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Payment (PIP)
- A Guide on how to complete the
Medical Assessment Form.
(See also the companion guide Personal
Independence Payment (PIP) A Guide to the
Rules)
April
2013
Completing the Medical Assessment Form
This form asks for details on how your illness or health problems affect
your everyday care, supervision and mobility needs. It is important to
describe the help that you actually need, rather than the help you receive.
You may find that you are repeating yourself in different sections. This is
fine, it is better to put in too much information than miss out any details
on how the condition affects you.
Many of the questions may not be relevant to you. Remember the same
form is used for all health conditions, however you may still be awarded
PIP even where only a few pages are relevant to your condition.
At the end of this guide (see Appendix One) you will find the point scoring
for each category that is used.
Remember you need to score 8-11 points for the standard rate and 12 or
more points for the enhanced rate from questions 3-12 to get the Daily
Living Component; and you need to score 8-11 points for the standard
rate and 12 or more points for the enhanced rate from questions 13 and
14 to get the Mobility Component.
If one descriptor applies for at least 50% of the time that will apply
If two or more descriptors apply for at least 50% of the time then
the descriptor with the highest point score applies
Where no descriptor is satisfied for 50% of the time BUT two or
more apply and when they are added together they apply for more
than 50% of the time then you will score for the descriptor that
applies on the greatest proportion of time OR where they apply for
the same proportion of time the one that scores highest will apply
For each section we have tried to put statements or questions which act
as a prompt to help you complete the form as successfully as possible.
Question 1 - Please tell us who are the professionals best placed
to advise us on your circumstances
This gives space for up to three people who are involved with your care.
This could be a support worker, Community Psychiatric Nurse (CPN),
social worker, GP, Consultant Psychiatrist etc. If you have a number of
people who know you it may be best to list them in the order of who
knows most about your condition. The DWP may write to them for more
information so make sure they are aware of how your condition affects
you on a daily basis and what you can and cannot do because of your
condition.
List all your medication and tablets and where possible how much and
how often they are taken, you can attach a repeat prescription form if you
have a spare one. Also list any other treatment or support you receive,
e.g. seeing someone from the Community Mental Health Services on a
regular basis or counselling and therapy.
Explain the help you need to prepare and cook a meal. Do you need
motivation and encouragement to begin the cooking process? Do you need
supervision to ensure your safety and security? Are you more likely to cook if
there is someone there to remind you? Are you able to work out sell-by dates
or read or understand cooking instructions? Give any examples of incidents or
occasions where accidents have happened because of your mental health
problems.
Much of this section may not be applicable, but consider whether there
are times when you need reminding or prompting to eat or drink.
Taking the correct medication at the right time can often be crucial in ensuring
peoples conditions do not deteriorate and making sure that they do not need
to come into hospital. It is useful to explain if there have been times when you
have forgotten to take your medication, or have taken too much either
accidentally or deliberately, or if you self harm.
Do you have problems with washing and bathing and generally taking care of
your personal hygiene? These issues can be due to poor or lack of motivation
to deal with personal care or to stop any repetitive compulsive behaviour.
This section is often not relevant for people with mental health problems and
is more likely if people have problems such as incontinence. However, think if
you are sometimes so anxious that you may have had an accident, or if your
medication makes you so sleepy that you havent woken up and experienced
problems. Other issues could be where people dont use the toilet properly
due to self-neglect or incomplete self-awareness.
Do you need help from another person to help you communicate with other
people? This is more likely to apply to people who have problems such as
deafness and need help with sign language. But you may need help to
express or understand complicated material.
This activity looks at your ability to read and understand signs, symbols
and words. For many people this section may not be relevant, but think
about whether there are ever times when you are too ill to understand
things and need support from another person to understand letters etc
11a Do you need another person to help you mix with other
people?
This looks at your ability to have contact with other people, not just people you
know well but also strangers. Try to explain the difficulties you experience and
any anxiety or stress these situations cause you, or if you avoid social
situations. Engaging in this means in a socially appropriate manner including
understanding body language and being able to establish relationships.
