Personal Independence Payment - Advice York · Personal Independence Payment (PIP) toolkit Page 2...

Personal Independence Payment Fact sheet pack 1. Conditions of Entitlement

2. Assessment Criteria

3. Differences and similarities between Disability Living Allowance and PIP

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

Access to other benefits and services

Reassessing existing Disability Living Allowance claimants for PIP - updated December 2013

How to make a claim for PIP

Completing the ‘How your disability affects you’ form

Assessment Process and Assessment Providers

Decision and payment

Access to work

Special rules for terminal Illness - updated December 2013

Supporting young people to claim PIP - updated December 2013

People approaching age 65 and over

Supporting PIP claimants who are in a vulnerable situation

Disputes process

Changes in circumstance

Postcode map

ISBN: 978-1-78153-630-8 © Crown Copyright 2013 Published by the Department for Work and Pensions gov.uk/dwp/pip-toolkit

https://www.gov.uk/dwp/pip-toolkit

Personal Independence Payment (PIP) toolkit

ISBN: 978-1-78153-631-5 © Crown Copyright 2013 Published by the Department for Work and Pensions Version 4.0: October 2013 Page 1 of 5 gov.uk/dwp/pip-toolkit

Conditions of entitlement for PIP

Who is eligible for PIP and what circumstances affect payment of PIPContents

• Claiming PIP

• Required period condition

• Residence and presence

• Age

• Assessment criteria

• Award duration and reviews

• Decision on entitlement

• Hospitals or similar institutions

• Care homes

• Detained in legal custody

• Overlapping benefits

• Passporting arrangements

• Special rules for terminal illness

Key facts

• PIP has replaced Disability Living Allowance (DLA) for working age people

• People cannot claim DLA and PIP at the same time

• Children under the age of 16 and people aged 65 and over cannot claim PIP

• Claimants must have a long term health condition or disability to qualify for PIP

• Individuals are assessed on their ability to complete a number of key everyday activities

• Claimants need to be present in Great Britain for at least 104 weeks out of the last 156weeks to qualify for PIP

• Both components of PIP cease to be payable 28 days after the claimant is admitted toan NHS hospital

• The daily living component of PIP ceases to be payable after 28 days of residency incare home where the costs of the acccommodation are met from public or local funds.

• PIP ceases to be payable after 28 days where someone is being detained in legalcustody

• There are special rules for people who have a terminal illness



Page 2 of 5 gov.uk/dwp/pip-toolkit

Claiming PIP

PIP has replaced Disability Living Allowance (DLA) for people who were aged 16 to 64 on 8 April 2013 or who reach age 16 after that date. This was initially for new claims only.

People cannot get DLA and PIP at the same time.

From 28 October 2013, existing DLA claimants can claim PIP. Their DLA entitlement ends when DWP make a decision on their PIP claim. People waiting for DWP to make a decision on a DLA claim cannot claim PIP.

Required period condition

In order to be entitled to PIP, claimants have to satisfy a qualifying period of three months and a prospective test of nine months. These two conditions are referred to as the ‘required period condition’ and help establish that the health condition or disability is likely to be long-term.

The qualifying period establishes that the claimant has had the needs for a certain period of time before entitlement can start and the prospective test shows they are likely to have continuing needs for a specified period after the award starts.

The three month qualifying period and the nine month prospective test align the PIP definition of a long-term health condition or disability with that generally used by the Equality Act 2010 and its published guidance.

Claims can be submitted during the qualifying period but entitlement to PIP cannot start until the qualifying period has been satisfied.

Residence and presence

Claimants will need to be present in Great Britain, habitually resident in the United Kingdom (UK), Ireland, the Channel Islands or the Isle of Man and not subject to immigration control.

They must have been present for at least 104 weeks out of the last 156 weeks in Great Britain.

DWP treats serving members of Her Majesty’s Forces and their families as habitually resident in Great Britain when serving and stationed abroad.

A temporary absence abroad for up to 13 weeks may be allowed, or up to 26 weeks if the absence is specifically for medical treatment. The claimant should notify DWP if they are planning to go abroad for four weeks or more.

More information: existing DLA claimants and PIP

https://www.gov.uk/government/publications/reassessing-existing-dla-claimants-for-pip





The PIP residence and presence conditions are the same as those for Disability Living Allowance (DLA), Attendance Allowance (AA) and Carers allowance (CA).

Age

Children under the age of 16 are not eligible to claim PIP; they can claim DLA and continue to do so until they are 16.

PIP cannot be claimed from age 65 except in certain circumstances where there has been a recent award of benefit. Entitlement can continue after the age of 65 if a claimant is already in receipt of PIP when they turn 65, providing they continue to satisfy the conditions of entitlement.

Assessment Criteria

PIP is made up of two components – one to help with daily living needs and one for mobility. To determine entitlement to the two components and the level of benefit award, individuals are assessed on their ability to complete a number of key everyday activities.

Award duration and reviews

PIP awards will normally be made for a fixed period and will be reviewed on a regular basis. At the end of the fixed period an award ends and a new claim will need to be made.

There are no specific health or disability conditions that automatically entitle someone to PIP or to particular award duration.

Decision on entitlement

Entitlement is decided by a DWP Decision Maker, taking full account of the claimant’s evidence, including any additional evidence they submit in support of their claim, evidence from professionals who support the claimant and the report provided by the assessment provider.

Hospitals or similar institutions

Both components of PIP cease to be payable 28 days after the claimant is admitted to an NHS hospital. Privately funded patients are unaffected by these rules and can continue to be paid either component of PIP.

If a claimant is in hospital or a similar institution at the date entitlement to PIP starts, PIP is not payable until they are discharged.

More information: supporting young people to claim PIP

More information: people approaching 65

More information: decision and payment

https://www.gov.uk/government/publications/supporting-young-people-claiming-pip



https://www.gov.uk/government/publications/pip-and-people-approaching-age-65


https://www.gov.uk/government/publications/pip-decisions-and-payment

https://www.gov.uk/government/publications/pip-decisions-and-payment




Care Homes

The daily living component of PIP ceases to be payable after 28 days of residency in care home where the costs of the accommodation are met from public or local funds.

PIP mobility component can continue to be paid. People who fully self fund their placement are unaffected by these rules. If a claimant is in a care home at the date of entitlement, PIP daily living component is not payable until they leave.

Linked spells in hospital and a care home

Spells in hospital are linked if the gap between them is no more than 28 days. The daily living component for spells in a care home is also linked if the gap between them is no more than 28 days. There is no link for the mobility component because payment is not affected when in a care home.

Both components of PIP will stop being paid after a total of 28 days in hospital. The daily living component of PIP will stop being paid after a total of 28 days in a care home. If a claimant moves between a hospital and care home or vice versa, these periods will also link.

Detained in legal custody

PIP ceases to be payable after 28 days where someone is being detained in legal custody. This applies whether the offence is civil or criminal and whether they have been convicted or are on remand.

Suspended payments of benefit are not refunded regardless of the outcome of proceedings against the individual. Two or more separate periods in legal custody link if they are within one year of each other.

Overlapping benefits

PIP mobility component overlaps with War Pensioner’s Mobility Supplement (WPMS). PIP daily living component overlaps with Constant Attendance Allowance (CAA).

The overlapping benefit is always paid in full and PIP is reduced by the amount of the overlapping benefit.

Those in receipt of an Armed Forces Independence Payment (AFIP) will not be entitled to claim PIP. AFIP is a new benefit for members of the Armed Forces and former members of the Armed Forces who have been

More information Veterans UK website

http://www.veterans-uk.info/welfare_reform.html




seriously injured as a result of their service since the introduction of Armed Forces Compensation Scheme (AFCS) in 2005.

From 8 April 2013, service personnel and veterans awarded a Guaranteed Income Payment of 50% or more under the Armed Forces Compensation Scheme (AFCS) will be eligible for AFIP.

Veterans not entitled to AFIP will be able to apply for PIP in the usual way.

Passporting arrangements

Entitlement to PIP provides a gateway to other benefits, such as Carer’s Allowance and schemes sponsored by other Departments such as the Blue Badge Scheme. The links to passported benefits, that are currently available through DLA, have been maintained where possible.

Motability

The Motability scheme will allow claimants to use all or part of their enhanced rate of the mobility component of PIP to buy or hire a vehicle.

Special rules for terminal illness

Claimants deemed as terminally ill (having a progressive condition where they are not expected to live for more than six months) are exempt from the ‘qualifying period’ and ‘prospective test’. These claimants are entitled to the enhanced rate of the daily living component automatically from the date of claim but will be assessed for the mobility component. People who claim under these provisions will be exempt from a face to face consultation.

More information:

PIP and other benefits

Carers Allowance

blue badge scheme

Motability website

More information: special rules for terminal illness

https://www.gov.uk/government/publications/access-to-other-benefits-and-services-for-pip-claimants


https://www.gov.uk/carers-allowance

https://www.gov.uk/browse/driving/blue-badge-parking

http://www.motability.co.uk/

https://www.gov.uk/government/publications/pip-and-special-rules-for-terminal-illness




PIP Assessment Criteria

Details of the Assessment Criteria for PIP and guidance on how this is applied Contents Risk and safety

Support from other people Introduction

Aids and appliances The activities

Moving around Guidance on applying the criteria

Daily living activities explained Reliability

Mobility activities explained Time periods, fluctuations and descriptor choices Assessment criteria examples

Key Facts

Individuals are assessed on their ability to complete a number of key everyday activities

There are 10 daily living activities and 2 mobility activities

Each activity has a number of descriptors representing varying levels of ability to carry out the activity

For a descriptor to apply the claimant must be able to carry out the activity safely, to an acceptable standard, repeatedly and in a reasonable time period

The ability to carry out an activity will be considered over a period of time to take account the affects of a fluctuating health condition or disability

The assessment takes into account where claimants need the support of another person or persons to carry out an activity

The assessment takes into account where individuals need aids and appliances to complete activities

Individuals will receive a point score for each activity that will determine whether a component is payable, and if so, at what rate.



Introduction

PIP has two components – daily living and mobility. Both components are For more information: payable at a standard or enhanced rate, depending on the claimant’s needs. PIP Assessment

Guide To determine entitlement to the two components and the level of payment, individuals are assessed on their ability to complete a number of key everyday activities for example, relating to their ability to dress and undress, make budgeting decisions, communicate and getting around.

Within each activity there are a number of descriptors, each representing a varying level of ability to carry out the activity.

Individuals will receive a point score for each activity, depending on how well they can carry them out and the help they need to do so.

The total scores will determine whether a component is payable, and if so, whether at the standard or enhanced rate. The entitlement threshold for each component is eight points for the standard rate and 12 points for enhanced.

The Activities Full details of the

There are a total of 12 activities: activities can be found on page 12 of

Daily Living Activities: this document 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



https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/183075/pip-assessment-guide.pdf


Mobility activities:

Planning and following journeys

Moving around

Example of an activity descriptor – Taking Nutrition

A Can take nutrition unaided. 0

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

C Needs a therapeutic source to be able to take nutrition. 2

D Needs prompting to be able to take nutrition. 4

E Needs assistance to be able to manage a therapeutic source to take nutrition.

