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PIP medical report forms – review and sample

Personal Independence Payment sample medical report formYou may never have seen one. Or you may only have ever seen your own.

Which is why we’ve now published a sample PIP PA4 medical report form.

If you’ve never had a PIP medical it gives you the chance to learn in advance what kind of evidence the health professional is going to be collecting about you. Which means you can prepare more effectively to try to ensure that they get all the evidence they need to compile an accurate report.

If you already have your own PIP medical report, it gives you the opportunity to compare it with ours. Our sample is by no means a good report. It’s intended to be about average and there are certainly lots of grounds on which we would challenge it.

But if yours is even less detailed than our sample one, then you have got something you can definitely challenge at a hearing.

We haven’t yet finished updating our guide to challenging a PIP medical report. Though most of it will remain the same there are some issues we want to address in more detail and there have been some changes to the layout of the medical report. The new guide will be out before the next newsletter.

But two there are a number of issues which stood out for us.

Ignoring further medical evidence
Use of further medical evidence was very poor. In the majority of cases, reports from other health professionals, such as GPs or consultants, are listed in the ‘evidence considered’ section and then simply never referred to again. Therefore any contradictions between the evidence of the HP and other health professionals are never brought to the attention of the decision maker or dealt with.

Failure to address contradictions in the evidence would be sufficient for a report to be found unacceptable using the DWP’s own PIP audit criteria and would certainly not impress a tribunal.

Not saying where evidence came from

Some HPs were careful to explain where each item of evidence came from. In particular, was it the claimant questionnaire or something allegedly said during the face-to-face interview?

But many simply used phrases like: ‘ He reports that . . ‘ or ‘Reported difficulties are consistent with . . .’

It’s vital that the decision maker knows this. Because, once again, if there is a contradiction between what the claimant said in their questionnaire and what they allegedly said at the assessment then this should be considered both by the health professional and by the decision maker.

The fact that the PIP medical report does not have a section for setting out which options the claimant selected in their questionnaire makes it even easier for contradictions to be ignored.

But it also makes it easier for the report to be challenged at a tribunal

For more on this, see the link below to the full article, including the best ways to prepare for a medical, and ‘Who’s better: Atos or Capita?’.

Lack of detail
Evidence gathering seemed to be generally haphazard. Most reports were woefully short on detail, with just a sentence or two dealing with each activity in the Functional history, for example.

If there is detailed evidence in your PIP questionnaire but the health professional selects a lower scoring descriptor based on much flimsier evidence, you have strong grounds for a challenge. Soi, make sure you do the best job you possibly can of your PIP1 questionnaire and a poor face-to-face assessment will be less of a threat to your benefits – at tribunal at least.

Who’s better: atos or capita?
Is there an advantage in having your medical with one company rather than the other? We’d say not.

Both rely to some extent, though in different places, on standard responses. This is particularly noticeable where Atos are employing former ESA assessors. Many ESA veterans will recognise this extract from an Atos HP’s PIP mental state examination:

Does not look tired.

Looks overweight.

Well kempt.

Neatly dressed.

Looks well.

Did not appear to be trembling.

Increased sweating was not apparent

Normal facial expression.

Interaction normal, not restless or withdrawn.

But Capita also has its standard phrases, for example in the General appearance’ section..

We did see one example of a Capita assessor giving their qualification as ‘Health professional’, rather than something more specific, such as physiotherapist, for example. They did this both at the start and the end of the medical report, something which is entirely unacceptable. We saw no examples of Atos staff failing to give their medical qualification

Overall, however, there was enormous variability in the quality and level of detail of reports from both companies and we can see no advantage in being seen by either.

Be prepared for your medical
Here’s our five top tips to help ensure you are prepared for your medical:

  • make the best job you can of your questionnaire, giving as much detail as possible, and read through it before your medical;
  • provide supporting evidence if you are able, medical and/or otherwise;
  • before your medical, learn as much as you can about the procedure and the types of evidence that will be collected;
  • your medical starts when you leave your home - give very careful thought to how you travel to the medical, because it will be taken into account and inaccurate assumptions may well be made;
  • be aware that you are being observed and unspoken judgements are being made about you throughout the assessment – so if anything causes you physical or emotional pain or discomfort, say so clearly.

