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MR PIP Atopic Eczema?

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5 months 1 week ago #292146 by orfoster
MR PIP Atopic Eczema? was created by orfoster
Hello everyone.

How much evidence would someone need for PIP MR? I've got severe Eczema and have been awarded Standard Daily Living, I've got a letter from my Dermatologist Consultant evidencing how much it impacts me which covers a number of the descriptors, I've also been applying for Uni and the assessment done at home and over the phone produced reports supporting issues with my hands, concentration and moving. Would all of these count as evidence for MR?
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5 months 1 week ago #292170 by Gordon
Replied by Gordon on topic MR PIP Atopic Eczema?
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Yes, these would be relevant but evidence can only go so far, you need to go back to your claim form and have a good look at what you wrote side-by-side with the criteria you are trying to meet.

Have you requested a copy of the assessment report, if not then I would do so as this can help you understand how the Decision was made.

Gordon

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5 months 1 week ago #292219 by orfoster
Replied by orfoster on topic MR PIP Atopic Eczema?
Thank you for this, I've got a copy of the PA4 the few issues I have are.

1. Preparing food, given 2 points for using aids but my hands are always cracked in the knuckles etc which means holding pots and pans are painful this is supported by Consultant letter who also says driving is painful and so I limit my driving (should this be 4 points for supervision)?

2. taking nutrition - awarded no points, however, again, I have special cutlery I use but in addition to this, my consultant has confirmed that due to low mood I am prompted by my partner to eat because eating very regularly cracks my lips as I open my mouth and then following this its sore for days.

There are other descriptors I am querying as well as my condition is quite severe but the above ones were the ones I was wondering about as technically with those it would push me into 12 points from standard?
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5 months 1 week ago #292229 by orfoster
Replied by orfoster on topic MR PIP Atopic Eczema?
Here is what I've written for my MR

Facts of the case

My medical conditions
Chronic Atopic Eczema. I experience pain and cracked skin in the joints of my elbows, knees, lower back, face, lips, neck, eye lids a significant amount of the time, this interrupts sleep and impacts my daily life significantly including my mood and anxiety levels.
Asthma
Hayfever
Stigma
Carpal Tunnel


I attach the following evidence;
- Letter from Consultant Dermatologist
- Occupational Health Report from Employer
- Full GP Patient Print out
- Study Tech Remote Assessment
- Study Tech Home Visit Assessment
- Photos of aids


Preparing food
Preparing food, awarded b, disputing, seeking e,
As a result of my cracked skin in my knuckles and inside of my hands, I struggle to grip lifting things as gripping causes pain, even wearing gloves so for example pans on the hob lifting them it causes pain in the cracked skin in my hands with the weight and the way I grip so I need assistance with preparing food, being stood at the hob causes my skin to be further sore and irritated, I cannot safely cut up food due to the pains in my cracked hands holding a knife.
Evidence in Supporting Consultant Dermatology Letter

Taking nutrition
Eating and drinking, awarded a, disputing, seeking d
I do only eat around 1 main meal a day, it hurts to eat because of the dry skin around my lips, opening my mouth to take food causes splits to my lips causing yet further pain, the pain is then ongoing in a cycle and is not helped by steroid medication which tightens the skin on my mouth making it worse before it gets better, cutting up food is painful due to the pain in my cracked skin on my hands and fingers, I therefore have cutlery that assists. In addition to this, it also means I am put off eating and so my partner prompts me to eat all of the time.
Evidence in Supporting Consultant Dermatology Letter, Photo of special cutlery.

Managing Therapy - medications
Awarded b, not disputed.

Washing and bathing
Awarded b, disputed, seeking 4f
As a result of the broken skin and eczema on the backs of my knees my partner helps me in and out of the shower or bath most of the time. Due to the broken skin on the inside of my elbows I cannot wash my back, particularly my lower back which has a bad eczema patch, my partner assists me in washing my lower back due to the pain of bending my arms behind my back.
Evidence, Supporting Letter from Partner

Managing Toilet needs
Awarded b, not disputed.

Dressing and undressing -
Awarded b, disputed, seeking e.
I can’t dress my upper half without assistance, my lower too regarding the backs of my knees but regarding my upper I have a bad patch on my lower back, the back of my neck and in the insides of my elbows, the oils and creams applied are sticky and have a burning sensation, touching these causes further pain and renders the application of the medication pointless and therefore I cannot do this reliably, my partner assists me.
Evidence in supporting Letter from Partner and…..XXXX

Communicating Verbally
Awarded a, not Disputed.