6

F Cannot convey food and drink to their mouth and needs another person to do so.

10

Guidance on applying the criteria

As the assessment will consider a claimant’s ability to undertake the activities, inability to undertake activities must be due to the effects of a health condition or disability and not simply a matter of preference by the claimant.

Health conditions or disabilities may be physical, sensory, mental, intellectual or cognitive, or any combination of these.

The impact of all impairment types can be taken into account across the activities, where they affect a claimant’s ability to complete the activity and achieve the stated outcome.



For example, a claimant with a severe depressive illness may physically be able to prepare food and feed himself, but may lack the motivation to do so, to the extent of needing prompting from another person to carry out the task.

However, some activities focus on specific elements of function. For example, moving around relates to the physical aspects of walking, whilst engaging with other people face to face relates to the mental, cognitive or intellectual aspects of interacting with other people.

As the assessment principles consider the impact of a claimant’s condition on their ability to live independently and not the condition itself, claimants with the same condition may get different outcomes. The outcome is based on an independent assessment and all available evidence.

Evidence may come from a variety of sources including:

The form – ‘How your disability affects you’

A factual report from the claimant’s GP

Evidence from other health professionals involved in the claimant’s care

Any other evidence from other professionals involved in supporting the claimant, for example social worker or support worker.

The assessment will provide impartial advice, and will be carried out by an independent assessment provider.

The majority of claimants will be assessed at a face-to-face consultation.

The most appropriate descriptor for each activity will be selected, based on the assessment and any available evidence.

Regular reviews will take place during the lifecycle of a PIP award to ensure that the award still meets the claimant’s support needs.

Reliability

For a descriptor to apply to a claimant the claimant must be able to reliably complete the activity as described in the descriptor. Reliably means whether they can do so:

safely – in a manner unlikely to cause harm to themselves or to another person, either during or after completion of the activity;

to an acceptable standard;

More examples of sources of evidence in: PIP information booklet

Examples of how the assessment criteria could be applied are on pages 25 and 26 of this document

For more information: The assessment process



https://www.gov.uk/government/publications/how-your-disability-affects-you-pip-information-booklet


https://www.gov.uk/government/publications/the-pip-assessment-process-and-providers


repeatedly – as often as is reasonably required; and

in a reasonable time period – no more than twice as long as the maximum period that a non-disabled person would normally take to complete that activity.

DWP recognises that the reliability criteria are a key protection for claimants, and, as a result of feedback received during the consultation on the PIP Moving Around criteria (held between 24 June and 5 August 2013), measures will be put in place to ensure that the reliability criteria are properly and consistently applied as part of the assessment.

Example – Reliability

Using a walking stick a claimant can walk a distance of between 20 and 50 metres. However the exertion of doing so means they can only walk that distance twice a day. You would reasonably expect someone to walk 50 metres more than twice a day. Therefore the claimant does not reliably satisfy descriptor D, because they cannot do so repeatedly. The individual can walk shorter distances up to 20 metres and repeat them as often as they need to. The individual therefore satisfies descriptor E and receives 12 points.

For more information: PIP regulations

A Can stand and then move more than 200 metres, either aided or unaided

0

B Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided

4

C Can stand and then move unaided more than 20 metres but no more than 50 metres

8

D Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres.

For example, this would include people who can stand and move more than 20 metres but no further than 50 metres, but need to use an aid or appliance such as a stick or crutch to do so

10

E Can stand and then move more than one metre but no more than 20 metres either aided or unaided

12



http://www.legislation.gov.uk/uksi/2013/377/contents/made

Time periods, fluctuations and descriptor choices

The impact of most health conditions and disabilities can fluctuate. 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. The descriptor choice should be based on consideration of a 12 month period. This should correlate with the Qualifying Period and Prospective Test for the benefit – so in the three months before the assessment and in the nine months after.

A scoring descriptor can apply to claimants in an activity where their impairment(s) affects their ability to complete an activity, at some stage of the day, on more than 50 per cent of days in the 12 month period. The following rules apply:

If one descriptor in an activity is likely to apply on more than 50 per cent of the days in the 12 month period – the activity can 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 is likely to apply on more than 50 per cent of the days in the period, then the descriptor chosen should be the one which is the highest scoring. For example, if D applies on 100% of days and E on 70% of days, E is selected.

Where one single descriptor in an activity is likely to not be satisfied on more than 50% of days, but a number of different scoring descriptors in that activity together are likely to be satisfied on more than 50% of days, the descriptor likely to be satisfied for the highest proportion of the time should be selected. For example if B applies on 20% of days, D on 30% of days and E on 5% of days, D is selected.

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 disability as if any treatment or further intervention has not occurred.

The timing of the activity should be considered, and whether the claimant can carry out the activity when they need to do it. For example if taking medication in the morning (such as painkillers) allows the individual to carry out activities reliably when they need to throughout the day, although they would be unable to carry out the activity for part of the day (before they take the painkillers), the individual can still complete the activity reliably when required and therefore should receive the appropriate descriptor.



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 – the adverse event has to be likely to occur.

Support from other people

The assessment takes into account where claimants 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 various types of support:

Supervision is a need for the continuous presence of another person to avoid a serious adverse event occurring to the claimant. The risk must be likely to occur in the absence of such supervision. To apply, supervision must be required for the full duration of the activity.

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

Assistance is support that requires the presence and physical intervention of another person to help the claimant complete the activity - including doing some but not all of the activity in question. To apply, assistance only needs to be required for part of the activity.

A number of descriptors also refer to another person being required to complete the activity in its entirety. These descriptors would apply where the claimant is unable to reliably undertake any of the activity for themselves, even with help.

Activities 7 and 9 refer to Communication support and Social support, which are defined in the notes to the activities later in this document.

The assessment does not look at the availability of help from another person but rather at the underlying need. As such claimants may be awarded descriptors for needing help even if it is not currently available to them – for example, if they currently manage in a way that is not reliable, but could do so with some help.

Activity 7 can be found on page 19 and activity 9 can be found on page 21.



Aids and appliances

The assessment takes into account where individuals need aids and appliances to complete activities. In this context:

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

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.

This may include mainstream items used by people without an impairment, where the claimant is completely reliant on them to complete the activity. For example, this would include an electric can-opener where the claimant could not open a can without one, not simply where they prefer to use one.

Activity 11 refers specifically to ‘orientation aids’, which are defined as specialist aids designed to assist disabled people in following a route.

Claimants 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.

When considering whether it is reasonable to expect a claimant to use an aid or appliance that they do not usually use, the health professional will consider whether:

The claimant possesses the aid or appliance.

The aid or appliance is widely available.

The aid or appliance is available at no or low cost.

It is medically reasonable for them to use an aid or appliance.

The claimant was given specific medical advice about managing their condition, and it is reasonable for them to continue following that advice.

The claimant would be advised to use an aid or appliance if they sought advice from a professional such as a GP or occupational therapist.

The claimant is able to use and store the aid or appliance.

Activity 11 can be found on page 23.



The claimant is unable to use an aid or appliance due to their physical or mental health condition – for example, they are unable to use a walking stick or manual wheelchair due to a cardiac, respiratory, upper body or mental health condition.

Assistance 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 claimants to follow a route safely. Activity 11 therefore explicitly refers to the use of an ‘assistance dog’. Assistance dogs are defined as dogs trained to help people with sensory impairments.

‘Unaided’

Within the assessment criteria, the ability to perform an activity ‘unaided’ means without the use of aids or appliances and without help from another person.

Moving around

Activity 12 considers a claimant’s physical ability to move around without severe discomfort such as breathlessness, pain or fatigue. This includes the ability to stand and then move up to 20 metres, up to 50 metres, up to 200 metres and over 200 metres.

This activity should be judged in relation to a type of surface normally expected out of doors such as pavements and includes the consideration of kerbs.

Standing means to stand upright with at least one biological foot on the ground with or without suitable aids and appliances (note – a prosthesis is considered an appliance so a claimant with a unilateral prosthetic leg may be able to stand whereas a bilateral lower limb amputee would be unable to stand under this definition).

“Stand and then move” requires an individual to stand and then move independently while remaining standing. It does not include a claimant who stands and then transfers into a wheelchair or similar device. Individuals who require a wheelchair or similar device to move a distance should not be considered able to stand and move that distance.

Activity 12 can be found on page 24.



Aids or appliances that a person uses to support their physical mobility may include walking sticks, crutches and prostheses.

When assessing whether the activity can be carried out reliably, consideration should be given to the manner in which they do so. This includes but is not limited to, their gait, their speed, the risk of falls and symptoms or side effects that could affect their ability to complete the activity, such as pain, breathlessness and fatigue. However, for this activity this only refers to the physical act of moving. For example, danger awareness is considered as part of activity 11.

Moving around activity principles

For individuals who cannot stand and then move 20 metres they will receive 12 points and therefore the enhanced rate of the mobility component regardless of whether they need an aid or appliance.

However, as with all of the activities in the assessment, in order for a descriptor to apply, consideration must be given to the manner in which the claimant can complete the activity.

This means that if individuals can stand and then move more than 20 metres but can’t do so in a safe and reliable way, they should receive 12 points and the enhanced rate.

The following example illustrates how this will work in principle.

Example – Moving around activity

A claimant can walk distances of up to 40 metres before becoming breathless and needing to stand still, and have a short rest of about a minute before walking that distance again. They can walk at a reasonable pace, without pain and can repeatedly walk short distances, provided they can stop every 40 metres or so to catch their breath. The claimant is therefore awarded descriptor C, eight points, because they are able to walk distances of between 20 and 50 metres safely, to an acceptable standard, repeatedly and in a reasonable time period.

More information can be found in section 3 of: PIP Assessment Guide

A Can stand and then move more than 200 metres, either aided or unaided

0





B Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided

4

C Can stand and then move unaided more than 20 metres but no more than 50 metres

8

D Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres.

For example, this would include people who can stand and move more than 20 metres but no further than 50 metres, but need to use an aid or appliance such as a stick or crutch to do so

10

E Can stand and then move more than one metre but no more than 20 metres either aided or unaided

12

F Cannot, either aided or unaided stand; or move more than one metre

12



Daily Living activities

Activity 1 – Preparing food

This activity considers a claimant’s ability to prepare a simple meal. This is not a reflection of a claimant’s cooking skills but instead a consideration of the impact of impairment on ability to perform the tasks required. It assesses ability to open packaging, serve food, peel and chop food and use a microwave oven or cooker hob to cook or heat food.

Notes:

Preparing food means the activities required to make food ready for cooking and eating, such as peeling and chopping.

Cooking food means heating food at above waist height – for example, using a microwave oven or on a cooker hob. It does not consider the ability to bend down – for example, to access an oven.

A simple meal is a cooked one-course meal for one from fresh ingredients.

Packaging includes tins, which may require the use of a tin opener.

In this activity aids and appliances could include, for example, prostheses, perching stool, lightweight pots and pans, easy grip handles on utensils and single lever arm taps.

Pre-chopped vegetables are not considered an aid or appliance. However, a claimant who is reliant on them because they would be unable to peel or chop fresh vegetables may be considered as requiring an aid or appliance or support from another person to complete the activity.

