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PIP - Managing therapy - Significant functional problems

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9 years 2 weeks ago - 9 years 2 weeks ago #131275 by Jane Breeze
PIP

PIP application so far:-

1. Application Jan 14
2. Consultation with ATOS – Oct 14
3. Got 7 points in total
4. Reconsideration remained at 7 points – 5th Jan 15
5. Appeal application made – 29th Jan 15
6. Response from DWP – still 7 points – 11th March 15

Managing therapy or monitoring a health condition – I got 1 point and feel I am due the full 8 points as my therapy takes more than 14 hours a week. It is in fact a minimum of 3 hours everyday of every year and often much more. I am prompted regularly and get help every week though not as often as I could do with, as support is just not available. I have given varying evidence during the application process to show this.


According to DWP I have not shown (in questionnaire or consultation) ‘significant functional problems’ with this activity. I have not come across this term in any of the guides and wonder what actually constitutes significant functional problems.

Can anyone please help, advise. I can provide more information if needed.


Breeze
Last edit: 9 years 2 weeks ago by Gordon.

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9 years 2 weeks ago #131282 by Gordon
Breeze

By "significant functional problems" they are saying that either your treatment does not require supervision, prompting or assistance or you can manage your treatment without supervision, prompting or assistance.

There are two aspects to this Descriptor that you need to tackle.

First you need to show that the total time taken for your treatments is at least 14 hours per week. You say you need more than this! You need to check the assessment report and the Decision Makers Statement of Reasons to see whether they agree that you that your treatment takes this amount of time, if they do then you do not need to take any further action in regard to this, but if they do not then you will have to show to the Tribunal panel that you do.

Secondly you need to show that you need supervision, prompting or assistance throughout the 14 hours. You don not say what the nature of the treatment is, but that should not matter.

If you need supervision then you need to explain why this is the case and what potentially might happen if you were not, for example; is there a chance that you would over or under medicate?

If you need prompting, you need to explain why, what would happen if you weren't prompted; for example; if you are diabetic and need to be prompted to check your insulin levels, not being prompted could have serious health implications.

If you need assistance then you need to explain why and what assistance you need, you need to show that you cannot manage the treatment without assistance not that it is simply easier for you to do so with it. for example; if you have upper body mobility problems and need to apply treatments to your feet and are physically unable to reach them yourself or with an aid.

Your primary goal is to show that you meet the criteria, then to show that the DM's and assessors opinion is wrong.

Gordon

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9 years 2 weeks ago #131286 by Jane Breeze
Hi Gordon

Thank you very much for your prompt reply.

I have chronic eczema which takes a lot of time to manage in order for me to function at all. Without treatment and therapy I would not survive, I would not be here. It is hard enough as it is, I suffer anxiety, stress and bouts of depression, find it hard to mix with people and need encouragement and prompting to do this as a consequence of my condition.

Mostly I do my therapy myself and have had to all my life, though my condition has got worse as the years have passed by. I live on my own and rely on some support from a good friend and my mother they both prompt me each day and assist when they are around once or twice a week, often over the weekend, (please note I am 46yrs of age.)

You mention that I need to show I am prompted throughout the 14 hrs, I am prompted by phone call or text and some visits. In the guides I have read my understanding is that I need to be prompted at some time during that day, not necessary for the duration. Is this different in the case of managing therapy.

Your help so appreciated

Breeze

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9 years 2 weeks ago #131304 by Gordon
Breeze

As much as the government have tried to make these assessments empirical so that decisions can easily be derived through a combination of computer programming and, in principal, sound decision making, the reality is that in many areas it as much about credibility as anything else.

So the things you need to explain are whether you always need prompting in order to undertake your therapy, it is the majority of the time or less. The fewer the occasions where prompting is required the less likely you are to receive an award.

If you don't receive the prompting what would happen? Would you not carry out the treatment and if you did not, what impact would this have on your health, if missing one treatment would have limited impact on your health then you are less likely to receive an award, but if the impact would be significant then the this would emphasise the need for the prompting.

When is the prompting required, immediately before the therapy is started, or can you manage if it is earlier in the day, the further away from the treatment the prompting is the less likely it is going to be believed that it is required.

Do you start the treatment immediately after prompting or does it have to be done at specific times of the day? Is there a period of time in which the prompting would be effective and outside of which it would not?