Examples of difficulties you may have:
I am scared of meeting new people I can appear aggressive towards
I have paranoid thoughts about other other people
people I tend to become very withdrawn and
The voices I hear make it difficult to dont want to talk to people
concentrate on what people are I can suffer panic attacks when
saying to me meeting new people
I find it very difficult to trust anyone I I get easily intimidated by people
dont know well If I feel threatened or unsafe I can
I get scared about meeting new become verbally or physically
people aggressive towards others
I get easily confused when talking to I wouldnt go to appointments unless
people I dont know a family member or friend came with
When I am stressed I can behave in me
a way that other people find strange, I suffer from a Personality Disorder
cannot understand, or upsetting which makes it difficult for me to form
any meaningful relationship with
people and leads to trust issues.
This is an important section. If you only complete this section in the whole
pack this may lead to an entitlement to the Mobility Component.
13b - Do you need help from another person, guide dog or specialist aid
to get to a location that is unfamiliar to you?
13c Are you unable to get out because of severe anxiety or distress?
In this page you need to describe the problems that you have with walking in
places that are unfamiliar. The person may be able to go to lots of places near
their home, like the post office or shops, but how would they cope if they had
to go to somewhere like Birmingham and get about without someones help or
assistance.
Describe in your own words the help you need whether it is someone to make
sure you or members of the public are kept safe or that you need
encouragement to go outdoors. Explain if you need someone to keep you
calm if you feel anxious, panicky or aggressive. You may need help if you
become lost, confused or distracted.
These questions only apply if you have physical problems with walking.
Use this box to include any information that you have not been able to include
anywhere else on the form and you think will be relevant. Detail any hospital
admissions and times that you have been taken to hospital for your own
safety. If you have had any other treatments that you have not been able to
include may be added. If there are any particular incidents or situations that
demonstrate the problems you have, then write about them here.
There may be groups or organisations that give you help and support not in
connection with particular activities that might have a bearing on your claim.
They may talk to you, listen to you and encourage you. If you did not have this
support your condition may deteriorate and you may put your well being in
danger or have to be admitted to hospital. Give as much information about the
support you receive and what would happen without it.
You can also send in additional supporting evidence with the completed form,
such as care plans, information or letters from health professionals or support
workers. Before you do this though think about whether these really help to
support your case, if they have not be written specifically with a PIP claim in
mind the evidence may not give a full picture about how your condition affects
you.
Declaration
You will need to sign the form. The declaration states that you
understand and will comply with the rules. You should sign and date the
form and return it to the DWP in the envelope provided.
You have one month from the date the form was sent to you to return it.
If you cannot return it in time then contact the DWP to explain why, e.g.
because you need help and your support worker cant see you before a
certain date, and ask them to extend the time limit. If you state that you
have a mental health condition you will usually be given an extra two
weeks to return the form.
It is a good idea if possible to keep a copy of the form and any supporting
evidence you send in with it.
Appendix One: Daily Living and Mobility Activities
and Descriptors
The definitions below are from the PIP Regulations and may assist to
explain some of the terms used in assessing PIP.
Cook means heating food at or above waist height (i.e. not bending
down to use a low oven)
Simple meal means a cooked one-course meal for one person using
fresh ingredients
For people living in the City, information and advice is available from the:-
Benefits Campaign
on 0116 2543399 Monday Wednesday 1.00-4.00pm.
There are a number of other advice agencies within Leicester. Please see the
link below for an Advice Services Guide:
http://www.leicester.gov.uk/your-council-services/housing/housing-and-
council-tax-benefits/big-benefit-changes/
If you have any comments or suggestions on this factsheet then please send them
to:-
WARNING
The information in this guide is as accurate as possible at the time of
production. However, it is only a guide, and therefore cannot be completely
accurate and cover every possible situation.
We recommend that you always seek advice from a competent person in cases
of doubt.