A Can prepare and cook a simple meal unaided. 0

B Needs to use an aid or appliance to be able to either prepare or cook a simple meal. 2

C Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave.

For example: may apply to claimants who cannot safely use a cooker hob and hot pans.

2

D Needs prompting to be able to either prepare or cook a simple meal.

For example: may apply to claimants who lack motivation, who need to be reminded how to prepare and cook food or who are unable to ascertain if food is within date.

2

E Needs supervision or assistance to be able to either prepare or cook a simple meal.

For example: may apply to claimants who need supervision to prepare and cannot safely use a microwave oven or to claimants who cannot prepare or safely heat food.

4

F Cannot prepare and cook food. 8



Activity 2 – Taking nutrition

This activity considers a claimant’s ability to be nourished, either by cutting food into pieces, conveying to the mouth, chewing and swallowing; or through the use of therapeutic sources.

Notes:

A therapeutic source means parenteral or enteral tube feeding using a rate limiting device such as a delivery system or feed pump.

A key consideration when considering whether supervision is required should be whether the claimant has a real risk of choking when taking nutrition.

A Can take nutrition unaided. 0

B Needs –

to use an aid or appliance to be able to take nutrition; or supervision to be able to take nutrition; or

assistance to be able to cut up food.

2

C Needs a therapeutic source to be able to take nutrition.

For example: may apply to claimants who require enteral or parenteral feeding but can carry it out unaided.

2

D Needs prompting to be able to take nutrition.

For example: may apply to claimants who need to be reminded to eat or who need prompting about portion size.

4

E Needs assistance to be able to manage a therapeutic source to take nutrition.

For example: may apply to claimants who require enteral or parenteral feeding and require support to manage the equipment.

6

F Cannot convey food and drink to their mouth and needs another person to do so. 10



Activity 3 – Managing therapy or monitoring a health condition

This activity considers a claimant’s ability to:

i. appropriately take medication in a domestic setting and which are prescribed or recommended by a registered doctor, nurse or pharmacist;

ii. monitor and detect changes in a health condition; and

iii. manage therapeutic activities that are carried out in a domestic setting and prescribed or recommended by a registered doctor, nurse, pharmacist or healthcare professional regulated by the Health Professions Council;

and without any of which their health is likely to deteriorate.

Notes:

Managing medication means the ability to take prescribed medication in the correct way and at the right time. Monitoring a health condition or recognise significant changes means the ability to detect changes in the condition and take corrective action as advised by a healthcare professional.

This activity does not take into account medication and monitoring requiring administration by a healthcare professional.

Examples of prescribed or recommended medication include tablets, inhalers and creams and therapies could include home oxygen, domiciliary dialysis, nebulisers and exercise regimes to prevent complications such as contractures. Whilst medications and therapies do not necessarily have to be prescribed, there must be a consensus of medical opinion that supports their use in treatment of the condition.

Supervision due to the risk of accidental or deliberate overdose or deliberate self harm is captured in these descriptors as the person would require continuous support from another person in order to prevent this.

For the purpose of this activity, the majority of days test does not require the individual to actually be receiving therapy on the majority of days in a year. However, the descriptor would still need to accurately describe the claimant’s circumstances on a majority of days –on a majority of days the statement about how much support an individual needs a week must be true. For example, if a claimant needs assistance to undergo home dialysis for three hours on Monday and Friday, they would not actually be receiving therapy on a majority of days in a year. However, on a majority of days in the year, the statement that they need “assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week” would still apply as it accurately describes the level of support needed in a week.



A Either –Does not receive medication or therapy or need to monitor a health condition; or Can manage medication or therapy or monitor a health condition unaided.

0

B Needs either –

to use an aid or appliance to be able to manage medication; or

supervision, prompting or assistance to be able to manage medication or monitor a health condition.

1

C Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week.

2

D Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 hours a week but no more than 7 hours.

4

E Needs supervision, prompting or assistance to be able to manage therapy that takes more than 7 hours a week but no more than 14 hours.

6

F Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week.

8



Activity 4 – Washing and bathing

This activity considers a claimant’s ability to wash and bathe, including washing their whole body and getting in and out of an un-adapted bath or shower.

A Can wash and bathe unaided. 0

B Needs to use an aid or appliance to be able to wash or bathe.

For example: suitable aids could include a long-handled sponge, shower seat or bath rail.

2

C Needs supervision or prompting to be able to wash or bathe.

For example: may apply to claimants who lack motivation or need to be reminded to wash or require supervision for safety.

2

D Needs assistance to be able to wash either their hair or their body below the waist.

For example: may apply to claimants who are unable to make use of aids and who cannot reach their lower limbs or hair.

2

E Needs assistance to be able to get in or out of a bath or shower. 3

F Needs assistance to be able to wash their body between the shoulders and waist. 4

G Cannot wash and bathe at all and needs another person to wash their entire body. 8



Activity 5 – Managing toilet needs or incontinence

This activity considers a claimant’s ability to get on and off the toilet, to clean afterwards and to manage evacuation of the bladder and/or bowel, including the use of collecting devices.

This activity does not include the ability to manage clothing, for example fastening and unfastening zips or buttons, as this is covered in activity 6.

Notes:

Toilet needs means the ability to get on and off the toilet, evacuation of the bladder and bowel and clean oneself afterwards.

Managing incontinence means the ability to manage evacuation of the bladder and/or bowel including using collecting devices and clean oneself afterwards.

Claimants with catheters and collecting devices are considered incontinent for the purposes of this activity.

A Can manage toilet needs or incontinence unaided. 0

B Needs to use an aid or appliance to be able to manage toilet needs or incontinence. For example: suitable aids could include commodes, raised toilet seats, bottom wipers, bidets, incontinence pads or a stoma bag.

2

C Needs supervision or prompting to be able to manage toilet needs.

For example: may apply to claimants who need to be reminded to go to the toilet or need supervision to get on and off the toilet safely.

2

D Needs assistance to be able to manage toilet needs. 4

E Needs assistance to be able to manage incontinence of either bladder or bowel. 6

F Needs assistance to be able to manage incontinence of both bladder and bowel. 8



Activity 6 – Dressing and undressing

This activity assesses a claimant’s ability to put on and take off culturally appropriate, un-adapted clothing that is suitable for the situation. This may include the need for fastenings such as zips or buttons and considers the ability to put on/take off socks and shoes.

A Can dress and undress unaided. 0

B Needs to use an aid or appliance to be able to dress or undress.

For example: suitable aids could include modified buttons, zips, front fastening bras, trousers, velcro fastenings and shoe aids.

2

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.

For example: may apply to claimants who need to be encouraged to dress. Includes a consideration of whether the claimant can determine what is appropriate for the environment, such as time of day and the weather.

2

D Needs assistance to be able to dress or undress their lower body. 2

E Needs assistance to be able to dress or undress their upper body. 4

F Cannot dress or undress at all. 8



Activity 7 – Communicating verbally

This activity considers a claimant’s ability to communicate verbally with regard to expressive (conveying) communication and receptive (receiving and understanding) communication.

Notes:

This activity considers the ability to convey and understand verbal information with other people in one’s native language.

Basic verbal information is information conveyed in a simple sentence.

Complex verbal information is information conveyed in either more than one sentence or one complicated sentence.

Verbal information can include information that is interpreted from verbal into non-verbal form or vice-versa – for example, speech interpreted through sign language or into written text.

Communication support means support from another person trained or experienced in communicating with people with specific communication needs (for example, a sign language interpreter) or someone directly experienced in communicating with the claimant themselves (for example, a family member).

Individuals who cannot express or understand verbal information and would need communication support to do so should receive the appropriate descriptor even if they do not have access to this support. For example, a deaf person who cannot communicate verbally and does not use sign language might need another person to support them in another way – such as by writing verbal information down – even if they do not routinely have such help.

A Can express and understand verbal information unaided. 0 B Needs to use an aid or appliance to be able to speak or hear.

For example: may apply to claimants who require a hearing aid or an electrolarynx.

2

C Needs communication support to be able to express or understand complex verbal information.

For example: may apply to claimants who require a sign language interpreter.

4

D Needs communication support to be able to express or understand basic verbal information. For example: may apply to claimants who require a sign language interpreter.

8

E Cannot express or understand verbal information even with communication support.

12



Activity 8 – Reading and understanding signs, symbols and words

This activity considers a claimant’s ability to read and understand signs, symbols and words.

Notes:

This activity considers the capability to read and understand written or printed information in the person’s native language.

Basic information is signs, symbols or dates. Complex information is more than one sentence of written or printed standard size text – for example, text found in utility bills and bank statements.

Consideration needs to be given to whether the claimant can read and understand information both indoors and outdoors. In doing so consideration should also be given to whether the claimant uses or could reasonably be expected to use aids or appliances, such as a large magnifier to read text when indoors and a portable magnifying glass to do so when outdoors. If the claimant is unable to complete the activity as described either indoors or outdoors, the descriptor may apply.

To be considered able to read, claimants must be able to see the information.

For the purpose of this activity, accessing information via Braille is not considered as reading.

A Can read and understand basic and complex written information either unaided or using spectacles or contact lenses.

0

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 information.

For example: may apply to claimants who require low vision aids.

2

C Needs prompting to be able to read or understand complex written information.

For example: may apply to claimants who require another person to explain information to them.

2

D Needs prompting to be able to read or understand basic written information.

For example: may apply to claimants who require another person to explain information to them.

4

E Cannot read or understand signs, symbols or words at all.

For example: may apply to claimants who require another person to read everything for them.

8



Activity 9 – Engaging with other people face to face

This activity considers a claimant’s ability to engage with other people, which means to interact face to face in a contextually and socially appropriate manner, understand body language and establish relationships.

Notes:

An inability to engage socially must be due to the impact of impairment and not simply a matter of preference by the claimant.

Social support means support from a person trained or experienced in assisting people to engage in social situations, or someone directly experienced in supporting the claimant themselves (for example a family member), who can compensate for limited ability to understand and respond to body language, other social cues and assist social integration.

‘Psychological distress’ means distress related to an enduring mental health condition or an intellectual or cognitive impairment. However, this condition may have a physical root cause.

When considering whether claimants can engage with others, consideration should be given to whether they can engage with people generally, not just those people they know well.

A Can engage with other people unaided. 0

B Needs prompting to be able to engage with other people.

For example: may apply to people who need encouragement to interact with others by the presence of a third party.

2

C Needs social support to be able to engage with other people.

For example: may apply to people who are only able to interact with others by the presence of a third party.

4

D Cannot engage with other people due to such engagement causing either – overwhelming psychological distress to the claimant; or

the claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person.

8



Activity 10 – Making budgeting decisions

This activity considers the ability of a claimant to make everyday budgeting decisions.

Notes:

Complex budgeting decisions are those that are involved in calculating household and personal budgets, managing and paying bills and planning future purchases.

Simple budgeting decisions are those that are involved in activities such as calculating the cost of goods and change required following purchases.

Assistance in this activity refers to another person carrying out elements, although not all, of the decision making process for the claimant.

A Can make complex budgeting decisions unaided. 0

B Needs prompting or assistance to be able to make complex budgeting decisions.

