Worked example by condition

PIP answers for heart failure

A worked example showing how the 12 PIP activities can be described for someone living with heart failure. Every answer is written in the first person, in the plain wording assessors look for, and each one weaves in the reliability factors that decide how an activity scores.

How heart failure affects a PIP claim

Heart failure does not mean the heart has stopped. It means the heart can no longer pump well enough to keep up with what the body asks of it, and on a form that translates into a very particular set of problems: being out of breath doing ordinary things and sometimes even lying flat, a tiredness that arrives after the smallest effort and does not lift with rest, feet, ankles and legs that swell and feel like lead as fluid builds up, and spells of feeling weak, light-headed or faint, which the water tablets and blood pressure medication that keep the condition under control can make worse. Some people cough at night and sleep propped up on pillows. Because you can look perfectly well sitting in a chair, and because the worst of it only shows when you move, assessors regularly underestimate how little you can safely do.

That is why your answers have to describe effort and recovery, not just whether you managed something once. An activity only counts as something you can do if you can do it safely, to an acceptable standard, repeatedly and in a reasonable time. If you can stand at the hob for five minutes before you have to sit down and get your breath back, you are not cooking a meal to an acceptable standard. If you can walk to the corner but then need ten minutes on a wall before you can turn round, you cannot do that distance repeatedly. If a hot shower leaves you dizzy enough to fall, it is not safe to have one alone. Fluid builds up and drains away, so you will have heavier and lighter days; write about your worst and most common ones, not the morning after a good night.

Two habits make a heart failure form far clearer. The first is to measure things: how many metres before you stop, how many minutes to recover, how many times you have to sit down halfway through a task, how many pillows you sleep on. The second is to name the routine that keeps you safe, such as weighing yourself every morning and ringing the heart failure nurse when the number jumps, the water tablets that tie you to a toilet all morning, and the help you need from another person for the things that leave you breathless. Needing that help and not getting it counts too. The example below does exactly that, activity by activity. The DWP always makes the final decision, but describing your day accurately gives your form the strongest chance of being understood.

How your health condition affects youPIP2 · Q3
3. Preparing food
Does your condition affect you preparing food, or prevent you from doing so? (Put a cross in one box below)
✓ Yes
Tell us about the difficulties you have with preparing food and how you manage them.
My heart failure means I cannot stand at a cooker for long enough to make a meal. After four or five minutes on my feet I am out of breath, my legs feel heavy and shaky and I start to go light-headed, so I have a perching stool in the kitchen and I do all the peeling and chopping sitting on it, with the board pulled to the edge of the worktop. Even sitting down I have to keep stopping to get my breath back, so a simple meal that should take twenty minutes takes me the best part of an hour. I cannot lift a pan of water onto the hob or carry it to the sink to drain, because my arms tire so quickly and I once felt faint while holding a hot pan, which frightened me badly, so I use small lightweight pans and cook things I can do in the microwave instead. On my worst days, usually two or three a week, when my ankles and legs are badly swollen and I am more breathless than usual, I cannot manage the kitchen at all and I have toast or whatever my daughter has left in the fridge for me. By the evening I am always too exhausted to cook, so if nobody has made anything I go without. I rely on the perching stool and the light pans to prepare food at all, and even with them I cannot do it repeatedly or in a reasonable time on most days.
★ Suggested descriptor · 3b · 2 points
A perching stool and lightweight pans are aids the form counts; say how many minutes you can stand before you have to sit, and what holding a hot pan is like when you feel faint.
How your health condition affects youPIP2 · Q14
14. Moving around
Does your condition affect you moving around? (Put a cross in one box below)
✓ Yes
Tell us more about the difficulties you have with moving around and how you manage them.
How far can you walk using any aids or appliances you need? (Put a cross in one box below)
✓ How far you can walk: Between 20 and up to 50 metres
I cannot walk far because of my heart failure. On a normal day I manage somewhere between thirty and forty metres on level ground before I am so short of breath that I have to stop, and I need to stand still or sit for three or four minutes before I can go any further. My legs feel heavy and weak because of the swelling, and if I push on I get a tight, pressing feeling across my chest and go light-headed, which is why I never go anywhere without my husband in case I need to sit down suddenly. Any slope or a couple of steps cuts what I can do in half, and cold weather makes the breathlessness worse. I cannot repeat the distance. Walking from the car park to the surgery door and back is about as much as I can do in a day, and I am worn out for the rest of it. I walk slowly and I do not use a stick, because the limit is my heart rather than my joints; what I need is somebody with me and somewhere to sit. On my worst days I am breathless just getting from the bedroom to the bathroom and I do not go outside at all. I cannot stand and move even fifty metres safely, repeatedly or in a reasonable time.
★ Suggested descriptor · 14c · 8 points
Give the metres before you must stop and the minutes you need to recover; a distance you can only manage once, then not again that day, is not one you can do repeatedly.
The other activities

What to cover for each one. Your paid form writes the full answers for you.

