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Thread: Claiming for PIP, need help/advice please.

  1. #1
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    Claiming for PIP, need help/advice please.

    Hello

    My wife is about to apply for PIP and I would like some help please. She has been diagnosed in 2012 with Mixed-Connective Tissue Disease and Raynauld's. In the last 6 weeks she has been admitted to hospital with Pulmonary Embolism (blood clot of the lungs) and Pneumonia (currently in hospital for). Both of these are indirectly linked to MCTD which weakens the immune system.

    We want to claim honestly but not sure how they would interpret her illness. Basically some days she is bed ridden due to swollen ankles and knees, with severe pain in shoulder and back. I'm guessing this bit entitles her to everything.

    However some days she is fully mobile (of sorts) and can be up and about with just limited problems.

    Currently these days are split around 90% bad 10% good, but can be 50/50 or even 10/90. Day to day and month to month there is no pattern to how she will be. Although summer months are slightly better than winter ones.

    So my question is how do we go about explaining this while still getting PIP? We are not going to claim she is bed ridden for her to be caught out and about but at the time don't want to make it sound like she is ok (when she is not).

    Any help would be greatly appreciated.

    Thank you

  2. #2
    Senior Member AmyS's Avatar
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    Hi jgw,

    I have no knowledge about Mixed Connective....

    I do have experience of Raynauld's. This could be either hands or feet, or both. If it is her hands, I know people can suffer badly with their fingers, i.e. gripping, holding and difficulty in keeping them warm. It would depend on the degree of how bad she suffers with this. Another forum catering specifically for Raynauld's some have claimed care allowance, as they are unable to grip, hold a pan, cut a vegetable, pour the kettle for a cup of tea (just examples). With swelling and numbness and life coming back into the fingers can cause shooting pains.

    Have you made your claim for PIP, or are you at the stage of filling out forms?

    Seriously consider seeking a professional to help you fill out the forms. i.e. CAB or similar. They write it differently to the way we portray our problems.

    Good luck.

  3. #3
    Senior Member catlover's Avatar
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    It might be worth keeping a diary to help track the fluctuation in your wife's condition. PIP is awarded based on whether it is more likely than not that you meet a particular descriptor (eg can walk and stand more than 1m but not more than 20m). You don't have to meet that descriptor all the time but would need to meet it more often than not. Assessors and decision makers will have enough knowledge of most conditions to know, and in some cases expect, that the functional effects may fluctuate. They are also pretty good at picking up when someone is exaggerating (e.g. only talking about their worst days) so your wife will need to describe the problems she experiences with PIP activities on her worst days and also how it is on better days and then try to be as accurate as possible about what proportion of days are bad days (the days on which she meets a particular descriptor).

  4. #4
    notnamedbill
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    Hi jaw

    I have Small Vessel Disease or Small Vessel Ischemia (dependant upon the doctor) with spasms and raynauds. Like your wife I am irratic when it comes to doing things, I have spent the majority of the last two months in bed because change in temperature brings it on and I cannot or donnot have the werewithall to get up! But over the summer when it was constant this trigger didn't affect me, change in emotion affects me and doing affects me so I didn't get off scot free.

    So why am I saying this: DWP am not interested in this sort of information. They are only interested in how it affects your wife's day to day living and only on what is the majority of the time. When I am at my worst I cannot put my socks on but that's not included because it is not the majority of the time.

    My condition as deteriorated and it is now 75:25 but when I applied for PIP it was 50:50 (bad:not as bad). I was honest and filled in the forms accordingly and got std mobility and 5pts towards care. I am now awaiting the outcome of a tribunal and I think enhanced mobility and std care is about correct for me.

    Whether you like me take the honest approach is up to you but if I could start again no way would I mention the 50:50 bit, I get the feeling that the DWP divide by 9 and times by 7 when it comes to judging these things, purely to compensate for the over egging of the disability. But it maybe that everybody over eggs to compensate for the DWP. Wish I'd have known this before I started to apply!

