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TOPIC: PIP Form Question 2 - Communiating

PIP Form Question 2 - Communiating 1 year 1 month ago #200248

Even after reading the guide, I'm uncertain exactly about what is expected from this question. I'm completing the PIP form for my daughter, who has great difficulty communicating both verbally and in writing due to severe depression and anxiety, as well as difficulty concentrating and understanding. I'm not sure if this question covers anything other than physical difficulties and it doesn't seem to include difficulties with written communication?

what I have written so far is as follows, is this OK?

I can speak clearly, but I get confused and anxious due to my severe depression and anxiety, and I have difficulty concentrating, following a thread or argument, remembering or understand a complex sentence or series of ideas, statements or instructions.

As a result, on almost all occasions when I need to speak to someone except about something simple or to do something simple like make a small purchase, I need someone to speak for me and then to interpret what the reply is so I can understand. They have to break it down so I can follow, and carefully prompt me with one idea at a time so I can understand and decide how to respond. This takes a long time; sometimes I need my helper to talk to me for a few minutes before I can respond.

Due to severe depression and anxiety I can only reliably express a basic idea not anything more complex. Even when it is a good day and time (about twice a week in the afternoon or early evening) and I know and feel comfortable with the person (for example my doctor) I cannot always reliably express any complex ideas or thoughts and due to my anxiety and distress I often don’t attempt to do so, or just say what I think they want me to say.

Due to severe depression and anxiety, and episodes of dissociation, as well as difficulty concentrating and difficulty understanding, remembering or following a sentence which includes a series of ideas or statements, I can only understand a simple sentence or basic idea. With anything more complex I get lost and don’t understand what is being said. This is true even on a good day and at a good time. If I’m at my best, and feel relatively comfortable and relaxed I can understand a sentence including a series of two or three ideas (at most), but this is quite rare, perhaps on average once a week for an hour or two.

I also need supervision at all times even for safe activities due to my suicide attempts and self-harming.

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PIP Form Question 2 - Communiating 1 year 1 month ago #200268


I assume you mean question 9 and not 2 :)

Question 9 is about the claimants ability to speak intelligibly and to hear, issues with communicating in writing would come under question 10 Reading.

Although you have explained your daughter's problems I don't feel that you have explained in adequate detail why she has these, it may be that you have done so elsewhere on the form, but you really need to repeat it in each section if necessary.

You mention depression and anxiety, but given the fact that the DM is not medically trained are these sufficient to cover the level of disability you describe?

It might help if you explain in more detail how your daughter understands or indeed doesn't, verbal communication. So if someone speaks to her, what does she hear? Is it all the words but she can't interpret them? Does she hear the first word and then spends so much time trying to understand that so that she effectively does not hear the following words?

I have to warn you that given the level of difficulty you have written about the DM may be expecting some level of cognitive impairment.


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PIP Form Question 2 - Communiating 1 year 1 month ago #200278

The problem is that I'm describing how her condition affects her, but I'm also not medically qualified so I don't know why. My feeling is that my daughter's diagnosis doesn't include all that is wrong with her. It may also be that her medication is dulling her cognitive processes as she does seem to have got worse since on the medication, but to say so I'd be making a medical assessment that I'm not qualified to make.

Her diagnosis is emotionally unstable personality disorder (BPD), "possible autism", severe depression and anxiety, for which she is on 3 sets of (I believe) quite strong medication. She obsesses about what people say and think about her and has had what seems to be some psychotic episodes. She frequently thinks about and plans suicide and has tried to commit suicide on 4 occasions getting more frequent recently. She dissociates and is unable to concentrate and feels tired and lethargic all the time. All this will be related I think to depression and anxiety (heightened by severe BPD) and probably her medication. The doctor says he has never dealt with such a difficult and severe case (and he trained in mental health). Her counsellor says she probably has a "thought disorder". Due to BPD she frequently drinks large quantities of alcohol to try to deal with the pain.

