Claiming Benefits

As Fibromyalgia is an invisible disability, it can be difficult to score points under the Personal Independence Payment (PIP)  test and Universal Credit assessments. There are many different assessments to go through, and unfortunately, there are hoops to jump through. This article will go through the steps you should take before claiming, and then detail the different claims that you can make as someone who suffers with fibromyalgia. 

Muscle pain, ‘fibro fog’, fatigue and memory problems are all reasons one should be receiving Attendance Allowance (AA), Personal Independence Payment (PIP), or Employment and Support Allowance (ESA).Unfortunately, the assessments are not always advanced enough to pick up on these symptoms.

Many have claimed PIP with fibromyalgia, however. There have been tribunals that resulted positively for those with Fibromyalgia. Although the diagnosis comes often after ‘ruling-out’ many other possible conditions, in itself it is still a disease covered by PIP. 

Many people will think that due to their current employment they do not have the right to claim PIP. This is not the case. There will be questions asked about your work, and how you manage to travel to and from work, however, you can still receive payments whilst being employed.

Before Claiming

Prior to claiming, it is worth evaluating the effect fibromyalgia has had on your life. This can be emotionally challenging, but necessary preparation for PIP. It is advised to look at :

• How your travel (even to the shops) has been affected 

• If your care for your children or pets has been made harder

• If cooking food or caring for yourself has been made harder

• How your household budget has changed, what new costs you’ve had to add.

• What adjustments you have made to your routine (it might be useful to think about whether your sleeping patterns or eating patterns have changed due to fibromyalgia)

• How your ability to do household chores has changed 

• If you’ve had to move home due to fibromyalgia 

• Any new safety concerns or precautions you take since the symptoms started

It is important to look at your entire routine, as the DWP state that a descriptor of your condition that applies in 24 hours, applies for that day. This means that looking at your sleep, or your daily routine within a day is as important as looking at your week or month as a whole. The decision makers for PIP are looking to see if you can carry out a tast (like cooking supper, for example) to an “acceptable standard”. If your memory or flare-ups limit how you can do daily chores, make a note of this.

Once you have looked at your lifestyle and routine, it is worth digging deeper into each change you’ve had to make. Ask yourself why you had to make the change, what differences that change has brought about in your life and if you need to recover from a task before moving onto the next one. Good advice is to mark all the activities you do in a week, and then assess how they have been changed by fibro. If you’re eating more ready meals or easy food than you did before the onset of your symptoms, make a note. 

There is a specific PIP category known as ‘planning’ - which covers mobility. Look into how your transport and travel has been slowed due to fibro. Even things such as missing busses or trains due to fibro fog can be indicators for the decision makers. There is also an ‘activity’ section which covers moving and exercising. You have to be able to be mobile “as often as reasonably required”. If you can’t walk to the shops and walk your dog on the same day due to fibro, then this would help you in your assessment. 

Preparing Your Claim

It is important to go into the claim having recently seen your GP. Although they are not always the most helpful, you might want to book an appointment to make sure they are totally up-to-date on your symptoms and your current condition. It is vital in this appointment you cover mental symptoms too, such as memory or concentration problems.

Ask if your GP will refer you to a specialist, if you  have not been already. Have your medical reviewed. After doing this, contact your local council and ask for an occupational therapy assessment. This is often done through a department of local councils known as “adult social care”. An occupational therapist will visit you and talk to you about how you are managing at home. After this assessment has taken place, ask for a copy. This could be supportive of your claim for Universal Credit and PIP. It is also useful for you to read over it, and see if there is any information that is contrary to what you have claimed, or might undermine it. 

Make sure you have access to proof of identity and your national insurance number before beginning your claim.

Claiming Benefits

ESA 

This is a claim for people who are struggling to work, or have limited capacity to work, due to their disability. To make this claim, there is an initial form that one has to fill out. The details and the form itself can be found here. 

Once you have provided the necessary information, you will then have to demonstrate your capacity for work at a Work Capability Assessment. This assessment begins with a questionnaire, sent to you, to be completed and returned.

 After this, usually, you must attend an assessment in person. This is a medical assessment with a healthcare professional.They will assess you in person, and then provide the information to the DWP. From here,  you will hear if your claim is successful.

For more detailed information on ESA, an overview is available on the government website.

PIP

PIP is a payment for people who need extra care or struggle with mobility due to their disability. The movement and planning sections outlined above are important to consider when applying for PIP. 

This claim also begins with a form, found by ringing the DWP. All previous claim documents (such as the one from your local council) should be sent with this form too. 

You will then have a medical assessment, similar to that for ESA. After this, you will learn the results of your claim .

AA

This allowance is only for people over 65 years old. If you are, and have care needs, then you should make a claim for AA. 

The form for this can be found here. You can also ring the AA helpline. 

In this case, usually just the form is needed. There may be an assessment but this is rare. 

Once You’ve Claimed

After making a claim you should hear back within a month. It is worth chasing if you do not hear back in reasonable time. 

If your claim is unsuccessful, you can appeal it. The first stage is known as a mandatory reconsideration. Here, the DWP will look over their decision and decide whether or not to change it. 

If the decision remains unchanged, do not be disheartened. You can then appeal to a tribunal, independent of the DWP. Only 4% of PIP decisions were changed at mandatory reconsideration level. However, at tribunal, 65% of appeals were overturned. 

Once your claim is confirmed, it will be made clear to you how you will be receiving the benefits. 

Although it can be a minefield attempting to apply for benefits with Fibromyalgia, there are routes to receiving the help you need.