For example: may apply to claimants who need to be encouraged or reminded to make complex budgeting decisions.

2

C Needs prompting or assistance to be able to make simple budgeting decisions.

For example: may apply to claimants who need to be encouraged or reminded to make simple financial decisions.

4

D Cannot make any budgeting decisions at all. 6



Mobility activities

Activity 11 – Planning and following journeys

This activity considers a claimant’s ability to work out and follow the route of a journey.

Notes:

A person should only be considered able to follow an unfamiliar journey if they are capable of using public transport (bus or train).

Consideration should be given to safety and whether there would be a substantial risk to the claimant or others if they went out alone.

Orientation aids are specialist aids designed to assist disabled people in following a route.

‘Psychological distress’ means distress related to an enduring mental health condition or an intellectual or cognitive impairment. However, this condition may have a physical root cause – such as unmanageable incontinence which leads to anxiety about making journeys.

Small disruptions and unexpected changes, such as roadworks and changed bus-stops, are commonplace when following journeys and consideration should be given to whether the claimant would be able to carry out the activity as described if such commonplace disruptions occur.

A Can plan and follow the route of a journey unaided. 0

B Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant.

For example: may apply to claimants who are only able to leave the home when accompanied by another person.

4

C Cannot plan the route of a journey. 8

D Cannot follow the route of an unfamiliar journey without another person, assistance dog, or orientation aid.

10

E Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant.

For example: may apply to claimants who are unable to leave the home at all.

10

F Cannot follow the route of a familiar journey without another person, assistance dog or orientation aid.

12



Activity 12 – Moving around

This activity considers a claimant’s physical ability to move around without severe discomfort such as breathlessness, pain or fatigue. This includes the ability to stand and then move up to 20 metres, up to 50 metres, up to 200 metres and over 200 metres.

Notes:

This activity should be judged in relation to a type of surface normally expected out of doors such as pavements on the flat and includes the consideration of kerbs.

Standing means to stand upright with at least one biological foot on the ground with or without suitable aids and appliances (note – a prosthesis is considered an appliance so a claimant with a unilateral prosthetic leg may be able to stand whereas a bilateral lower limb amputee would be unable to stand under this definition).

“Stand and then move” requires an individual to stand and then move independently while remaining standing. It does not include a claimant who stands and then transfers into a wheelchair or similar device. Individuals who require a wheelchair or similar device to move a distance should not be considered able to stand and move that distance.

Aids or appliances that a person uses to support their physical mobility may include walking sticks, crutches and prostheses.

When assessing whether the activity can be carried out reliably, consideration should be given to the manner in which they do so. This includes but is not limited to, their gait, their speed, the risk of falls and symptoms or side effects that could affect their ability to complete the activity, such as pain, breathlessness and fatigue. However, for this activity, this only refers to the physical act of moving. For example, danger awareness is considered as part of activity 11.

A Can stand and then move more than 200 metres, either aided or unaided. 0 B Can stand and then move more than 50 metres but no more than 200 metres, either aided or

unaided. 4

C Can stand and then move unaided more than 20 metres but no more than 50 metres. 8 D Can stand and then move using an aid or appliance more than 20 metres but no more than

50 metres.

For example, this would include people who can stand and move more than 20 metres but no further than 50 metres, but need to use an aid or appliance such as a stick or crutch to do so.

10

E Can stand and then move more than one metre but no more than 20 metres either aided or unaided.

12

F Cannot, either aided or unaided – stand; or move more than one metre.

12



Standard

Enhanced

No Entitlement

Dressing/Undressing

Managing toilet needs

Washing/Bathing

Preparing food

2

2

2

2

Standard

Enhanced

No Entitlement

PIP Assessment Criteria – Example 1

Example 1 – Joanne:

Joanne is 25 and has restricted movement in her upper limbs. She lives alone and receives no help with carrying out daily activities.

Joanne uses a range of aides and appliances to help her carry out her daily living activities. She uses these to prepare food, wash and bathe, dress and undress and manage toilet needs. As a result she scores points against four of the daily living activities. Her total score for daily living is eight points, and therefore she is entitled to the standard rate of the daily living component.

Joanne is capable of planning and following journeys and is physically capable of walking well over 200 metres. As a result, she does not score points against any of the mobility activities. Her total score for mobility is zero points, and therefore she’s not entitled to the mobility component.

1212

Daily Living

8 points

= Standard rate

Standard

Enhanced

No Entitlement

Daily Living

Dressing/Undressing

Managing toilet needs

Washing/Bathing

Preparing food

8 points

= Standard rate

2

2

2

2

1212

88 88

00 popoiinnttss

== No EntitlNo Entitleemmeenntt00 00 Mobil

Standard

Enhanced

No Entitlement

iti yMobil ty



Standard

Enhanced

No Entitlement Washing/Bathing

Dressing/Undressing

2

2

Standard

Enhanced

No Entitlement

Moving Around

12

PIP Assessment Criteria – Example 2

Example 2 – Derek:

Derek is 61 and has problems with one of his hips.

Derek’s hip problems restrict his movement and in particular affect his ability to bend. As a result he uses an aid to wash and bathe and needs some assistance to dress his lower body. He scores against two daily living activities (four points in total) and so is not entitled to that component.

Derek can walk around 40 metres using a stick at a slightly slowed pace with some discomfort. He would therefore normally score ten points for the ‘Moving around’ activity (in the table that’s descriptor ‘d’).

But the case manager must also consider whether Derek can carry out each activity ‘safely, to an acceptable standard, repeatedly and in a reasonable time period’. Derek can walk around 40 metres, but after doing so he is exhausted and cannot repeat it again for several hours.

He therefore can’t do that activity ‘repeatedly’ and so gets more points. Descriptor ‘e’ is appropriate, so Derek scores 12 points. That’s enough to automatically qualify him for the enhanced rate of the mobility component.

1212

Daily Living

4 points

= No entitlement

Standard

Enhanced

No Entitlement

Daily Living

Washing/Bathing

Dressing/Undressing

4 points

= No entitlement

2

2

1212

88 88

00 00 Mobility

12 points

= Enhanced rate

Standard

Enhanced

No Entitlement

Mobility

Moving Around

12 points

= Enhanced rate

12





Differences and similarities between Disability Living Allowance (DLA) and PIP

Details of how PIP and DLA are similar and how the two benefits are different Contents

• Similarities

• Differences

Key facts

• Some elements of PIP are similar to DLA whilst other elements are quite different

• PIP and DLA are paid for extra costs arising from having a long term health condition or disability

• PIP and DLA are not affected by income or savings and are not taxable

• PIP and DLA have two components

• PIP and DLA passport to additional support

• PIP and DLA have special rules for poeple who are terminally ill

• PIP is claimed in a different way to DLA

• PIP has different qualifying rules to DLA

• PIP has different eligibility criteria

• PIP has a different assessment process to DLA

• PIP awards will normally be of fixed duration

• Claimants need to make a new claim to PIP when their award comes to an end




Similarities between DLA and PIP

Like DLA, Personal Independence Payment is a benefit paid as a contribution to the extra costs arising from having a long term health condition or disability and can be claimed by people whether they are in or out of work.

PIP is not affected by income or savings and is not taxable.

For more information: PIP assessment criteria

Similar to DLA, there are two components for PIP, but with different eligibility criteria.

PIP has a daily living component and a mobility component. Awards will be made up of one or both of these components. Each component has two rates of payment, a standard and an enhanced.

PIP will passport to additional support DWP recognises the value of additional help that passported benefits provide. These are things like the Blue Badge, Carer’s Allowance, Motability scheme and public transport concessions. DWP has maintained the current passporting arrangements wherever possible, and is working with other Government Departments and the Devolved Administrations sponsoring their own schemes to ensure that passporting arrangements under PIP remain appropriate for their schemes and maintain the administrative benefits of the current links with DLA.

For more information: access to other benefits and services

Special rules for terminal illness will still apply For more information: special rules for terminal illness

This will mean they can claim for PIP immediately, will be dealt with more quickly and are guaranteed payment of the enhanced rate of the daily living component of PIP without having to wait until they satisfy the qualifying period or prospective test. They will also be able to apply for the mobility component and receive that immediately if they qualify. As with DLA, if claiming under special rules, the claimant or third party will be encouraged to submit a DS1500 doctor's report.



https://www.gov.uk/government/publications/pip-assessment-criteria







Differences between DLA and PIP

Claiming For more information: how to make a claim for PIP

Claims for PIP will be made in two parts – with the normal initial contact being via telephone. When the claim has been made DWP will send a form so the claimant can tell them how their health condition or disability affects their daily life, both on good and bad days and over a range of activities.

For more information: claimants in vulnerable situations

Additional support is available for claimants who have difficulty with the process for claiming.

PIP has different qualifying rules to DLA.

To qualify for help, new PIP claimants must have needed help for 3 months or more (this is known as the qualifying period) and be likely to need help for the next 9 months (this is the prospective test period).

Assessment Criteria


Entitlement to DLA is based on an individual’s condition and their needs arising from this. Entitlement to the two components of PIP and the level of benefit award will be assessed on the individual’s ability to complete a number of key everyday activities. This looks at how well individuals can complete activities, whether they need to use aids and appliances to do so and whether they need help from another person.

Unlike DLA, this does not distinguish between help needed during the day and night.

Assessment

For more information: assessment process and providers

A fair, more objective and transparent assessment of individuals by an independent health professional will be introduced for PIP.

The health professional works for an organisation that carries out assessments for the DWP.

https://www.gov.uk/government/publications/how-to-make-a-claim-for-pip


https://www.gov.uk/government/publications/supporting-pip-claimants-in-vulnerable-situations









Face-to-face consultation

In most cases the assessment will involve a face-to-face consultation; this will be with a health professional to discuss their circumstances in detail.

Awards

Awards will be subject to more systematic reviews and will normally be of fixed duration. There are no automatic entitlements for specific conditions within PIP; everyone will be assessed as an individual. Claimants will have their award periodically reviewed, regardless of the length of the award. Some conditions worsen or improve over time; reviewing individual’s awards will ensure that everyone continues to receive the most appropriate level of support.

If someone is awarded PIP DWP will tell them how long the award is for. DWP will write to them to tell them how and when they need to tell them about any change in circumstances.

When someone’s award comes to an end, they can decide to make a further claim to PIP, if they still have needs arising from their health condition or disability. DWP will write to claimants 14 weeks before the end of their PIP award to remind them that their award is ending and advising them what to do if they think their needs are likely to continue. PIP awards are not renewable, claimants will need to make a new claim.




Access to other benefits and services Personal Independence Payment (PIP) can provide entitlement to other benefits and servicesContents

• Introduction

• DWP benefits and schemes

• HMRC and HM Treasury benefits and schemes

• Vehicles and associated schemes

• Business Innovation and skills

• Cabinet Office

• Communities and local government

• Department for Education

• Department of Health

• Department for Transport

• Other help and support

Key facts

• PIP provides entitlement or ‘passports’ to other help and support provided by DWP, other Government Departments, and devolved administrations.

• These arrangements are broadly the same as those that apply for Disability Living Allowance (DLA).

