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PiP phone call - gave no points for mental health
- Onceuponatime6789
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3 years 7 months ago #259448 by Onceuponatime6789
PiP phone call - gave no points for mental health was created by Onceuponatime6789
Hi everyone,
Thanks for letting me onto the forum and for all your help!
A bit about my claim:
Eating disorder for 15 years (I have come to simply exist with the daily behaviour of an ED and haven't had any recent treatment in years, so little recent evidence on this)
Panic disorder (daily panic attacks began around 6 years ago, they now happen multiple times a day)
Depression (10+ years)
My partner helps and essentially acts as a carer in all these matters
Sent in a lot of evidence - my medical notes, confirmation of diagnosis, letters from a psychiatrist who is prescribing to me currently, ambulance reports (when the panic attacks are bad concerned bystanders have several times called 999)
What's gone against me has been that I work full time (I have an obsessive unhealthy relationship with work, often pushing myself to repeated panic attacks in fear of losing my job). Secondly, I've found when I explain day to day difficulties to health professionals they don't care to write it down and focus only on diagnosis. It doesn't result in the kind of evidence the DWP want going on paper. I was recently seeing counsellors rather than GP for support and both told me 'they have a policy of not writing letters".
Had my assessment recently and they've awarded me zero points for everything, when I asked for a copy of the assessor's report.
Could I ask please for:
1) suggestions on where on earth I can get the evidence the DWP want - any recommended professionals who could be relied on to both help and write a letter? My GP isn't much help.
2) feedback on this letter that I'm drafting in hopes it might influence their decision. I've found this very painful to write, and there are many other points and descriptors that I feel Im eligible for - but exhausting to tackle everything that's wrong in the report.
In the toilet needs area, I said I needed support to prevent the danger of purging or laxative abuse, but she said that is outside the scope of this activity - is that right please? What could I do instead to have them factor this need in?
Dear sir/madam,
I have received a copy of the PA4 form following my recent assessment. This is not a request for a Mandatory Reconsideration but I wish to state that I disagree with the recommended scores the assessor has put on the PA4.
It is well known that mental health services do not have the resources to give ongoing psychiatric input when it is having little positive benefit and I feel that I have been unfairly assessed because this is my position and because I have a very supportive partner who provides the help I would otherwise receive from Mental Health Services.
I’ll detail below concentrate on some of the specific areas that I feel have been most clearly incorrectly assessed and the medical evidence provided. This list is not exhaustive.
2. Taking nutrition ‘can take nutrition unaided’ suggested by assessor
‘D. needs prompting to be able to take nutrition’
Missing up to three meals occurs on 4-5 days per week and bingeing (with or without purging) which occurs over many hours every day, cannot be considered as taking adequate nutrition.
Evidence - recent psychiatric reports detailing both missing meals and purging. Hands shake during panic attacks and after purging, making it hard to manage.
3. Managing therapy or monitoring condition - ‘can manage therapy or monitor a health condition unaided’ suggested by assessor
‘C. needs supervision, prompting or assistance to manage these no more than 3.5 hours per week’
Evidence - GP’s letter confirms confusion and needing help to take medication. Noted also in psychiatrist’s letter
4. Making budgeting decisions - “Can manage complex budgeting decisions unaided” suggested by assessor
‘B - needs prompting or assistance to be able to make complex budget decisions’
Assessor’s comment here states discharge from Cognitive Behavioural Therapist 29/10/2019 gave a score of mild depression and mild anxiety.
This is incorrect, the score on the letter is 21/27 which as per the published NHS criteria this score is for severe anxiety and severe depression.
As a result of these conditions, and my bulimia, I engage in excessive and unstoppable spending around food and need assistance to curb these episodes.
Evidence - example bank statement
5. Managing toilet needs or incontinence - ‘A. Can manage toilet needs or incontinence unaided’
C. ‘needs supervision or prompting’’
Supervision is required to prevent the danger of purging or laxative abuse and the effects these have on the body.
11. Planning and following journeys - ‘a. Can plan the route of a journey unaided’.
‘B. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress’
Partner provides this prompting. Panic attacks occur repeatedly when outside the house and can come out of the blue, causing overwhelming psychological distress.
Although during the assessment I underwent a single sedentary phone call, within the home, without experiencing a full panic attack, this does not signify that they can undertake an outside journey or extended physical movement without panic attacks.
During the call I repeatedly mentioned the anxiety and nerves I was experiencing and struggled to get enough breath to be heard. The assessor often complained it was hard to hear me.
Evidence - medical notes detailing panic attacks
Cheers!
Thanks for letting me onto the forum and for all your help!
