Pip mental health

[fizzwizz]

My award letter came yesterday - I got 15 points for daily living and 4 points for mobility. I'm so relieved that the process is over and thought I'd share my experience. My conditions are recurrent depression, anxiety and possible borderline personality disorder. This is my timeline:
08/08/14: telephone call made to request form
22/08/14: form received, deadline for return 08/09/14 - so only giving me 2 weeks to complete the form!
07/08/14: rang to request extension, was given new deadline of 22/09/14
19/09/14: form returned by registered post. Supporting letter from CPN included
23/09/14: text message received from dwp confirming receipt of application
30/09/14: letter received from ATOS confirming receipt of application
01/12/14: rang ATOS to check progress. Was advised that I had been approved for a home visit (although I hadn't requested one) & they were waiting for an assessor to be available in the area
17/12/14: letter received advising me that the home visit would take place on 07/01/15 between 9am and 11am
17/12/14 to 07/01/15: went into total panic about the assessment and read every forum post I could find... (thank you to everyone who shared their experiences)
07/01/15: the assessor arrived at 9am. I'd worked myself up into a terrible state and was worried the assessment would be cancelled as a result but the assessor was lovely and gave me time to calm down. She explained that she was a CPN and so had experience of mental health issues. She asked about my medical history, diagnoses & medications, then about my social and work situations. She then went through the daily living and mobility activities in the order that they're listed on the PIP2 form. She was sympathetic and supportive throughout and was open about what she was writing on her form. She then stated that this would form the basis of her report to the DWP. I was very relieved when the assessment was over and pleased that it seemed to go well.
08/01/15: began stressing about all the things I'd left out of the assessment...
14/01/15: letter received from ATOS stating that the assessor's report had been quality checked and passed to the DWP
16/01/15: award letter received!

I was awarded the following points:
Preparing food: need supervision or assistance - 4
Taking nutrition: need prompting - 4
Managing therapy: need supervision, prompting or assistance - 1
Dressing and undressing: need prompting or assistance - 2
Engaging with other people: need prompting - 2 (I thought this should have been higher but I'm not complaining!)
Planning and following journeys: need prompting to avoid significant mental distress - 4

I'm considering requesting a mandatory reconsideration in relation to the mobility. Although the points awarded are in line with the guidance given by the DWP, I don't believe that they reflect the actual wording of the descriptors or the purpose of the benefit. The dwp guidance appears to twist the meaning of the descriptors just so they can exclude people with mental health issues from the mobility element. However whether I will have the energy to challenge this is another matter!

I hope my post is of some help to others who are still going through the application process & wish you all well with your assessments. If anyone has any questions please feel free to ask.

[Flymo]

Congratulations on sticking with the process and for achieving the Daily Living award.

Though there's no guarantee of getting as assessor with particular expertise, it was clearly beneficial that you had a CPN as your assessor. I would hope the assessment providers try to make use of the specialist knowledge of their assessors wherever possible, for example by directing cases that are predominantly mental health to assessors with mental health expertise.



I expect your query with the Mobility award is the usual question about the applicability of the 'following' descriptors in the "planning and following journeys" activity to mental health. Unfortunately, those descriptors are not the finest piece of drafting ever to leave the offices of Parliamentary Counsel, though I believe their inapplicability to almost every mental health condition is clear from the descriptors themselves.


Those with mental health conditions usually score points from "planning and following journeys" through the two descriptors about overwhelming psychological distress.

Those who find going out too distressing on the majority of days even if accompanied should be awarded "cannot undertake any journey because it would cause overwhelming psychological distress to the claimant" for 10 points.

Those who can manage to go out on the majority of days, but would find it too distressing without someone going with them should be awarded "needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant" for 4 points.


The 'following' descriptors are "cannot follow the route of an unfamiliar/familiar journey without another person, assistance dog or orientation aid". The interpretation that is being applied to these descriptors is that they should be construed narrowly - the need for human/canine/technological assistance must relate specifically to following the route of a journey assuming you have a suitable route plan. In some cases, a mental health condition might destroy route finding ability, for example by making someone so anxious that they genuinely cannot keep themselves orientated and implement the route plan safely, though this would be rare and these claims are likely to be scrutinised carefully.

The 'following' descriptors are aimed primarily at people with visual impairment, cognitive difficulties (such as dementia), learning difficulties and some who are on the autistic spectrum.

I can see little justification for the "following" descriptors being taken as applying to anyone who could justify the need for accompaniment on the majority of days. The purposive approach to statutory interpretation requires looking for the intent of the legislation. I believe that intent that the "following" descriptors should be narrowly construed is clear, as there are descriptors specifically relating to psychological distress.


