Personal Independency Payment (PIP)

Overview

If you have a disability or long term illness which affects your daily living and/or your mobility, you may be entitled to PIP, a benefit to help pay for the extra needs you have as a result.

If you qualify for PIP because of your disability or long term illness, it will be paid to you regardless of your income, savings, National Insurance contribution record and it is a tax free benefit. You can also receive PIP if you are working or studying. The PIP payments you receive do not have to be spent on paying for the extra needs you have.

Disability Living allowance (DLA) replacement

PIP is available for all new claimants and replaces DLA (if you are between the ages of 16 and 64 and if you were under 65 on 8 April 2013). The Department of Work and Pensions (DWP) are currently assessing existing working age DLA claimants to move them to PIP. The DWP are making reassessments when:

  • You have reported a change to your care or mobility needs
  • You were aged 16 to 64 years old on 8 April 2013 and you have a DLA fixed award which is due to expire
  • You turn 16 years of age (unless you are a child and have been awarded DLA under the special rules for terminal illness)
  • You have chosen to claim PIP instead of your DLA

What if I'm a carer too?

If you are receiving Carers Allowance because you look after someone else who is disabled, but you have care needs too, you are also entitled to make a claim for PIP for yourself. PIP will not affect the Carers Allowance you claim. In turn if you have a carer they may be entitled to Carers Allowance too, and you both may be entitled to help with your council tax (you can receive extra help if you are disabled and/or a carer).

How do I qualify for PIP?

You must satisfy the following criteria to qualify for PIP:

  • You must be between the ages of 16 and 64 and under 65 on 8 April 2013 if you are being reassessed (existing DLA claimants)
  • You must satisfy the daily living and/or mobility activities test; and
  • You have satisfied those tests for at least three months and be likely to continue to satisfy those tests for at least nine months after the three month qualifying period
  • You have no immigration conditions attached to your stay in the UK

You will be able to remain on PIP if you claimed or received it before you reached the age of 65.

The PIP components

PIP is made up of two components:

  • A daily living component; and
  • A mobility component

Each of the components can be paid at either:

1. The standard rate

This relates to your ability to carry out daily living/ mobility activities is limited by the physical or mental condition you have

2. The enhanced rate

This relates to your ability to carry out daily living/ mobility activities is severely limited by the physical or mental condition you have

The rates for standard and enhanced daily living component is £55.10 and £82.30. For the mobility component it is £21.80 and £57.45.

Making a claim

To start a new claim for PIP you will need to telephone the Department for Work and Pensions (DWP) on 0800 917 2222 (textphone 0800 917 7777). Lines will be open between 8am and 6pm, Monday to Friday. Someone can make the call on your behalf, but you must be present at the time.

The purpose of the initial claim is to check basic eligibility criteria and taking administrative information from you. If the eligibility conditions are not satisfied, you will be sent a disallowance letter.

If you satisfy the eligibility conditions an individually barcoded form is sent to you ‘How your disability affects you’ called form PIP2.

The PIP2 form will ask for information about how your condition affects you and you can also provide supporting evidence to support your claim. On the form there is a section for ‘additional information’, which can be completed by a carer or medical professional or friend. Evidence to include could be a report from an occupational therapist or consultant, information from your doctor or a support worker, or a statement from a carer/friend/ family member. It is important to keep a copy of your form and any evidence you send.

The form is long and complex, so you should take your time to complete it, and remember that you don’t have to complete it all in one go. Look at the 12 activities that are listed and work out which tests you satisfy before you fill in the form. It may be a good idea to get your carer to do the same to make sure that you don’t miss anything out. What is important to remember when answering the questions is ‘whether you need the help, not whether you are already getting it’.

You may want to consider contacting a local advice agency to locate an experienced welfare benefits adviser in your area to help you with the form.

Time limits

You have one month to return the completed PIP2 form, otherwise if you don't return it without good cause, this can result in the claim being terminated.

Assessment

The form and any supporting evidence are then sent to a health professional. If enough information has been provided the assessment can be completed at this stage but most people will be asked to attend a face-to-face consultation. The health professional will then send a report to the decision maker.

The PIP assessment

In order to qualify for PIP you will have to score a certain number of points. There are twelve activities and ten of these activities assess daily living and two of these activities assess mobility. For each activity there are a set of ‘descriptors’ or tests.

To qualify for each component you will need:

Standard rate of the daily living component

You will need a score of at least eight points from the ten activities that assess daily living (activities 1-10).

Enhanced rate of the daily living component

You will need a score of at least twelve points from the ten activities that assess daily living.

Standard rate of the mobility component

You will need a score of at least eight points from the two activities that assess mobility (activities 11-12).

Enhanced rate of the mobility component

You will need a score of at least twelve points from the two activities that assess mobility.

Claiming under the special rules

There are special rules in place for claiming PIP if you have a terminal illness. You are considered to be terminally ill if you have a progressive illness and your life expectancy is likely to be less than six months.

Key points:

  • It is impossible to predict how long someone may live and some people who receive PIP under the special rules do live much longer than six months
  • It is not necessary to satisfy the qualifying period criteria (ie you've had the disability or been in ill health for three months, and likely to have the disability or be in ill health for a further nine months).
  • It is not necessary to have been present in Great Britain for 104 weeks out of the last 156 weeks before claiming, you only need to be present at the time of claiming.
  • Your PIP claim should include a DS1500 form which is available from your GP or consultant
  • You will be given a freepost address for the DS1500 when you (or someone on your behalf) make the claim over the phone
  • You will not have to complete the How your disability affects you form (PIP2) and will not need a face-to-face consultation either. Instead, you or your representative will be asked extra questions whilst you are on the phone about your condition and how it affects your ability to get around
  • You will automatically qualify for the enhanced rate of the daily living component. Payment of the mobility component will be determined on whether you need help to get around, and if you do how much help is required .

