Benefit Information: What I've learnt... - Andover Fibromyal...

Andover Fibromyalgia & ME Community Group

2,781 members537 posts

Benefit Information: What I've learnt gathering evidence for Personal Independence Payment (PIP)

Admin_AFMCG profile image
Admin_AFMCGPartner
0 Replies

Hi Everyone!

:)

I am gathering evidence for my PIP at the moment, here's some tips and things I've learnt;

1.Gather evidence from the healthcare professionals you cited in your claim plus others involved in your care. If your report seems to be in anyway inaccurate, speak with your healthcare professional and discuss the areas of the report.

2. If your healthcare professional is unwilling to listen then try no to get stressed and ask them politely if they have read the PDF guide called DWP medical (factual) reports – a guide to completion to help them write the report.

If not, it might be an idea to ask them to please read the guide and then point out any parts you feel need adjusting always refer to the guide itself to explain why you feel either more information sound be added or amended.

ie: The report may say you have 'good days' and 'bad days' and an assessor may interpret this to mean good days are like other healthy people which mean capable of all tasks. This guide says in Question 2 – History of conditions to use the wording mild, moderate or severe in regards to symptoms. So, you may mention this and ask it they could amend it to use this wording as you do not have any 'good days' as others would perceive them as symptoms occur 24/7 but vary between mild & severe.

Here an excerpt of DWP medical (factual) reports – a guide to completion for Healthcare Professionals

2 Report Completion

2.1.1 All Medical Reports

Please complete the forms as fully as you can from your medical records and your

knowledge of the patient. It is not necessary to interview or examine the patient in

order to complete the report.

In the reports, we are looking for evidence based on clinical facts.

If you would like to

offer your opinion, please make sure it is supported by factual evidence.

A summary of any relevant information in hospital letters can be helpful.

2.4 Personal Independence Payment (PIP) factual

report

2.4.1 Background

Factual reports for patients claiming Personal Independence Payment (PIP) may be

requested where the Assessment Provider believes that further evidence will help

inform their advice to the Department.

The assessment for PIP considers the claimant’s ability to carry out a series of

everyday activities. The relevant activities are:

• Preparing food

• Taking nutrition

• Managing therapy or monitoring a health condition

• Washing and bathing

• Managing toilet needs or incontinence

• Dressing and undressing

• Communicating verbally

• Reading and understanding signs, symbols and words

• Engaging with other people face to face

• Making budgeting decisions

• Planning and following journeys

• Moving around

DWP Medical Reports – A Guide to Completion 9

The completed report should be returned within 5 working days from the date of

receipt.

2.4.2 Specific questions

Date when last seen

If your patient has not been seen recently by you, please tell us when and

where the patient was last seen by another healthcare professional.

Question 1 – Disabling conditions

List all the health conditions or impairments which may affect the patient’s

current functional abilityand the dates of when these conditions first

presented.

Question 2 – History of conditions

Please detail the patients past and present history. Details of the past history

can be very useful, especially when it demonstrates a change in condition

over a period of time, rather than simple statements such as “suffered since

1999”.

It is helpful to state whether the conditions are mild, moderate or severe although it is accepted that this is subject to individual interpretation, and if appropriate, whether they are well controlled or not (diabetes, asthma,

epilepsy etc). Include details of any relevant special investigations or tests for

each condition and the results.

Question 3 – Symptoms and variability

Information should be based on the patient’s clinical record and include both

day-to-day and longer-term fluctuations. Include the frequency and duration of

exacerbations and specify if the condition is well controlled.

Question 4 – Relevant clinical findings

Entitlement to PIP is based on the impact of the individual’s impairment

or health condition(s) on their everyday life. Please provide details of

examination findings related to the severity or impact of any health conditions or impairments.

Question 5 – Treatment: current, planned, response and diagnosis

Information could include details of drug and non-drug treatment, aids and

appliances used (prescribed or, if known, non-prescribed), specify

frequency of treatment and, for medication, dose as relevant.

Question 6 – Effects of the disabling condition(s) on day-to-day life

DWP Medical Reports – A Guide to Completion 10

If known, it would be helpful to have information on the patient’s ability to

carry out the relevant activities at 2.4.1.

We are looking for facts, not opinion, with the date of the observation. If

you would like to offer your opinion, please make sure it is supported by

factual evidence.

Question 7 – History of threatening or violent behaviour

The purpose of this section is to identify those patients who may pose a threat

to a healthcare professional if invited to a face-to-face assessment.

Question 8 – Patient travel to an assessment centre

A small number of patients are unable to travel to an examination centre and

may be offered a taxi or assessment in their own home if required. Patients

who travel to an examination centre are entitled to claim travelling expenses.

Question 9 – Additional Information

This section is not asking for opinion but provides space to answer any

specific questions raised and an opportunity to add any other relevant

information.

Read more or point Healthcare Professionals to the guide using the following link;

gov.uk/government/publicati...

I have added a few areas in bold as we often struggle with reports saying we can do tasks and it is not stated that the ability to do these tasks are dependent on the severity of our symptoms mild, moderate or severe at that time of day ie the condition fluctuates

Many Healthcare Professionals seem reluctant to state that an illness fluctuates, however this guides asks them to write this and how it affect daily activities.

3. Send a covering letter with all evidence, listing it and numbering it ie: 1. Prescription Print Outs then add number 1. to the photocopied documents/evidence. Here's link to a draft letter to send to address in number 4.

Draft Letter from Citizen Advice Bureau:

citizensadvice.org.uk/benef...

4. Photocopy the completed PIP form to keep for reference. Need help completely PIP see information in 5. below. Either Photocopy ALL evidence and send with the claim or after sending claim with a covering letter including list by recorded post to:

Personal Independence Payment New Claims

Post Handling Site B

Wolverhampton

WV99 1AH

5. My last top tip, that is important is make sure you always contact the charities like FMAUK, UK Fibromyalgia, Action for ME, ME Association etc to read their guides to completing Benefit Claims.

Here's a post will information that may help

Useful Websites and Helplines, see post below;

healthunlocked.com/afmcguk/...

Other Helpful Links for PIP

How to claim PIP Gov UK Website

gov.uk/pip/how-to-claim

PIP mock test

benefitsandwork.co.uk/perso...

Tables with descriptions of the points that may be awarded (8 to 11 points in total to get the standard rate, or. • 12 points to get the enhanced rate)

citizensadvice.org.uk/Globa...

Information about supporting evidence:

citizensadvice.org.uk/benef...

PIP Guide from Disability Rights

disabilityrightsuk.org/pers...

If anyone else would like to add anything or mention their experiences gathering evidence please do, as I'd be interested to hear your top tips

Emma :)

Please Note: This post is unlocked so it can be found by search engines and also shared via Facebook/Twitter to hopefully help others claiming PIP

Written by
Admin_AFMCG profile image
Admin_AFMCG
Partner
To view profiles and participate in discussions please or .