A Guide to Personal Independence Payment (PIP)

[JohnP]

This post provides some information on PIP, it relies on published information and has links to useful sites.

What is PIP?

In 2013 changes to the UK welfare system were made, these included the introduction of a new benefit, personal independence payment (PIP) which is to replace disability living allowance (DLA) for people between 16 and 64 years of age. In 2012 there were over 3 million DLA claimants, the UK government estimates that by 2018 600,000 less people will qualify for PIP.

It is important to stress that PIP is not concerned with the disease or illness of the claimant. Its award is based on the claimant's ability to live a normal life and their mobility. This has implications which will be discussed later

About the new benefit

Key points are:

It is managed by The Dept for Work and Pensions
It is tax free
It is not means tested and is not affected by any earnings or other income you have
It is for the claimant not any carer
The claimant can qualify even if they have no one caring for them
It can be spent how the claimant wishes
Its acts as a "passport" to other benefits, including things such as the Motability Scheme
It has two components; a daily living component (For help in every day life) a mobility component (For help in getting around)
Each component has two levels of payment; a standard rate, and an enhanced rate. The rate paid is dependent upon if your ability to carry out daily living or mobility is limited or severely limited

Who can claim PIP

To be entitled you must meet all of the following:

1. Be between 16 and 64. (If you are 65 you cannot claim PIP but if you received PIP before your 65th birthday you will stay on
PIP)
2. Have been living in the UK for 104 out of the 156 weeks before making a claim
3. You should normally live in the UK (including the Channel Islands, Republic of Ireland, and the Isle of Man)

You must also satisfy:

A) The daily living and/or mobility activity tests
B) Have satisfied these tests for a period of at least 3 months before payment is made.
C) Be likely to continue to meet the tests for at least 9 months after payment is made

If you are terminally ill there are special conditions. This is covered later

The PIP Assessment

The assessment is detailed, and will consider both physical and mental conditions which may affect daily living or mobility

Posts on the forum have spoken about what appear to be irrelevant questions, this may be due to the assessor following a process designed to assess physical and mental well being

The assessment will consider 12 criteria

Criteria 1 - 10 relate to daily living

1.  Preparing food
2.  Taking nutrition
3.  Managing therapy or monitoring a health condition
4.  Washing and bathing
5.  Managing toilet needs or incontinence
6.  Dressing and undressing
7.  Communicating verbally
8.  Reading and understanding signs, symbols, and words
9.  Engaging with people face to face
10. Making budgeting decisions

Criteria 11 and 12 relate to mobility

11. Planning and following journeys
12. Moving around

Points are awarded against each criterion (Details of the scoring system can be found in Appendix B and Appendix C of "PIP Guide to Claiming". This is attached a a pdf and is downloadable from http://www.disabilityrightsuk.org/personal-independence-payment-pip. Disability Rights UK has tried to ensure that the guide is accurate but stress that the system may change it is recommended that you read the latest version of their guide)

Points are scored when you cannot complete  tasks reliably, that is to say:

a) safely (without causing harm to you or another person)
b) to an acceptable standard (as an example if you were still not clean after washing)
c) repeatedly(without being overcome by pain or fatigue. as an example you might be able to cook one meal without help but would not be a able to repeat this without assistance)
d) in reasonable time (no more than twice as long as a person without your condition would take)

How is the assessment made?

This uses:

1) The Claim Form
2) Any evidence you submit
3) A report from a face to face consultation if you are invited to one

In addition you doctor may be asked to provide a factual report. You can find more information about this at https://www.gov.uk/government/publications/dwp-factual-medical-reports-guidance-for-healthcare-professionals

Your ability will be assessed on the basis of your ability to meet the criteria on the majority of days (Over 50%) in the previous 3 months and as anticipated in the next 12 months

How long will you get PIP for?