You or your representative can ring 0800 917 2222 to make the claim.

The PIP point scoring system

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 any one or more of the following –

(i) to use an aid or appliance to be able to manage medication;

(ii) supervision, prompting or assistance to be able to manage medication.

(iii) supervision, prompting or assistance to be able to 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. For reasons other than psychological distress, cannot plan the route of a journey. 8 points.

d. For reasons other than psychological distress, 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. For reasons other than psychological distress, 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.

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'

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.

Variable and fluctuating conditions

Taking a view of ability over a longer period of time helps to iron out fluctuations and presents a more coherent picture of disabling effects. Therefore the descriptor choice should be based on consideration of a 12 month period.

Scoring descriptors will apply to individuals where their impairment(s) affects their ability to complete an activity on more than 50 per cent of days in the 12 month period. The following rules apply:

If one descriptor in an activity applies on more than 50 per cent of the days in the period – i.e. the activity cannot be completed in the way described on more than 50 per cent of days – then that descriptor should be chosen.

If more than one descriptor in an activity applies on more than 50 per cent of the days in the period, then the descriptor chosen should be the one which applies for the greatest proportion of the time.

Where one single descriptor in an activity is not satisfied on more than 50 per cent of days, but a number of different descriptors in that activity together are satisfied on more than 50 per cent of days – for example, descriptor ‘B’ is satisfied on 40 per cent of days and descriptor ‘C’ on 30 per cent of days – the descriptor satisfied for the highest proportion of the time should be selected.

Awaiting treatment

If someone is awaiting treatment or further intervention it can be difficult to accurately predict its level of success or whether it will even occur. Descriptor choices should therefore be based on the likely continuing impact of the health condition or impairment as if any treatment or further intervention has not occurred.

Reliably, in a timely fashion, repeatedly and safely

An individual must be able to complete an activity descriptor reliably, in a timely fashion, repeatedly and safely; and where indicated, using aids and appliances or with support from another person (or, for activity 10, a support dog). Otherwise they should be considered unable to complete the activity described at that level.

Reliably means to a reasonable standard.

In a timely fashion means in less than twice the time it would take for an individual without any impairment.

Repeatedly means completed as often during the day as the individual activity requires. Consideration needs to be given to the cumulative effects of symptoms such as pain and fatigue – i.e. whether completing the activity adversely affects the individual’s ability to subsequently complete other activities.

Safely means in a fashion that is unlikely to cause harm to the individual, either directly or through vulnerability to the actions of others; or to another person.

Risk and Safety

When considering whether an activity can be undertaken safely it is important to consider the risk of a serious adverse event occurring. However, the risk that a serious adverse event may occur due to impairments is insufficient – there has to be evidence that if the activity was undertaken, the adverse event is likely to occur.

Aids and appliances

The assessment will take some account of aids and appliances which are used in everyday life. In this context:

Aids are devices that help a performance of a function, for example, walking sticks or spectacles.

Appliances are devices that provide or replace a missing function, for example artificial limbs, collecting devices (stomas) and wheelchairs.

The assessment will take into account aids and appliances that individuals normally use and low cost, commonly available ones which someone with their impairment might reasonably be expected to use, even if they are not normally used.

Individuals who use or could reasonably be expected to use aids to carry out an activity will generally receive a higher scoring descriptor than those who can carry out the activity unaided.

Support dogs

We recognise that guide, hearing and dual sensory dogs are not ‘aids’ but have attempted to ensure that the descriptors capture the additional barriers and costs of needing such a dog where they are required to enable individuals to follow a journey safely.

Support from other people

The assessment will take into account where individuals need the support of another person or persons to carry out an activity – including where that person has to carry out the activity for them in its entirety. The criteria refer to three types of support:

Assistance is support that requires the presence and physical intervention of another person i.e. actually doing some or all of the task in question. This specifically excludes non-physical intervention such as prompting or supervision which are defined below. To apply, this only needs to be required for part of the activity.

Prompting is support provided by reminding or encouraging an individual to undertake or complete a task but not physically helping them. To apply, this only needs to be required for part of the activity.

Supervision is a need for the continuous presence of another person to avoid a serious adverse event from occurring to the individual. There must be evidence that any risk would be likely to occur in the absence of such supervision. To apply, this must be required for the full duration of the activity.

Unaided

Within the assessment criteria, the ability to perform an activity ‘unaided’ means without either the use of aids or appliances or assistance/prompting/supervision from another person.

Epilepsy

Epilepsy is a marked example of a fluctuating condition where an individual can have no functional limitation one minute and considerable limitation the next. Assessment should be based on the impact this causes.

Key to assessing individuals with epilepsy is the consideration of risk. Within each activity, the relevant descriptor should apply to a person with epilepsy if there is evidence that a serious adverse event is likely to occur if the person carried out the activity in that descriptor. It is essential to consider the likely effects of any seizure – type and frequency of fit, associated behaviour, the postictal phase and whether there is likely to be sufficient warning to mitigate any risk of danger.