PIP - Taking Nutrition

Hi craig3474

I absolutely would say that you cannot take on food safely, reliably or to an acceptable standard because of your condition. Does anyone have to help you aspirate? If they do - you should score more. 2c is 2 points, and if you need help at all, then 2d or 2e - whichever is more relevant. Taking liquid food where you still choke is not to an acceptable standard - and it is not like you chose this option! Argue hard.

BIS

Hi Craig3474,
To expand on what BIS has said, perhaps I can shed some light on the law. 2 cases that I think are especially relevant are
PA v SSWP (PIP) [2019] 270 (AAC)

CW v SSWP (PIP) [2022] UKUT 281 (AAC) also has reference UA-2021-000241-PIP
CW confirms that the elements of the definition are separate- hence points can be given for eg just a failure to chew and swallow food properly, or for just needing help to chop up food etc.

The earlier case of PA discusses whether taking liquid food amounts to an inability to take nutrition to an acceptable standard. The claimant in that case also required prompting as it was painful for her to eat. There had been some weight loss as well, but this had not been explained in the reasons given by the First Tier tribunal.

The Upper Tribunal Judge in PA basically said that the FtT somewhat ignored some rather obvious issues and their explanation of facts and law were inadequate as a result.
I don't think that the Judge confirmed that a solely or majority liquid diet based on relevant health problems automatically gives rise to points under Descriptor 2, (ie you only have liquid food therefore you can not take nutrition) my understanding is that you need to consider the reasoning behind the use of liquid food.
Firstly, at the very least liquid food is either special food from the chemist, or needs to be blended. If blended then an aid or appliance is required. This is 2 points.
PA had significant pain. Doing ANY PIP activity with a significant amount of pain will mean that an 'acceptable standard' can never be reached.
An acceptable stanndard is one of the 4 criteria of Reg 4(2A). All 4 criteria must be met
Thie other three criteria are
safety
Reasonable time
Repetition as reasonably required across the whole day.

Risk of choking would indicate help (supervision?)is required due to safety issues.
If pain or risk of choking causes slow eating ie taking twice that of normal eater then this also indicates help is required.
What is the normal amount of times most people would either eat and/or drink across the day, and potentially at night certainly in respect of eg a glass of water if you wake up? This could be eg 3 meals per day and 5 drinks but if you have extra needs and get thirsty quite often, your personal repetition may need to be more than a standard number. If you fail to eat/drink on every single potential repetition which would also include an adequate amount . (This is my opinion, because I don't belive you can show a proper repetition to an acceptable standard if your food intake each time is only a very small mouthful or a thimble of water. ) Thus if you fail to 'repeat' this is likely to indicate a need for help, likely to be prompting.

Any failure if just one of the criteria shows that some sort of physical intervention from a human or gadget will be required. However Descriptor 2f requires 'cannot convey food or drink to mouth'. This seems to involve an inability to lift food/drink to mouth, eg caused by an arm problem, or perhaps a mechanical eating problem where you can't actually open your mouth yourself. I guess it could also comprise mental health issues where you don't wish to eat.
With a risk of choking this would indicate a need for supervision- also 2 points -2b. Help to cut uo food is also 2b. Whilst not specifically stated blending is in my view exceedingly finely chopped food and hence assistance to blend food I would argue equates to 'assistance to chop food' If you need prompting, perhaps because you fail to eat because it is too painful, then it's 4pts 2d.
2c refers to therapeutic food source, this eg a pik line - feeding via a tube to stomach or intravenously. Likewise 2e refers to help with this sort of feeding device.
Whilst caselaw suggests you would be unlikely to get points for both Descriptor 2 &3 for exactly the same reasons. If eg after eating there needs to be some sort of aspiration, or eg physical therapy from another to ensure no choking hazard remains, it might be possible to argue points under Descriptor 3 for the relevant amount of timed therapy, as well as eg supervision to eat or prompting? If choking is a constant risk and physical therapy us required or could be required throughout day to avoid or alleviate choking or other health issues, then this could also fall under Descriptor 3 therapy.
At the risk of a terrible pun...I hope this gives food for thought, and helps shed a light on the Taking Nutrition Descriptor.
Let us know if you need more info.
LL26