Reading and understanding
Awarded a, disputed, seeking 8c
My eyes are often flared on my eye lids, this means reading is uncomfortable and I increase font size. As a result of my skin flaring I have difficulties concentrating on reading things due to pain and irritation on flare up points, this means I have a delay in reading complex information. Text to speech software provided by Student Disability Grant.
Evidence in Page 7 and 8 of Study Tech Assessment.

Engaging others face to face
Awarded a, disputed, seeking c
I do not engage with my family and friends regularly, I do avoid this where possible and my family regularly comment on this. I do not have any close local friends as I avoid building relationships due to my anxiety socialising with others.
In the briefing room at work, on given the choice where I place myself I place myself in the Galley, away from passengers, I work a limited amount so that I don’t have to engage with others.

Moving around
Awarded a, disputed, seeking e
I am in pain in the backs of my knees on moving any distance from standing up, I am in pain from any point, the skin behind my knees are broken which causes instant pain and discomfort at all times.
Evidence in Letter from Consultant Dermatologist.

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5 months 1 week ago #292232 by BIS
Replied by BIS on topic MR PIP Atopic Eczema?
Hi orfoster

Well done on your response. I just have a couple of suggestions which you can use or ignore.

Chronic Atopic Ezema - I would put a quote from the NHS website which says, "...there's currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally", - which is in line with my experiences. www.nhs.uk/conditions/atopic-eczema/

I suggest the above simply because the person reading your MR may not get what an unpleasant severe condition it is and just think you have an 'itch" even with the professional letters.

Preparing Food
Start with you need assistance to prepare a simple meal and say what your partner does. You can't prepare a simple meal safely or reliably because of the pain and the severely cracked skin from your Chronic Atopic Eczema - (you need to keep reminding them why you can't do things). Then go on to say that you can't cut food because of the pain and the risk of you cutting yourself and the bit about the hot pans. Remind them that pain is exhausting which affects concentration which is why you cannot do this reliably.

Taking Nutrition
I would move the bit about your partner to the beginning. Put in that it's your chronic Atopic Eczema again that causes you to avoid eating. Then all you have written is great. You have put in about the special cutlery - but i think you need to point out that this has little impact on your cycle of pain and it must affect your mood if your hungry but are avoiding eating.

Washing and Bathing.
This is going to be a much slower process than someone who doesn't have Chronic Atopic Eczema - so remind them of that. Are you slowed down by the pain? Are you exhausted by the pain? Do you avoid washing at all? Include any of these that are relevant.

Dressing and Undressing
Add the condition again. Put your need for help from your partner first and then why. If you are slow and exhausted - say so.

Reading
With our eyelids so painful, does this make it difficult to read notices at all? I was wondering if there are any safety issues around campus. And I just thought—is there an issue when you're preparing food about reading? Can you read things off labels or do your get your partner to read - can you always see on things like a microwave. If this is an issue - adjust the preparing food answer.

Engaging with others.

It's not clear whether the anxiety you suffer is a separate condition (in which case you haven't listed it) or it is symptomatic of your eczema. Either way - make sure that is clear and press home the impact this has on your mental health. Put the word mental health in your answer, or they will miss it.

Moving around
You won't have a chance of changing their mind if you don't give them a fuller reply. I have a chronic pain condition - so I get where you're coming from - but they won't. So when you stand up - you're in pain. Do you start moving straight away? Does the pain make you breathless? Does the pain make you shaky? Can you feel the tightening skin? Does the pain make you want to cry out? ...Do you have to stop when you have started walking.? Does the pain make you walk much more slowly? Just telling them you're in pain is not enough. If you have to take any medication for the pain - say so. You're at college, so they will say that you can walk 200m - and therefore, you have to paint a clear picture of the impact the condition and pain have.

Hope this helps

BIS

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5 months 1 week ago #292249 by Gordon
Replied by Gordon on topic MR PIP Atopic Eczema?
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Yours and BIS's posts are both excellent but I feel you have failed to address the issue that has actually prevented you from scoring higher. namely the use of aids.

Let me give you an example; you mention carrying pans in regard to Preparing and Cooking a Simple Meal. The DWP will argue that you do not need to do this, you can place an empty pan on the hob and fill it using a smaller contained that you can reasonably lift, when cooked you can remove the food using a slotted spoon so you do not have to worry about boiling water being spilt.

You may argue that your response covers this issue but you do not mention aids even once in your letter, you are relying on those reviewing your award to make the same leap, it is very unlikely that they will.

Gordon

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