A worked example showing how the 12 PIP activities can be described for someone living with peripheral neuropathy. 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.
Peripheral neuropathy is damage to the nerves that run out to the hands, arms, legs and feet. In its most common form it affects the longest nerves first, so it usually starts in the toes and feet, feels as if it is creeping upwards and later reaches the fingers and hands. What it leaves behind is a strange mix of too much feeling and too little: burning, stabbing or shooting pain and pins and needles, alongside a numbness that means you cannot feel the floor under you, a stone in your shoe or how hot the water is. Many people also have weak feet or hands, cramps and poor balance. The cause varies. Diabetes is the most common one in the UK, and if that is yours, our diabetes example covers the insulin and blood sugar side of the form. Others include some chemotherapy treatments, years of heavy drinking and low vitamin B12. For some people no cause is ever found. The form does not ask which one you have. It asks what the damage stops you doing.
This is a condition that is easy to miss from the outside. You may walk steadily enough with your eyes on the floor, and shake hands without anyone realising you can barely feel it. The difficulties live in the details: the pan handle you gripped without noticing it was hot until the blister came up, the cut on your finger you only found when you saw blood on the chopping board, the fall in the bathroom at night with the light off. Because the nerves in your feet no longer tell your brain where your feet are, many people end up relying on their eyesight to stay upright, so balance is often much worse in the dark, with your eyes shut to rinse your hair or while pulling a jumper over your head. Those are exactly the moments to write about.
Everything then runs through the reliability rules. 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. With neuropathy, "safely" does a great deal of the work. Cooking with hands that cannot feel heat or keep hold of a knife is not safe, even if the meal gets made. Walking on feet you cannot feel, when you have already fallen several times this year, is not safe either. So say what has actually happened: the burns and cuts you did not feel, the falls and near misses, the sores on your feet you only found later. Then add the aids you use, the help you get, how long things take and how often the pain flares. Tablets for nerve pain can leave some people drowsy, dizzy or with blurred vision, so if yours do, include that too. The example below does exactly this, activity by activity. The DWP always makes the final decision, but describing your day accurately gives your form the strongest chance of being understood.
What to cover for each one. Your paid form writes the full answers for you.
Once the plate is in front of you, describe whether numb fingers mean you cannot hold a knife and fork firmly enough to cut up meat, or you drop cutlery and spill drinks because you cannot feel your grip. Mention any thick-handled cutlery or lidded cup you rely on, or someone cutting your food up for you. If your hands are not affected and you eat without any trouble, say so and leave this one alone.
List the nerve pain medication you take and when, and say whether drowsiness or fog from it means you lose track of doses, so someone fills a dosette box or reminds you. Mention it if numb fingers make it hard to press tablets out of blister packs or open bottles. Checking your feet every day for cuts, blisters and signs of infection is part of managing neuropathy, so if you cannot bend or see the soles of your feet and someone else does it, describe that too.
Explain that you cannot trust your hands or feet to tell you how hot the water is, and mention the thermometer you use or the person who tests it before you get in. Describe what happens to your balance when you close your eyes to rinse your hair or lift a leg over the side of the bath, and whether you rely on a shower seat, grab rails or someone being nearby. Say whether you can wash and dry your feet properly, including between the toes, and how long it all takes.
Numb fingers can make it hard to tell whether you have cleaned yourself properly, so mention any toilet aid you use or help you need. Getting up from a low seat on weak, unsteady legs is where some people fall, so say if you use a raised seat or a grab rail. Some neuropathy also affects the nerves that control the bladder or bowel; if yours does, describe any urgency, accidents or pads plainly, and if none of this applies to you, leave this one alone.
Describe how numb fingertips make buttons, zips, hooks and other small fastenings slow or impossible, and mention any button hook, Velcro fastenings or elastic laces you depend on. Explain why you sit down to dress, because standing on one leg for trousers or pulling a top over your head so you cannot see can tip you over. If you wear an ankle support or splint for foot drop, say whether you can fit it and get a shoe on over it yourself, and how long dressing takes on a bad day.
Peripheral neuropathy affects the nerves to your limbs, so it does not usually touch speech, hearing or understanding. What might count is nerve pain medication leaving you so drowsy or foggy on most days that you cannot follow what a doctor is telling you and need someone with you to take it in. If you speak, hear and understand people normally, leave this one alone, because an honest no makes the rest of your form more believable.
Reading is about seeing and understanding written information, which neuropathy in the hands and feet does not affect for most people. If diabetes has also damaged your eyes, or your pain medication gives you blurred vision or leaves you too drowsy to take in a letter on most days, explain that and say who reads things with you. Otherwise answer honestly that you can read, since trouble holding a page with numb fingers is not what this question measures.
Constant burning pain and nights broken by it can wear you down, so describe any low mood or anxiety that means you now avoid people, cancel plans or need someone with you before you will see anyone. Say how often that happens and what it looks like in a normal week. Keep this about being with people face to face; the difficulty of getting there on your feet belongs under moving around, and if you are comfortable with people, say so.
Neuropathy does not usually affect managing money, so if you handle your own bills and budgeting, say so. What might count is fog from nerve pain medication, or exhaustion after nights of burning feet, leading to missed bills or muddled sums, with someone now checking your account for you. Fumbling coins or a bank card with numb fingers is a physical problem rather than a budgeting one, so it does not belong here.
This question is about planning and following a route, not about how far you can walk, which belongs under moving around. Most people with neuropathy can still find their way, so be honest if that is you. What can count is anxiety after previous falls that is bad enough to stop you going out unless someone is with you, or medication leaving you drowsy and muddled on a route; say how often it happens and who goes with you.
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 peripheral neuropathy; yours is written for you. £99.99 one-off.
This is a worked example, not a script. It shows one honest way a person with peripheral neuropathy 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 neuropathy, your worst and most common days, the burns, cuts and falls that have really happened to 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 neuropathy 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.
Tell us about your neuropathy in your own words and we will write one full activity for you, free, before you pay anything.
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