The envelope from DWP is already open. Someone has highlighted the bit about medical evidence, and someone else has said, more than once, that the clinic letter they already have ought to be enough. It lists the diagnosis. It is three sentences. It will not do the work they think it will do.
A PIP GP letter is decided, at this end, on what you can do in a day, not on the name of the condition. Personal Independence Payment is a functional benefit. The decision maker is not awarding points for a label. They are trying to see a typical day, including a bad one.
The real question is whether the evidence describes function, or whether it only repeats a clinic letter you already possess.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately.
What a PIP GP letter needs to show
The short version is this. A useful letter describes washing, dressing, cooking, toilets, leaving the house, walking, mixing with people, and the help that is actually required, including on a bad day. A short note that only lists the diagnosis is usually not enough. I have seen both. Only one of them is worth the appointment.
Here is the longer version, because people are often sent to us after a refusal, holding a letter that was written as a courtesy and then used as evidence.
What I look at in clinic is a day, in order, not a diagnosis in isolation. How you wake. Whether someone has to prompt you, physically help you, or stay in the room. The kitchen: can you prepare a simple meal safely, or is the risk the hob, the knife, the forgetting, the standing. Washing: is it the getting in, the getting out, the motivation, the pain, the breathlessness, the time it takes so that the rest of the morning is gone. Dressing: buttons, shoes, the decision to get dressed at all. Toilets and continence, asked plainly, because embarrassment is how this section gets left blank and then scored as if nothing were wrong. Medicines: prompting versus something a carer has to do. Communicating, reading, mixing, money. Then mobility: planning a journey, going out, walking, the after effects, whether you pay for that walk later the same day.
I ask about variation. PIP is often lost on the sentence “but some days I can.” Some days I can is not the legal test they think it is. The question is how you manage most of the time, and what happens on a bad day that is still a typical bad day, not a hospital admission. If you can shower if someone stands outside the door and it takes an hour and you then go back to bed, that is not “can shower.” It is worth saying plainly. Understatement in a consulting room becomes a blank on a form.
The pattern matters more than the single reading. Depression with a tidy appearance in clinic at 11am is not evidence that mornings are fine. Back pain that lets you sit here for 30 minutes is not evidence that you can stand to cook. I will look, and I will also listen to what a relative says when you have gone to the toilet. Then I will check it with you. This is medical evidence, not advocacy dressed as medicine. I write what the assessment supports. I do not write what would be convenient for the claim.
Bring what you already have. The PIP form if it has been started. The decision letter if there is one. Clinic letters, therapy letters, occupational therapy, psychiatry, pain clinic, a diary of a week if you have kept one. I read them. I do not paste them. A stack of old appointments is not the same as an account of function. The piece most people miss is that DWP already knows you have a diagnosis. Someone, somewhere, wrote it down. What they do not have is the day.
What I will not do
I will not promise an award. Nobody honest can. The decision is DWP’s, and then, if it goes that way, a tribunal’s. A GP can set out function after an examination. That is ordinary medico legal adjacent work, and it is still not a result.
I will not copy a template that says you need help with everything if the examination does not show that. Inflated letters get recognised. They help nobody, and they can harm the next letter that is true.
I will not write it without seeing you. A request by email with a diagnosis and a deadline is not an assessment. We work face to face at 466 Green Lanes, or as a home visit if you cannot travel. The house is often the more honest room for this kind of letter, because stairs, the bathroom, and the bed you have ended up living in are part of the evidence. A home visit is £250 in the day, £450 at night, up to an hour. Clinic is 30 minutes for £100 if you are coming in for advice first. A disability supporting letter is listed at £500 on the appointments and fees page, confirmed in writing before we start. Further revision of a letter starts at £100.
When to come in sooner
Come in sooner if a deadline is already in the letter. Mandatory reconsideration and tribunal windows do not wait for a convenient week. Bring the date. Tell us on the first call. We will say what is realistic. We will not invent a turnaround.
Come in sooner if the only document you have is a diagnosis letter, and you have not yet described a day to anyone medical. That is the usual gap.
Do not wait on a letter, and do not come here first, if you are acutely unwell.
- Chest pain, or a suspected stroke: 999.
- Severe breathlessness, or a severe allergic reaction: 999.
- Heavy bleeding: 999 or A&E.
- Thoughts of ending your life with a plan, or you are not safe in the house tonight: 999 or A&E, not a benefits letter appointment.
- A collapse, a first seizure, or a head injury with confusion: A&E.
- A child with a fever who is floppy, or a rash that does not fade: 999.
A supporting letter is for the claim. It is not care. If the thing that is failing is the day itself, we can still examine you as a GP, at clinic prices, and deal with the letter when you are safe to talk about forms.
How we approach this at Clinique Alpa
You call 020 8882 8088, or send a WhatsApp enquiry to 447742163571 without putting your medical records in the thread. Say that you need evidence for PIP, and whether there is a date. We confirm the fee in writing. Then you attend for an unhurried assessment at Palmers Green, or we come to you.
I take the history of the day. I examine what needs examining. I read what you have brought. I write to the questions PIP actually asks, in plain English, as independent evidence. You get the letter securely. If a solicitor or a welfare adviser has asked for specific wording, bring that request. I will answer the question they asked if the examination supports an answer. I will not sign a draft they wrote.
Read the medical reports page if you want the process in one place. If you cannot get to Green Lanes, the home visiting GP route is the same doctor, in the house the form is trying to describe.
If the form is due this week, say so on the call. Then come in and describe a day, including a bad one.
Evidence that describes a typical day, written after you have been seen. Read our fees page, or call 020 8882 8088. Clinic 30 minutes £100. Disability supporting letters are listed at £500, confirmed in writing. In an emergency call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, GP and founder of Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.