Behind the Assessment: What Really Goes On in a PIP Assessor's Mind

By Humairaa, Clinical Support Manager at Medacs Healthcare.

When someone asks me what actually goes on inside my head during a PIP assessment, I always pause for a second. Not because I don't know the answer. But because the answer is more layered than most people expect.

I joined Medacs back in 2023 as a Health Professional, moved into Clinical Coaching at the start of 2025, and stepped into my Clinical Support Manager role at the end of last year. Before all of this, I worked as a post-operative Surgical Nurse in the NHS, across general surgery, urology, ophthalmology, gynaecology, maxillofacial, plastics, you name it. It was mostly cancer surgeries on a ward that was created during Covid as an Ultra Green ward so surgeries could continue.

I loved the clinical work. What I didn't love was the unsociable hours. I have young children, and I was missing out on very important milestones with them, educationally and personally. The sacrifice was becoming unattainable, and I was feeling very 'bogged down' by understaffing, workload, and the unpredictability of shift patterns. I needed something different. A new challenge.

Honestly, what made me stay at Medacs was the continuous support I had on my way to progression. The time, the effort, the training, the amplifying of skills I already had. It made me feel valued and gave me confidence I hadn't had before. It might sound corny, but here at Medacs, we do care about our Health Professionals, and the sky really is the limit. My move from approved HP to Clinical Coach to CSM took two years. Everyone is visible, from admin all the way up to higher management, and growth in this company isn't stunted, it's watered and grown with attentive hands.

Anyway, back to the assessment. Here's what actually happens on my side of the conversation.

Before we even start talking, I've already been thinking about you

Every assessment I do starts long before the conversation itself.

We have systems that let us look at supporting evidence sent in by the claimant. This can be GP reports, hospital reports, letters from relatives, support plans, and the PIP2 or AR1 form, which is the questionnaire filled out by the claimant.

I make notes on what's stated. I look at the medications listed, the conditions reported, and the functionality described.  I always ensure that I familiarise myself with the health conditions I am going to discuss. I really enjoy learning about different health conditions, every day is a learning day in this role. Then all of that goes into the document I'll use during the assessment itself, ready for writing the report afterwards.

I'm not looking for reasons to disbelieve you. I'm building a working picture, so that when we speak, I can ask better questions and understand your account more thoroughly.

When we start talking, the first thing I want is for you to feel safe

Whether the assessment is face-to-face or by telephone changes how I approach the opening. I personally prefer face-to-face, but with telephone assessments, I really focus on making sure my voice sounds calming, reassuring, and clearly, audibly listening. You can tell so much from a voice.
Whichever format we're in, I always lead with compassion. That's our bread and butter as practitioners. I introduce myself, I explain every part of the assessment, so you know exactly what to expect, and I treat the whole thing as a conversation. That helps ease any anxieties.

I always advise claimants to be honest and not to worry about anything they're disclosing to me, because there's no judgement here at all. This is your assessment. I'm building a picture of how your conditions affect your day to day life for the case manager who considers all of the available evidence when making the decision. That's really important to say out loud. If you want a break at any point, we take one. If you've got someone with you for support, they're welcome.

And I never take anything personally. I understand how difficult it can be for some people to really speak about their conditions and the impact these have. Just because I'm not doing 'hands-on' clinical work doesn't mean I've left those skills behind. Compassion, reassurance, understanding, those are core nursing values, and they absolutely come with me into every assessment.

The bit that really matters: understanding your actual life

My job is to build a picture of what your daily life is really like. Not what it looks like on paper. Not what a diagnosis might suggest. What it actually is.

That's why I ask open-ended questions. The whys, the whens, the whats. Those are the ones that give me the fullest picture of your function and how your conditions affect you day-to-day. And when the questions are open, my report ends up being more accurate too, because it's a true reflection of what you've told me.

I've got loads of go-to questions, honestly. But if I had to name one that seems small but often unlocks something really important, it's this:

"Can you tell me step by step exactly how you get on and off the toilet?"
Humairaa, Clinical Support Manager at Medacs Healthcare

That question is a game changer. Most people initially say something like 'Yeah, I'm fine with that, I can manage.' But once you ask it in that step-by-step way, the information that comes back can genuinely change the descriptor choice. It sounds like a small thing. It really isn't.

