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Thread: PIP claim, and finding out what your doctors have said

  1. #1

    PIP claim, and finding out what your doctors have said

    It has been 32 weeks (8 months) since the DWP received my PIP2, and I am still waiting to be offered a date for assessment by ATOS. I have read that claimants now have an average of 35 weeks’ wait for a medical, so I am hoping that I may be hearing from them soon. And I need to start preparing.

    When I completed the PIP2, I did so rather hurriedly, and I now realise that I have omitted, or underreported, some of my medical problems, and the debilitating effect they have on my daily functioning. I will have to articulate this at the assessment, but I need to be sure that what I’m saying is corroborated by my medical records.

    I didn’t submit any letters of support with my claim; I simply gave the names of my GP and two hospital consultants as the healthcare professionals whom the DWP and ATOS could ask for further information. I have no idea if any of them has been contacted.

    I will be seeing my GP next week. With ESA, doctors are sometimes asked to fill in the form ESA113—is there a similar form for PIP? And if so, do I have the right to request to see a copy from my doctors?

    I was placed in the Support Group for ESA without a medical, and that took only thirteen weeks. I didn’t ask for the ES85A, but I know that I was given a prognosis of twelve months. At this rate, I will be getting another ESA50 through the door before my PIP claim is sorted.

  2. #2
    Senior Member sea queen's Avatar
    Join Date
    Nov 2011
    Just tell the truth when you go.
    My daughters GP/consultant wouldn't know 'everything' about how her condition affects her, so they could only give a smal picture of her abilities
    Sea Queen

  3. #3
    Senior Member
    Join Date
    Mar 2014
    I'm in the process of putting a Mandatory Reconsideration together for my recent PIP decision and I received the form my GP completed from DWP when I asked for the reconsideration. In my case he's just listed the conditions I have, medications I take, referrals made that I'm waiting for and so on. Other than saying in his opinion I couldn't attend a face to face using public transport due to fatigue and severe anxiety he's made no other comment on functional problems.

    There was a section where he was asked about the functional impact of my conditions on my everyday life and he just wrote "unknown" , which is fair enough and what I would expect as I treat him as someone who will diagnose a condition and offer medical treatment so other than explaining symptoms to him I don't talk about the impact on the kind of things they need to understand for PIP as I don't feel there's anything he can do about it and don't want to waste his time with it.

    I think probably in most cases GP's notes will be about the illness you have and the treatment/tests prescribed, but no more than that and he can only comment on what he actually knows for sure to be the case.

    As sea queen said, just tell it as it is and you should be fine

  4. #4
    Senior Member sea queen's Avatar
    Join Date
    Nov 2011
    A few years ago I went with my daughter to our small GP's surgery which isn't that wheelchair friendly.
    On this occasion we needed to use a different wheelchair which was too wide to go therough the corridor to Gp's room so we took her walking frame. The GP remarked that he hadn't realised she could walk as she walked in!
    That's what brought it home to me that they really didn't know what she can and can't do.
    Sea Queen

  5. #5
    Senior Member
    Join Date
    Dec 2013
    PIP is based on the functional effects of your health conditions and disabilities on your ability to carry out the PIP activities. As noisynoodle points out, doctors rarely have much of an idea about functional effects - they treat symptoms rather than assess disability.

    Unless you happen to have undergone some sort of functional assessment, for example by an occupational therapist, physiotherapist or as part of compiling a care plan, it is unlikely you will have a professionally prepared summary of the functional effects of your conditions to use as part of a PIP claim.

    The most important role of medical evidence in a PIP claim is to establish a medical basis for the functional effects you claim. A one to two page summary of history, diagnosis, key symptoms, prognosis and current treatment is usually sufficient. Claimants sometimes go overboard in providing detailed medical evidence when this is rarely necessary.

    It is possible for the assessment provider to contact one of the people you have nominated on your claim form, but it is relatively rare for them to do so. The most common time an approach is made is if the claimant's condition indicates assessment may be inappropriate and one or more of the medical professionals is likely to have a good view of the functional effects of the claimant's condition (as may be the case for those with severe mental health problems, autistic spectrum disorders, learning difficulties or cognitive problems). An approach may be made if there is doubt that the claimed functional effects relate to a genuine medical condition, or if factual information is needed about the claimant's medical condition, in which case a factual report will most likely be requested from the claimant's GP (similar to the ESA113, though adapted for PIP). Making contact is at the discretion of the assessment provider.

    It is unlikely that the assessment provider will contact a medical professional if the claimant has failed to explain the functional effects of their condition adequately. In the absence of a professional functional assessment, it will be uncommon that a health professional can give an adequately detailed account of the claimant's functional problems, and it is really down to the claimant to explain the difficulties they have.

    The delay involved in accessing your medical records or in using the Data Protection Act to get a copy of your file from the assessment provider makes it impossible to be certain what information the assessment provider has on you, as it's an evolving situation whilst assessment is ongoing. It's possible for an approach to be made to one of your health professionals after any face to face assessment.

    Rather than concerning yourself with what evidence might have been obtained from your health professionals, I suggest it is more constructive to make the case for the award of benefit. It is possible for a good quality explanation from you to overcome a mistaken explanation from a health professional - as I said, doctors often have a poor to non-existent picture of the functional limitations faced by their patients.

    I hope the sticky PIP thread gives helpful guidance in making the case for the award of PIP.

  6. #6
    Thanks, everyone.

    You've cleared things up for me quite considerably.

    My claim is based largely on a psychiatric disorder. Obviously, mental health patients do have physical health problems as well, which are often overlooked, both by the patient and their physicians.

    I was concerned that I hadn’t mentioned at all a chronic gastrointestinal disorder, which does affect my ability to eat and drink. I’ve realised now that I also failed to mention it on the ESA50. I do, however, remember discussing it with a doctor at an assessment some years ago, so it should still be on my record.

    If there any doubts, ATOS can always send for more information from my GP.

  7. #7
    Senior Member
    Join Date
    Dec 2013
    Atos' PIP operations are pretty much independent from their ESA operations. It's possible that information from the ESA system will have been provided to those assessing your PIP claim, though this is unlikely and you should not rely on it.

    If you've missed things out and want now to make an additional written submission, you are free to do so - send a copy both to DWP and to the assessment provider covering your area - Atos or Capita. You should use the addresses on the letters you have in relation to PIP. You should also take a copy of any additional submission to a face to face assessment in case the assessor hasn't been sent a copy.

    If you make an additional written submission, you should make it clear that the information provided applies from the date of claim, and supplements what you now regard as an inadequate explanation on the PIP2 questionnaire.

  8. #8
    Thanks, Flymo.

    I was hospitalised shortly after I made the claim, and I do have a consultant’s report that I could copy and send to supplement my claim. I’ll also take a copy to the medical to show to the assessor. It contains information regarding the gastrointestinal condition.

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