Entitlement to Personal Independence Payment (PIP) is decided upon by a DWP Decision Maker known as a Case Manager usually after a face to face assessment by a Health Professional
Personal Independence Payment (PIP) is a benefit for people with a long-term health condition or impairment, whether physical, sensory, mental, cognitive, intellectual, or any combination of these. It is paid to make a contribution to the extra costs that disabled people may face, to help them lead full, active and independent lives
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The assessment for PIP looks at an individual’s ability to carry out a series of key everyday activities. The assessment considers the impact of a claimant’s health condition or impairment on their functional ability rather than focusing on a particular diagnosis. Benefit will not be paid on the basis of having a particular health condition or impairment but on the impact of the health condition or impairment on the claimant’s everyday life.
PIP has two components
• The Daily Living component – intended to act as a contribution to the extra costs disabled people face in their day-to-day lives that do not relate to mobility; and
• The Mobility component – intended to act as a contribution to the extra costs disabled people face in their day – to – day lives related to mobility.
Both components are payable at either a standard rate or an enhanced rate, depending on a claimant’s circumstances.
A persons claim for PIP is overseen by a Department for Work and Pensions (DWP) employee called a Case Manager.
Case Manager
The Case Manager acting as the Decision Maker for the DWP will review the claimants assessment report and all other evidence in the case, before making a decision about benefit entitlement. In all cases the Case Manager will consider the claimant’s own estimation of their needs in the claimant questionnaire and any additional evidence available. The Case Manager is not a health professional
The PIP Assessment
The assessment for PIP looks at an individual’s ability to carry out a series of key everyday activities. The assessment considers the impact of a claimant’s health condition or impairment on their functional ability rather than focusing on a particular diagnosis. Benefit will not be paid on the basis of having a particular health condition or impairment but on the impact of the health condition or impairment on the claimant’s everyday life.
The activities explored during the PIP assessment are:
Daily Living (10 activities):
• preparing food • taking nutrition
• managing therapy or monitoring a health condition
• washing and bathing • managing toilet needs or incontinence
• dressing and undressing • communicating verbally • reading and understanding signs, symbols and words
• engaging with other people face to face
• making budgeting decisions
Mobility (2 activities):
• planning and following journeys
• moving around
Each activity contains a series of descriptors which define increasing levels of difficulty carrying out the activity. A numeric score is allocated to each descriptor. Claimants will be allocated a descriptor (and score) for each activity during the assessment.
The total scores for all of the activities related to each component are added together to determine entitlement for that component. The entitlement threshold for each component is 8 points for the standard rate and 12 points for the enhanced rate.
PIP assessment providers are responsible for carrying out the PIP assessment. Health Professionals (HPs) advise the DWP and Case Manager on the impact of the claimant’s health condition or impairment, on their ability to carry out key everyday activities and recommend which of the assessme nt criteria set out in legislation they believe apply to that individual. The decision for benefit entitlement rests with the Case Manager
Health Professional have specialist training in assessing the impact of disability on an individual’s functional ability . The role differs from the therapeutic role of reaching a diagnosis and/or planning treatment. The HP’s role is to as sess the functional effects of the claimant’s health condition or impairment on their everyday lives in relation to the assessment criteria.
The Assessment descriptors and Points
Health Professional (HP)
HPs should not consider the point scores associated with descriptors or whether these will confer entitlement to the benefit if chosen by Case Managers. HPs should only consider whether the descriptor is appropriate to the claimant’s circumstances.
Each activity has a number of descriptors, which describe different levels of ability to carry out the activity. When you’re assessed for PIP, the Health Professional will advise the DWP which descriptors apply to you. Each descriptor carries a number of points, ranging from zero to 12. You’ll score a certain number of points depending on which descriptors apply. The DWP will decide whether you can get PIP, and at what rate, depending on how many points you score.
Below are the assessment descriptors and the points allotted to each.
