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PIP: completing mobility when can walk but not sta

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3 years 11 months ago #259726 by T
I have a condition called POTS that means any time I am vertical my body struggles to keep enough blood going to my brain and I experience tachycardia, dizziness and then fatigue. It is at its absolute worst if I have to stand still for even 2 minutes (I can't stand to brush my teeth without a heart rate of 150) but if I walk around the symptoms are reduced. They don't go but moving your legs helps gets blood back to your brain. I do walk more than a mile but I have excessive heart rate and fatigue the whole time. Exercise is a recommended treatment so I push myself to do my therapy even though it makes me symptomatic.

I have medical evidence through a tilt table test that this is what my heart rate does on standing and I record my heart rate during walking through exercise tracking apps.

I'm looking for advice on how I present this on my PIP form please, particularly on mobility, as it's all written in ways that look like they don't apply to me but my condition does leave me unable to get out and about without planning and rest. Is this where the idea of 'to a reasonable standard' applies? I don't use any aids but for example today I went for my COVID jab today and has to sit on the floor in the queue outside because my heart rate was 170bpm after I had walked to the centre (1 mile away). I have come home and have been resting for 3 hours.

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3 years 11 months ago - 3 years 11 months ago #259734 by Catherine
Hello T and welcome to the forum,

This one has had me thinking! Strictly this is beyond the scope of this forum, since we don’t give individual advice, however, at least for the minute, this is my best shot.

As I am sure you are aware there are two components to the mobility assessment, the second, moving around does not immediately seem a good fit for you, since clearly you can walk more than 200m.

I would be looking at the first one, Going out, which seems to be more hopeful. You cannot be said to be able to do an activity if you cannot do it ‘reliably’. Which means

• Safely – in a fashion that is unlikely to cause harm to themselves or to another person.
• To a necessary and appropriate standard – given the nature of the activity.
• Repeatedly – as often as is reasonably required.
• In a timely manner – in a reasonable time period.

Not all journeys are those taken on foot. In the Upper Tribunal case SB c SSWP (PIP) [2019] UKUT 274 (AAC) the judge said ‘ I am in agreement with the Secretary of State’s representative that the tribunal should not limit themselves to considering, solely, an ability to follow the route of a journey through driving a motor car. (paragraph 10). This could be flipped to say that not all journeys are on foot. And clearly many journeys are far too long to reasonably be walked. Does your condition mean that you reliably undertake journeys on public transport, or drive yourself, without someone being with you? If you can’t then you need to explain this in the first question in the mobility section.

Similarly are you safe going out walking on your own – remembering that this includes going to places which are not familiar and where people may not know you or your needs. You clearly have exceptional medical needs, which to my layman’s eye would seem to need urgent attention if you are poorly. Would a stranger know what to do?

If you need to rest for 3 hours after walking for a mile, I would suggest that you cannot do the journey ‘repeatedly’, which is one of the criteria for ‘reliably’. (If you need a significant rest after walking 200m then I go back on what I said about the 'moving around' question, since you can't be said to do that one reliably.)

Do come back to us if you have any more questions, and perhaps some our members will have suggestions for how you can approach this.
Catherine

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 3 years 11 months ago by Catherine.

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3 years 11 months ago - 3 years 11 months ago #259737 by LL26
Hi T,
This one has me thinking too!
My understanding of mobility regulation 2 is that you have to stand then move. Thus sort if assumes you are sat down, as I can't imagine it was intended to apply to lying down or being on all fours, as this doesn't seem very likely. So you are sat down, get up, stand and walk off. All of these things you seem to be able to do. So, perhaps you can't score points here unless you can fit within the 'reliably' criteria which Catherine has already explained.
Walking under mobility 2 is not what I call the 'duracell test'. If you watch TV adverts there is a toy, which is wound up, and goes and goes until it runs out of power. All PIP descriptors have to be done safely, to an acceptable standard, repeatedly and within a reasonable time. Are you putting yourself at risk by walking so far? Do you feel severe discomfort at any point whilst you walk? This could be pain, breathlessness or racing pulse and feeling like you will pass out, (or whatever other symptoms you get when the POTS problems kick in.) Any walking done with severe discomfort doesn't count, so if you walk a mile and all but 20 yards is in severe discomfort, your PIP ability is only 20 yards, and you could legitimately put 0 to 20 m on the form. Alternatively, if by walking you are putting yourself at risk, even though you can actually walk quite far, only some, or maybe none of it is "safe". (Which is why
PIP walking is not like the go on forever duracell battery advert!)
On the basis that you may need to be accompanied to stay safe, then perhaps points should be achieved via mobility 1d or 1f. It doesn't matter if you do go out alone, the crux is whether you should, and whether if I was watching a fly on the wall documentary of your life, would I be thinking, 'why aren't you with someone' and be shouting at the TV!
Have a think about what happens when you walk, in terms of pain, fatigue etc, danger to your health, the fly on the wall observer's comments etc etc. Be brutally honest, and consider all 4 reliability factors. All 4 have to be satisfied, so repeatedly per Catherine is also something to consider.
Compare your mobility to both descriptors and decide where you fit in. Then you need to write the form to match which descriptor you are aiming for. Both descriptors could apply.
I hope this helps.
LL26

Nothing on this board constitutes legal advice - always consult a professional about specific problems
Last edit: 3 years 11 months ago by LL26. Reason: omission
The following user(s) said Thank You: Catherine

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