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TOPIC: PIP rejected because of home medical assessment

PIP rejected because of home medical assessment 5 days 21 hours ago #241331

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
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PIP rejected because of home medical assessment 5 days 20 hours ago #241340

Hi Elizabeth

I'm sorry that you are struggling with your MR submission.

I may be wrong, and obviously I am only commenting on the snippet you have written here, but I read through what you said several times and I became confused over the pattern of your weekly cycle, and the first thing I would do is to go back to what you originally said in your report and then what you said at the assessment and what the assessor has written.

You say that for the majority of the time you are in bed, but you also describe having bad days, average days and a single good day. Now you may well stay in bed on your average days, but if you had 3 bad days, 3 average days and 1 good day - an assessor may assume you are not severely fatigued for the majority of the time. I know you said it could be four days. (I am playing devil's advocate here - not questioning the truth of what you said). What you need to do is look back at what you said, and counter what she has said. Yes you can disagree with their opinion, by citing what you previously wrote and what you said.

As regards the walking. You say that you go out once a week (when you are well enough). I don't know whether you said you always use your wheelchair when you go out. But if you are out for several hours and you walk even with a stick, perhaps from the car to a shop and back again, the assessor is likely to assume (perhaps unfairly) that you can walk a distance of 50m. You can only say that the assessor's assumptions are wrong and what you do in reality.

It is always challenging when you have a condition that is variable and then people assume you can do more than you can. I would also include medical information from a reputable site like NHS choices that muscle wasting is not one of the recognised symptoms of ME (but muscle fatigue is).

Regarding the use of any aids such as for cooking. If you don't use them, you need to make sure you have explained why they would not help you. (Grip, balance, safety issues... etc)

Hope this helps a little

BIS

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Nothing on this board constitutes legal advice - always consult a professional about specific problems

PIP rejected because of home medical assessment 5 days 19 hours ago #241350

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

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PIP rejected because of home medical assessment 5 days 18 hours ago #241352

E

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Based on what the assessor has written I agree that they have assumed that your "good" days mean that you are fully functional. This is always a difficult area for claimants to explain, we often use terminology that makes sense to us; "good, bad, average" but has a totally different meaning to those assessing us.

I would start by using different terminology, for example; "at my worst, on average, at best" and then for each of these explain how long you are affected in this way, don't use percentages rather days, weeks. etc., the legal test is the majority of days. then how you are affected. It may be that even at your best you cannot complete an activity.

Remember, you must be able to complete the activities "reliably".

Don't assume that those looking at your claim will make the connections that you would expect, if you cannot do something explain why in detail and if the same problem affects your ability to complete multiple activities then explain it for each.

If you can't do an activity explain why, so why are you unable to cook? Break it down into the components, so preparing the ingredients versus cooking them, selecting the ingredients versus cutting and chopping. You need to explain why suitable aids will not help you complete the activity and why assistance or supervision also will not help.

Gordon

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PIP rejected because of home medical assessment 5 days 15 hours ago #241356

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!! :blush:

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

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PIP rejected because of home medical assessment 5 days 9 hours ago #241359

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.
The following user(s) said Thank You: ET

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