This is based on individual circumstances

Short term awards are for 2 years if changes can be expected
Long term awards are for 5 - 10 years if significant changes are less likely
Ongoing awards will apply in a minority of cases where needs are stable and change unlikely

If I am terminally ill what happens?

If you are terminally ill and cannot reasonably be expected to live for more than 6 months special rules apply:

1) The application will be fast tracked (but the terminal illness must be made known at the time of claim)
2) There is no 3 month qualifying period
3) The residency rules ("Have been living in the UK for 104 out of the 156 weeks before making a claim") do not apply you simply have to be resident in the UK

A really useful source of information on claims under what are called "Special Rules" can be found here https://www.mariecurie.org.uk/help/money/benefits-entitlements/living-with-terminal-illness/special-rules

Your doctor may be asked to complete a special form (DS1500). This is obviously sensitive since the patient may not be told that they have a terminal illness. The previous link https://www.gov.uk/government/publications/dwp-factual-medical-reports-guidance-for-healthcare-professionals has details.



What happens if I am in hospital or a care home?

1. You can claim PIP but will not be paid it until you leave
2. If you receive PIP and go into hospital you will receive PIP for the first 28 days of any stay
3. If you are in a care home you will receive the mobility payment (if awarded this)
4. If you go into a care home you will lose the daily living component after 28 days but will still receive the mobility payment (if awarded this)

What evidence can I give to the assessor?

Disability UK says that a diary is a useful piece of evidence. It should be completed by you. if you cannot do so a carer can help.

The PIP Guide to Completion attached to this or available from the link http://www.disabilityrightsuk.org/personal-independence-payment-pip has details and examples of diaries in Appendix D.

They suggest that you:

1. Adapt this to suit your situation
2. If you are helped to complete it say so in the application form
3. Include your name, address, and National Insurance number on every page

If I get PIP what else might I claim

Earlier PIP was described as a "passport" the implications if you receive PIP are:

1. If someone cares for you for more than 35 hours per week and you have received the daily living component of PIP they can claim Carers Allowance
2. If you have PIP the benefits cap for your household does not apply
3. You may be entitled to other benefits (see page 10 of the attached guide for a full list)
4. You may be able to get help with Council Tax
5. If you receive the enhance mobility portion of PIP you can exchange all or part of it for a Motability Car, scooter, or powered wheelchair.
6. You may be able to get a Blue Badge
7. If you receive the enhance mobility rate you will be exempt from road tax on your car, or a 50% discount if you get the standard rate (BUT YOU HAVE TO APPLY!) https://www.gov.uk/driving-medical-conditions/vehicle-tax-exemptions

Final Thoughts

When I first read of problems with PIP I was deeply concerned and raised the matter at the UKAAG. It was clear that the situation was new since PIP was gradually being rolled out across the UK. At that time there was little practical information on the internet, this has now changed.

In this post I have tried to highlight the best sources of practical advice.

Best practice would seem to be:

* Recognise that it is your ability to undertake the assessed criteria or tasks that is important
* The assessment will almost certainly consider matters that do not relate to you. The process is meant to deal with people with different types of affliction
* Make your claim promptly, straight away if you have a terminal prognosis, after 3 months otherwise
* Prepare (The Industrial Society used a mantra "To fail to prepare is to prepare to fail")
       - Keep a detailed diary (or get someone to help you do this)
       - Read the guidance on completing the application form
* Use relevant information. Be concise but detailed. The assessor will probably be very busy and under stress. Try to make their job as easy as possible. Giving them masses of detail about Amyloidosis rather than the impact it has on you will not be helpful to them and will not add to your case
* Perhaps try to get some assistance. I understand that some Macmillan Nurses will assist claimants in filling in the claim form, using their experience.

I have locked this post so that it remains as a source of information rather than a post for discussion. If people have experiences of the PIP process can they share them in separate posts so that forum members can identify good and less good practice. Finally if you come across any valuable sources of information please share them. I will edit the post from time to time to add new internet links