Monday, 27 March 2017

Cystic Fibrosis - Part 2: Transfer from DLA to PIP 2

Update on my fight against DWP's decision on my PIP application:

Today (Monday, 27 March 2017) I spent 2 hours and 30 minutes with my Social Worker discussing and taking action on the decision made by the DWP to deny me my PIP claim.

Upon reading the letter I had received dated 20 March 2017, my Social Worker agreed it was quite clear the decision maker based the outcome of my claim on the 1 hour interview I had with the assessor.

I had an email from Adam Everett at the Warrington Guardian about the email I sent on Saturday evening.

In the past I have made contact with Adam on a regular basis with progress on past medical trials aimed to improve quality of life in CF.

Adam, who specialises in the health topics for the local newspaper, reacted with shock by the outcome of my PIP claim.

Here is a quote Adam managed to get from the DWP Press Office about how the outcome of a PIP claim is made.
"Decisions for PIP are made following consideration of all the information provided by the claimant, including supporting evidence from their GP or medical specialist.

Anyone that disagrees with a decision can ask us to look at it again, and if they're still unhappy with it they can appeal to an independent tribunal."
Below is a scanned copy (using Optical Character Recognition) of the letter with added observations that is evident the decision maker did not look at the evidence provided.

How I made my decision

I looked at all of the information available to me, including:
  • the "How your disability affects you" form
  • the information provided by the letter from your consultant
  • the information provided by the letter from your consultant
  • the information provided by the letter from your consultant
  • the information provided by the letter from your consultant
  • the information provided by the letter from your consultant
This told me the type of help, and how much help you need.

I used this information to look at whether you can carry out 12 activities and the amount of help you need. A score is given for each of these.

There are 10 activities for the daily living part of PIP and 2 for the mobility part.

If your total score for the daily living activities is between 8 and 11 you'll be awarded the standard rate. If your score is 12 or more you'll be rewarded the enhanced rate. This is the same for the mobility activities.

Daily Living - for the 10 daily living activities you scored:

Preparing food (scored out of 8)
You can prepare and cook a simple meal unaided - 0
In my application I stated that when in a low mood or unwell, I lose my appetite or need help preparing meals. I stated my partner helps with meal preparation, which encourages me to eat. Otherwise I would mess meals.

At the consultation with the assessor I stated that my partner, who was there with me, makes a majority of the meals due to me not having any motivation as a result of my low moods.
Eating and drinking (scored out of 10)
You can eat and drink unaided - 0
In my application I stated that when in a low mood or unwell, I lose my appetite or need help preparing meals. I said that my diet is a very important part of my treatment for my condition and I need to eat regular meals and have to take a substantial amount of medication with meals to aid absorption.

When I am unwell and produce a great amount of sputum, this suppresses my appetite and I lack motivation to eat. Therefore I am constantly reminded by my partner to eat.
Managing your treatments (scored out of 8)
You can either manage medication / therapy or monitor your health condition unaided, or you don't need to - 0
In my application I described how I use medical aids to help remind me what medication I need to take and at what time. I stated how my partner helps by making sure I have the required medication when we go out from the house.

I gave good examples the consequences I face should I miss a dose of medication i.e. stomach ache, diarrhea, heartburn, GORD issues, breathing issues and also result in me being more prone to infection.

I stated it can take up to 30 minutes to do treatment and if unwell can possibly take as much as 5 hours per day to do all my treatments.

I stated exercise is encouraged by my physiotherapist to help maintain lung function and that I get support with this.

I concluded that my high treatment burden affects my mood and my partner often prompts me to do my treatment.
Washing and bathing (scored out of 8)
You can wash and bathe unaided - 0
In my application I stated the importance of personal hygiene, daily washing and oral hygiene for preventing infection. Especially if I have been exposed to an unwell person, or if I'm on IV treatment.

I said I have a portacath used for IV access for antibiotics, and during IV treatment I struggle with personal care as a result of fatigue caused by the medication.

I stated I get help from another person to wash otherwise it would take me twice as long to wash if unaided.
Managing your toilet needs (scored out of 8)
You can manage your toilet needs or incontinence unaided - 0
In my application I stated I suffer from incontinence as a result of not taking my medication correctly or eating food that I unknowingly have intolerance to.

I stated my partner does the laundry and ironing at home as I find this a strain to do whether I am well or not.

I stated when on IV treatment I need to be close to a toilet more often due to high volume of liquid intake.
Dressing and undressing (scored out of 12)
You can dress and undress unaided - 0
In my application I stated that when unwell it takes me twice as long to get dressed due to having to rest as a result of breathlessness. I said I particularly have issues putting on socks and shoes due to the strain it has on my chest.