I'm always listening for what you're not saying

Whether it's face-to-face or by telephone, I'm listening for the pauses. The hesitations. Any signs of pain. Any signs of distress. If we're face-to-face, how are you presenting? Are you audibly or visibly upset? These non-verbal cues are so important, and they help me make sure the assessment is as comfortable as possible for you.

Let me give you an example. I had a face-to-face assessment recently with a young lady who was clearly, deeply struggling with her mental health, from her appearance to the tears rolling down her face throughout. Alongside the evidence provided, I knew straight away that her mental health was significantly affecting her life. So we took the assessment at her pace. We had breaks. Cups of water. Reassurance. It was a really tough conversation, but I hope she left it feeling heard, not judged.

That's the balance I always try to hold. I'm attentive and observant, but I'm respectful and non-judgemental. And honestly, if you're a nurse, that's already in your core. It's why we came into the role in the first place, isn't it?

There's a narrative on social media that PIP assessors are trying to 'catch people out.' I want to gently correct that, because it really isn't true. There's no catching out. I'm here to assess how your conditions affect you day-to-day, alongside my own clinical knowledge and any other supporting evidence. My questioning style is very open. I'll often summarise what you've told me back to you, 'Okay, you've told me x, y, z, can I just confirm that's correct?', so you know I've been listening properly.

When we finish talking, the real work begins

After we've said goodbye, I move into what I think of as the quiet, careful part of the job. I write the report.

I go back through everything you told me. I re-read your PIP2 form. I look at your supporting evidence. I think about your account against the PIP descriptors, and  ensure the information I document reflects your day-to-day functional experience. I don't guess. I don't shortcut. And I don't project.

I explain my reasoning clearly, so that when the DWP case manager reads my report, they have the fullest possible picture to base their decision on. That report is the most important thing I do all day. It's the reason I take my time.

A story that reminds me why I love this work

Not long ago I was observed by someone from the DWP itself during one of my assessments. I know, scary, right? But actually, she was lovely. Afterwards, she sent me some really lovely feedback on how I'd handled the assessment. She mentioned the compassion, the attentiveness, and the understanding I showed the claimant throughout.

That feedback genuinely meant a lot to me. Not because it validates the job in some abstract way, but because it reminded me that when we get this right, when we hold space for someone properly, it's noticed. It matters. And that's what I want every assessment I do to feel like.

What I want you to know

If you're a claimant reading this, please don't worry about your assessment. I'm not here to catch you out. I'm not here to judge. I just want you to know that you can answer every question honestly and openly, knowing that you have been listened to and understood. I'm just doing my job on behalf of the DWP as thoroughly and compassionately as I can and ensuring that your voice has been heard.

If you're a clinician thinking about becoming an assessor, I want you to know something really important. This is a new skill. Please don't be so hard on yourself if it takes some time to pick up. You've probably come from a background where you're already so well-versed and highly skilled. But think back, what did you have to do to become that skilled in the first place? Exactly. You started right at the beginning and built up your knowledge. That's exactly what you'll do here too. Just like you put the work in before, you'll do the same in the world of PIP, and you'll be brilliant at it.

"This is a new skill. Please don't be so hard on yourself if it takes some time to pick up. You started right at the beginning once before, and built up your knowledge. That's exactly what you'll do here too."

Humairaa, Clinical Support Manager at Medacs Healthcare

And one more thing, you don't de-skill in this role. You just use your clinical knowledge in a different way.

If you're thinking about it, come and have a look

If you're thinking of moving over into PIP assessment work, I would honestly encourage you to explore what Medacs Healthcare has to offer. (I'm not biased, promise!) But if you're looking for that next career moves as an assessor, and you want to be in a company where achievements are celebrated as equally as struggles are supported, then it really is a no brainer.

That, more than anything, is why I love this work.

About the author

Humairaa is a Clinical Support Manager at Medacs Healthcare, supporting Functional Assessors through Stages 4 and 5 and beyond. She joined the company in 2023 as a Health Professional, moved into Clinical Coaching in early 2025, and stepped into her CSM role at the end of that year. Before joining Medacs, she worked as a post-operative Surgical Nurse in the NHS.

(link to PIP-021 landing page, What Happens in a PIP Assessment)
(link to PIP-025 Resilience in the Role)
(link to PIP-026 Day in the Life series)