Daily Living Activities
1. Preparing food.
a. Can prepare and cook a simple meal unaided. 0 points.
b. Needs to use an aid or appliance to be able to either prepare or cook a simple meal. 2 points.
c. Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave. points. 2 points
d. Needs prompting to be able to either prepare or cook a simple meal. 2 points.
e. Needs supervision or assistance to either prepare or cook a simple meal. 4 points.
f. Cannot prepare and cook food. 8 points.
2. Taking nutrition.
a. Can take nutrition unaided. 0 points.
b. Needs –
(i) to use an aid or appliance to be able to take nutrition; or
(ii) supervision to be able to take nutrition; or
(iii) assistance to be able to cut up food. 2 points.
c. Needs a therapeutic source to be able to take nutrition. 2 points.
d. Needs prompting to be able to take nutrition. 4 points.
e. Needs assistance to be able to manage a therapeutic source to take nutrition. 6 points.
f. Cannot convey food and drink to their mouth and needs another person to do so. 10 points.
3. Managing therapy or monitoring a health condition.
a. Either –
(i) does not receive medication or therapy or need to monitor a health condition; or
(ii) can manage medication or therapy or monitor a health condition unaided. 0 points.
b. Needs either –
(i) to use an aid or appliance to be able to manage medication; or
(ii) supervision, prompting or assistance to be able to manage medication or monitor
a health condition. 1 point.
c. Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week. 2 points.
d. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week. 4 points.
e. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 7 but no more than 14 hours a week. 6 points.
f. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week. 8 points.
4. Washing and bathing.
a. Can wash and bathe unaided. 0 points.
b. Needs to use an aid or appliance to be able to wash or bathe. 2 points.
c. Needs supervision or prompting to be able to wash or bathe. 2 points.
d. Needs assistance to be able to wash either their hair or body below the waist. 2 points.
e. Needs assistance to be able to get in or out of a bath or shower. 3 points.
f. Needs assistance to be able to wash their body between the shoulders and waist. 4 points.
g. Cannot wash and bathe at all and needs another person to wash their entire body. 8 points.
5. Managing toilet needs or incontinence.
a. Can manage toilet needs or incontinence unaided. 0 points.
b. Needs to use an aid or appliance to be able to manage toilet needs or incontinence. 2 points.
c. Needs supervision or prompting to be able to manage toilet needs. 2 points.
d. Needs assistance to be able to manage toilet needs. 4 points.
e. Needs assistance to be able to manage incontinence of either bladder or bowel. 6 points.
f. Needs assistance to be able to manage incontinence of both bladder and bowel. 8 points.
6. Dressing and undressing.
a. Can dress and undress unaided. 0 points.
b. Needs to use an aid or appliance to be able to dress or undress. 2 points.
c. Needs either –
(i) prompting to be able to dress, undress or determine appropriate circumstances for remaining clothed; or
(ii) prompting or assistance to be able to select appropriate clothing. 2 points.
d. Needs assistance to be able to dress or undress their lower body. 2 points.
e. Needs assistance to be able to dress or undress their upper body. 4 points.
f. Cannot dress or undress at all. 8 points.
7. Communicating verbally.
a. Can express and understand verbal information unaided. 0 points.
b. Needs to use an aid or appliance to be able to speak or hear. 2 points.
c. Needs communication support to be able to express or understand complex verbal information. 4 points.
d. Needs communication support to be able to express or understand basic verbal information. 8 points.
e. Cannot express or understand verbal information at all even with communication support. 12 points.
8. Reading and understanding signs, symbols and words.
a. Can read and understand basic and complex written information either unaided or using spectacles or contact lenses. 0 points.
b. Needs to use an aid or appliance, other than spectacles or contact lenses, to be able to read or understand either basic or complex written information. 2 points.
c. Needs prompting to be able to read or understand complex written information. 2 points.
d. Needs prompting to be able to read or understand basic written information. 4 points.
e. Cannot read or understand signs, symbols or words at all. 8 points.