Then accept that none of this will necessarily make the assessment report more accurate. But it will greatly improve your chances of being successful at appeal.

You can download a copy of the sample PA4 medical report from the PIP members page.

Comments  

#22 Deb 2016-09-09 11:53
Tiff, how did you get on? What was the result for your mobility claim?
Best wishes
#21 lynn063 2015-11-18 00:23
hi am a little worried my award is comeing to a end for pip in june 2016 . will I have to go for a face to face ass .I hated it the last timeit was horrible?i don't know what to expect I get the lower rate mobility rate
#20 Bev 2015-11-14 15:01
Hi all
Does anyone know how long does it take to get a decision from the medical assssment pls.
+1 #19 borkwen 2015-11-09 18:29
Patrick, just contact the DWP office that deals with your claim and ask for a copy of the PA4 (their report of your assessment) and read thoroughly to see if it reports accurately what you told them.
-1 #18 patrick mccann 2015-11-09 15:54
where can i get a ppi pa4 form from.???.as never heard of them before.
+1 #17 kathy 2015-11-09 06:42
Quoting Eli48:
[quote name="borkwen"]shevie, i'm coming to the conclusion that the DWP changes and discussion on the different distance descriptors are largely irrelevant - because if the assessor / decision maker is following the correct procedure, it is whether a claimant can repeatedly, reliably and in a timely manner that results in achieving or failing the descriptor. Therefore, if it's 20 metres or 200 metres it makes little difference if that distance cannot be repeated. Repeating 20 metres 10 times will is the same as covering 200 metres.

The words are, 'Reliably, Repeatedly, safely, and in a timely manner.

Indeed. The devil is in the detail. for mobility, the DLA form asked all of the questions about 'Reliably, repeatedly, safely etc, quite explicitly regarding speed, distance and time, plus 'tell us more about the manner in which you walk', and the section on falling and stumbling. The PIP form omits these questions, and I am sure that many people are not aware of the regs, which I feel are not being applied. The narrow descriptors, as with the ESA which give examples of specific activities lend themselves to literal interpretation of the close questions format. Possibly many applicants are denied benefit because they are not aware of the regulations. I intend to use these words repeatedly when I describe how my disability affects me. When I claimed ESA, I gave examples of impaired function in detail pertaining to everyday activities of my choice.
#16 kathy 2015-11-09 06:05
Quoting borkwen:
I'm glad that info about car as mobility aid helps Kathy. I was particularly interested to read your follow up about underactive thyroid. Although eventually diagnosed with ME/CFS 10 years ago I've kept an open mind and recently realised my various symptoms all seem to have links to hypothyroidism (including low basal temperature).
I've had to start seeing a new GP & although he was easy to talk to, he dismissed the possibility of hypo-t, saying that people have quite varied 'normal' body temperatures and that basic thyroid tests a year ago were normal. Not sure what to do now.

Diagnosed over 20 years ago, the tests were less sophisticated than they are now. Hypothyroidism is a slow insidious disease, for which the obvious symptoms don't manifest until the damage has been well and truly done. The symptoms tend to creep up on you and there is a certain amount of natural adjustment - ie wearing warmer clothing. I was at the point where my speech was slurring when tired, and literally the brain switches off - so would sit down in the afternoon for a few minutes and then realise that a couple of hours had passed. It wasn't Until I got a serious chest infection that I saw the doctor and pointed out the little lump in my neck. A physical exam revealed changes to the gland - mult inodular goitre, and general enlargement. The commonest symptom is the need to clear the throat. It feels as if something is stuck. There is a huge fluctuation withing normal range amongst the population. The section on the website link explains this. Unless you have had a test before, then no one will know what is normal for you. http://www.thyroiduk.org.uk/tuk/testing/thyroid_blood_tests.html
+2 #15 Eli48 2015-11-08 22:30
[quote name="borkwen"] shevie, i'm coming to the conclusion that the DWP changes and discussion on the different distance descriptors are largely irrelevant - because if the assessor / decision maker is following the correct procedure, it is whether a claimant can repeatedly, reliably and in a timely manner that results in achieving or failing the descriptor. Therefore, if it's 20 metres or 200 metres it makes little difference if that distance cannot be repeated. Repeating 20 metres 10 times will is the same as covering 200 metres.

