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Need Some Clarification if Possible Before Writing MR Letter
- MSWarriorLady
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11 months 1 week ago #285459 by MSWarriorLady
Need Some Clarification if Possible Before Writing MR Letter was created by MSWarriorLady
Hello all, I wonder if anyone can help? I have recently had the decision on my first PIP claim and was awarded low rate for Mobility (which I agree with) but no award for Daily Living. I scored 6 points over the 6 areas I declared difficulties with. One of the questions where I failed to gain points is 'managing health condition/therapy' where I feel I should score 2 points.
I have a daily exercise plan prescribed by NHS Neurology Physio for spasticity and balance issues caused by MS. Because the physio has assessed me in clinic and seen me stumble and lose balance when walking and when attempting the exercises, she has stated (in writing) that I must be supervised when doing them daily at home, and for a time afterwards because my balance and stiffness is worse directly after doing them. Also because the exercises are painful to do and I don't feel too good afterwards, my family have to make sure I do them. They take around one and a half hours each week at 15 minutes daily. The exercise plan is to stabilise and slow progression of current symptoms and will be ongoing.
The decision maker has not mentioned their reasons for awarding 0 points apart from to say the cut and paste phrase ' you can manage meds/therapy unaided or do not need to' in the scoring box. So have not explained how they came to that conclusion.
Am I right in thinking I can challenge this? They did not list the letter from physio in evidence considered - in fact they didn't list anything apart from my form.
Also, with regard to descriptors Dressing and Engaging with Others they have disregarded widespread fibro pain and anxiety/depression due to 'your medication is stable and you have no speialist input'.
My medication for pain is something we are still trying to get right and my GP/MS team/Rheumatologist only suggest pregabalin which I cannot tolerate at a therapeutic dose.
My medication for anxiety/depression was increased earlier this year and I am also receiving therapy from an NHS mental health service.
Am I right in thinking they shouldn't be using low level meds as a 'reason' for assuming the issue is not significant?
I have proof of increased meds and of therapy, proof of physio . I would be happy to gain an award of standard rate so only need 2 points more.
My 6 points are all for use of aids as prescribed by an OT
Can anyone help by sharing their views on what I'm querying? I'd be really grateful
I have a daily exercise plan prescribed by NHS Neurology Physio for spasticity and balance issues caused by MS. Because the physio has assessed me in clinic and seen me stumble and lose balance when walking and when attempting the exercises, she has stated (in writing) that I must be supervised when doing them daily at home, and for a time afterwards because my balance and stiffness is worse directly after doing them. Also because the exercises are painful to do and I don't feel too good afterwards, my family have to make sure I do them. They take around one and a half hours each week at 15 minutes daily. The exercise plan is to stabilise and slow progression of current symptoms and will be ongoing.
The decision maker has not mentioned their reasons for awarding 0 points apart from to say the cut and paste phrase ' you can manage meds/therapy unaided or do not need to' in the scoring box. So have not explained how they came to that conclusion.
Am I right in thinking I can challenge this? They did not list the letter from physio in evidence considered - in fact they didn't list anything apart from my form.
Also, with regard to descriptors Dressing and Engaging with Others they have disregarded widespread fibro pain and anxiety/depression due to 'your medication is stable and you have no speialist input'.
My medication for pain is something we are still trying to get right and my GP/MS team/Rheumatologist only suggest pregabalin which I cannot tolerate at a therapeutic dose.
My medication for anxiety/depression was increased earlier this year and I am also receiving therapy from an NHS mental health service.
Am I right in thinking they shouldn't be using low level meds as a 'reason' for assuming the issue is not significant?
I have proof of increased meds and of therapy, proof of physio . I would be happy to gain an award of standard rate so only need 2 points more.
My 6 points are all for use of aids as prescribed by an OT
Can anyone help by sharing their views on what I'm querying? I'd be really grateful
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- BIS
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11 months 1 week ago #285476 by BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
Replied by BIS on topic Need Some Clarification if Possible Before Writing MR Letter
Hi MSWarriorLady
I'm sorry you find yourself in this position.
