PIP assessment attended

The following is a colleauges report having attended a PIP assessment (Atos sub-contractor) with a client. Client suffers from back and leg pain, arthritis in his hands and bladder incontinence so the focus was on physical problems.

The assessor (qualification not stated - possibly a physio) introduced herself and explained the purpose of the assessment and checked he understood. She updated the form on her computer as she went along and took photocopies of any relevant paperwork to be sent back to DBU. She took his ID and then started her questions. This was more of a conversation but was framed as follows:

Was there a diagnosis of his condition and how long had he had it?
Where was his pain?
Did he have any other conditions?
Does his condition vary?
Does he take medication? She listed the meds and went through what each one was for. Did he need assistance with his medication? Are there any side effects?
Living arrangements? Who does he live with, where does he sleep? Where is the toilet?
Work history including when he last worked, why did he stop work and what was his job?
How did he get to appt?
What does he do during the day?
Is there anything he likes to do?
What time does he get up and go to bed? How long does it take to get to sleep? Does he wake at night and does he get up to go to the toilet at night?
Does he have problems with incontinence? Is it a lack of control? How often does he have accidents? Does he take medication for this? Does it work?
Does he have problems getting on and off the toilet?
She then asked again about nightime needs, meds and sleeping.
Then back to the daytime routine asking:
Once awake how long does it take before he gets up?
Does he have difficulties with washing and bathing?
Getting dressed?
Making meals?
Swallowing?
How many times does he sleep in a day and how long each time?
Does he go out during the day?
Does he have problems mixing with others?
Does he walk in his garden?
Does he go to the supermarket with his wife?
Does he understand budgeting?
Can he go to unfamiliar places and would he ask someone he didn’t know for directions? Does he need someone with him when he goes to new places?
When you walk where is the pain and is it at the onset of walking? How far can you walk before you need to stop and how fast can you walk? Is there anything else that happens when you walk?
Is there anything else that needs to be mentioned?
How often does he see his GP?
Does his wife want to contribute anything?

She then included his wife’s name and my name on the form to be submitte4d and advised on the next steps. She was under the impression that her form would go directly to the DM at DWP rather than back to ATOS. She estimated it would take about 8 weeks for a decision.

There were no questions directly related or designed to tease out responses to address specific descriptors within each relevant activity. When clients response was vague/unclear there were no follow up questions designed to ellicit a more specific answer. There were no questions about, for example, how long it took the client to complete a task or how frequently he had a problem. There were many leading questions.

sounds pretty like the one I attended

Sounds a bit like a few DLA Tribunals I’ve attended! I suppose I’m glad the assessments are taking place.

Just had a client on the phone that was turned down for PIP, and said much the same thing. She felt that the HCP had judged her, as soon as she walked in the door, and felt the whole assessment was a waste of time. Yes/no answers and no opportunity to explain her answers.

HCP apparently said, “ah you can use a microwave” (which she can but only to heat up meals her daughter has prepared for her) and still gave her 0 points.

And strangely within a week of THAT decision, out pops an ESA50 in the post!

well just to give a different outlook the assessment I went to was excellent -the client had physical problems - one hip replaced, the other waiting, and mental health problems - drug dependency, depression. The assessor was a physio and he was very inquisitorial. He asked him about getting in and out of the bath and the client said he could manage, there was no point bothering about him. The assessor came back and asked him if it hurt, did he have any difficulty. He added that it probably wasn’t good for his hip sitting right down in the bath and that he should have aids and adaptations. He was also very understanding about his mental health problems. At the end he summarised which activities he felt the client scored in. I felt he’d missed one out so I pointed it out and he asked more questions about that. He scored the client points in all the categories he said and the one i added and the award was enhanced daily living. He only made 4 points on mobility but that was probably fair.

Peter’s description of the main questions does confirm that we are right to be worried. From the list of questions, I could see very little/nothing in relation to the ‘majority of days in the required period’ test (12 months), and perhaps worse, very little suggesting a proper understanding or application of the requirements of the ‘reliability’ regulation. I am not clear from the thread whether it was obvious that the HP had already read all of the background medical evidence in relation to the claimant - as we know they are supposed to (para 2.6.6 of the PIP Assessment Guide).

I have been developing a document for companions to take to ESA/PIP medicals to assert their rights to speak and take notes etc, but it seems to me it should be expanded to embrace the above shortfalls, as well as the implications of CE/3883/2012 (qualifications of the HP). We probably don’t want to alienate the HP too much such that they might abandon the interview (leading to more delays etc), but the initial anecdotal evidence suggests a replication of many of the problems we have seen with ESA. Of course, some HPs will be great and thorough - its probably only the other 75% (whatever) we should be worried about!

Been alerted by a couple of recent clients that they were asked questions in relation to the 50% but it was not phrased explicitly. Two different centres. Wigan and Manchester I think. They were asked to describe the frequency they were bed bound and to balance that against the days they were up and about so to speak. Both clients said they hadn’t really thought about it at which point the assessor lead them with “so roughly 50/50 then?” and both clients, in the absence of anything better to say went with that.

Of course 50/50 immediately means the client is saying that they don’t satisfy an activity for “more than” 50%. Job done from an ATOS perspective.

Of course if we were to have led a client in that manner in a tribunal or in obtaining medical evidence I think we know what would happen next.