Help! PIP Review form

Please bear with me as I’m struggling to know how to describe my current problem, so I might go around the houses a bit, but hopefully someone can make sense of this!

I am trying to fill in my PIP review form. When I first applied for PIP two years ago, my ability to carry out the daily living components was due to a mix of physical and mental health problems. I described these problems on my form, but focused much more on the physical symptoms as these were very prevalent and all-encompassing for me at the time. Now, my physical health has improved a lot due to new medication, but for most of the daily living activities I’m still finding myself struggling, and it’s obvious to me now that this is just as much to do with my mental health.

For example, when I first applied for PIP, I wasn’t able to prepare food safely, reliably etc due to a mix of physical weakness (which meant I couldn’t hold a knife properly, for example) and lack of working memory/ability to focus. On my form, I focused mostly on the physical weakness and only brushed past the mental symptoms. Now, I am physically able to hold a knife, but I’m still finding I’m not able to prepare food safely and reliably because my mental health symptoms mean I don’t concentrate properly and often leave the hob on or don’t shut the fridge, I often forget to eat or, as has mainly been the case for the past few weeks, I simply can’t motivate myself to prepare meals.

So, my ability to perform the daily living activities hasn’t changed, but my symptoms and my understanding of how those symptoms affect my ability to do things have, if that makes sense…?

I have recently been advised to seek an adult ADHD assessment, because I seem to have absolutely all of the symptoms (poor executive brain function, poor working memory, inability to focus, forgetfulness, social anxiety, impulsivity, severe emotional dysregulation and overwhelm, restlessness, clumsiness etc, etc) and this would explain why I struggle in life. I have always had these symptoms but didn’t recognise them for what they were when I first applied, so I didn’t put a lot of emphasis on them in my original application - as I said, I focused mainly on the physical symptoms. But now the physical stuff is much better, I’m finding that I’m still struggling, and in some ways things have got worse because I’m now living on my own and have no one to help me.

The deadline for getting my PIP review from back is 3 August. I currently don’t have anything new to support my evidence for the “daily living” issues, other than my recent self-referral for an ADHD assessment, for which I am still awaiting an appointment.

To summarise: although I am physically much stronger now, nothing much has changed in my ability to carry out the daily living activities. The only difference is that I now recognise that my mental health symptoms are equally responsible for my daily living issues, but I didn’t focus on these in my original application.

One of the boxes on the review form is “tell us if something has changed”. Should I say “no change” then talk about how my mental health symptoms affect my ability to do the activities, even though that means my answer is going to look a little different from my original application? Or, do I need to expressly state that there has been a change because my physical health is much better now, but then comment that this improvement in my physical health hasn’t improved my ability to perform the tasks? Will they want to see further evidence of my mental health issues now that I’ll be giving these as the main reason for my struggling with daily activities? Will they want me to do another interview? (I’m terrified of that!) Any advice welcome. Thanks.

Hi Gordon,

I’m not sure if my physical symptoms alone would be enough to score me the points I need now. I think that when considered in combination with my mental symptoms they ought to… but I didn’t focus that much on the mental symptoms in my original application compared with the physical symptoms, which formed the bulk of my application.

For example, in my original application, for “preparing food” I described how I was too physically weak and dizzy to hold a knife properly, and that I couldn’t concentrate on what I was doing due to brain fog, and so was at risk of injuring myself.

Now the muscle weakness and dizziness are much less… I can usually grip a knife now without too much trouble. But I’m finding I still get terrible brain fog and problems concentrating, which makes it difficult to prepare food safely - I am prone to leaving the hob on, for example. Also, I just can’t bring myself to prepare food most of the time due to my mental health - I can’t even bring myself to attempt it. But I didn’t mention that part in my original application because I was focusing more on the muscle weakness and dizziness.

So the answer to why I can’t perform this activity is going to look quite different now, as you can see. I can’t claim to still suffer most of the time from muscle weakness, because I don’t. I CAN say that I usually can’t bring myself to prepare food, but that will be new information to them..

The question says “has anything changed”. Am I supposed to read that as “has anything changed in my symptoms”? Or “has anything changed in my overall ability to perform the activity”? If the latter, I can probably state “no change”. But if the former, I don’t know what to write that isn’t going to look very different from my original application and possibly trigger another interview. Which I am desperate to avoid, because it’s horrible and last time it made my anxiety and distress much worse and my overall health declined for several weeks afterwards. I just don’t want to go through that all over again.

Thank you for your reply. I will take a look at the booklet this evening.

I am on medication on an ongoing/long-term basis for my mental health (I have a diagnosed mood disorder and PTSD) but I think I need additional treatment because I still find daily life very difficult, and I will be asking the ADHD consultant about this.

Last year I had a clinical psychologist I was seeing regularly (privately) but had to stop as it was too expensive (£180 per hour!), since then I’ve only been able to afford normal counselling.

If the DWP ask for my GP records, this might not be good... I had a mental health review at the GP a few months ago and when they asked how I was doing, I gave a fairly positive report and said I was “managing ok at the moment although still had some anxiety”. Which was true at the time! But my mood fluctuates, some weeks I feel I’m managing better than other weeks, and in my good periods I like to hope that I’m recovered now, so I’m all positive and upbeat. But those good periods never last, I always go back to feeling awful, and that latest GP report won’t be representative of the whole picture.

That report also doesn’t reflect the fact that what IS consistent is that my brain NEVER works properly, and things like the significant emotional dysregulation, lack of ability to concentrate, severe brain fog, social anxiety, risk-taking and distressing levels of forgetfulness, they are there ALL the time, and they ALWAYS make life difficult, which is why I’m having the ADHD assessment, to see if it’s ADHD or something else that is causing me these difficulties.

Perhaps going more in my favour is the fact that I am still under the care of a psychiatrist, who I’ve had appointments with twice in the last year to discuss my mental health - most recently my suspicion that I have ADHD - and I have a letter from her to my GP saying that she spoke to me about the lack of focus and memory problems that I came to her about, and advised me to seek a consultation with an ADHD specialist. Maybe I should include that with my review form?

I also have the letter I wrote to the ADHD specialist in advance of my appointment, which gives a very detailed list of my mental health symptoms. And I have a symptoms diary I could send too. This shows things like how I left the hob on, how I had a panic attack before a work meeting, how I couldn’t go out to get food because I was in a terrible state emotionally, and how I got overwhelmed because I had four tasks on my to-do list and couldn’t cope, so none of them got done. Do you think I should include those?