A bit about my claim:
Eating disorder for 15 years (I have come to simply exist with the daily behaviour of an ED and haven't had any recent treatment in years, so little recent evidence on this)
Panic disorder (daily panic attacks began around 6 years ago, they now happen multiple times a day)
Depression (10+ years)
My partner helps and essentially acts as a carer in all these matters
Sent in a lot of evidence - my medical notes, confirmation of diagnosis, letters from a psychiatrist who is prescribing to me currently, ambulance reports (when the panic attacks are bad concerned bystanders have several times called 999)
What's gone against me has been that I work full time (I have an obsessive unhealthy relationship with work, often pushing myself to repeated panic attacks in fear of losing my job). Secondly, I've found when I explain day to day difficulties to health professionals they don't care to write it down and focus only on diagnosis. It doesn't result in the kind of evidence the DWP want going on paper. I was recently seeing counsellors rather than GP for support and both told me 'they have a policy of not writing letters".
Had my assessment recently and they've awarded me zero points for everything, when I asked for a copy of the assessor's report.
Could I ask please for:
1) suggestions on where on earth I can get the evidence the DWP want - any recommended professionals who could be relied on to both help and write a letter? My GP isn't much help.
2) feedback on this letter that I'm drafting in hopes it might influence their decision. I've found this very painful to write, and there are many other points and descriptors that I feel Im eligible for - but exhausting to tackle everything that's wrong in the report.
In the toilet needs area, I said I needed support to prevent the danger of purging or laxative abuse, but she said that is outside the scope of this activity - is that right please? What could I do instead to have them factor this need in?
Dear sir/madam,
I have received a copy of the PA4 form following my recent assessment. This is not a request for a Mandatory Reconsideration but I wish to state that I disagree with the recommended scores the assessor has put on the PA4.
It is well known that mental health services do not have the resources to give ongoing psychiatric input when it is having little positive benefit and I feel that I have been unfairly assessed because this is my position and because I have a very supportive partner who provides the help I would otherwise receive from Mental Health Services.
I’ll detail below concentrate on some of the specific areas that I feel have been most clearly incorrectly assessed and the medical evidence provided. This list is not exhaustive.
2. Taking nutrition ‘can take nutrition unaided’ suggested by assessor
‘D. needs prompting to be able to take nutrition’
Missing up to three meals occurs on 4-5 days per week and bingeing (with or without purging) which occurs over many hours every day, cannot be considered as taking adequate nutrition.
Evidence - recent psychiatric reports detailing both missing meals and purging. Hands shake during panic attacks and after purging, making it hard to manage.
3. Managing therapy or monitoring condition - ‘can manage therapy or monitor a health condition unaided’ suggested by assessor
‘C. needs supervision, prompting or assistance to manage these no more than 3.5 hours per week’
Evidence - GP’s letter confirms confusion and needing help to take medication. Noted also in psychiatrist’s letter
4. Making budgeting decisions - “Can manage complex budgeting decisions unaided” suggested by assessor
‘B - needs prompting or assistance to be able to make complex budget decisions’
Assessor’s comment here states discharge from Cognitive Behavioural Therapist 29/10/2019 gave a score of mild depression and mild anxiety.
This is incorrect, the score on the letter is 21/27 which as per the published NHS criteria this score is for severe anxiety and severe depression.
As a result of these conditions, and my bulimia, I engage in excessive and unstoppable spending around food and need assistance to curb these episodes.
Evidence - example bank statement
5. Managing toilet needs or incontinence - ‘A. Can manage toilet needs or incontinence unaided’
C. ‘needs supervision or prompting’’
Supervision is required to prevent the danger of purging or laxative abuse and the effects these have on the body.
11. Planning and following journeys - ‘a. Can plan the route of a journey unaided’.
‘B. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress’
Partner provides this prompting. Panic attacks occur repeatedly when outside the house and can come out of the blue, causing overwhelming psychological distress.
Although during the assessment I underwent a single sedentary phone call, within the home, without experiencing a full panic attack, this does not signify that they can undertake an outside journey or extended physical movement without panic attacks.
During the call I repeatedly mentioned the anxiety and nerves I was experiencing and struggled to get enough breath to be heard. The assessor often complained it was hard to hear me.
Evidence - medical notes detailing panic attacks
Cheers!
- BIS
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- Posts: 8502
3 years 7 months ago #259485 by BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by BIS on topic PiP phone call - gave no points for mental health
Hi Danielle
Welcome to the forum, you might want to have a look at the following FAQ which explains where everything is
Welcome to Benefits and Work
Work doesn’t affect personal independence payment (PIP) in so far as PIP is not means-tested and you can be paid PIP whether you are working full-time, part-time or not at all. So, you could work as a merchant banker earning millions and still be eligible for PIP.
However, you do need to be aware that work can affect the points you score in your PIP assessment and thus whether you are eligible for an award and at what rate. This is because any physical or mental activities that you undertake in the course of your work, or more probably any activities the health professional assumes you undertake, can be taken into account when deciding what points you score in the PIP medical assessment.
So, if your work involves moving around then this can be taken into account when deciding what you score for the mobility component of PIP. And if you manage to get yourself out of bed, washed and dressed, buy a bus or train ticket and travel to work then this can all be taken into account for both the daily living and the mobility components of PIP.
Any activities in your place of work, such as writing or typing, talking to customers or colleagues and moving around the workplace can also be taken into account.
So clearly you have a lot of panic attacks, which must be distressing. They are going to want to know how long they are, are there any triggers and how you manage them in the course of your working day.
