This information should not be relied upon as legal or professional advice. Read the disclaimer.

Personal Independence Payment (PIP) is a non-means-tested benefit intended to help with the extra costs arising from ill health or disability. It has two components:

  • mobility component, based on an individual’s ability to get around; and
  • “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”). 

PIP is replacing Disability Living Allowance (DLA) for people of working age. 

Beginning in 2022, PIP is being replaced by Adult Disability Payment in Scotland, as part of the devolution of extra-costs disability benefits.  

Timetable for introducing PIP

PIP was introduced for new claims in Great Britain from April 2013, and the Department for Work and Pensions (DWP) has reassessed most existing working-age DLA claimants for PIP. In Northern Ireland, PIP started to replace DLA from 20 June 2016. 

All existing DLA claimants who were under 65 on 8 April 2013 are being 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.

Assessment criteria

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 for the “daily living” component and 2 for 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 DWP 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, London, Southern England and Scotland (though PIP is being replaced in Scotland with Adult Disability Payment, which does not use outsourced assessments – see below). Capita holds the contracts covering Wales, Central England, and Northern Ireland.

A claim for PIP must usually be 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. 

Disability Rights UK and Citizens Advice have produced guides on how best to approach filling in the PIP2 form, and on the kinds of information and evidence relevant to a PIP claim.

The completed PIP2 form and any accompanying evidence submitted by the claimant are forwarded to the assessment provider, who decides whether a consultation is necessary. If so, this can be done face-to-face or virtually by telephone or video.

Following the consultation, or on the basis of written information alone (if this is considered sufficient), the assessment provider completes a report, which is forwarded to the DWP. A DWP “Case Manager” will review the report, along with all other evidence gathered, 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.

Assessments

Most PIP claimants will be required to attend an assessment as part of their claim. This may take place in-person or remotely via telephone or video. Face-to-face assessments are conducted 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. This is to establish 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 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 process for challenging benefits decisions.

Reviews

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. 

PIP in Scotland

Under the Scotland Act 2016, responsibility for disability benefits including PIP was devolved to the Scottish Government and Parliament. Beginning in 2022, PIP is being replaced by Adult Disability Payment (ADP). New claimants will claim ADP. The Scottish Government estimates that it will take until the end of summer 2024 to move all PIP awards to ADP.

Challenging PIP decisions

PIP decisions can be challenged in the same way as other benefits 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.

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 local Citizens Advice. Local advisers can be found using the postcode finder on the AdviceLocal webpage

Further Information

Disclaimer

The Commons Library does not intend the information in this article to address the specific circumstances of any particular individual. We have published it to support the work of MPs. You should not rely upon it as legal or professional advice, or as a substitute for it. We do not accept any liability whatsoever for any errors, omissions or misstatements contained herein. You should consult a suitably qualified professional if you require specific advice or information. Read our briefing for information about sources of legal advice and help.