The words are, 'Reliably, Repeatedly, safely, and in a timely manner.
#14 borkwen 2015-11-06 14:40
shevie, i'm coming to the conclusion that the DWP changes and discussion on the different distance descriptors are largely irrelevant - because if the assessor / decision maker is following the correct procedure, it is whether a claimant can repeatedly, reliably and in a timely manner that results in achieving or failing the descriptor. Therefore, if it's 20 metres or 200 metres it makes little difference if that distance cannot be repeated. Repeating 20 metres 10 times will is the same as covering 200 metres.
When I apply again I am going to put that I cannot walk any distance repeatedly (a person without health problems can walk all day if necessary - I could do that before illness as many can in the course of their work).
I think we need to keep things very simple for those assessing us and challenge irrational assumptions.
#13 shevie 2015-11-06 12:33
Quoting borkwen:
People might be interested to know something that came up at a recent tribunal i had concerning PIP.
I challenged the statement a previous tribunal had made that 'I was able to go shopping'. Yes, I can park in the car park and walk around the supermarket (although not repeatedly which is still a problem with many assessments) but the shop is 8 miles away! As I cannot in practice use public transport because of the significant amount of walking, waiting and standing that would involve, I said that a car is a mobility aid and the reason I need the higher mobility payment.
The judge looked at one of the huge reference books on benefit rules and a car falls clearly under the definition of 'mobility aid'. Just because most people who use cars are not disabled does not negate the fact that they are for many.
Please encourage everyone to mention this. Running a car is a significant cost and for a lot of people with mobility problems their only means of leaving the house.

I have just read this with great interest. I have just this last week been invited to apply for PIP(like its a nice garden party!)having been on higher rate DLA mob and care. I have a motability car, live 5 miles from nearest bus stop. Hubby does most of shopping because its difficult for me to walk, as i wear a special boot (car is adapted for hand controls) I see that you say that you can go shopping and walk round a supermarket. But I am now confused because i thought that things had changed recently and that being able to walk more than 20 metres would automatically mean you could no longer get higher rater mobility. Have i read that wrong?
#12 Eli48 2015-11-05 14:21
[You can request a home visit, as they will not supply transport.
#11 borkwen 2015-11-05 14:05
I'm glad that info about car as mobility aid helps Kathy. I was particularly interested to read your follow up about underactive thyroid. Although eventually diagnosed with ME/CFS 10 years ago I've kept an open mind and recently realised my various symptoms all seem to have links to hypothyroidism (including low basal temperature).
I've had to start seeing a new GP & although he was easy to talk to, he dismissed the possibility of hypo-t, saying that people have quite varied 'normal' body temperatures and that basic thyroid tests a year ago were normal. Not sure what to do now.
+2 #10 nannyg 2015-11-05 10:50
I'm still on DLA but noticed that my postcode is about to be PIP'ed
I am in a wheelchair due to spinal injuries and get higher mobility and middle care & I attend the Nat Neuro in London, who keep an eye on me LOL!. I've not worked since a RTA in 1995. Prior to this I was a highly qualified nurse & working as a Director of Operational Services at an inner London hospital!! My case went to court where the judge said "It is common knowledge that M*** **** will never work again" If & when I'm asked to attend for a medical (they will have to supply transport!) Shall I put the judges comments on the form or a copy in writing from the local newspaper??? I will also be refusing to be assessed by anyone other than a doctor as I myself would probably "out rank" these so called 'health professionals' Grrr!!!
+1 #9 kathy 2015-11-05 06:26
I am amazed at the assessor's comment regarding the client taking Levothyroxine, prescribed for an underactive thyroid gland, 'She thinks it helps.' Hypothyroidism, which I have had for over 20 years, is very serious indeed. Although if managed correctly with the optimum dose of replacement hormone, it is not in itself a disabling condition. However, it is one of the few conditions that that qualifies a sufferer for free prescriptions for life because it is life threatening, to ensure the patient can afford the medicine. If you stop taking it, eventually you will slip into a coma and die. This was spelt out to me when I was diagnosed. The dosage is monitored with a blood test every 6 months with a blood test. Given this lady's comorbid conditions it would be harder to monitor by classic symptoms alone.
+3 #8 kathy 2015-11-05 05:32
Quoting borkwen:
People might be interested to know something that came up at a recent tribunal i had concerning PIP.
I challenged the statement a previous tribunal had made that 'I was able to go shopping'. Yes, I can park in the car park and walk around the supermarket (although not repeatedly which is still a problem with many assessments) but the shop is 8 miles away! As I cannot in practice use public transport because of the significant amount of walking, waiting and standing that would involve, I said that a car is a mobility aid and the reason I need the higher mobility payment.
The judge looked at one of the huge reference books on benefit rules and a car falls clearly under the definition of 'mobility aid'. Just because most people who use cars are not disabled does not negate the fact that they are for many.
Please encourage everyone to mention this. Running a car is a significant cost and for a lot of people with mobility problems their only means of leaving the house.