9. Engaging with other people face to face.
a. Can engage with other people unaided. 0 points.
b. Needs prompting to be able to engage with other people. 2 points.
c. Needs social support to be able to engage with other people. 4 points.
d. Cannot engage with other people due to such engagement causing either –
(i) overwhelming
psychological distress to the claimant; or
(ii) the claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person. 8 points.
10. Making budgeting decisions.
a. Can manage complex budgeting decisions unaided. 0 points.
b. Needs prompting or assistance to be able to make complex budgeting decisions. 2 points.
c. Needs prompting or assistance to be able to make simple budgeting decisions. 4 points.
d. Cannot make any budgeting decisions at all. 6 points.
Mobility Activities
1. Planning and following journeys.
a. Can plan and follow the route of a journey unaided. 0 points.
b. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant. 4 points.
c. Cannot plan the route of a journey. 8 points.
d. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. 10 points.
e. Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant. 10 points.
f. Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid. 12 points.
2. Moving around.
a. Can stand and then move more than 200 metres, either aided or unaided. 0 points.
b. Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided. 4 points.
c. Can stand and then move unaided more than 20 metres but no more than 50 metres. 8 points.
d. Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres. 10 points.
e. Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided. 12 points.
f. Cannot, either aided or unaided, –
(i) stand; or
(ii) move more than 1 metre. 12 points.
Personal Independence Payment (PIP) daily living component points scores
To get an award of the daily living component, you need to score:
8 points for the standard rate
12 points for the enhanced rate
For daily living, the points need to be scored from activities 1-10 above.
You can only score one set of points from each activity, if two or more apply from the same activity only the highest will count. So, for example, if:
4 d. Needs assistance to groom. 2 points
4 g. Needs assistance to bathe. 4 points
both apply you will receive only the 4 points for the ‘Bathing and grooming’ activity. These can then be added to points for other activities, such as ‘Dressing and undressing’
Personal Independence Payment (PIP) Mobility Component Points Scores
To get an award of the mobility component you need to score:
8 points for the standard rate
12 points for the enhanced rate
For mobility, the points need to be scored from mobility activities 1-2 above.
As with daily living above, you only score the highest points that apply to you from each activity, but you can add points from activities 1 and 2 together to reach your final total.
Reconsideration of Your Claim
Discuss the decision with the DWP
If you’re not happy with the decision regarding your claim contact the DWP to discuss the decision once you’ve got the letter explaining why you’re not eligible.
You can tell them why you don’t agree and give more information to support your argument, eg if your circumstances have changed.
You can also contact DWP before they contact you. The telephone number and address will be on your decision letter.
Contact the DWP as soon as possible if you think they’ve overlooked something or if your situation has changed.
Mandatory Reconsideration
If you’re still unhappy with the decision on your claim, you can contact the DWP and formally ask them to look at their decision again. This is called ‘mandatory reconsideration’ – you have to do it before you can appeal a decision.
- You can phone or write to DWP and ask for a mandatory reconsideration – the details are on your decision letter.
- You have to ask for a mandatory reconsideration within 1 month of the date of your decision letter.
- You must give reasons why you’re asking for a reconsideration. You might want to include further information to support your case.
- You’ll receive a ‘mandatory reconsideration notice’ as a response.
How to appeal
When the DWP sends you the outcome of their reconsideration, it will include two copies of a Mandatory Reconsideration Notice. You will need to send one copy to HM Courts and Tribunal Service (HMCTS) with your appeal form. Your appeal won’t be accepted without the notice.
To appeal, you need to fill in form SSCS1A. You should also read the guide produced by HMCTS called ‘How to appeal against a decision made by the Department for Work and Pensions‘. This will help you to fill in the form correctly.
If you can’t download the online form, you can get a paper copy from a Citizens’ Advice Bureau or other advice agency.
If you can’t get a form in time to meet your one-month deadline to appeal, you can send a letter instead. However, if you have a good reason for why you might miss the deadline, it’s best to get in touch with HMCTS to see if you can extend the time limit.