    Kel
    Last edited by notnamedbill; 18-10-14 at 02:41. Reason: Auto spelling

  5. #5
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    Quote Originally Posted by notnamedbill View Post
    Whether you like me take the honest approach is up to you but if I could start again no way would I mention the 50:50 bit, I get the feeling that the DWP divide by 9 and times by 7 when it comes to judging these things, purely to compensate for the over egging of the disability. But it maybe that everybody over eggs to compensate for the DWP. Wish I'd have known this before I started to apply!
    I'm not suggesting you or anyone else has done it, but dishonestly overplaying the effects of your disability is a criminal offence - potentially fraud by false representation contrary to s. 2 Fraud Act 2006, possibly some benefit specific offences.

    The assessors and decision makers are aware of the possibility of exaggeration, which will tend to cast doubt on the entire set of claims made by the claimant.


    Regulation 7 of The Social Security (Personal Independence Payment) Regulations 2013 (SI 2013/377) gives clear rules as to which descriptor applies when the condition varies. PIP is about ability across a day, and the assessment of which descriptor applies depends on the proportion of days a limitation exists.

    The best advice I can give is to give a clear and specific explanation of how your condition varies. To give an example of specific, it is much better to say "on at least 5 days a week" than "most of the time". "Around half the time" is particularly troublesome, as it is unclear which side of the "50% of days" line that claim should fall.

    A diary can prove helpful in illustrating the pattern of variability.


    I've gone further into variability and reliability (safely, to an acceptable standard, repeatedly and in a reasonable time period) in the sticky PIP thread.


    Quote Originally Posted by notnamedbill View Post
    My condition as deteriorated and it is now 75:25 but when I applied for PIP it was 50:50 (bad:not as bad). I was honest and filled in the forms accordingly and got std mobility and 5pts towards care. I am now awaiting the outcome of a tribunal and I think enhanced mobility and std care is about correct for me.
    The tribunal remakes the original decision, so is unable to consider deterioration taking place after assessment. Subsequent deterioration can be considered if you report a change of circumstances.

  6. #6
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    Thank you for your help, wife is still in hospital having been diagnosed with pneumonia. This is another problem with MCTD, it is an auto-immune condition so picking up illnesses and hospitals stays is likely to become a regular occurrence for her. I'm doubting they take this into account as secondary illnesses and hospital stays related to MCTD are not guaranteed (can't think of a better word). Though I'm guessing it adds a little weight to the claim being genuine.

    Think the best option is for her to consult her specialist before filling in any forms, as he will probably be giving evidence and an opinion it may be best to get his take on things.

  7. #7
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    Quote Originally Posted by jgw View Post
    Thank you for your help, wife is still in hospital having been diagnosed with pneumonia. This is another problem with MCTD, it is an auto-immune condition so picking up illnesses and hospitals stays is likely to become a regular occurrence for her. I'm doubting they take this into account as secondary illnesses and hospital stays related to MCTD are not guaranteed (can't think of a better word). Though I'm guessing it adds a little weight to the claim being genuine.

    Think the best option is for her to consult her specialist before filling in any forms, as he will probably be giving evidence and an opinion it may be best to get his take on things.

    Hi Jgw,

    if you was to claim PIP, and you get it, it could well get stopped as your wife would be in hospital to much,

    sure someone with a bit more info on this will belong to give you all the ins and outs of being in hospital why claiming PIP

  8. #8
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    Quote Originally Posted by marcus6 View Post
    Hi Jgw,

    if you was to claim PIP, and you get it, it could well get stopped as your wife would be in hospital to much,

    sure someone with a bit more info on this will belong to give you all the ins and outs of being in hospital why claiming PIP
    It stops after 28 consecutive days in hospital but starts again when you leave.

  9. #9
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    Periods of hospitalisation separated by less than 28 days are joined together and PIP payments are suspended the total of all joined periods of hospitalisation exceeds four weeks.
    Last edited by Flymo; 22-10-14 at 02:17.

  10. #10
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    Think the best option is for her to consult her specialist before filling in any forms, as he will probably be giving evidence and an opinion it may be best to get his take on things
    No benefit today (ESA or PIP) is awarded on the basis of illness, any illness, and medical opinion counts for very little regardless of the eminence of the provider.
    It is effects of that illness you must focus on and you must do this in has much depth has you possibly can and all in relation to the activities in the 'Descriptors'. So if you can show those to your medical adviser and ask if they can provide support in respect of them as it is this area of your application you must really make your impact. As for medical evidence a simple summary of your condition(s) supported by an up to date meds list supplied by your GP is sufficient.

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