I wouldn't be surprised if the applicability of the "following" descriptors to mental health becomes the subject of an Upper Tribunal ruling in due course. If such a ruling is made, it will bind the First-tier Tribunal and will have to be followed by DWP (otherwise everyone whose decisions didn't embody the Upper Tribunal decision would just appeal to a tribunal).

[Saddan]

Well done will u get the pip backdated?

[fizzwizz]

Hi Flymo and thank you for your kind and considered response. Please accept my apologies for not replying as promptly, but for various reasons I am not always able to reply in a timely manner – though I will try to respond as soon as I am able.

I agree that Upper Tribunal decisions on the 'Planning and following journeys' activity are highly likely, and I'm sure that we would all welcome some definitive decisions on this point.

My query with the mobility award is indeed the usual question about the applicability of the 'following' descriptors in relation to mental health. I very much agree that the descriptors are far from the finest piece of drafting ever to leave the Parliamentary Counsel.

I disagree, however, that their inapplicability to almost every mental health condition is clear from the descriptors themselves. There is much in the guidance that twists the natural language of the descriptors to exclude people with mental health issues from qualifying for an award. There is very little in the actual wording of the descriptors to suggest that mental health issues should be excluded from consideration.

I have not read the primary legislation relating to PIP. However I have read the PIP Assessment Guide in detail. In the introduction it states that PIP '...is paid to make a contribution to the extra costs that disabled people may face, to help them lead full, active and independent lives'.

At 1.1.5 it states that in relation to the mobility component, it is 'intended to act as a contribution to the extra costs disabled people face in their day-to-day lives related to mobility'.

I would appreciate your response regarding whether the above statements are compatible with the contents of the primary legislation in relation to excluding claimants with mental health issues when there is a clear need for accompaniment throughout a journey, and therefore a reasonable expectation of incurring extra costs in order to provide such an accompanying person.

In every other activity the meaning of the wording of the descriptors is compatible with the natural language of the descriptor, and there is at least some attempt to follow a logical progression of need.

In relation to 'planning and following journeys' however, any relation to actual meaning or logic- however tenuous in relation to other descriptors- appears to have been entirely disregarded. The requirements to be able to complete an activity reliably, safely, to an acceptable standard and repeatedly are suddenly suspended in favour of an entirely arbitrary new set of standards – which appear to be designed to specifically exclude the majority of people with mental health issues- regardless of their additional needs – and their associated costs.

In considering whether a person with a mental health condition could reasonably expect to incur costs for being supervised outdoors, we could consider the huge disparities between the natural language of the descriptors for 'planning and following' a journey, and the DWP guidance:

A: Can plan and follow the route of a journey unaided: 0 points
B: Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant 4 points
C: Cannot plan the route of a journey 8 points
D: Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid 10 points
E: Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant 10 points
F: Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid 12 points

In relation to point B the natural language of the descriptor suggests that the claimant needs prompting to 'undertake' a journey but would be capable of completing the journey on their own after such prompting. However the DWP guidance twists this natural language and asks the assessors to ignore this natural interpretation, and induces them to apply a distorted representation that bears little resemblance to the original descriptors.

The DWP guidance explicitly states that a claimant would meet the point B descriptor if they require constant supervision throughout a journey to avoid harm to themselves or other people. A claimant in this situation would not qualify for an award of the mobility component, despite having a clear need for somebody to accompany and supervise them outdoors,and despite the clear cost implications of this.

Additionally a claimant who qualifies for point B would incur costs each time they need to undertake a journey.

For point C, a claimant with a mild learning disability who the guidance specifically states would not need any supervision or accompaniment on the actual route of a journey, and could cope with asking for help if there were some disruptions during their journey, would qualify for the standard rate, despite clearly not having a need for someone to accompany them outdoors.

So taking all of this into consideration, I don't believe that the guidance to the DWP assessors follows either the stated aims of the benefit or the natural language of the descriptors and I would appreciate your further guidance in this matter.

[fizzwizz]

Hi Saddan. Yes, the award was backdated to the date of my telephone application on 08/08/14. £1846 was paid into my account yesterday

[Flymo]

My query with the mobility award is indeed the usual question about the applicability of the 'following' descriptors in relation to mental health. I very much agree that the descriptors are far from the finest piece of drafting ever to leave the Parliamentary Counsel.

I disagree, however, that their inapplicability to almost every mental health condition is clear from the descriptors themselves. There is much in the guidance that twists the natural language of the descriptors to exclude people with mental health issues from qualifying for an award. There is very little in the actual wording of the descriptors to suggest that mental health issues should be excluded from consideration.

