Denied Personal Independence Payment (PIP)

Refused PIP

About Personal Independence Payment (PIP)

Personal Independence Payment (PIP) is a new form of disablement benefit which has replaced the previous 20 year old Disability Living Allowance. The introduction of the PIP on 10th June 2013 is part of the UK governments’ wider reform to the welfare system so more benefits changes can be expected in the future.

The PIP is aimed at providing benefits for disabled people that are aged from 16 to 64 and it represents a major change to disability benefits. Under the Disability Living Allowance (DLA) there were believed to be over 3 million claimants, but by 2018 the UK government believes that under the new PIP there will be 600,000 fewer claimants so it is important that you understand the new PIP policies and eligibility requirements.

How much is PIP?

PIP award payments are worked out in two separate components called “daily living” and “mobility”. Depending on the severity of your disability you will receive one or both of the component payments.

The payments are usually made every 4 weeks, are tax free and can be received if you are in work or not.

Daily living claim amounts

Standard – £53

Enhanced – £79.15

Mobility claim amounts

Standard – £21

Enhanced – £55.25

An assessment of your disability and how it affects you will need to be made in order to qualify. Details can be seen in the paragraph below.

How is the Personal Independence Payment assessed?

Your eligibility for PIP will not depend on what type of illness you have, rather it will be assessed as to how the illness affects your daily life.

You will need to fulfil certain age and general eligibility requirements and fill out the “how your disability affects you” form at http://www.dwp.gov.uk/docs/pip1003-how-your-disability-affects-you-form.pdf

This will then start an assessment process whereby health professionals will look into your personal circumstances and illnesses/disabilities and how they affect you. Medical evidence will be provided by yourself, GP or consultant as well as non-medical evidence which can come from family, friends or social workers. Usually a claimant will need to attend a consultation with a health professional who will then provide the evidence to the claims department at the Department for Work and Pensions and the case manager will decide whether to award a PIP payment, at which rate and for how long.

Once an award has been made for PIP the claimant can expect to have to attend regular interviews in order to provide updates on their personal disability circumstances.

Eligibility for PIP

In order to qualify for a PIP payment you must have a health condition that affects your daily living and mobility as well as passing the general eligibility requirements. The general eligibility requirements are standard questions with a yes or no answer, but the mobility and daily living activity questions have multiple choice answers and each answer given has a score applied which when added up goes towards helping to assess whether a claim is valid or not.

General eligibility

  • You must be aged 16 to 64
  • You must be in Great Britain when a claim is made (with certain exceptions such as members of the armed forces)
  • You must have been in Great Britain for 2 of the last 3 years
  • You must be habitually resident in the UK and not subject to immigration control
  • You must have a long term disability which presents you with problems relating to mobility and daily living (see details below)

Eligibility regarding daily living difficulties

Each of the criteria in this section are split into smaller subsections whereby an answer will be weighted upon the severity of the impairment. Scores can range from a 0 though to an 8 (an 8 means the applicant would qualify for standard rate of payment) to the highest score of 12 (a score of 12 applies to enhanced rate payments).

Preparing and eating food – A score of 0 would apply to an answer such as “Able to prepare and cook a simply meal unaided” or “can eat food unaided”. The highest score for this criteria would be answers respectively of “can’t cook or prepare food” and “needs another person to convey food and drink to their mouth”.

Washing, bathing and using the toilet – Lowest scores would apply to the answers “can wash and bathe without assistance”, “can use the toilet unaided”, “can dress and undress unaided”. Highest level scores would apply to “cannot wash or bathe unaided and requires another person to wash ones whole body”, “needs assistance to manage incontinence of both bladder and bowel”, “unable to dress or undress at all”.

Communicating and reading – A low score in the section would relate to an answer such as “can express and understand verbal communication with no assistance” and “able to read and understand complex written information with no assistance or with spectacles of contact lenses”. A high score that is a 12 or 8 respectively would have an answer such as “unable to understand verbal information at all even with communication support” and “unable to read signs, words or symbols at all”.

Managing medicines and treatments – A score that is in the 0 range for this section would have an answer such as “no medication or therapy needed for a health condition” or “medication/therapy for a health condition can be managed unaided”. The highest scoring answer (an 8) in this section would be someone that “needs supervision, prompts or assistance to manage therapy for more than 14 hours per week.

Decisions with money – A low score would mean a person was “able to manage complex budget decisions” whereas a person that “cannot make any financial decisions as all” would be classed as having a high score in this section.

Engaging with others – A person that “can engage with other people unaided” would have a low score in this section, whereas a person that cannot engage with others because such engagement would cause either “overwhelming psychological stress to the applicant” or the applicant would “exhibit behaviour that would result in substantial risk of harm to another person” will score the highest mark in this section.

Eligibility regarding mobility difficulties

There are fewer criteria to follow in the mobility section. These are:

Planning and following journeys – If an applicant for PIP can display that they “can plan and follow a route of a journey with no assistance” they will score the lowest mark in this eligibility section. The highest mark would be someone that would answer yes to the statement “unable to follow the route of a familiar journey without the assistance of another person, orientation aid or guide dog.

Moving around – A person that “is able to stand and move 200 metres or more unaided or aided” would be awarded the lowest score, whilst the highest score would go to someone that “is unable to stand or move for more than 1 metre either on their own or aided”.

If you have your claim for PIP accepted it can be a gateway to obtaining new benefits such as working tax credits, housing benefits, income support, etc. Or if you receive additional benefits, once your PIP claim is accepted this could lead to an increase in payments from your other benefit entitlements.

I currently receive DLA. What do I do?

If you are currently receiving DLA you should be aware that this benefit is being phased out and you will need to apply for the new replacement benefit called Personal Independence Payment (PIP). It is important to note that even though PIP is a replacement for DLA if you receive DLA you will not be automatically enrolled for PIP, you will need to make new PIP claim.

The Department for Work and Pensions will start to write to all DLA claimants from October 2015 introducing the new PIP benefit and inviting an existing DLA claimant to make a claim for the new PIP benefit. Until that date DLA payments will continue to be issued as normal.

How to make a claim for PIP

From 10th June 2013 it became possible to make a claim for PIP (if you are currently a DLA claimant you should wait until the Department for Work and Pensions contact you with details).

New claims can be made over the telephone by calling the number 0800 917 2222.

Questions that may be asked over the telephone include:

  • Date of birth and contact details
  • National insurance (NI) number
  • Doctor, consultant or relevant medical professionals name
  • Details of time spent in hospital or care home
  • Bank details

You will then be sent the “how your disability affects you” form which can also be viewed online.