Personal Independence Payment (PIP) is replacing Disability Living Allowance (DLA) for people of working age. Like DLA, PIP is non-means-tested and is intended to help with the extra costs arising from ill health or disability. It has two components:
- a mobility component, based on an individual’s ability to get around; and
- a “daily living” component, based on ability to carry out other key activities necessary to be able to participate in daily life.
Each component has two rates (“standard” and “enhanced”).
Timetable for introducing PIP
PIP was introduced for new claims in Great Britain from April 2013, and the Department for Work and Pensions expects that all existing working age DLA claimants will have been reassessed for PIP by 2020-21. In Northern Ireland, PIP started to replace DLA from 20 June 2016.
All existing DLA claimants who were under 65 on 8 April 2013 will be reassessed for PIP, including those who were awarded DLA indefinitely or “for life”.
The PIP criteria differ from those for DLA, so some people who were getting DLA will not qualify for PIP following reassessment, or will qualify for different components. This means that following reassessment for PIP some DLA claimants will no longer be eligible for certain “passported” benefits or schemes, including Motability. However, some people will qualify for PIP who didn’t previously qualify for DLA, or will receive more than they did under DLA.
The Coalition Government said that the assessment for PIP was designed to provide “a more holistic assessment of the impact of a health condition on an individual’s ability to participate in everyday life.” It covers sensory impairments, developmental needs, cognitive impairments and mental conditions, as well as physical disabilities. There is no automatic entitlement to PIP for people with particular health conditions.
The assessment looks at the person’s ability to undertake 12 different activities: 10 relate to the “daily living” component and 2 relate to the mobility component. Each activity has “descriptors” representing varying levels of ability to carry it out, each with a points score. The total scores for all of the activities related to each component are then 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.”
Making a claim
The Department for Work and Pensions is responsible for handling claims for PIP and making decisions on entitlement to benefit. Contracted assessment providers are however a key element in the process. Atos Healthcare (operating as Independent Assessment Services) holds the contracts for undertaking PIP assessments in Northern England and Scotland; and in London and Southern England. Capita Business Services Ltd holds the contracts covering Wales and Central England; and Northern Ireland.
A claim for PIP must usually initiated by a phone call to DWP. The purpose is to collect basic information about the claimant, and for DWP to determine whether the person may require additional support through the claims process. Once it’s established that the person meets the basic entitlement conditions relating to age and residence, they are sent form PIP2, “How your disability affects you,” with an accompanying information booklet Claimants have one month to return the completed PIP2 form. If it is not returned within one month, the claim may be refused.
The completed PIP2 form and any accompanying evidence submitted by the claimant are forwarded to the assessment provider, who decides whether a face to face consultation is necessary.
Following the face to face consultation (or on the basis of written information alone, if this is considered sufficient), the assessment provider completes a report, which is then forwarded to DWP. A DWP “Case Manager” will review the report, along with all other evidence in the case, before making the decision on the claim. The decision on entitlement to PIP is made by the DWP, not the assessment provider’s health professional.
There is a special fast-track claims process for claimants who are terminally ill.
Face to face assessments
Most PIP claimants will be required to attend a face to face assessment as part of their claim. This may take place at a designated assessment centre or (in certain circumstances) in the claimant’s own home. Claimants should not have to travel more than 90 minutes each way by public transport to their assessment. Failure to attend an assessment appointment without good reason can result in the claim being refused.
Assessments are undertaken by health professionals (likely to be a nurse, nurse practitioner or occupational therapists) employed by Atos or Capita. At the consultation, the health professional will ask questions about the claimant’s circumstances, their health condition or disability and how this affects their daily life. The purpose is to determine the extent to which the person’s condition affects their ability to undertake the 12 activities in the PIP assessment, not the fact that a person has a particular condition.