Go back and read the guide to PIP claims and reviews - page 42. I am not an assessor - but I would definitely challenge the fact you didn't get the points. Do read through the pages in the guide to make sure you have given enough details as to why if you do not do this (prescribed) treatment - your condition will deteriorate. You also need to emphasise why the decision is key - and that is in two areas - your physical health, but also your mental health. If the exercises are painful, you won't want to do them, and that is an added reason why when you suffer from anxiety, the added help is key. Point out in your MR that the "Assessor was incorrect in saying that you had no specialist input and failed to read the letter from (give date, name and position) and take into account the necessity of this exercise as prescribed, which you previously submitted with your form."
Dressing and Undressing - Unless someone has fibro pain - they won't know what you're talking about. So go back and look at what you said - do you require help? Would you stay in your pyjamas if you couldn't get help? Does it take you twice as long as a normal person to get dressed? Are you using any aids? Do you have to stop because of the pain? Does your anxiety increase due to the pain? Are you constantly worried about your spasticity when getting dressed? Is your balance affected even if you sit down and get dressed? Does the pain you're in stop you from moving ....? etc etc. You might have mentioned some none of them. I only throw out a few ideas to make sure that you have explained everything. Too often, claimants assume that the assessor will understand and, therefore, don't explain what might seem obvious. You may have done all this, but always go back and check - because it's quite possible the assessor won't have direct experience with your conditions. Also, the impact is very personal - so two people with fibro will experience very different things.
In terms of the medication - they always want it as proof that you are 'really struggling'. As you rightly have pointed out - finding suitable medication is problematic, and you need to reiterate that the reason you don't take more is that you can't. It doesn't mean that you don't need it. No, they can't refuse you because you are on a low dose.
Communicating with others - repeat the difficulties you have look at page 68 of the guide and see if you missed anything or you need to strengthen anything.
Do have a look at the Guide to PIP Appeals, which has the advice about putting in for an MR. Don't waste time on any issues that won't score you the extra points.
BIS
I'm sorry you find yourself in this position.
Go back and read the guide to PIP claims and reviews - page 42. I am not an assessor - but I would definitely challenge the fact you didn't get the points. Do read through the pages in the guide to make sure you have given enough details as to why if you do not do this (prescribed) treatment - your condition will deteriorate. You also need to emphasise why the decision is key - and that is in two areas - your physical health, but also your mental health. If the exercises are painful, you won't want to do them, and that is an added reason why when you suffer from anxiety, the added help is key. Point out in your MR that the "Assessor was incorrect in saying that you had no specialist input and failed to read the letter from (give date, name and position) and take into account the necessity of this exercise as prescribed, which you previously submitted with your form."
Dressing and Undressing - Unless someone has fibro pain - they won't know what you're talking about. So go back and look at what you said - do you require help? Would you stay in your pyjamas if you couldn't get help? Does it take you twice as long as a normal person to get dressed? Are you using any aids? Do you have to stop because of the pain? Does your anxiety increase due to the pain? Are you constantly worried about your spasticity when getting dressed? Is your balance affected even if you sit down and get dressed? Does the pain you're in stop you from moving ....? etc etc. You might have mentioned some none of them. I only throw out a few ideas to make sure that you have explained everything. Too often, claimants assume that the assessor will understand and, therefore, don't explain what might seem obvious. You may have done all this, but always go back and check - because it's quite possible the assessor won't have direct experience with your conditions. Also, the impact is very personal - so two people with fibro will experience very different things.
In terms of the medication - they always want it as proof that you are 'really struggling'. As you rightly have pointed out - finding suitable medication is problematic, and you need to reiterate that the reason you don't take more is that you can't. It doesn't mean that you don't need it. No, they can't refuse you because you are on a low dose.
Communicating with others - repeat the difficulties you have look at page 68 of the guide and see if you missed anything or you need to strengthen anything.
Do have a look at the Guide to PIP Appeals, which has the advice about putting in for an MR. Don't waste time on any issues that won't score you the extra points.
BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems
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