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Pip assessment scored low points
- S123
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1 week 18 hours ago #304441 by S123
Pip assessment scored low points was created by S123
Hello, just wanted some advice. My daughter who has stage 4 endometriosis which is severe ( her insides are joint together). She had her assessment and the assessor was a physiotherapist. She gave the points on mobility that my daughter cannot stand and move without stopping and is in pain.
But on the daily points of washing cooking and putting on clothes, it was stressed that due to the severity of her condition when she lifts her arm it pulls and stretches her stomach and that goes onto her stomach hip and leg pain intensifying suddenly so she stays in her nighties, needs help to change her soiled clothes as endo makes her bleed severely, cannot have a shower to clean herself without help as she also faints and vomits, getting in out of the shower along with washing herself is impossible with the pain and without help. Then making food she cannot stand up straight has to clutch her stomach. Cooking chopping or carrying plates for food is impossible. My question is; if they acknowledged her mobility but why not her physical health of washing cooking and bathing which she cannot do? Would it be possible to try to get the higher points as they hv awarded her only for 2 yrs when she told them it’s few surgeries to have in the next few yrs. any advice pls. It seems they are deliberately not giving the points
But on the daily points of washing cooking and putting on clothes, it was stressed that due to the severity of her condition when she lifts her arm it pulls and stretches her stomach and that goes onto her stomach hip and leg pain intensifying suddenly so she stays in her nighties, needs help to change her soiled clothes as endo makes her bleed severely, cannot have a shower to clean herself without help as she also faints and vomits, getting in out of the shower along with washing herself is impossible with the pain and without help. Then making food she cannot stand up straight has to clutch her stomach. Cooking chopping or carrying plates for food is impossible. My question is; if they acknowledged her mobility but why not her physical health of washing cooking and bathing which she cannot do? Would it be possible to try to get the higher points as they hv awarded her only for 2 yrs when she told them it’s few surgeries to have in the next few yrs. any advice pls. It seems they are deliberately not giving the points
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4 days 22 hours ago #304499 by BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by BIS on topic Pip assessment scored low points
Hi S123
I'm sorry to hear of the position your daughter finds herself in. I can't tell you whether or not your daughter should put in for a Mandatory Reconsideration. Her chances of getting the decision overturned are not good - only 27% of MRs are successful - but that doesn't mean she shouldn't try, and those that win absolutely think it's worth it. Many who don't win believe they are still right and fight through the appeal process. Appeals are more successful, and about 67% are won by the claimants. I only give you this information to say that it is challenging to do it - not that your daughter shouldn't. She has to do what is right for her - I just want her to be aware you have a fight on your hands.
Did you get a copy of the assessment report? It's called a PA4. If your daughter doesn't have a copy, then she would be wise to ring and ask for it. This should give you a better idea of why they came to the decision they did.
Did you ask for a recording of the assessment or did you keep a recording yourselves? It can be helpful if you did.
You ask why she didn't score for the daily living part of PIP - I can't tell you why she didn't, though I could make a guess - but you can find out from the PA4.
Please don't be offended by what I say next, and I could be completely wrong. She was assessed by a physiotherapist who may have very little knowledge of Stage 4 endometriosis and just how debilitating it can be. I think there's a good chance the phsyio accepted difficulty in walking the majority of the time, but did not accept that she couldn't lift her arms to get dressed, or sit at a chair and chop vegetables or carry a plate. I can see that they might assume that your daughter is 'choosing not to' rather than 'she can't'. Please don't think that's my view - I'm guessing at what the assessor might have thought. As I said, I could be wrong, but whatever the reasoning behind the decision, the assessor is expressing an 'opinion' and you need to find a way of showing them that they are incorrect.
Did you use our guides to complete her form? Have a look at the Guide to PIP claims and reviews, and ensure that you have had a look at page 17 and what it says about 'reliability.' I think the assessor may well not have thought this through and it's an area that you can push. As your daughter vomits and faints, I would argue that she cannot fulfil the reliability criteria.
Look at the Guide to PIP Appeals - on how to put in for an MR. Once you have a copy of the PA4. There is also the guide on how to challenge a medical report - which you might find useful.
I think the attitude to her condition is reflected in the short award length and the fact that your daughter said she was to be operated on and they therefore want to review to see if her condition improves. A two year award means that she could receive the review form in a years time! If you put in for an MR you can ask for a longer award length.
Your daughter only has one month from the date on the decision letter to put in for an MR. If could take 7 - 19 days for the PA4 to arrive. If she can't get it quickly - send off the MR, but say that you will be sending further information once you have got the PA4.
Come back and ask if you have any further questions.
BIS
I'm sorry to hear of the position your daughter finds herself in. I can't tell you whether or not your daughter should put in for a Mandatory Reconsideration. Her chances of getting the decision overturned are not good - only 27% of MRs are successful - but that doesn't mean she shouldn't try, and those that win absolutely think it's worth it. Many who don't win believe they are still right and fight through the appeal process. Appeals are more successful, and about 67% are won by the claimants. I only give you this information to say that it is challenging to do it - not that your daughter shouldn't. She has to do what is right for her - I just want her to be aware you have a fight on your hands.
Did you get a copy of the assessment report? It's called a PA4. If your daughter doesn't have a copy, then she would be wise to ring and ask for it. This should give you a better idea of why they came to the decision they did.
