RE: PIP assessment for fluctuating conditions

Hi Kuju2

No I would not talk about " better days ". You are advised to avoid value judgements and generalisations as PIP Assessors are skilled in manipulating these to apply to something that was not intended.
You need to focus on PIP " points ". You will see from our guides that these are awarded not because of the severity of a health condition but due to the restrictions that your health condition imposes on your daily life.
So I advise that you every day upto 4 September keep a diary of all the pain, anxiety, tiredness, restrictions caused by your condition and also the help needed from other people.
The Assessor may ask about family holidays and looking after pets with the intention of making a generalisation that they can falsely apply to daily life.
I would advise having a good read of the BenefitsandWork PIP Fibromyalgia Case Studies that I quote below:-
Case studies
Ferzana
Ferzana was diagnosed with fibromyalgia a year ago, after experiencing muscle stiffness, widespread
pain and brain fog for several years. She lives with her husband and teenage daughters. The Social
Prescriber at Ferzana’s GP practice has been very helpful to her in understanding her diagnosis and
suggested that Ferzana might qualify for PIP.
Due to pain and stiffness in her hands, arms and legs, Ferzana has been finding it difficult to cook the
meals that she used to. She bought a perching stool to use in the kitchen and she uses a gadget to
help her open bottles and jars. Ferzana scores 2 points for needing an aid to prepare or cook a
simple meal (descriptor 1b).
Ferzana’s brain fog means that she constantly worries about making sure she has taken her
medication properly. Her husband helps her by organising her medication into a dosette box each
Sunday and she has a reminder app on her phone that beeps when she needs to take it. Ferzana
scores 1 point for needing an aid to be able to manage her medication (descriptor 3b).
Ferzana finds taking a shower very tiring so she uses a garden chair in the shower cubicle so that she
can sit down to wash herself. The PIP assessor accepts that her use of a garden chair shows Ferzana
reasonably requires an aid to be able to wash or bathe, so she scores 2 points (descriptor 4b).
The stiffness in her muscles and her general pain levels mean that on 5 days a week Ferzana finds it
hard to get on and off the toilet. She feels embarrassed about this and wants to avoid anyone
helping her, so she holds on to the towel rail for support. Ferzana scores 2 points for needing an aid
to be able to manage her toilet needs (descriptor 5b).
By the time she has had her shower, Ferzana feels exhausted, and she finds the effort of bending to
dress her lower body causes dizzy spells. She will sit in a chair and her eldest daughter helps her to
put on her trousers, socks and shoes. Ferzana scores 2 points for needing assistance to be able to
dress or undress her lower body (descriptor 6d).
Ferzana enjoys going out and can usually plan and follow a journey, but her muscle stiffness, pain
and fatigue mean the distance she can walk is now much shorter than previously. She doesn’t
currently use any walking aids, but she has to stop and rest after walking around 40 metres. She
would be able to repeat this distance later in the day but if she tried to walk further or push herself
too hard, she would be too exhausted to continue. Ferzana can stand and then move unaided more
than 20 metres but no more than 50 metres, so she scores 8 points (descriptor 12c).
Ferzana scores a total of 9 points for the daily living activities and 8 points for the mobility activities.
This means she is awarded the standard rate of both the daily living and mobility components of PIP.

Laura
Laura has been struggling with Fibromyalgia for some years. She takes oral medication, performs
light base exercises and attends a CBT course due to her heightened anxiety levels. She suffers
intense pain in her joints especially her shoulders, back and legs. Laura is exhausted by most
activities of daily living, resulting in her needing to sleep after any exertion. She experiences daily
headaches that result in blurred vision. Laura lives alone but her friend spends most of the day with
her to provide help and support. Laura experiences fibro fog, which in turn makes her anxiety worse.
Claiming PIP for Fibromyalgia Supplementary Guide
9
Laura used to enjoy cooking and likes to choose what she will eat. If she sits down, she can try to
start preparing ingredients but on 5/7 days per week, this triggers such pain in her joints that her
friend has to take over. Laura scores 4 points for needing assistance to prepare a simple meal
(descriptor 1e).
Laura finds the process of having a shower exhausting. Due to leg pain, she is unable to get into the
bath, even with grab rails to help her. Laura’s friend physically supports her and helps her to lift her
legs over the side of the bath. Laura can wash herself slowly once she is in the bath. She scores 3
points for needing assistance to get in and out of the bath (descriptor 4e).
Although able to choose her clothes, Laura finds the process of dressing so exhausting that it takes
her more than twice as long as it used to. In particular, the act of trying to raise her arms to get them
into her clothing leaves Laura needing to lie down for at least an hour. Her friend will help her if
available, but if she is alone, it takes her around 10 minutes to put on a t-shirt and cardigan. Laura
scores 4 points for needing assistance to be able to dress her upper body.
Headaches are a daily problem for Laura, causing her to experience blurred vision. She finds a
magnifier helps her with reading when this happens. Laura scores 2 points for needing to use an aid
to be able to read or understand basic information (descriptor 8b).
Since developing fibromyalgia, Laura feels very anxious in social situations and will avoid dealing with
people unless she absolutely has to. Laura attends CBT sessions and these focus on supporting her
to engage more effectively with other people. When she does go out, she needs her friend to be
with her to help her to remain calm and support her in speaking to people. Laura scores 4 points for
needing social support to engage with other people (descriptor 9c).
Lauras’s fibro fog impacts on her concentration and memory. She relies on handwritten notes from
her friend as reminders for tasks that are not part of her usual daily routine. She cannot focus for
long enough to deal with her post and needs her friend to help her to deal with bills that arrive.
Laura scores 2 points for needing assistance to make complex budgeting decisions (descriptor 10b).
Laura only leaves the house to attend medical appointments. Her friend plans their route as Laura
become easily confused. Laura knows the way to familiar places like her GP or the local pharmacy
but when faced with somewhere she hasn’t been many times before, Laura will panic. She is
sensitive to noise and becomes easily disorientated. She is unable to retain directions and could not
ask for help without support from her friend. Laura scores 10 points for being unable to follow the
route of an unfamiliar journey (descriptor 11d).
Laura becomes exhausted when walking. She has been prescribed a stick by her GP for support and
this enables her to walk from her front door to her friend’s car on the street outside. For distances
longer than this, her friend helps to push Laura in a wheelchair. Laura score 12 points for being able
to stand and then move more than 1 metres but less than 20 metres (descriptor 12e).
Laura scores 19 points for the daily living activities and 22 points for the mobility activities. Laura
would be awarded the enhanced rate of both the daily living and mobility components of PIP.

Let me know how you get on.
David