Q4

Eating and drinking

What to mention

This is about getting food and drink to your mouth and swallowing it, not about cooking, so it is often unaffected by heart failure. What can count is being too breathless to get through a full meal without stopping, a daily fluid limit set by your heart team that someone has to help you keep track of, or being so exhausted that you need reminding to eat at all. If you can eat and drink normally once a plate is in front of you, say so and leave this one alone.

Q5

Managing your treatments

What to mention

Describe the whole routine: several tablets at set times, water tablets that have to be timed around leaving the house, weighing yourself every morning and knowing when a jump on the scales or worse swelling means ringing the heart failure nurse. Say whether you do all of this reliably on your own or whether someone fills a dosette box, reminds you or keeps an eye on the scales because breathlessness and tiredness make you forget or lose track. Mention any monitoring at home such as blood pressure, and what has gone wrong when a dose or a weigh-in was missed.

Q6

Washing and bathing

What to mention

Explain what heat and steam do to your breathing, and whether standing for a shower leaves you dizzy enough to need a shower seat, a grab rail or somebody in the house in case you feel faint. Mention that washing your hair with your arms raised, and bending to reach your feet over swollen legs, are the parts that leave you gasping, and say if someone does them for you. Cover how long it all takes and how often you settle for a wash at the sink instead.

Q7

Using the toilet and managing incontinence

What to mention

Water tablets can mean needing the toilet urgently and often for hours after each dose, and getting up several times a night, so describe any accidents, the pads you wear or the commode you keep by the bed because you cannot get there in time when you are breathless. Getting up from a low toilet can also bring on dizziness, so mention a raised seat or a frame if you use one. If your continence and getting on and off the toilet are fine, say so honestly.

Q8

Dressing and undressing

What to mention

Describe how bending forward to reach socks, shoes and trousers squashes your chest and leaves you breathless, and how swollen feet and legs mean shoes no longer fit or someone has to help with your lower half. Mention any long-handled shoehorn or sock aid, and the rests you need partway through, so that dressing takes far longer than it should. Say if on bad days you stay in what you slept in because the effort is too much.

Q9

Talking, listening and understanding

What to mention

Heart failure does not usually affect speech or understanding, so only claim this if something real applies. Being too breathless to finish a sentence, or so tired and foggy after a bad night that you cannot follow a conversation or remember what the nurse told you, can be described here. If you speak, hear and understand normally, an honest no makes the rest of the form more believable.

Q10

Reading

What to mention

Reading is rarely affected by heart failure, so answer honestly. If poor sleep and exhaustion mean you cannot concentrate on a letter long enough to take it in, or someone goes through hospital letters and medication changes with you because you lose the thread, explain that. Keep it about understanding and holding on to written information rather than eyesight.

Q11

Mixing with other people

What to mention

Describe how breathlessness, exhaustion and the fear of feeling faint in company have changed how you see people, and whether low mood or worry about your heart means you now avoid visitors and turn down invitations. Mention it if you need someone with you to cope, or encouragement before you will see anyone at all. Keep this about being with people, not about the physical journey to reach them.

Q12

Managing money

What to mention

Most people with heart failure can manage their own money, and if that is you, say so. If exhaustion and low mood mean bills get missed, or fog after bad nights makes you lose track of what has been paid so that a partner has to check your account and sit with you for the bigger decisions, describe that support and what happens without it.

Q13

Planning and following a journey

What to mention

This question is about leaving home and following a route, not about how far you can walk, which belongs under moving around. Say whether you can still plan and follow a journey once you are out, and mention it only if fear of collapsing away from home, or confusion from tiredness, means you cannot go anywhere unless someone is with you. If the journey itself is fine and the problem is purely distance, be honest and put the difficulty where it belongs.

Your own answers, for every activity

The tips above are general pointers. Your paid form gives you a full, ready-to-copy answer for all 12 activities, written from your exact conditions, medication, aids and bad days, not a general example. This is a worked example for heart failure; yours is written for you. £99.99 one-off.

How to use this example

This is a worked example, not a script. It shows one honest way a person with heart failure might describe their bad days, so you can see the level of detail and the plain wording that assessors are trained to look for. Please do not copy it word for word. Your own answers should reflect your heart failure, your worst and most common days, the distances and minutes that are true for you, the aids you actually use and the help you actually need or go without, because that is what the assessment is about and that is what makes an answer ring true.

Notice that not every activity has to be claimed. Being honest about what heart failure does not change makes the difficulties you do describe more believable, so there is no need to stretch every question. If you would rather start from your own words, tell us about your health and we will write your answers from your own conditions, in the same first-person style, ready for you to read, edit and copy onto your PIP2 claim form or AR1 review form.

K
Karol Slusarczyk
Founder, FillMyPIP · t/a Benefits Expert · ICO:00014179042

I have spent years helping people describe their conditions accurately on PIP forms, and I built FillMyPIP from that experience. I wrote this worked example to show, honestly, the kind of detail and wording that helps an assessor understand a real day with heart failure. I am not a solicitor, a doctor or a DWP employee, and this is guidance, not legal or medical advice.

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