MR PIP Atopic Eczema?

Thank you BIS & Gordon for this, I've made some of the suggested changes which I hope make it a bit better?

I have 9 points so far so its on taking Nutrition and one other area to then get enhanced so hopefully with what I've added this will help?

Facts of the case

My medical conditions
Chronic Atopic Eczema. I experience pain and cracked skin in the joints of my elbows, knees, lower back, face, lips, neck, eye lids a significant amount of the time, this interrupts sleep and impacts my daily life significantly including my mood and anxiety levels.
Chronic Atopic Eczema -Quote from the NHS website which says, "...there's currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally", - which is in line with my experiences. www.nhs.uk/conditions/atopic-eczema/

Asthma
Hayfever
Stigma
Carpal Tunnel

I attach the following evidence;
- Letter from Consultant Dermatologist
- Occupational Health Report from Employer
- Full GP Patient Print out
- Study Tech Remote Assessment
- Ergonomic Workstation Assessment Report
- Photos of aids

I wish to dispute the following descriptors;

Preparing food
Preparing food, awarded b, disputing, seeking e,
I need assistance to prepare a simple meal, my partner chops vegetables for me….. I cannot prepare a simple meal safely or reliably because of the pain and the severely cracked skin from my Chronic Atopic Eczema. I can’t cut food because of the pain and the risk of cutting myself. The pain I am in is exhausting which affects my concentration which is why I cannot do these activities reliably. I struggle to grip lifting things as gripping causes pain, even wearing gloves so for example utensils in the kitchen, gripping them and utilising them causes pain in the cracked skin in my hands with the grip, weight and movement so I need assistance with preparing food, being stood at the hob causes my skin to be further sore and irritated by steam particularly on my face and arms and so I cannot at the cooker.
Evidence in Supporting Consultant Dermatology Letter

Taking nutrition
Eating and drinking, awarded a, disputing, seeking d
As a result of my chronic Atopic Eczema I only eat around 1 main meal a day I am put off eating and so my partner prompts me to eat all of the time, it hurts to eat because of the dry skin around my lips, opening my mouth to take food causes splits to my lips causing yet further pain, the pain is then ongoing in a cycle and is not helped by steroid medication which tightens the skin on my mouth making it worse before it gets better, cutting up food is painful due to the pain in my cracked skin on my hands and fingers, I therefore have cutlery as an aid that assists.
Evidence in Supporting Consultant Dermatology Letter, Photo of special cutlery.

Managing Therapy - medications
Awarded b, not disputed.

Washing and bathing
Awarded b, disputed, seeking 4f
As a result of the broken skin and eczema on the backs of my knees my partner helps me in and out of the shower or bath most of the time. Due to the broken skin on the inside of my elbows I cannot wash my back, particularly my lower back which has a bad eczema patch, my partner assists me in washing my lower back due to the pain of bending my arms behind my back.
Evidence, Supporting Letter from Partner

Managing Toilet needs
Awarded b, not disputed.

Dressing and undressing -
Awarded b, disputed, seeking e.
As a result of my Chronic Atopic Eczema I need assistance from my partner as I can’t dress my upper half without assistance most of the time, my lower body too regarding the backs of my knees but regarding my upper I have a bad patch on my lower back, the back of my neck and in the insides of my elbows, the oils and creams applied are sticky and have a burning sensation, touching these causes further pain and renders the application of the medication pointless and therefore I cannot do this reliably, my partner assists me by ensuring I don’t disrupt these areas while dressing.
Evidence in supporting Letter from Partner and…..XXXX

Communicating Verbally
Awarded a, not Disputed.

Reading and understanding
Awarded a, disputed, seeking 8c
As a result of my Chronic Atopic Eczema I have flared on my eye lids most of the time, this means reading is uncomfortable and I increase font size. As a result of my skin flaring I have difficulties concentrating on reading things due to pain and irritation on flare up points, this means I have a delay in reading complex information. I have Text to speech software provided by Student Disability Grant.
Evidence in Page 7 and 8 of Study Tech Assessment.

Engaging others face to face
Awarded a, disputed, seeking c
As a result of my Chronic Atopic Eczema I do not engage with my family and friends regularly due to my condition severely impacting my mental health, I do avoid this where possible and my family regularly comment on this. I do not have any close local friends as I avoid building relationships due to my anxiety socialising with others around the way I look particularly my face as the skin is regularly red and inflamed.
In the briefing room at work, I discuss my adjustments for my role and I am therefore placed in the Galley, away from passengers, I work a limited amount so that I don’t have to engage with others.

Moving around
Awarded a, disputed, seeking e
I am in pain in the backs of my knees on moving any distance from standing up where my skin is tight from the broken skin, this splits and is open and weeping, the pain is incredibly uncomfortable and makes me want to cry, I am slower to walk as a result, my University Course will be at a small campus the size of a medium size house, it is agreed I can utilise funded transport to and from the campus which can take me to the door which is in place as a result of the at home assessment undertaken.
Evidence in Letter from Consultant Dermatologist, Occupational Health report from Employer, Ergonomic Workstation Assessment.

N.B Pushing oneself to mobilise on occasion has been discussed by Judge Markus in the 2016 case: The undefined term ‘to an acceptable standard’ has been considered in many cases particularly in relation to how pain affects the ability to complete an activity reliably. In the unpublished case of CPIP/2377/2015 the effects of pain, its severity and frequency, and the extent of any rests, are all considered relevant to the question of whether a claimant can complete a mobility descriptor ‘to an acceptable standard’. The effects of pain are also considered in [2016] UKUT 326 (AAC)where Judge Markus holds that even if someone may be able to carry out an activity repeatedly and within a reasonable time, they still may not be able to complete it ‘to an acceptable standard’ if they do so with difficulties such as pain or breathlessness.