Did you ask for a recording of the assessment or did you keep a recording yourselves? It can be helpful if you did.
You ask why she didn't score for the daily living part of PIP - I can't tell you why she didn't, though I could make a guess - but you can find out from the PA4.
Please don't be offended by what I say next, and I could be completely wrong. She was assessed by a physiotherapist who may have very little knowledge of Stage 4 endometriosis and just how debilitating it can be. I think there's a good chance the phsyio accepted difficulty in walking the majority of the time, but did not accept that she couldn't lift her arms to get dressed, or sit at a chair and chop vegetables or carry a plate. I can see that they might assume that your daughter is 'choosing not to' rather than 'she can't'. Please don't think that's my view - I'm guessing at what the assessor might have thought. As I said, I could be wrong, but whatever the reasoning behind the decision, the assessor is expressing an 'opinion' and you need to find a way of showing them that they are incorrect.
Did you use our guides to complete her form? Have a look at the Guide to PIP claims and reviews, and ensure that you have had a look at page 17 and what it says about 'reliability.' I think the assessor may well not have thought this through and it's an area that you can push. As your daughter vomits and faints, I would argue that she cannot fulfil the reliability criteria.
Look at the Guide to PIP Appeals - on how to put in for an MR. Once you have a copy of the PA4. There is also the guide on how to challenge a medical report - which you might find useful.
I think the attitude to her condition is reflected in the short award length and the fact that your daughter said she was to be operated on and they therefore want to review to see if her condition improves. A two year award means that she could receive the review form in a years time! If you put in for an MR you can ask for a longer award length.
Your daughter only has one month from the date on the decision letter to put in for an MR. If could take 7 - 19 days for the PA4 to arrive. If she can't get it quickly - send off the MR, but say that you will be sending further information once you have got the PA4.
Come back and ask if you have any further questions.
BIS
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4 days 16 hours ago #304532 by S123
Replied by S123 on topic Pip assessment scored low points
Thank you for your prompt answer. Yes she’s got the PA4 form but not the letter of the award yet. Basically the physio said that she can use a aid to cook and Wash herself, even after saying that standing for her is hunched and clutching her stomache as her insides pull, that to safely cut and make food plus carry it safely is not possible due to her back legs and hips in constant pain. As to her washing herself on the bath /shower, when she lifts her arms the part of her stomach which is stuck inside starts the pain suddenly and then it’s a downward spiral that she needs assistance otherwise she will not have a shower or get dressed due to the severity of pain she faints. The physio ticked aids on all of hers. I did say to my daughter as soon as you get your award letter challenge it tjerwose next he you’ll be doing the same again. Using her phone was repeated shin and her driving license which she passed at the age of 18 when she was healthy and she told them she doesn’t drive. They even asked her has she got debts. She’s just scared that if she challenges it she might loose what she will get
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4 days 13 hours ago #304536 by S123
Replied by S123 on topic Pip assessment scored low points
Sorry Bis, I think I didn’t clearly make the point. The actual letter of award hasn’t arrived this was the Pa4 that I read and came to this. Now I don’t know if the final outcome would be the same or if they’ll change it. I was trying to prepare my daughter that once she gets the letter and according to the pa4 should we do a mr of it’s the same. Don’t know if the actual award might be different.
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3 days 23 hours ago - 3 days 23 hours ago #304557 by BIS
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Replied by BIS on topic Pip assessment scored low points
Hi S123
The decision maker is a non-medical person - so yes, nine and a half times out of 10 they follow what the assessor has said. If your daughter is happy with the mobility award - say so in the Mandataory Reconsideration and make it clear that you are only challenging the daily living award. Yes, there is a risk in challenging, but I've only ever known two people to have their awards downgraded at MR level. Most people find their award stays the same. Obviously, your daughter has to do what is right for her.
Frankly, when you said your daughter had a physiotherapist assess her, I think she was at a disadvantage - because she is likely to say your daughter can use aids, but she may well not understand the debilitating effect of her pain.
I'm afraid they are allowed to ask about debts because there is a question about a claimant's ability to manage money.
I would suggest you need to address the food issue. There is nothing that says a person has to prepare food standing up - so you won't win that argument as she's making it at the moment. Better to concentrate on the impact of pain from a sitting position - dizzy, shakiness, which means holding a sharp instrument has safety issues. Being constantly tired, means that she could not do an action repeatedly.
BIS
The decision maker is a non-medical person - so yes, nine and a half times out of 10 they follow what the assessor has said. If your daughter is happy with the mobility award - say so in the Mandataory Reconsideration and make it clear that you are only challenging the daily living award. Yes, there is a risk in challenging, but I've only ever known two people to have their awards downgraded at MR level. Most people find their award stays the same. Obviously, your daughter has to do what is right for her.
Frankly, when you said your daughter had a physiotherapist assess her, I think she was at a disadvantage - because she is likely to say your daughter can use aids, but she may well not understand the debilitating effect of her pain.
I'm afraid they are allowed to ask about debts because there is a question about a claimant's ability to manage money.
I would suggest you need to address the food issue. There is nothing that says a person has to prepare food standing up - so you won't win that argument as she's making it at the moment. Better to concentrate on the impact of pain from a sitting position - dizzy, shakiness, which means holding a sharp instrument has safety issues. Being constantly tired, means that she could not do an action repeatedly.
BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 3 days 23 hours ago by BIS.
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