Complaints about the face to face assessment or about the conduct of the health professional should be made initially through the relevant assessment provider’s complaints procedure. If the person also disagrees with the decision on their claim and wishes to challenge it, they will have to do this separately through the normal reconsideration and appeals process.
Most people awarded PIP will be reassessed periodically. In August 2018 however the DWP issued updated guidance so that people receiving the highest level of support under PIP, and whose needs are unlikely to change or may get worse, will receive an “ongoing award” of PIP with a “light touch” review after 10 years. Light touch reviews after 10 years now also apply to PIP claimants at or above State Pension age (unless they report a change in their needs). the Library Reserch briefing: ESA and PIP reassessments gives further information.
PIP in Scotland
Under the Scotland Act 2016, responsibility for disability benefits including PIP was devolved to the Scottish Government and Parliament. Disability Assistance for Working Age People (DAWAP) will replace PIP in Scotland. New claims for DAWAP will be taken from early 2021, and existing PIP claimants in Scotland will be transferred to the new benefit between 2021 and 2024.
Challenging PIP decisions
When the DWP Case Manager has made their decision on entitlement to PIP, the claimant is sent a letter which should set out the reasons for the decision, and the points awarded for each descriptor. The letter will also explain what the claimant needs to do if they are not happy with the decision.
Claimants seeking to challenge a PIP decision must first request that DWP undertakes a Mandatory Reconsideration (MR) of the decision. This must normally be within one calendar month of the decision date. Late requests may not be accepted.
Following receipt of the MR request, a separate DWP Case Manager will look at the decision, along with any additional evidence or information that has been provided, to decide if the decision is fair and consistent with the evidence.
The claimant is sent a Mandatory Reconsideration Notice (MRN) advising of the outcome, and of their right to appeal against the decision to an independent First-Tier Tribunal. If the claimant is still unhappy with the decision and wishes to challenge it further, they must lodge an appeal directly with HM Courts and Tribunals Service. An appeal can only be lodged once the Mandatory Reconsideration Notice has been received.
The time limit for lodging an appeal is one month from the date of the MRN. Late appeals may be accepted if the Tribunal considers it would be fair and just to do so, but there is an absolute time limit of 12 months from the end of the normal one month time limit.
HM Courts and Tribunals Service booklet SSCS1A, How to Appeal Against a Decision Made by the Department for Work and Pensions gives an overview of the appeals process and what happens at each stage. Links to other resources which may be of help to people seeking to challenge PIP decisions are given at the end of this page.
Challenging decisions: how can MPs help?
Decisions on entitlement to PIP can only be made by reference to the criteria set out in legislation and the relevant case law. There is no discretionary power to award PIP where a person doesn’t satisfy the conditions.
The role of the Tribunal is to consider whether the DWP’s decision was correct, on the basis of the evidence available, and the relevant legislation and case law. Tribunals are judicial bodies. MPs cannot intervene to secure a particular result for a constituent, where they would not otherwise satisfy the conditions for benefit.
Often the best way an MP can help a constituent is to signpost them to an agency with appropriate expertise to help with benefit appeals – such as a Citizens Advice Bureau.
- Research briefing: ESA and PIP reassessments
- Research briefing: Motability scheme
- DWP: Personal Independence Payment Handbook
- DWP: Personal Independence Payment toolkit
- DWP: PIP assessment guide
- DWP: Advice for Decision Making (Chapters P1-P6)
- NIdirect: Personal Independence Payment
- Independent Assessment Services (Atos)
- Capita: Personal Independence Payment
- Disability Rights UK: Personal Independence Payment: a guide to making a claim
- Citizens Advice: Personal Independence Payment
- Turn2us: PIP guides
- Advicenow: PIP Mandatory Reconsideration Request Letter Tool
- Advicenow: How to Win a PIP Appeal
- pipinfo: an adviser guide to personal independence payment regulations & case law
- Swansea Council: Guide to Completing the PIP 2 form – How Your Disability Affects You (PDF 267 KB)