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Specific/common/red flag conditions which definitely qualify for PIP

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2 years 7 months ago #271512 by M
Hello,

I've read in some places online, that specific conditions are more likely to be awarded a successful claim. A similar thing happened with someone I know, when they discussed the disabling effects of their arthritis, their PIP claim was unsuccessful. However, when they were later diagnosed with fibromyalgia they were successful. Is there any truth in any of this?

And, I guess the other reason I ask is because I have a range of conditions, varying from mental health, learning difficulties and physical health and wondering if its worth putting examples for each/all of my conditions on my MR, or if its just better to focus on core key conditions where PIP assessors are more likely to give someone a reward for.

Alternatively, do I give examples for all of my conditions/ilnesses when relevant just because it helps to strengthen my case?


These are the 2 articles I am referring to and have quoted from them below -
Article 1 = What illnesses and health conditions qualify for PIP? DWP reveals who gets payments (cited below and relevant parts copied and pasted with reference)
Article 2 = PIP rules change means claimants with these 21 conditions could get DWP back pay (cited below and relevant parts copied and pasted with reference)

Article 1: www.birminghammail.co.uk/news/midlands-n...qualify-pip-21185901

Figures show that 82 per cent of PIP claims are recorded as having one of these five most common disabling conditions:

Psychiatric disorders (which includes mixed anxiety and depressive disorders)
Musculoskeletal disease (general)
Musculoskeletal disease (regional)
Neurological disease
Respiratory disease


Article 2: www.birminghammail.co.uk/news/midlands-n...backpay-pip-20793279
The key conditions are:

Agoraphobia
Alcohol misuse
Anxiety and depressive disorders (mixed)
Anxiety disorders
Autism
Bipolar affective disorder (Hypomania / Mania)
Cognitive disorders
Dementia
Depressive disorder
Drug misuse
Learning disability
Mood disorders
Obsessive compulsive disorder (OCD
Panic disorder
Personality disorder
Phobias
Post-traumatic stress disorder (PTSD)
Psychotic disorders
Schizoaffective disorder
Schizophrenia
Stress reaction disorders

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2 years 7 months ago #271519 by peter
Hi M

Sorry I haven’t had a chance to read the articles you highlighted but here”s an answer to your question based on my experience.

First provide full details of all your issues whether physical or mental including evidence as much as possible for each issue.

Second, for physical disability, mention all the aids you have to use on your worst days. These include everything from perching stools through specialists cutlery and kitchen tools even to embarrassing stuff like aids to bottom wiping.

Third, where you get help from professionals, family members and friends try to get letters from each of them saying what they have to do for you.

In all cases consider your worst day. Don’t let pride or bravery make you understate how much help you need.

I hope this helps

Regards
Pete

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2 years 7 months ago #271537 by LL26
Hi M,
I am aware of the articles you quote, they crop up regularly in various newspapers. First of all there are no conditions which are precluded from PIP. Conditions such as depression and back ache are very common conditions and therefore it is statistically more likely that claimants with these conditions will get PIP.
The newspaper articles are misleading in saying which conditions get PIP; it is a statistical analysis that's all.
If you have a common condition or one that is widely understood it is much more likely that DWP will have heard if it and be aware of the nuances involved. Something rare or unusual may not be known by the Decision Maker and hence may get refused. simply due to lack of understanding.
My experience shows that illnesses like eg ME have traditionally been greeted with poor press and a group of naysayers who suggest that this isn't a real illness and people are malingerers. Unfortunately poor training and or poor calibre of assessors has not dispelled these myths. Whilst I am not trying to defend assessors, if they are aware of this sort of negative press, it is going to be much more difficult to convince the assessor how ill you really are.
Also, the assessor will make comments such as 'only on first line or zero medication' hence not serious illness and hence zero points.'
On the flip side, terminal illness gets fast tracked and will automatically qualify for PIP.
In the middle there is a whole range of serious conditions which are well understood by most people and it is easier to convince an assessor you should get PIP.
Other conditions such as back ache can be very debilitating, but can also be fairly minimal. If the claim form is a bit vague, it is again very easy for the assessor to simply assume that your kind of backache is the trivial kind and hence not award PIP.
PIP is awarded on loss if function rather than diagnosis. So whether you have autism, back ache, cancer or amputation etc etc you should score points if you can not perform a PIP descriptor activity to the required standard. None of these or any other specific condition which isn't a terminal illness will automatically give a right to PIP either. So if 100 people who all have backache claim PIP it is likely you will get 100 different points scores, ranging from zero, some points and sufficient points to entitle an enhanced rate of PIP. The same could be true of cancer, depression or any other health problem.
Whilst diagnosis isn't required as such. as indicated above, a vague diagnosis of just back pain may just be ignored but if the back pain is caused by eg MS or cancer or whatever this suddenly becomes more credible. This might of course be because with a diagnosis often comes better evidence such as scans or xray and or a consultant report which is often more convincing to an assessor.
My advice when dealing with any medical condition rare or common - Spell it out to DWP don't assume they have heard if the illness, explain in full, especially eg why you only take first line medication etc.
As Pete has explained, write about all your disabilities or illnesses. Dont forget that some health problems have a cumulative effect. Eg Arthritis may be bearable but with depression it might be much worse ir the medication has less effect. Perhaps the heart medication you take gives a side effect to increase incontinence?
If you have poor mobility then you might not be able to bend over to attend to your feet. Does this exacerbate foot ulcers etc? Many things can be linked.
Everything is relevant if it has the ability to affect how you can ir can't do PIP activities.
Bear in mind also if you don't mention something which then flares up, or simply comes up in the assessment discussion or worse still at a tribunal hearing, you run the risk of trivialising something important (and hence it gets discounted or ignored) or being accused of exaggerating because you haven't mentioned it earlier.

I hope this clarifies.
LL26

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2 years 7 months ago #271563 by Angel
Hi, Many people focus on their conditions when applying for PIP/DLA, and consequently are unsuccessful. PIP/DLA is awarded on how you are AFFECTED by your conditions. You need medical info to ‘back up’ what you are saying, but conditions affect people differently; so they are not used per se.
The following user(s) said Thank You: denby, BIS

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2 years 7 months ago #271626 by Northern Boy
I had that “1st line medication only issue quoted” in the response to either the rejection of my original & / MR rejection. That was in 2018, took 4 years to get to a tribunal hearing scheduled for 21st June 2022 that was cancelled on the day

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2 years 7 months ago #271627 by Gary
Hi Northern Boy

That's not good news, why was it cancelled, have they given you a new date?

Gary

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