So, in my assessment, she can't think clearly or concentrate enough to communicate well because her severe depression and anxiety and emotional pain dulls her cognitive processes it causes her to be tired and lethargic, and along with BPD stops her sleeping (she is often awake all night) which exacerbates this. Similarly her alcohol consumption seems to make her more depressed and dulls her cognitive processes. Her possible autism presumably has an impact on this too. Because of severe social anxiety (and mild agoraphobia) since communicating is a social activity, she panics and mildly dissociates - which again impacts her cognitive processes. She suffers from memory loss and difficulty thinking clearly, for whatever reason.

This is all, however a guess about how her condition causes cognitive impairment. The fact is I know it does, from what she says and from what I observe, but I don't really know why.

I thought I had already explained how she fails to understand verbal communication. She understands words and simple sentences. What she struggle with is a series of ideas, instructions or concepts (ie complex sentence(s). She hears the idea or instruction, but can't remember or process what follows, stringing or relating the ideas to each other to understand the whole sense of what has been said. So if we say a simple idea to her, she understands. If we then say something else, she might understand it, but then when communicating a 3rd idea to her, she seems to get "lost" in all the details. Whilst she could understand the 3rd idea on it own, she doesn't follow the overall argument or how the 3 ideas relate to each other. So, even though we try to use simple words and phrases and to speak slowly to allow her to take it all in, repeating what we have said, she almost always says "I don't understand what your're talking about" by the time we get to the 3rd or 4th idea. At that point she is so anxious or overwhelmed and emotionally disturbed that no amount of explaining can make her understand what we're saying at all.

What do you think? How could I explain why she has such problems?

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PIP Form Question 2 - Communiating 1 year 1 month ago #200293


The standard she need to meet are very high, the difference between basic and complex is very barrow, there is an example in the PIP Claim guide that is taken from the DWP guidance.

This may be a silly idea, bit have you asked her to explain her problems?

If her communication is so restricted I would have expected those treating her to be able to comment, have you spoken to them?

Are you her appointee?


The bottom line is that all you can do is make the arguments and see what is said by the assessor and Decision Maker.


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PIP Form Question 2 - Communiating 1 year 1 month ago #200321

It's all very difficult. The benefits advisor for her psychiatrist recommended that she make me her appointee, which she agreed to, but unfortunately despite submitting the request for both ESA and PIP, and ESA eventually confirming it had been received, for neither benefit have we heard anything. I could push this, but if I did so, and especially since it would require my daughter to be interviewed, which she couldn't cope with, and the fact she actually wants me to manage her claim but not her benefits, I don't think the appointee request would succeed.

My daughter finds it very stressful and difficult to explain exactly how she feels, and it can take days for her to respond, and she tends to explode emotionally and aggressively because of her BPD and even become suicidal when pushed to respond about such things. So if I pushed for more detail from her, it would actually hurt and put her and me at risk. The deadline for this claim form is a week away. Pushing this would be likely to mean we couldn't actually get her agreement to complete and sign the form in time to meet the deadline (because she would go into melt-down for a while and she only has a good day once or twice a week).

The same problem applies in getting information from her doctor - because my daughter would have to ask for it. She doesn't permit her doctor to talk to me. The next time she sees her doctor is after the deadline in any case.

I'm trying to help my daughter in very difficult circumstances.

For ESA, presumably because of her suicidal tendencies, aggressiveness and difficulties such as this, she was not required to attend a face to face, but was placed straight in the support group.

Thanks again.

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PIP Form Question 2 - Communiating 1 year 1 month ago #200326


IT does sound like she might have met the criteria for Substantial Risk and was placed in the SG due to this.

Be aware, the Assessment Providers for PIP are much more aware of a claimant being violent than seems to be the case for Maximus and ESA.

This could be an advantage and force them to a Paper Based Review but it can also act against her and necessitate an appointment at the AP's offices rather than a home assessment.

But without support from her GP neither a PBR or home assessment are likely.


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