekly cycle’ when asked in the assessment about good and bad days, and variability.
I described my 'usual weekly cycle' as being a usual outing of just a few hours on a Saturday followed by a week of rest because of the exertion of this. This usually being 3-4 'bad days', followed by a couple of 'average days' then one 'good day'.
But I also said that this varied a lot dependent on if I have anything different occurring that week i.e appointments, etc. But she has not noted this or taken account of it.
I didn't say it was every Saturday, but she has assumed because the assessment was on a Tuesday, going by this pattern i should have been having a 'bad day' not a 'average one'.
I'm housebound, and spend the majority of my time in bed asleep or resting. Leaving the house only on average once a week with the help of my husband, and only on a good day.

* She has also decided i could walk more than 50m but no more than 200m given her clinical findings at the assessment. Yet the entire assessment was conducted with me led in bed, i only got out to sit on the edge of the bed (with the help of my husband and adjustable bed) for the examination. She never saw me stand or walk at all. She never asked me to either. I am unable to walk more than 10m (with a stick or help of another person) before needing my wheelchair.

* She has made note that through out the assessment i was alert and had good concentration and could use my mobile phone. But she hasn't noted that my husband did most of the talking, because my memory and concentration is very bad and i used extensive lists for things such as medications, aids etc.

* I'm reliant on my husband for all my meals, and rely on snacks and drinks left by him in the day while hes at work. I am unable to shower alone, i cannot get in or out of the bath with out the use of aids and assistance due to bad balance, co ordination and dizziness due to hot environment. But for both of these activities the HP has decided i can manage these with just aids.

I have started a letter explaining these main inconsistencies with her report. But I am finding it really hard to know if I am doing the right thing by arguing these points, given what is recommended in your guides about challenging their opinions. But i don't know what else to do!

As well as the fact that I have no supporting evidence that can back me up. I have had severe ME for approx 20 yrs, and POTS/Vasovagal syncope which causes dizziness, (as well as a number of other conditions, which are less relevant). But because I am unable to see my GP regularly, and because there is no specialist doctors involved in my care anymore, I simply don't have any recent medical evidence.

I would be very grateful for any advice anyone has.

Am I correct in challenging the report in this way? And if not, how can I challenge it?

Sorry for such a lengthy message, i just am really unsure as what to do for the best.

Izzy
x

Hi Bis,

Thank you for your quick reply. Sorry if some of it was a little confusing!

I have to admit how she came to that conclusion confused me as well! I have checked and doubled checked what I said and what she has put in the report.

She wanted to know about variability and good/bad days. She lists in the functional history section most of what I said to her. This is what she put:

' She has good and bad days. Today is an average day, she has had a migraine the last few days and this is resolving now. On a bad day she is not able to speak or have any light in the room. She is only able to cope with communicating with her husband, she does not do anything on a bad day but sleep. She has about a couple of average days a week and a better day that she is able to go out for a few hours on the Saturday. The general pattern is that she goes out on the Saturday then Sunday is a bad day which she has pain and fatigue which will last until Tuesday or Wednesday when she starts to pick up for the Saturday. She usually spends all of her time in bed, she eats and watches tv whilst in bed.'

When she was justifying her descriptor choices, she has said

' Variability reports 3-4 bad days, 2 averages days and 1 better day when she is able to leave the home however SOH shows she went shopping on Saturday and therefore inconsistent with reports that today is a average day'

However, in my history there is no mention of a shopping trip that Saturday, the only thing she has recorded is that I occasionally accompany my husband food shopping on a Saturday if I am well enough to.

Looking at all these things I came to the conclusion that she had made the mistake of assuming that I had done my 'normal weekly cycle' and been out on the Saturday before my assessment and so on the day of my assessment (Tuesday), I should therefore been having a 'bad day'.

Would this be the conclusion you would come to?

Really, I have varying degrees of bad days, (I.e bad, worst and just about tolerable!!), am I'm thinking maybe I didn’t use the right wording possibly? I’m always severely fatigued and in varying degrees of pain.

As regards to the walking, yes, I always use my wheelchair when out of the house. She has noted this in the functional history part of the report. I told her the furthest I can manage is from our house to our parking space which is approx 10m, or a few steps around a charity shop if I'm feeling ok (but this is rare). Whilst using my walking stick and holding onto my husband, pausing and stopping on the way. This takes me a couple of minutes to do. I then have to rest for a while before I would be able to do it again.

I am finding explaining some of the sections very difficult because I simply am unable to do them, such as the cooking.

How do I explain it's not a choice? but that I simply don’t have the energy to do these tasks unaided or at all. And does that even count?

Thanks again
Izzy

Hi Gordon,

Thank you for the reply. I worked out how to change the name. I thought i had done that first, but apparently not!!

Thank you for the advice, I will try and explain the days using different terminology in the letter. Your right it is really hard to explain to them, especially when i don't have any 'good days' in their definition of it!

Basically the general problem is that even at my best I cannot complete most of the activities reliably or at all. I thought that I had got a handle on the whole process and explained it as well as I possibly could in my form, but now i'm completely doubting myself.

I completely understand about breaking it down into components etc, and explaining the problems etc. And that's what I tried to do all through my form, using the guides.
But to give you a example of the reason why i'm struggling to do that in the MR (for example for the cooking element).
The fact is I cannot physically sit or stand for more than a few minutes without feeling dizziness, pain, or fatigue and having to go and lie down again. So i'm unable to cook a meal from start to finish even with help, or the use of aids.

But I just don't know how to say that any other way or to break it down into components. Other than I simply physically am unable to do it...and that just doesn't seem to be enough detail for them!

Any advice on how I can word this would be great, as this is the situation with a lot of my activities.
As i'm extremely stressed at the short amount of time I have to do this and send it in right before Xmas.

Thanks again
izzy

ET, in regards to your lack of recent medical evidence, are you able to talk to your GP over the phone? I often communicate with my GP over the phone or using their online services. All communications are digitally recorded and at least are proof of medical involvement.