• The Scottish and Welsh Governments may choose to use different passporting rules for their schemes to those that apply in England

Introduction

This document sets out the main support that is passported from PIP. Support may be administered by local authorities, and for many benefits and schemes there are additional qualifying conditions. For some schemes, such as Blue Badge, there are alternative ways of accessing the benefit that do not rely on a particular rate or component of PIP or DLA.




For DWP benefits, Housing Benefit and council tax reductions, DWP will share information to enable claimants to automatically access other disability benefits and services. In most other cases, claimants will need to use their PIP award letter as proof of entitlement.

In this document, all references to a disabled child or disabled children for passporting purposes apply only to a qualifying young person aged 16 or over because PIP is not available to children under the age of 16.

DWP benefits and schemes

Passported benefit or scheme PIP Component and rate (England, Scotland and Wales)

Additional information where applicable

Disability premium in HB, IS and JSA

Any rate or component of PIP

Severe disability premium in HB, ESA, IS, JSA /Additional amount for severe disability in Pension Credit

Standard or enhanced rate daily living component

Enhanced disability premium in HB, ESA, IS, JSA

Enhanced rate daily living component

n/a

Carer’s Allowance Standard or enhanced rate daily living component

If Carer’s Allowance is awarded, it may affect some of the benefits that the disabled person receives. It will not however affect the PIP award. Further information about Carer’s Allowance can be found on www.gov.uk.

Carer premium in the income-related benefits and the Additional amount for carers in Pension Credit


n/a

https://www.gov.uk/carers-allowance






Carer’s Credit Standard or enhanced rate daily living component

This is not a cash benefit. It helps carers build up qualifying years for the basic state pension and additional state pension.

Disabled child premium Any rate or component

Enhanced disability premium (child)


Childcare costs disregard in HB Any rate or component

No non-dependant deductions in HB, ESA, IS, and JSA


Child support – special expenses incurred by non- resident parent due to disability of 2nd child


Student eligibility for income-related ESA

Christmas bonus

Any rate or component

n/a




HM Revenue and Customs and HM Treasury benefits and schemes



Tax Credits: For further information see HM Revenue & Customs Tax credits

– Disability element of Working Tax Credit


– Severe disability adult element of Working Tax Credit


– Defining an adult as incapacitated and a child as disabled for the childcare element of Working Tax Credit


– Disabled child element of Child Tax Credit


Severely disabled child element of Child Tax Credit


– Extension to employer- provided childcare tax exemption


– Reduced VAT for grant- funded installation of heating equipment, security goods or connections of gas supply


n/a

http://www.hmrc.gov.uk/taxcredits/start/who-qualifies






Vehicles and associated schemes



Motability Enhanced rate mobility component

Motability is an independent charity.

Further information about the Motability scheme can be found at www.motability.co.uk

Treatment of hire cars for disabled people as short life assets

Standard or enhanced rate mobility component

Insurance Premium Tax exemption for vehicles leased through Motability

Zero VAT for vehicles leased through Motability

Enhanced rate mobility component

Schemes administered by HMRC

Vehicle Excise Duty exemption/reduction

Enhanced rate mobility component (exemption) Standard rate mobility component (50% reduction)

For further information see www.gov.uk

Business Innovation and Skills

Passported benefit or scheme PIP Component and rate (England and Wales)

PIP component and rate (Scotland)

Parental leave from work

Right to request flexible working

Cancellation of student loans


Income disregard for deferring repayment of 'mortgage style' student loans


No passport as yet

http://www.motability.co.uk/understanding-the-scheme/how-it-works

https://www.gov.uk/vehicle-exempt-from-car-tax




Cabinet Office

Passported benefit or scheme PIP Component and rate (England and Wales)


Proxy voting without medical attestation

Enhanced rate mobility component

No passport as yet for Scottish parliamentary elections

Communities and Local Government

Passported benefit or scheme PIP Component and rate (England only)

Council tax discount disregards:

– Severe mental impairment disregard

– Live-in care worker disregard

Standard or enhanced rate daily living component (this also applies in Scotland and Wales)

Housing renewal grants:

– Disability premium Any rate or component

– Severe disability premium Standard or enhanced rate daily living component

– Enhanced disability premium Enhanced rate daily living component

– Disabled child premium Any rate or component

Local council tax reductions (prescribed requirements and default scheme):

– Childcare costs disregard Any rate or component

– No non-dependant deductions Standard or enhanced rate daily living component

– Disability premium Any rate or component

– Severe disability premium Standard or enhanced rate daily living component

– Enhanced disability premium Enhanced rate daily living component




Further information about Communities and Local Government schemes in Scotland and Wales can be found on www.scotland.gov.uk and www.wales.gov.uk.

Department for Education

Passported benefit or scheme PIP Component and rate (England only)

16-19 Bursary Fund vulnerable groups element


Department of Health


Income disregards in care home funding

Any mobility component; any daily living component for temporary residence.

In England receipt of PIP will also be considered in the same way as DLA when calculating entitlement to help with health costs under the NHS Low Income Scheme.

http://www.scotland.gov.uk/Topics/Government/local-government

http://wales.gov.uk/about/civilservice/directorates/lgc/?lang=en




Department for Transport

Passported benefit or scheme

PIP component and rate (England)


PIP component and rate (Wales)

Concessionary travel pass, without further assessment

8 points or more under activity 12 (Moving around) or under activity 7 (Communicating verbally)

Any rate or component of PIP.

Further information can be found on concessionary travel Scotland

8 points or more under activity 12 (Moving around).

Further information can be found on concessionary travel Wales

Blue badge, without further assessment

8 points or more under activity 12 (Moving around). Further information on the Blue Badge Scheme England

8 points or more under activity 12 (Moving around) or 12 points under activity 11 (Planning and following a journey). Further information can be found on the Blue Badge Scheme Scotland

8 points or more under activity 12 (Moving around) or 12 points under activity 11 (Planning and following a journey).

Further information can be found on the Blue Badge scheme Wales

Local authorities will be able to determine automatic entitlement to these schemes from the claimant’s award notification. If claimants with mobility problems do not meet the automatic entitlement criteria, they should contact their local authority, because they may still qualify under the further assessment category

Other help and support

Access to Work

Access to work is money for practical support to help people do their job. The aim of Access to Work is to support disabled people into work, and when in work to retain it by reducing the inequalities between disabled and non-disabled people and removing practical barriers to work. How much is awarded depends on circumstances rather than a direct passport from PIP.

For more information: access to work and www.gov.uk

http://www.transportscotland.gov.uk/public-transport/concessionary-travel

http://www.transportscotland.gov.uk/public-transport/concessionary-travel

http://wales.gov.uk/topics/transport/public/concessionary/fares/?lang=en

http://wales.gov.uk/topics/transport/public/concessionary/fares/?lang=en

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/192215/blue-badge-scheme-local-authority-guidance-paper.doc



http://www.transportscotland.gov.uk/road/blue-badge-scheme



http://wales.gov.uk/topics/transport/integrated/bluebadgescheme/?lang=en

http://wales.gov.uk/topics/transport/integrated/bluebadgescheme/?lang=en

https://www.gov.uk/government/publications/access-to-work

https://www.gov.uk/access-to-work




Universal Credit

For more information: www.gov.uk

For disabled claimants on Universal Credit, support will be provided through two limited capability for work elements. Based on the outcome of a Work Capability Assessment, these additional elements will be payable where a person cannot reasonably be expected to look for work, where the person has limited capability for work (LCW), or has limited capability for work and work-related activity (LCWRA).

Exemption from the Benefit Cap

Households will be exempt from the benefit cap where a claimant (of any of the benefits subject to the cap), partner or qualifying young person is entitled to PIP. An adult in receipt of PIP living with the household who is not the claimant, their partner or a qualifying young person does not exempt the household from the benefit cap. They are considered as a household in their own right.

Armed Forces Independence Payment (AFIP)

The Ministry of Defence (MoD) has introduced Armed Forces Independence Payment (AFIP), a new benefit that will provide financial support for injured service or ex-service personnel.

The benefit will simplify the financial support for members of the Armed Forces who have been seriously injured as a result of their service since the introduction of Armed Forces Compensation Scheme (AFCS) in 2005 and in the future.

For more information: Veterans UK website

AFIP claimants will receive a flat-rate benefit which for passporting purposes is the equivalent of the enhanced rates of the daily living and mobility components of PIP. Passporting arrangements for PIP and AFIP are broadly the same.

Claimants who choose to claim AFIP will not be eligible for PIP, DLA or Attendance Allowance (AA). Claimants who choose not to apply for AFIP will be treated as a, PIP or AA applicant in the usual way.

https://www.gov.uk/universal-credit

http://www.veterans-uk.info/20130313%20-AFIP%20passports-%20U.pdf



Reassessing existing Disability Living Allowance (DLA) claimants for PIP

Details of how existing DLA claimants will be invited to claim PIP

Key facts

PIP replaced DLA for people who were aged between 16 and 64 on 8 April 2013. Initially, this was for new claimants only

DWP will gradually start to reassess existing DLA claimants for PIP

From 28 October 2013 onwards, DWP will start to invite some existing DLA claimants

living in Wales, West Midlands, East Midlands and East Anglia to claim PIP

From 13 January 2014, reassessment areas extend to postcodes beginning: DG, EH, TD

and ML

From 3 February, areas further extend to include postcodes beginning: CA, DL, HG, LA

and YO

DLA claimants do not need to take any action until they are told to do so by DWP

Most existing DLA claimants will not be affected until 2015 or later

People cannot get DLA and PIP at the same time

Contents

Introduction

Gradually introducing reassessment

The process for reassessing existing DLA claimants

October 2015

Important information about existing DLA claimants and PIP

ISBN: 978-1-78153-641-4 © Crown Copyright 2013 Published by the Department for Work and Pensions Version 5.0: December 2013 Page 1 of 6 gov.uk/dwp/pip-toolkit


Introduction

We are introducing PIP in stages over a number of years for existing DLA claimants.

We will start reassessing existing claimants of DLA for the new Personal Independence Payment from 28 October gradually in parts of the country first.

This is similar to how we introduced PIP to new claimants from April 2013 and is the way we have been introducing our other programmes of change.

Alongside the phased introduction of natural reassessment activity, new claims to PIP will continue to be taken across Great Britain.

Gradually introducing reassessment

From 28 October 2013, DWP started inviting existing DLA claimants who live in Wales, West Midlands, East Midlands and East Anglia to claim PIP where:

we receive information about a change in their care or mobility needs. DWP will ask these claimants to claim PIP. We will not ask claimants to claim PIP if the change they are reporting will have no affect on their entitlement, for example someone going into a care home or hospital.

they are aged 16 to 64 and have a DLA fixed award due to expire on or after 17 March 2014. Claimants whose DLA fixed term award ends before 17 March 2014 will be invited to make a renewal claim for DLA and will be asked to claim PIP at a later date.

they turned 16 years old from 7 October 2013 (unless they have been awarded DLA under the special rules for terminal illness).

an individual chooses to claim PIP instead of their DLA.

This is referred to as natural reassessment.

From 13 January 2014, we will extend the areas where we're inviting existing DLA claimants to claim PIP (under the circumstances described above) to postcodes beginning DG (Dumfries and Galloway), EH (Edinburgh), TD (Galashiels) and ML (Motherwell).