Wherever you can you need to relate your need for treatment to the medical evidence that you have available, you need to try and show are supported by statements from the medical professionals treating you.

An appeal panel will look at all of your evidence from scratch and anything you have submitted specifically for the appeal and it is perfectly possibly that they will reach a different conclusion from the DWP, but I think you will have to put some work in to achieve this.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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9 years 2 weeks ago - 9 years 2 weeks ago #131333 by francis1969
Hi Breeze, I know what you go through! I also had problems deciphering this descriptor but from another aspect.

I have my partner to assist me in all aspects, not only due to my severe atopic eczema since birth (am now 45) but in addition, pompholyx eczema to hands and feet and prone to infections of the staph type, but also due to other chronic illnesses/disabilities I suffer. Hopefully, this should be enough to persuade powers that be, that descriptor 3 f equates to my situation due to amount of assistance required.

As I am sure you know, as I also suffer, my skin can and does get me down (I also suffer from depression, but my skin condition is not the only cause), and there are times that my partner has to prompt me (I sometimes call this nagging!). I know myself and am reminded that if I do not manage this therapy, then the deterioration to my health, not just my skin, is, can be and has been severe, leaving me housebound.

To be as brief as possible, my query surrounded how to persuade those making decision that the use of moisturisers, steroids, soap substitutes etc are forms of therapy!? Over the past 2 years, having seen 5 Consultant Dermatologists, and at least retaining 1 special nurse, all prescriptions/advice sheets to my GP what to prescribe, referred to all as drug therapy. I have also found amongst my documentation cons derm report advising me to continue with my Complete Emollient Therapy as discussed. Along with this, there is a vast amount of information available regarding Complete Emollient Therapy and Steroid Therapy. It is clear you class this as therapy.

Is it just the prompting that you need? Can you apply therapy to those parts of the body that are affected or are there parts you cannot reach, and why can't you reach, if this is applicable! (as I say, my own situation requires assistance with soap substitutes that are applied before showering on my back, below waist, legs and feet, I am assisted in shower and then with CET/steroids after.) My whole morning regime takes 3 hours, there is then the evenings and those times when this is more complicated!

Adding to above paragraph, knowing how eczema affects skin, after being prompted will person actually make sure you complete your therapy 'like a parent watching over a child doing homework! Are you depressed more often than not for whatever reason

The 'benefit' of having assistance as described, is that my partner is also able to 'supervise' to an extent making sure that those parts I am able to deal with as done properly and reliably. You & I both know what happens if we do not adhere to our regimen and how this further worsens absolutely everything, not just physically. When my time arrives, am hoping have done enough to qualify and quantify for 3f!

Just wanted to share my thoughts with you and let you know you aren't alone, not just regards PIP and eczema sufferers, but generally!
Know it doesn't have any bearing, but did you have DLA prior to PIP application?

Take care :-)
Last edit: 9 years 2 weeks ago by .

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9 years 1 week ago - 9 years 1 week ago #131422 by Jane Breeze
Hi Gordon

Please can you just clarify something for me, I know you have given me some more advice since the paragraph below taken from your first response to me but I just need to clarification on this point:

You wrote;

Secondly you need to show that you need supervision, prompting or assistance throughout the 14 hours. You don not say what the nature of the treatment is, but that should not matter.

I got this paragraph below From Page 20. Personal independence payment (PIP) claims on physical health, mental health and learning difficulties grounds. Version 17th July 2014.

Prompting is support provided by another person by reminding or encouraging a claimant to undertake or complete a task or explaining it to them but not physically helping them. To apply this only needs to be required for part of the activity.

please can you just confirm for me is this correct or has maybe case law moved on!(not sure if this is clear but I hope you get my drift, Im not a lawyer) , I understand PIP is quite new so things change.


Also this point from page 19 Personal independence payment (PIP) claims on physical health, mental health and learning difficulties grounds. Version 17th July 2014

In relation to supervision, prompting or assistance DWP explains that: the assessment will take into account whether individuals have an underlying need for support from another person, regardless of whether they have access to this, so if it would be reasonable for you to have support even if you don’t actually get it , then you should be scored on the basis that you need it.


Many thanks for your support, I really do suffer terribly, I often say I have half a life due to the time it takes to manage my condition. It really feels so.
Last edit: 9 years 1 week ago by Gordon.

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