I concluded that when I'm having a bad day I don't get dressed due to fatigue, breathlessness and chest tightness.
Communicating (scored out of 8)
You can express and understand verbal information unaided - 0
No information was given about communication as I have no issues here.
Reading (scored out of 8)
You can read and understand basic and complex written information either unaided or using glasses or contact lenses - 0
No information was given about communication as I have no issues here.
Mixing with other people (scored out of 8)
You can engage with other people unaided - 0
In my application I stated that due to being prone to chest infections, which easily damages my lungs, I said a simple cold could result in hospital admissions for IVs.
When I am on my IVs, I have no social life at all.

I said to avoid infection in order to preserve my lung function, I don't often socialise in fear of coming into contact with infection whilst outside.

I concluded I find this frustrating and distressing because it limits my social life significantly.
Making budgeting decisions (scored out of 6)
You can manage complex budgeting decisions unaided - 0
I stated I have standing orders with my bank to make paying for house bills easier to manage.
Your total score for the daily living part of PIP is 0 points. This means I can't reward you PIP for help with your daily living needs.

Mobility - for the 2 mobility activities you scored:

Planning and following a journey (scored out of 12)
You can plan and follow a route of a journey unaided - 0
In my application I stated I suffer a persistent cough, which can make me breathless and dizzy.

I said I have medication I take at particular times in the day and have suffered from bowel incontinence.

These cause me to feel overwhelmed and anxious, stopping me from going out without encouragement from another person.

I worry about missing medication whilst out, or not being able to get to the nearest toilet. Therefore I get concerned about visiting unfamiliar places and limits my social life.
Moving around (scored out of 12)
You can stand and then move more than 200 metres either aided or unaided - 0
In my application I stated that walking around shops no matter how big or small can be tiring and makes me breathless.

I always find a parking space as close to the entrance to shops as possible to do a small shop, or my partner does all the shopping if I am not well or in a low mood.

I stated that on a bad day I have not been able to walk more than 24 metres.
Your total score for the mobility part of PIP is 0 points. This means I can't award you PIP for help with your mobility needs.
Now that you have seen a breakdown of what I put in my application, that this does not match the scores given or the decision made below.
My decision

I made my decision using information about your health condition or disability including details of any treatment, medication, test results and symptoms. This information is the best we have available and enough to decide how much help you need. As your needs vary, my decision is based on the help you need most days.

You said you can manage communicating verbally, reading and understanding signs, symbols and words and making budgeting decisions. I agree you can manage these activities.

You said you have difficulties preparing food, taking nutrition, managing therapy or monitoring a health condition, washing and bathing, managing toilet needs or incontinence, dressing and undressing and engaging with other people face to face.

I have taken into account you have no physical restrictions, and although your condition can sometimes lead to hospital admissions however these have been infrequent.

Informal observations showed that you looked well with a normal complexion and appeared to be of an average build and did not look tired, and no signs of breathlessness was observed. You were found to have adequate memory and concentration and reported that you drive a car several times a week, which would suggest good cognition.

You did not appear anxious, withdrawn or agitated and reported that you mix with family and friends and had no problems engaging with the assessor.

You also stated that you are currently looking for employment.

In your social history you said that you go to the gym about 3 times a week and use the bike for 10 minutes then spend up to 40 minutes on the weight for strength building.

You stated that you are not the incontinence nurse as you accidents on not for the majority of days, and have no input from the mental health services. I decided you can manage these activities unaided for the majority of days.

You said you have difficulty planning and following journeys. I have taken into account you have no cognitive or intellectual impairment. You drive automatic car several times a week going to the gym, supermarket and visiting family and friends.

I have decided you can plan and follow the route of a journey unaided.

You said you also have difficulty moving around. I have taken into account you were observed to walk at a normal pace with a normal gait unaided and observed to rise from a chair unaided, and no breathlessness was observed, and you reported you go to the gym about 3 times a week and used the bike for 10 minutes.

I decided you can stand and then move more than 200 metres for the majority of the days.

This is consistent with your medical history, your description of a typical day, informal observations at your face to face consultation, how you engaged with the assessor, the available evidence and your mental state examination results.

I cannot consider any help you need not covered by the activities for daily living and mobility, including being near to a toilet and laundry.

For more information about PIP go to www.gov.uk/pip

Yours sincerely

Diane Chennell
Any claims I made in my application were evident in the letters sent by my consultants.

As you can see in the response above, it is evident by what Diane Chennell has written that she based the decision on the 1 hour I spent with the assessor.

It is of mine and the Social Worker's opinion Diane Chennell's decision shows very clearly the application and evidence provided by my consultants were not looked at.