Thanks for posting this. Without my car I would be virtually housebound, relying on lifts from others. I had considered my car as my most vital mobility aid - which it is, and the only aid that helps me travel reliably and safely. I thought of stating this when my turn comes to be assessed, but considered that it would be disregarded because the moving around criteria concentrates on what you can do with a pair of legs, or prostheses. Now I am assured that benefit law states that a car is a mobility aid. :-)
+2 #7 Tracey 2015-11-05 00:20
Hi All

Thank you for all your comments they make interesting reading and great advice as I've got my Tribunal on 16-11-15. Not looking forward to it.

I'll let you know what happens.
#6 ooohiduno 2015-11-05 00:19
My PA4 report only had questionaire listed, aditional evidence i sent with the questionaire wasnt listed or mentioned in the report.
iv got R.A. awarded std care, NO mobility. im now waiting for tribunal date. DWP decision makers are a less than honest bunch of people.... they have rubber stamped PA4 reort and changed and twisted things in their tribunal resonse letter
+4 #5 borkwen 2015-11-04 19:06
People might be interested to know something that came up at a recent tribunal i had concerning PIP.
I challenged the statement a previous tribunal had made that 'I was able to go shopping'. Yes, I can park in the car park and walk around the supermarket (although not repeatedly which is still a problem with many assessments) but the shop is 8 miles away! As I cannot in practice use public transport because of the significant amount of walking, waiting and standing that would involve, I said that a car is a mobility aid and the reason I need the higher mobility payment.
The judge looked at one of the huge reference books on benefit rules and a car falls clearly under the definition of 'mobility aid'. Just because most people who use cars are not disabled does not negate the fact that they are for many.
Please encourage everyone to mention this. Running a car is a significant cost and for a lot of people with mobility problems their only means of leaving the house.
+3 #4 Effie 2015-11-04 17:59
Thanks for taking the time and effort to pay this information it is greatly appreciated.
My PA4 report from capita stated health professional and never managed to find out their role.
I have just posted my reassessment off today so out of my hands until they get in touch.
Will compare last pA4 with new and yours and see if HP role is listed next time.
Thanks again.
+4 #3 Eli48 2015-11-04 16:32
I was awarded the highest rates of both components in PIP and I have legs and am not in a wheelchair. So whoever told you that is talking a load of rubbish. Appeal both. I think you were stitched up there.

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