PIP Appeal - sight issues but client not registered as “visually impaired”

Hi all

Just looking for any experience/advice people might have…

I have my first PIP appeal at the end of next month. Client has type1 diabetes and suffers from several related conditions. Client has particular problems with her sight and has been diagnosed with proliferative diabetic retinopathy. As a result client can experience sudden bleeding behind the eye which affects her sight in the short-term, and on a day to day basis she has no peripheral vision.

At the PIP medical the healthcare professional awarded client descriptor 11f - so 12 points so enhanced mobility. However the DM states in the submission that he does not accept she needs help to plan and follow a journey as “your sight is at a level that does not qualify as sight impaired”.

I have been researching but cannot find anything so far that indicates that a claimant has to be registered as visually impaired before they can qualify for 11f. Just looking at all the DWP Decision Makers Guides etc that I can find online but in the meantime I wondered if anyone else had come across this and had any thoughts/pointers?

DM also used a report DWP requested from clients opthamologist which wasn’t particularly helpful to client but not necessarily unhelpful either (just a bit vague and “no problems I am aware of…”). At the moment our appeal submission is mainly focused on the fact that the HCP gave client sufficient points for an award when he assessed her and the non-medically qualified DM took them away again simply because client iis not “registered”....

Thanks for reading

Sarah

Has client had a ‘Visual Impairment’ assessment ? If not , I would get a copy and an Opthamologist’s translation/explanation in ‘lay man’ terms describing the degree of visual impairment the claimant is likely to experience .
If no ‘Visual Assesmnment’ try and get one arranged .

I would also take a look at ‘RNIB’ Factsheet for PIP - they have link to their ‘Word’ document detailing what things to think about re : PIP prescribed activities .

Edited so it’s (hopefully) now coherent!

Presumably the issue is following a journey already underway or already planned in full when there is a sudden deterioration rather than the planning element? Planning can usually be delayed whereas that may not be possible for the journey itself. A lack of peripheral vision doesn’t necessarily prevent the ability to follow a journey either so I would want to know more about the specifics of the deterioration vis a vis the impact of the bleeds. What specifically can they not do in consequence? Proliferative diabetic retinopathy has many stages and different symptoms so you would need to be very clear about where that’s up to. Bleeding into the eye causes blurring but that can be anywhere on a scale from “slight” to “just about able to distinguish light from dark”. You may find opths. appear quite harsh on this as they will have seen many people with bleeds who they will say categorically can see everything they need to see in a meaningful way.

Example, post eye surgery my right eye had a bleed from stitches for about 6 months. From distance it wasn’t obvious to most people but close up most people would recoil. To all but my nearest relatives it appeared unchanged over a long period of time but, in fact, I only had any sense of it, and it only had any practical impact, within the first month. Even during that time I could see through the red and generally do what I needed to do. The left eye was absolutely clear but that was often misinterpreted by all consultants bar one as meaning I could use my “good eye”. My “good eye” was less reliable and more easily tired because it was reeling from having a new location and also because the right wasn’t working as it should. A lot of the assumptions about what the left could do were incorrect.

I’m not saying the DM or HCP is correct. More that you need to be very clear and detailed in what you present. 

Probably need to clarify the “no peripheral vision” bit too. Peripheral vision is literally no more than vision outside the centre. The question then is how wide and tall is the central vision. Also rods (as in rods and cones) are concentrated at the edges of the eye and impact on colour perception so you would want to know more about how that impacts e.g. reading maps, smartphone maps and so on. 

Similarly, PIP doesn’t take account of day and night but someone with no peripheral vision will have very different issues between day and night. That needs to be articulated as people have a tendency to describe day time stuff only and say they can do things when in fact, when you add in night time issues, overall it’s possible to make a case that they cannot do so reliably, repeatedly etc.

Given the lack of peripheral vision it would also be interesting to see if they could qualify as sight impaired anyway as, sadly, that would simplify matters in the simplistic world of decision makers. It’s also worth saying that anyone can be registered if their consultant thinks it would be of benefit to them so it’s not all about measurements. I have previously made a successful case for registration on the sole grounds it would open the door to someone getting DLA and getting a CEA card and being able to get out and afford the cinema. Unfortunately this is something most consultants seem blissfully unaware of and few are open to persuasion. Better to find a different opth. than argue over Snellen measurements etc. 

Always worth making the point that it’s about the functional impact of impairment rather than the being impaired itself though. An ophthalmologist can explain very specifically a series of measurements but they won’t of themselves explain the impact no matter how good the translation of terminology. Nothing in my measurements would indicate I have problems with following an unfamiliar journey for example and yet I can articulate precisely why I do in terms of my functional ability. That said, in a world of Google and Wikis it’s easy enough to figure out the meaning of terms for yourself in most cases and work from there to figure the potential consequences.

I’m not sure what a Visual Impairment Assessment is! There is a low vision assessment which is really about the need for aids. Please clarify.