Find the postcodes for reassessment in: PIP postcodes map and the text version of the PIP postcodes


https://www.gov.uk/government/publications/pip-postcode-map-uk


From 3 February 2014, we'll further extend these areas to postcodes beginning CA (Carlisle), DL (Darlington), HG (Harrogate), LA (Lancaster) and YO (York).

Further decisions on extending natural reassessment will be taken and communicated to the rest of the country in due course and will be informed by the experience of introducing reassessment in a gradual way first.

Children approaching age 16

DWP have already begun to notify parents or guardians of children approaching the age of 16 who have an existing award of DLA to inform them that that their child will be invited to claim on or shortly after their 16th birthday.

Children living in Wales, West Midlands, East Midlands and East Anglia will be invited to claim PIP when they reach age 16.

From 13 January 2014, children living in postcodes beginning DG, EH, TD or ML in southern Scotland and parts of the borders will also be invited to claim PIP when they reach age 16.

From 3 February 2014, children living in postcodes beginning CA, DL, HG, LA or YO in the north of England will also be invited to claim PIP when they reach age 16.

Children reaching age 16 and who live elsewhere in Great Britain will continue to receive DLA but will have their eligibility for adult DLA checked if their award is due to expire on or around their 16th birthday.

The process for reassessing existing DLA claimants

Existing DLA claimants do not need to do anything until they are contacted by DWP.

DWP will write to claimants individually and in plenty of time to explain what action they need to take and by when if they want to claim PIP. The invitation letter explains to the claimant what they need to do, how to make a claim, and the time limits for doing so.

For more detail on the process for children approaching age 16: supporting young people to claim PIP

For more information: how to make a claim for PIP

For more information: conditions of entitlement




https://www.gov.uk/government/publications/pip-conditions-of-entitlement


October 2015

From October 2015, DWP will start to reassess all remaining DLA claimants who were aged between 16 and 64 on the day that PIP was introduced (8 April 2013). All these remaining claimants with a DLA award will be invited to make a claim for PIP.

DWP will randomly select those DLA claimants with an indefinite award. Further details of how the random selection will work are not yet available. This is referred to as managed reassessment.

Claimants with an indefinite award made under the special rules for terminal illness or with a fixed term award expiring after September 2017 will be reassessed towards the end of the reassessment period.

Claimants who were aged between 16 and 64 on 8 April 2013, but have since reached age 65 or over will be treated as if they are still under the age of 65 for reassessment purposes. This means they may qualify for the mobility component of PIP if they satisfy the eligibility criteria.

DWP will not select a claimant for reassessment if they have had an assessment for DLA within the last six months.

DWP expects all invitations to claim PIP for existing DLA claimants to have been issued by September 2017, and that PIP will be dealt with under business as usual processes from May 2018.

Important information about existing DLA claimants and PIP

All existing DLA claimants who are invited to claim PIP will need to decide if they want to make a claim for PIP. It will not be an option to remain on DLA.

People cannot get PIP and DLA at the same time. A PIP decision will automatically end the DLA claim. If PIP is not awarded or not claimed then DLA will stop.

The claimant will have 28 days to make a claim to PIP when they are invited to claim. If they fail to do this, their DLA may be suspended after four weeks and after a further four weeks it may be terminated. If they do not comply with the PIP new claims process they may not be awarded PIP and their existing DLA award will be terminated. In these circumstances

For more information: supporting vulnerable claimants




their DLA will continue to be paid for a further 13 days following their next payday.

If the claimant is in a vulnerable situation further enquiries will be made before this action is taken.

If the claimant actively tells us they do not wish to claim, or if they withdraw the PIP claim, their DLA will stop.

There is no automatic entitlement to PIP even where an indefinite or lifetime DLA award has been made.

DWP will ensure that DLA remains in payment for all claimants who comply with the new claims process, until a decision on PIP has been communicated to them.

The DLA award will be extended if the claimant has made a claim to PIP within the specified timescales; their DLA award is due to end, but a decision has not yet been reached on the PIP claim.

Once a decision is made on the PIP claim no matter whether that decision is favourable or unfavourable, DLA will continue to be paid until 28 days after their next payday, until the PIP decision comes into force. These rules will also apply if the claimant is awarded PIP at a higher or lower rate than their previous rate of DLA or even disallowed altogether.

There will be no right of appeal against the decision to terminate entitlement to DLA unless the Department has incorrectly applied its legislative requirements (for example if DWP have invited someone who is outside of the qualifying age criteria to claim PIP). However, the claimant will have a right of appeal against the PIP decision.

There will be no right of appeal against the date when the claimant is selected for reassessment.

Where a claimant is in a vulnerable situation, DWP will offer support.

If an existing DLA claimant is reassessed for PIP after they have turned 65 and receives a nil award, their claim to PIP will automatically be treated as a claim to Attendance Allowance. They will not have to make a separate claim although they may be asked to provide further information.

For more information: supporting vulnerable claimants

For more information: people aged 65 and over





If a claimant living in Wales, West Midlands, East Midlands or East Anglia contacts DWP to voluntarily claim PIP they can do so. However, if they are in receipt of both the Higher Rate Mobility Component and Highest Rate Care Component of DLA, DWP will advise them not to proceed. This is because they will have no likelihood of receiving an increase in benefit. These claimants would only be asked to claim PIP if they tell DWP that their condition or needs have improved.

From 13 January 2014, the areas where this applies extend to postcodes beginning: DG, EH, TD and ML in southern Scotland and parts of the borders.

From 3 February 2014, the areas further extend to postcodes beginning: CA, DL, HG, LA and YO in the north of England.






What to expect when making a claim for PIP Contents

•• Basic entitlement conditions metHow to make a claim for PIP

•• Special rules for terminal illnessPreparing for the telephone call

•• Exceptions within the claiming processThe telephone call – what to expect

Key facts

• To start a claim for PIP, the claimant telephones DWP on 0800 917 2222

• It is important to have as much information to hand before telephoning DWP

• The telephone call can be made by someone supporting the claimant but the claimantmust be present

• The date of claim is the date of the telephone call once the claimant has agreed adeclaration which will be read out to them by the agent

• The claimant will be sent a form for them to explain how their condition affects theirdaily life

• The claim process is different for people claiming under the special rules forterminal illness

• There are provisions for people who do not speak English as their first language

• A paper claim form can be requested for someone who is unable to deal with DWP bytelephone and has no one to help them make the telephone call

• During the telephone call, if the telephony agent identifies that the claimant needsadditional support with completing the claim, they can arrange for DWP visiting officer toassist the claimant.

t

of 5 gov.uk/dwp/pip-toolkit


To start a claim for PIP, the claimant telephones DWP on:

0800 917 2222

Or for claimants who cannot speak or hear clearly by

Textphone: 0800 917 7777

Lines are open between 8am and 6pm, Monday to Friday.

This is a free call from BT landlines and most mobiles, however some mobile or non-BT landline providers may charge for the call. If the caller is concerned about the cost of the call, they can ask DWP to call them back.

This number is for new claims to PIP only.

Anyone who has already claimed PIP, or has a general query about PIP should call DWP on 0845 850 3322.

The telephone call can be made by someone supporting the claimant. The claimant must be present so that they can confirm the person supporting them has their permission to make the call.

Preparing for the telephone call

It is important that the claimant has all the basic information ready before telephoning DWP or it may delay progress of the claim. The claimant, or the person supporting them, needs to have:

• full name of the person claiming PIP

• National Insurance Number

• full address including postcode

• date of birth

• bank or building society account details (so we can arrange anypayments if the claimant qualifies for the benefit)

• daytime contact number

• GP or other health professionals details

• details of any recent stays in hospitals, care homes or hospices


• Nationality or Immigration status

• details of time spent abroad, if they have been abroad for more than four weeks at a time over the last three years

• details of any pensions or benefits that they or a family member may receive from another European Economic Area (EEA) state or Switzerland

• details if they are working or paying insurance to another EEA state or Switzerland.

The telephone call – what to expect

At the beginning of the telephone call the agent will ask the claimant a series of questions to verify their identity.

If the claimant is unable to answer these questions, the agent will continue to go through the rest of the questions on the application to gather as many details as possible, but DWP will need to take further action to verify the claimant’s identity.

The agent will go through the claim with the claimant.

Some of the questions have a ‘don’t know’ option.

The claimant will not have to answer detailed questions about their health condition or disability, just some questions to establish if they have a mental, cognitive or learning impairment. This will help DWP establish if the claimant may need additional support through the claim process.

The claimant will have the opportunity to tell DWP more about their health condition or disability and how it affects their daily living in the next stage of the claim process.

At the end of the initial telephone call, the claimant will be asked to agree a declaration that the agent will read out. When the claimant acknowledges this, the agent will submit the claim and the date of claim is set at this point.


Basic entitlement conditions met For more information: How your disability affects you form

The PIP Information booklet

Completing the form fact sheet

Once DWP have established that the claimant has met basic entitlement conditions relating to age and residence, a form called ‘How your disability affects you’ and an information booklet will be issued by post.

The claimant can use this form to describe how their health condition or disability affects their daily life, on both good and bad days and over a range of activities.


For more information: special rules for terminal illness

If the claimant meets the criteria for an award under the special rules for terminal illness, they will not be sent the 'How your disability affects you’ form. Instead, they will be asked some extra questions whilst they are on the telephone about their condition and how it affects their ability to get around.

Exceptions within the claiming process

People whose first language is not English

DWP uses a language interpreting service called ‘thebigword’. The telephony agent will use this on any call where the claimant’s first language is not English or where the caller is not comfortable continuing in English.

The agent will contact the interpreting service while the claimant is on the line and in most cases will be put through straight away to an interpreter for the appropriate language. A three way conversation will then enable completion of the PIP claim.

Claimants phoning from a landline in Wales will be able to select the option to speak in Welsh from the automated telephony service and be connected to a Welsh speaker at a DWP contact centre.

https://www.gov.uk/government/publications/how-your-disability-affects-you




https://www.gov.uk/government/publications/completing-the-pip-claim-form

https://www.gov.uk/government/publications/completing-the-pip-claim-form




Claimants who are unable to manage their own affairs

Where the claimant has an Appointee, Corporate Appointee, Power of Attorney or Curator Bonis, the person appointed to act on behalf of the claimant must telephone to make the claim; the claimant does not have to be present.

Paper Claims

Where a claimant is unable to deal with DWP by telephone, or needs extra help and they have no one to support them making a claim by telephone they can request that DWP post a paper claim form to them.

Claimants who are unable to deal with DWP by telephone, can write to DWP to request a paper claim form at the following address.

Personal Independence Payment New Claims Post Handling Site B Wolverhampton WV99 1AH

This form will be unique to the claimant and cannot be used by anyone else.

DWP can only accept claims on an authorised form that they have issued. Stocks of paper claim forms are not available to order from DWP.

A paper claim form will also be issued to claimants who do not have a National Insurance Number.

The claimant is given one month to return the paper claim form from the date the request was received. If received within one month, then the date of claim will be calculated from the date the form was issued. For more information:

supporting claimants in vulnerable situations

During the telephone call, if the telephony agent identifies that the claimant needs additional support with completing the claim, they can arrange for a DWP visiting officer to assist the claimant.