I have not read the primary legislation relating to PIP. However I have read the PIP Assessment Guide in detail. In the introduction it states that PIP '...is paid to make a contribution to the extra costs that disabled people may face, to help them lead full, active and independent lives'.

Your approach is to work out what you believe the legislation should say in order to achieve its stated aims. In common law legal systems the starting point is always the words of the legislation, not the principles behind the legislation. There is some scope to move away from a literal approach when the aims of the legislation demand it (the so-called purposive approach), but this does not extend to rewriting legislation wholesale in the tribunals and courts to implement the policy objectives behind the legislation more effectively.

The task of turning policy into legislation belongs to Parliament, not the courts - a principle that dates back to the Bill of Rights 1689. As Lord Reid noted in Pickin v British Railways Board [1974] AC 765, "The function of the court is to construe and apply the enactments of Parliament".


Preparatory steps leading to finished legislation, such as Parliamentary reports and Hansard (which contains the contents of Parliamentary debates), are known as travaux preparatoires and their use in interpreting legislation is not normally allowed. The main exception came about via Pepper v Hart [1993] 1 AC 593, which allowed reference to material in Hansard containing a clear statement by the minister/member promoting the bill in relation to legislation that is ambiguous, obscure or has a literal meaning leading to absurdity.

I suspect the quote you extracted from the PIP Assessment Guide or something very similar will appear in Hansard amongst the debates leading up to the Welfare Reform Act 2012 (the primary legislation upon which the secondary legislation of the PIP Regulations rests). However, this sort of statement about the broad philosophy behind PIP throws no light onto the meaning of the words in the 'following' descriptors, so cannot fall within the narrow Pepper v Hart exception.


The PIP Assessment Guide has no legal force - it is merely a guide to the interpretation of legislation that might ultimately be overturned by the Upper Tribunal or courts.



The 'following' descriptors are "cannot follow the route of [a familiar/an unfamiliar] journey without another person, an assistance dog or an orientation aid". This is the wording direct from Schedule 1 to The Social Security (Personal Independence Payment) Regulations 2013 (SI 2013/377), so is law.

Irrespective of what you want these descriptors to mean or what you believe they should mean, it is hard to escape "cannot follow [a route] ... without ... help" meaning the need for help must relate to the ability to follow a route for the descriptor to apply.

It seems impossible to fit someone who needs accompanying because of their mental health but who can follow a route without assistance into a descriptor that starts "cannot follow ...".

At 1.1.5 it states that in relation to the mobility component, it is 'intended to act as a contribution to the extra costs disabled people face in their day-to-day lives related to mobility'.

I would appreciate your response regarding whether the above statements are compatible with the contents of the primary legislation in relation to excluding claimants with mental health issues when there is a clear need for accompaniment throughout a journey, and therefore a reasonable expectation of incurring extra costs in order to provide such an accompanying person.

In every other activity the meaning of the wording of the descriptors is compatible with the natural language of the descriptor, and there is at least some attempt to follow a logical progression of need.

The conflation of three separate aspects of mobility (planning, following, overwhelming psychological distress) in the "planning and following journeys" activity is undoubtedly messy. This means you score points for whichever of these three aspects you are most restricted by and the other two areas are ignored. I believe this was a deliberate way to keep the Mobility component equally weighted between physical limitations on walking and other forms of mobility problems.

Three separate activities would be cleaner, but would require a supplementary rule that you count the highest score from the three activities towards the Mobility total. This would be an unhelpful complication in the simple "total the scores for each activity" approach used for PIP.

In relation to 'planning and following journeys' however, any relation to actual meaning or logic- however tenuous in relation to other descriptors- appears to have been entirely disregarded. The requirements to be able to complete an activity reliably, safely, to an acceptable standard and repeatedly are suddenly suspended in favour of an entirely arbitrary new set of standards – which appear to be designed to specifically exclude the majority of people with mental health issues- regardless of their additional needs – and their associated costs.

In considering whether a person with a mental health condition could reasonably expect to incur costs for being supervised outdoors, we could consider the huge disparities between the natural language of the descriptors for 'planning and following' a journey, and the DWP guidance:

[descriptors elided]

In relation to point B the natural language of the descriptor suggests that the claimant needs prompting to 'undertake' a journey but would be capable of completing the journey on their own after such prompting. However the DWP guidance twists this natural language and asks the assessors to ignore this natural interpretation, and induces them to apply a distorted representation that bears little resemblance to the original descriptors.

The DWP guidance explicitly states that a claimant would meet the point B descriptor if they require constant supervision throughout a journey to avoid harm to themselves or other people. A claimant in this situation would not qualify for an award of the mobility component, despite having a clear need for somebody to accompany and supervise them outdoors,and despite the clear cost implications of this.

