Epilepsy and PIP - practical experience

Paul_Treloar_CPAG - 13 October 2014 02:08 PM

it is strongly arguable that Pete satisfies descriptor 5(c) most of the time, in that he requires supervision to be able to manage toilet needs i.e. to watch and check for incontinence when a fit occurs

I agree with Paul about 5(c) supervision for toilet needs. This is the score that takes DWP case study Pete from below 8 to above 8. I’d argue that Pete could get points for all the supervision descriptors in activity 1 to 5 because of the ‘reliably’ criteria, which say that, to be able to these activities *safely*, he needs supervision >50% of the time.

I got 8 points for a client under the Cannot Prepare and Cook Food. My client had unpredictable and uncontrolled epilepsy, and was a danger to himself in the kitchen. He had taken blackouts and burned himself so his wife banned him from the kitchen.

To be fair, he was one of my very first PIP claimants, so maybe they were a wee bit more lenient then. Did have medical evidence from his GP and neurologist which helped.

He did get enhanced Daily Living, and mobility-cant remember without looking at file what other points were awarded for, but particularly remember the food one.

I’m ressurecting this thread as I have a case going to MR now. I have just done the sub and using CA/4332/2003 supervision to challenge the decision on activities 1 and 4. Caselaw is about falling but argueably should be used for fitting also.
My client has grand mal seizures and petit mal absences 75% at night time and 25% during the day. Uncontrolled by medication and unpredictable. Client gets no aura.
Has to bath (in shallow water to lessen risk) and shower supervised and with door unlocked in case of a fit. Cooking has to be supervised (he also has other issues which I hope would get him 2 points for prompting anyway for activity 1).
The question is are the situations he may fit predictable or unpredictable and if he did have a fit would it give rise to danger to himself and is this risk remote.
Considering the activities should be carried out safely, to a reasonable standard I would say that in my client’s case he requires supervision for the majority of the time when undertaking these activities. I know it’s DLA caselaw but seems appropriate here.

I’ve only just done the MR but my client only needs an extra 2 ponts having scored 6 reading and budgeting (dyslexia).

I’m also hoping to get mobility on activity 1 - 10 points cannot following the route of an unfamiliar journey. If he’s got 4 points for reading I can’t see how they could suggest he could follow a map (he also has memory issues so cannot remember directions).

Saw that you posted and decided to remind myself by re-reading the whole thread including my own earlier post. Funnily enough the thing that leaps out now is the lack of discussion on 4 and 7. I don’t think you necessarily need the DLA caselaw. I think we’re rapidly approaching the point where the penny is beginning to drop with advisers and tribunals (if not DMs on initial claims and MRs) that repeatedly, reliably, safely, reasonable time etc. are the key to all PIP claims.

My experience of grand mals is that bathing in shallow water is only needed if the person is unsupervised. No risk is reduced if you bathe in shallow water but the supervision is needed for all of the process. It’s also the case the outcome of a grand mal can effectively leave a person incapacitated physically (which manifests itself as almost complete exhaustion) and mentally (ability to communicate and comprehend) for a period afterwards that can be hugely significant i.e. it can be hours. I have been told it can be anything up to 7 or 8 hours before a person once again feels fully functioning. That would also vary depending on the time of day they triggered i.e. how much energy they had already expended. I have no evidence for that beyond anecdote but in my own personal experience someone I knew was certainly not up and running again for 4 plus hours after a 5 minute fit. They bathed in a relatively full bath under the supervision of their mother and that extended to making them rest immediately afterwards on the bed too.

Bearing that in mind, I think safely, repeatedly and reliably come into play on a whole host of activities we have hitherto perhaps too easily ignored. In other words, I think you’re in business and these are the standards of argument we should be presenting.

Mike Hughes - 10 July 2015 02:49 PM

Bearing that in mind, I think safely, repeatedly and reliably come into play on a whole host of activities we have hitherto perhaps too easily ignored. In other words, I think you’re in business and these are the standards of argument we should be presenting.

I hope you’re right. My appeal was immediately adjourned for GP records, which were never going to add anything to the evidence and in fact have proved not to - except that they say in bold caps that he does not have epilepsy. The Judge (who I think must be new, I’ve not seen him before and neither have my colleagues) also took it upon himself to tell us that he couldn’t say whether the tribunal might or might not choose to consider his enhanced rate mobility award and said it in a way that sounded like an implication that he thought the client has been faking his seizures all along.

In the meantime, his consultant neurologist has written to me stating that he does have epilepsy. He is also seeing a psychologist who has given a very provisional opinion that he has PTSD and a dissociative disorder but is not prepared to put that in writing for the tribunal.

I shall of course stick to the point that all this is pretty much irrelevant because a) his symptoms have not changed; b) there is absolutely no evidence to suggest he has been faking anything and c) most of it postdates the decision. And hope to get a different judge.