Completing the ‘How your disability affects you’ form

A summary of the information booklet that claimants receive with the form Contents

• The 'How your disability affects you' form

• About the questions in the form

• Help with completing the form

• Sending in supporting evidence

• The questions in the form

Key facts

• When a claim to Personal Independence Payment (PIP) has been made, DWP will post a form called ’How your disability affects you’ to the claimant

• The form will be personalised to the claimant and can only be used for them

• The form includes questions about the claimants ability to carry out key everyday activities

• Claimants should read the information booklet that comes with the form before they start to fill the form in

• The claimant should return the completed form within one calendar month

• Claimants who satisfy the criteria for the special rules for terminal illness will not be sent the form

• Claimants can send copies of supporting evidence with the completed form

The ‘How your disability affects you’ form For more information: 'How your disability affects you' form and information booklet

When a claim to PIP has been made, DWP will check basic eligibility conditions and will then post a 'How your disability affects you' form to the claimant with a PIP Information booklet. The form will be barcoded and contain basic claimant details so it should only be used by the person it is sent to.







Claimants should read the PIP Information booklet before they start to fill the form in.

A claimant may need to complete the 'How your disability affects you' form when they make a new claim to PIP, including if they are in receipt of DLA and are being reassessed for PIP, or if they are in receipt of PIP and their needs improve or get worse.

The claimant has one calendar month to return the completed 'How your disability affects you' form. An envelope will be provided in which they can return the form. If the claimant has not returned the form after 20 days, a reminder letter will be issued to the claimant. If the form has not been returned after one calendar month, the case will be referred to a DWP decision maker and the claim may be turned down or terminated unless there are good reasons why it hasn’t been returned in time.

Example notification letters can be found at: PIP forms and letters

Claimants who are making a claim to PIP because they are terminally ill will not have to complete the 'How your disability affects you' form. DWP will obtain the information required about mobility needs at the initial claim stage and the claimant will be encouraged to send in a DS1500.

For more information: special rules for terminal illness

Where claimants in vulnerable situations are unable to return their 'How your disability affects you' form, a referral direct to the assessment provider will be arranged.


If the claimant is unable to complete the 'How your disability affects you' form within the given timescales they should contact DWP by telephone on 0845 850 3322 to ask for an extension. Initially the telephony agent will be able to grant this.

Further extensions can be granted but only at the discretion of the DWP decision maker, who will consider whether there is good reason for the late return of the form.

If the claimant loses the 'How your disability affects you' form, they will need to contact DWP to request a further form.

About the questions in the form

When filling in the 'How your disability affects you' form the claimant may find it useful to have to hand:

For more information: 'How your disability affects you' form and information booklet

• details of their medication or an up to date printed prescription list if they have one; and

https://www.gov.uk/government/publications/the-personal-independence-payment-toolkit-for-partners/the-personal-independence-payment-pip-toolkit-for-partners#pip-forms-and-letters












• the name and contact details of any professionals who might be supporting them on a regular basis.

The 'How your disability affects you' form includes a number of questions about the claimant’s ability to carry out key everyday activities. These will help DWP to understand the impact of the claimant’s health condition or disability on their everyday life and to assess their entitlement to the benefit.


The questions will help establish whether claimants can do things:

• safely;

• to an acceptable standard;

• as often as they need to and are reasonably required to; and

• in a reasonable time period.

Other questions also ask about whether the claimant uses aids and appliances or has help from another person to carry out the activities.

In each section and for each question, there is a tick box for the claimant to state ‘yes’, ‘no’ or ‘sometimes’.

Claimants are asked to provide more detail in the “Extra Information” box so that they can explain how their health condition or disability affects their ability to carry out the activities; the difficulties they face and the help they need. Where they need help from another person, they can tell DWP what kind of help they need and when they need it.

Help with completing the ‘How your disability affects you’ form

If the claimant is having difficulty completing the 'How your disability affects you' form, they can ask a friend, relative, care provider or external organisation to assist them with completion.

DWP is providing advice and information to external organisations like Citizens Advice to ensure that they understand the PIP process. This will enable them to provide assistance and support to claimants throughout the claims process.






The claimant can also contact DWP by:

Telephone: 0845 850 3322

Textphone: 0845 6016677

The DWP telephony agent will be able to assist with basic enquiries and will also find out what level of support the claimant requires to complete the 'How your disability affects you' form. Depending on the level of support the claimant needs, the agent may arrange a call back to support the claimant in completing the form.


They may refer the most vulnerable cases to DWP Visiting for face to face support.

If a DWP Visiting Officer is at the home of a claimant when they decide that they want to claim PIP, the Visiting Officer will be able to assist the claimant to make the initial telephone call to claim PIP and to complete the ‘How your disability affects you’ form if appropriate.

Sending in additional supporting evidence

Claimants will be encouraged to send copies of supporting evidence with the completed 'How your disability affects you' form , for example, care plans, reports or information from professionals such as a GP, hospital doctor, specialist nurse or community psychiatric nurse.

For examples of types of supporting evidence: PIP information booklet

Claimants are advised only to send things in that they already have available to them. They are asked not to request evidence or other documents as this might slow down the claim or they might be charged a fee for asking for them.

The PIP Information booklet also suggests that claimants might want to write down a list of things they have needed help with or found difficult over a number of days. If the impact of their health condition or disability varies over time, they may also want to keep a record of this.

The completed 'How your disability affects you' form; any supporting evidence and notes that the claimant wants to send in should be sent back to DWP in the envelope provided.








The questions in the ‘How your disability affects you’ form

Details of the assessment criteria and how DWP uses the information the claimant provides: PIP assessment criteria

Q1 About professionals you may see

Claimants should provide details of where they see their health professional, such as the health centre or hospital address. These professionals may be contacted by the assessment providers to provide further information to support the claim.

Q2 About your health conditions or disabilities

By health conditions or disabilities, DWP means physical, sight, hearing or speech difficulty, learning, developmental or behavioural difficulties or mental health problems.

Q3 Preparing food

This section is about ability to prepare and cook a simple one course meal for one from fresh ingredients. This includes things like:

• food preparation such as peeling, chopping or opening a can; and

• safely cooking or heating food on a cooker hob or in a microwave oven.

Aids and appliances in this section might include things like, prostheses, perching stool, lightweight pots and pans, easy grip handles on utensils, adapted cutlery and single lever arm taps.

Q4 Eating and drinking

This section is about ability to eat and drink, including cutting food into pieces, getting food and drink to the mouth, chewing food and swallowing. It includes the use of therapeutic sources such as feeding tubes. A feeding tube could be a parenteral or enteral tube feeding with a rate limiting device such as a delivery system or feed pump.

Q5 Managing treatments

This section is about ability to monitor any health conditions, manage medication and manage treatments.

Q6 Washing and bathing

This section is about ability to wash and bathe, including getting in and out of a normal bath or shower.






Q7 Managing toilet needs

This section is about ability to manage toilet needs, including getting on or off and being able to use a normal toilet; being able to pass water or solids; dealing with incontinence, including any aids and appliances used, and cleaning afterwards.

Q8 Dressing and undressing

This section is about ability to dress and undress, including selecting, putting on and taking off appropriate and un-adapted clothing, which may include fastenings such as zips or buttons. This includes putting on and taking off socks and shoes.

Q9 Communicating

This section is about communicating with people in the claimant’s native language, including speaking to people and hearing and understanding what others are saying.

Q10 Reading

This section is about ability to read and understand signs, symbols and words written or printed in the claimant’s native written language and includes help the claimant might need, like someone reading for them. It does not include Braille.

Q11 Mixing with other people

This section is about ability to get on with other people and the claimant’s understanding of how others are behaving towards them and behaving appropriately to others, including whether severe anxiety or stress prevents them from doing this.

Q12 Making decisions about money

This section is about ability to make decisions about spending and managing money. This includes being able to understand how much things cost, how much change the claimant should get in a shop, managing budgets, paying bills and planning future purchases. It looks only at their decision making ability, not the physical elements of managing their money.




Q13 Going out

This section is about ability to work out and follow a route to another place, including using public transport, and whether severe anxiety or distress prevents the claimant from being able to go out. It does not look at the claimant’s physical ability to get around as this is covered in the next section.

Q14 Moving around

This section is about the claimant’s ability to physically move around. The questions ask how far the claimant is able to walk and whether they use aids and appliances to get around, including walking sticks, frames, prostheses or wheelchairs. It is important that the claimant details how long it takes and whether they have any side effects like pain, breathlessness, tiredness or dizziness.

Q15 Additional information

This section is for any other information the claimant wants to include. Carers, friends or family could also provide information in this section. It does not have to be filled in if the claimant feels they have included everything in the rest of the form.



Assessment Process and Assessment Providers

Details of how the assessment for PIP works Contents

Introduction

Face to face consultation

The assessment providers

Assessment providers' role

Atos Healthcare

Capita Health and Wellbeing

Key facts

The PIP assessment will be delivered by assessment providers working in partnershipwith DWP

Most people will be asked to a face-to-face consultation with a health professional aspart of the assessment process

The PIP assessment process will be managed by two assessment providers

In Scotland, North East and North West England and in London and Southern Englandthe assessment provider will be Atos Healthcare

In Wales and Central England, and in Northern Ireland, the assessment provider will beCapita Health and Wellbeing

Introduction

The PIP assessment will be delivered by assessment providers working in partnership with DWP.

The assessment will be conducted by a health professional who considers the evidence provided by the claimant, along with any further evidence they think is needed.




The assessment looks at people as individuals, and focuses on the impact their condition has on their daily lives and over a range of different activities.

The health professional will complete the assessment and will send a report back to DWP. A DWP decision maker will then use all of this information to decide entitlement to PIP. The health professional will not make a decision on entitlement to PIP.

Most people will be asked to a face-to-face consultation with a health professional as part of the assessment process. In some cases health professionals may be able to carry out the assessment without a face-to-face consultation.

This will be in cases where there is sufficient paper evidence to provide robust and fully justified advice on all aspects of the assessment. A paper-based assessment will also be carried out where a face-to-face consultation would be extremely distressing for the claimant. This will be decided on a case-by-case basis.

An example of this is for a person who is terminally ill and has applied for PIP under the special rules for terminal illness. In this case the assessment will be completed using information provided during the claims process and any further evidence gathered by the health professional.

Face-to-face consultation

The face-to-face consultation may take place at a designated assessment centre or in the claimant’s own home.

The claimant will be encouraged to take someone along to the consultation to support them if they would find this useful. The person can participate in the discussion. The person chosen is at the discretion of the claimant and might be, but is not limited to, a parent, family member, friend, carer or advocate.

If it is clear that the claimant requires more than one person to accompany them to enable them to attend a face-to-face consultation, this should be identified as part of the booking process. The assessment provider may decide that the claimant would benefit from a home visit rather than a consultation at a medical centre if they require multiple people to assist them to attend the face-to-face consultation.

For more information: Special rules for terminal illness





DWP have asked the assessment providers to ensure that claimants travel no more than 90 minutes (single journey) by public transport to their assessments. This figure is an absolute maximum and it is expected that travel time will be far less for the majority of cases.