Additionally a claimant who qualifies for point B would incur costs each time they need to undertake a journey.

For point C, a claimant with a mild learning disability who the guidance specifically states would not need any supervision or accompaniment on the actual route of a journey, and could cope with asking for help if there were some disruptions during their journey, would qualify for the standard rate, despite clearly not having a need for someone to accompany them outdoors.

So taking all of this into consideration, I don't believe that the guidance to the DWP assessors follows either the stated aims of the benefit or the natural language of the descriptors and I would appreciate your further guidance in this matter.

You cannot redefine legislation by contextual analysis. The starting point for interpretation are the words "cannot follow ... without ...", which is hard to construe as "can follow ... but needs ...".


So far as "undertake a journey" goes, there is a legal concept of the continuing act - something that continues to happen until it stops rather than happening instantaneously. Penetration is expressly defined a continuing act in s. 79(2) Sexual Offences Act 2003, so a sex offence can be committed if an act started consensually, consent is withdrawn and the withdrawal of consent is not honoured as quickly as reasonable in the circumstances.

The Oxford English Dictionary defines "undertake" in the sense of "undertake a journey" as "to take upon oneself", i.e. to take on the entire endeavour, not merely to set out. This means "undertake a journey" in the "overwhelming psychological distress" descriptors means "journey from beginning to end".


Your analysis of costs relating to "overwhelming psychological distress" is commendable, but does not reflect the reality of PIP. It would be nice if PIP was sufficient to pay for all the help a disabled person requires at fair market rates, but the reality is that it never intended to do so.

Local authorities have a statutory responsibility to provide social care according to need, or Direct Payments for the claimant to arrange their own social care if that is more suitable. A universal non means tested benefit like PIP uses an artificial scale of need to determine the level of support paid, not the actual costs incurred. As your quote from the PIP Assessment Guide says, "paid to make a contribution to the extra costs that disabled people may face" (emphasis mine).


Someone whose mental health is so poor that they cannot go out at all arguably faces higher costs than someone who can go out if accompanied. The person who cannot go out at all requires everything to come to them and will likely have to pay the additional costs involved.

[sandyp196]

i got awarded mobility for the mental health condition of agarophobia. i was awarded 10 points under planning journeys. i was awarded enhanced daily living. Both for 3 yrs and 9 months. i didnt expect to recieve the mobility element but im grateful because i do incur expenses that iv struggled to fund with just the esa and lr dla. i pay peoples bus fare and petrol to get me shopping, pick up prescriptions or take me to doctors, dentist etc. it mounts up. i didnt say any of this in my f2f.

[atmywitsend]

Sorry to hijack this thread slightly, but does no one with mental heath problems qualify for the mobility part of PIP? As I got 4 points the same as the OP here and I keep seeing people mentioning 4 points being the most you will get for it.

[Flymo]

Sorry to hijack this thread slightly, but does no one with mental heath problems qualify for the mobility part of PIP? As I got 4 points the same as the OP here and I keep seeing people mentioning 4 points being the most you will get for it.

As I said earlier in the thread:

Those who find going out too distressing on the majority of days even if accompanied should be awarded "cannot undertake any journey because it would cause overwhelming psychological distress to the claimant" for 10 points.

The onus is on the claimant to show it is is more likely than not they would suffer overwhelming psychological distress even if accompanied on the majority of days for this 10 point descriptor. Award of this descriptor gives enough points for an award of standard rate Mobility - or enhanced rate Mobility if the claimant scores 2 points or more on "moving around" (4 points is actually the lowest scoring descriptor that activity).

If it is felt the claimant could go out on on the majority of days but would suffer overwhelming psychological distress if not accompanied, the 4 point descriptor will be awarded.


I can think of at least one forum member who has been awarded the 10 point descriptor on mental health grounds.

[fizzwizz]

Hi atmywitsend, thank you for posting :-) As you point out many of us with mental health issues are really upset and confused about why we don't qualify for help with our needs when travelling outside, considering the extreme difficulties many of us face in this area. I think that for many of us with mental health issues 'going out' is an extremely difficult and distressing process from start to finish, and something many of us fervently wish we could avoid - but the demands of life mean we don't have that luxury and are forced to have to go out despite the horrors this causes us. So to have the legislation effectively dismiss our needs in this area as insignificant is very hurtful.

Like you, & I'm sure many more of us, I'm really trying to understand why?? Fortunately for us all this forum seems to be the best place for us to find our answers, particularly thanks to Flymo & his expert legal knowledge, and his kindness, diligence & willingness in sharing that knowledge with us