I don't know what sort of job you do (and you don't have to say) - but as I've said above they are going to be interested in whether you have contact with other people at work and how you manage your medical conditions in the course of a day. Has anyone had to make reasonable adjustments for you at work?
Have a look at our Guide to PiP claims and reviews. It's a large document, but it would be worth you looking at each question and the types of answers that are needed just to check that you have answered them in the way they want.
www.benefitsandwork.co.uk/help-for-claimants/pip
In terms of your questions:
1. It's often challenging to get decent letters from GP and it doesn't sound as if you have a supporting one. I'm afraid this is very much the luck of the draw. Did you include a letter from your partner and how they have supported you. If you didn't before you should do so now. If there is anyone else who can confirm your difficulties - then ask them to write a letter. Try to keep it to covering the PIP criteria
2. You may disagree with all parts of the report - but in your letter, you need to query the points where you feel you should have scored points. They are right in saying that the purging or laxative abuse is not covered under managing toilet needs (even though this is very distressing). You can see details in our guide. on what it covers.
www.benefitsandwork.co.uk/help-for-claimants/pip (page 44)
3. It's hard to comment on what you've written - because we don't know you or your medical conditions. I would strengthen your answer regarding the nutrition, emphasising that this is a constant problem with your bulimia and how the mental health aspects of the condition can make it impossible to stop purging. Regarding your planning and undertaking your journey - an obvious question to them will be how do you get to work and how do you manage it. If you say that is overwhelming, then you need to make sure that you have described it clearly to them. Have a look at our guide and make sure that you gave them the best possible answer. Obviously both your depression and anxiety are relevant.
Your bank statement is unlikely to be sufficient evidence that you have problems managing money. Make sure your partner writes about this in their letter. Also make sure that you make clear links from your condition, to the behaviour and onto the PIP criteria. The decision-maker is not a medical person - so without writing a novel-length reply, make sure you put in enough to challenge what has been written.
Good luck
BIS
Welcome to the forum, you might want to have a look at the following FAQ which explains where everything is
Welcome to Benefits and Work
Work doesn’t affect personal independence payment (PIP) in so far as PIP is not means-tested and you can be paid PIP whether you are working full-time, part-time or not at all. So, you could work as a merchant banker earning millions and still be eligible for PIP.
However, you do need to be aware that work can affect the points you score in your PIP assessment and thus whether you are eligible for an award and at what rate. This is because any physical or mental activities that you undertake in the course of your work, or more probably any activities the health professional assumes you undertake, can be taken into account when deciding what points you score in the PIP medical assessment.
So, if your work involves moving around then this can be taken into account when deciding what you score for the mobility component of PIP. And if you manage to get yourself out of bed, washed and dressed, buy a bus or train ticket and travel to work then this can all be taken into account for both the daily living and the mobility components of PIP.
Any activities in your place of work, such as writing or typing, talking to customers or colleagues and moving around the workplace can also be taken into account.
So clearly you have a lot of panic attacks, which must be distressing. They are going to want to know how long they are, are there any triggers and how you manage them in the course of your working day.
I don't know what sort of job you do (and you don't have to say) - but as I've said above they are going to be interested in whether you have contact with other people at work and how you manage your medical conditions in the course of a day. Has anyone had to make reasonable adjustments for you at work?
Have a look at our Guide to PiP claims and reviews. It's a large document, but it would be worth you looking at each question and the types of answers that are needed just to check that you have answered them in the way they want.
www.benefitsandwork.co.uk/help-for-claimants/pip
In terms of your questions:
1. It's often challenging to get decent letters from GP and it doesn't sound as if you have a supporting one. I'm afraid this is very much the luck of the draw. Did you include a letter from your partner and how they have supported you. If you didn't before you should do so now. If there is anyone else who can confirm your difficulties - then ask them to write a letter. Try to keep it to covering the PIP criteria
2. You may disagree with all parts of the report - but in your letter, you need to query the points where you feel you should have scored points. They are right in saying that the purging or laxative abuse is not covered under managing toilet needs (even though this is very distressing). You can see details in our guide. on what it covers.
www.benefitsandwork.co.uk/help-for-claimants/pip (page 44)
3. It's hard to comment on what you've written - because we don't know you or your medical conditions. I would strengthen your answer regarding the nutrition, emphasising that this is a constant problem with your bulimia and how the mental health aspects of the condition can make it impossible to stop purging. Regarding your planning and undertaking your journey - an obvious question to them will be how do you get to work and how do you manage it. If you say that is overwhelming, then you need to make sure that you have described it clearly to them. Have a look at our guide and make sure that you gave them the best possible answer. Obviously both your depression and anxiety are relevant.
Your bank statement is unlikely to be sufficient evidence that you have problems managing money. Make sure your partner writes about this in their letter. Also make sure that you make clear links from your condition, to the behaviour and onto the PIP criteria. The decision-maker is not a medical person - so without writing a novel-length reply, make sure you put in enough to challenge what has been written.
Good luck
BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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