Home consultations will take place:

at the claimant’s request, if supported by an appropriate healthcondition or disability, as determined by the assessor; or

when the claimant provides confirmation through their healthprofessional that the claimant is unable to travel on health grounds; or

at the assessment provider’s discretion for a business reason.

The consultation

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 lives.

The health professional may also carry out a short physical examination, but claimants will not be forced to do anything that causes them pain, embarrassment or discomfort.

The assessment providers will ensure that the health professionals have the right skills and experience to assess any claimant referred to them.

DWP believe that in most cases all health professionals should be able to assess the individual, even if they are not a specialist in their condition.

If the health professional feels they need more support before assessing someone, for example because the claimant has a condition they are unfamiliar with, the assessment provider will make someone with the appropriate skills available to either assist the original health professional or carry out the assessment themselves.

There is no time limit for face-to-face consultations. Consultations will be as long as necessary to reach the evidence-based conclusions on individual cases.




The assessment providers: Atos and Capita

The PIP assessment process will be managed by two assessment providers who have been appointed to see whether different providers could introduce innovation – with the exception of the assessment itself which must comply with the regulations and guidance. Having more than one provider means we can learn from these different models.

There are three regional contracts in place in mainland UK, and a further contract for Northern Ireland:

In Scotland, North East and North West England and in London and Southern England the assessment provider will be Atos Healthcare.

In Wales and Central England, and in Northern Ireland, the assessment provider will be Capita Health and Wellbeing.

Claimant reports change of address that may include change of

assessment provider

If a claimant reports a change of address into an area covered by a different assessment provider, DWP will check to see if case has been referred to the assessment provider.

If the case has not yet been sent to the assessment provider the change of address will be recorded and the case will proceed as normal, with the assessment provider covering the new address.

If the case is already with the assessment provider, DWP will establish which assessment provider the case is with.

If the current assessment provider does not cover the claimant’s new address, DWP will establish if that assessment provider can carry out an assessment without a face to face consultation. If they can the case proceeds without the need to change the assessment provider.

If a face to face consultation is required the current assessment provider will return the case back to DWP where the case will be reassigned to the assessment provider that covers the area the claimant has moved to.

For assessment provider postcodes: Postcode map





Assessment Providers’ Role

The assessment providers were selected following the usual procedures for open and fair competition and assessed against established and published selection criteria. The competition established clearly that the successful providers had best understood the Department’s requirements, particularly in relation to the needs of disabled people.

How the assessment providers carry out assessments is governed by regulations and guidance. Once the claimant sits down with the assessor, the experience will be very similar wherever you are in the country, everyone will be able to bring a companion, see a same sex assessor, claim back their travel expenses and so on. Whether someone is claiming in Liverpool (Atos) or Swansea (Capita) the assessor will be recruited for their empathy as well as medical qualifications. The assessors will encourage claimants to explain how they feel on a bad day as well as on a good day. The assessors will be providing advice to DWP – it is the DWP which will make the decision about entitlement to PIP.

The providers were encouraged to develop innovative solutions for some aspects of the process such as how appointments are booked, where assessments take place and how they communicate with claimants (for example, letters, text, email and so on). Both providers have different delivery models.




Atos Healthcare

Their service will be based on working with local partners, including the For more information: private health centres, physiotherapy practices and the NHS, using their ATOS website premises and staff to undertake face-to-face consultations. Working with these local partners Atos is able to offer PIP claimants familiar surroundings and experienced health professionals.

The reason Atos has adopted this approach is that:

experienced staff and suitable accommodation are already in place

Assessment Centres are often at the centre of established transportlinks, minimising the travel needs for many claimants

it provides a flexible network, with back up consultation centre optionsif needed.

The supply chain partners will undertake the face-to-face consultations – including the report writing.

Atos themselves will undertake all other aspects of the service including:

paper-based assessments

home consultations

booking appointments

complaints handling

payment of claimants’ expenses.

Atos plan to hold most consultations at assessment centres. Home consultations will be offered to claimants where appropriate.

If the Atos Health Professional decides that a face-to-face consultation is required, they will contact the claimant to arrange an appointment. After the assessment the claimant:

uses the reply paid envelope and personalised form to claim any

travel expenses incurred

is encouraged to provide feedback on Atos’ service

is signposted to partner charities and local services.



http://www.atoshealthcare.com/pip/


Capita Health and Wellbeing

Capita is planning to hold around 60% consultation in the claimant’s own home. The remainder will take place in assessment centres.

Their research with disabled people and their organisations showed that most claimants would prefer their consultation to take place at home. However for some people attending an assessment centre is a better option.

Capita's approach also allows claimants to choose their preferred method of contact (for appointment reminders and so on) and, once a health professional has decided that a face-to- face consultation is required, select their appointment time from a target range.

Capita will make initial contact with the claimant by post; the postal pack will include a letter, a booklet and DVD, a satisfaction survey and an expenses envelope.

Capita will provide claimants with access to a secure online Portal (in addition to a telephone enquiry centre) which will allow claimants to schedule and make amendments to their consultation appointments.

Capita’s assessment centres have been carefully selected close to public transport and accessible parking. After the assessment the claimant:

uses the reply paid envelope and personalised form to claim anytravel expenses incurred

is encouraged to provide feedback on Capita’s service

Is signposted to partner charities and local services

For more information: CAPITA website



http://www.capitahealthandwellbeing.co.uk/our-services/wellbeing-assessment-services/disability-assessments/personal-independence-payment-(pip)-assessments


Stakeholder Engagement

Both Atos and Capita are working with organisations supporting disabled people to develop their service proposals and will continue to do so to identify opportunities for continuous improvement. Both providers expect to employ a significant proportion of staff that have disabilities or long-term health conditions themselves.

Managing performance

DWP will monitor the performance of the assessment providers to ensure that they are conforming to the detailed specifications for the assessment laid out in their contract with DWP.

DWP has set clear service level agreements setting out expectations for service delivery, including the quality of assessments, number of days to provide advice to the Department and evidence of claimant satisfaction. DWP has not set any targets in relation to the outcome of PIP assessments. This will ensure that all the assessments, no matter where in the country, are consistent, fair, evidence based and delivered to the required quality standard.





Decision and payment

What happens when DWP has made a decision on a Personal Independence Payment (PIP) claim Contents

• PIP decision

• PIP awards and reviews

• Telling the claimant about the PIP decision

• PIP payments

Key facts

• The DWP decision maker will make a reasoned decision on entitlement to PIP

• The DWP decision maker will make their decision based on the impact of the claimant’s health condition or disability on their daily life and their ability to live independently

• The length of award will be based on an individual’s circumstances

• Claimants will have their award periodically reviewed

• Claimants will receive a letter giving the decision on the PIP claim and a clear explanation of how that decision has been reached

• The decision letter will include the point score for each descriptor and it will show how the evidence has informed the decision that has been made

• If a claim has been disallowed, or an existing award reduced, the DWP decision maker will try to telephone the claimant to discuss the decision

• Payment will usually be made every four weeks in arrears unless the award has been made under the special rules for terminal illness, in which case payment will be made weekly in advance

• Claimants should let DWP know of any change in their daily living or mobility needs ass soon as possible as the change may affect their entitlement

• Being in work or returning to work will not affect someone’s entitlement unless their needs have changed




PIP decision

The DWP decision maker will make a reasoned decision on entitlement. If the claimant is entitled to PIP, they will also decide the level of award and the length of any award. In all cases the decision maker will make a decision based on all the available evidence, such as:

• the report from the assessment provider; For more information: 'How your disability affects you’ form

• the ‘How your disability affects you’ form;

• any additional evidence that the claimant has provided; or

• further evidence that the assessment provider has provided.

If the decision maker is not satisfied with the report from the assessment provider or has any queries about the report or the evidence, they will be able to discuss the issue with the assessment provider.

PIP award and reviews

The decision maker will make an award of PIP based on the impact of the claimant’s health condition or disability on their daily life and their ability to live independently. The length of award for PIP will be based upon each claimant’s individual circumstances.

Over time a claimant’s needs may change and DWP wants to make sure that a person’s award of benefit reflects their current needs.

• Awards vary in length from nine months to 10 years, depending on when changes in a claimant’s needs could be reasonably expected, with reviews set at regular periods.

• The maximum time between reviews is 10 years.

• Limited term awards will be given where changes in needs may be reasonably expected – these will be up to two years and have a fixed end date.

• Awards made under the special rules for terminal illness will be for three years. The Daily Living component will be paid at the enhanced rate in all cases. Payment of the Mobility component will depend on whether the claimant needs help to get around, and if they do, how much help they need.






Claimants will have their award periodically reviewed, regardless of the length of the award. This will make sure everyone continues to receive the most appropriate level of support.

Telling the claimant about the PIP decision

DWP will send the claimant a letter giving a decision on the PIP claim and a clear reasoned explanation of how that decision has been reached.

If the claimant has been awarded PIP, the letter will detail the amount of the award, the length of the award and the reasons for making that decision. The point score for each descriptor will be included in the letter. The letter will also show how the evidence informed the selection of descriptors and the decision made. It will give details of how and when the claimant needs to tell us about any changes in circumstance. It will also signpost the claimant to other DWP benefits and services and local support organisations. The award letter will constitute a full statement of reasons for the decision.

For more information on mandatory reconsiderations and subsequent appeals: PIP disputes process

If the claimant has not been awarded PIP, the letter will give all the same information as the award letter and will constitute a full statement of reasons for the decision. The letter will also explain what the claimant needs to do if they are not happy with the decision and explain how they can request a mandatory reconsideration.

After the decision letter has been issued, if a claim has been disallowed or an existing award reduced then the DWP decision maker will try to phone the claimant to discuss the decision and explain the reasons for making that decision.

The purpose of the phone call is to ensure the claimant understands the reason why PIP has not been awarded or has been awarded at a lower rate and to answer any questions or concerns that the claimant may have about the decision. DWP believes that this approach will minimise the number of disputes.

If the claimant is still not happy with the decision after discussing it with the decision maker, the claimant can ask for a mandatory reconsideration.

https://www.gov.uk/government/publications/pip-disputes-process




PIP payments

Specific details of PIP payments including the date payments will start and their frequency will also be included in the letter sent to the claimant. PIP can be paid into a bank account, building society, credit union or Post Office® card account (POca). The claimant will be asked to provide these details when they make a claim to PIP.

Payment will usually be made every four weeks in arrears. Awards of PIP under the special rules for terminal illness will be made weekly in advance.

Change in the support required by the claimant

For more information: changes claimants should tell us about

Any change in a claimant’s daily living or mobility needs may affect their entitlement to PIP or the amount they receive. Claimants should let DWP know about the change as soon as they can so that DWP can review their PIP award and make sure they are receiving the right support.

A claimant or their representative should also tell DWP if they have been admitted to a hospital, hospice or care home or have been imprisoned as this may also affect their benefit.

Being in work or returning to work will not be a relevant change of circumstance. This is because PIP is available to people whether they are in work or not. PIP is not subject to tax and will not be means tested, so earnings and other sources of income will not affect the amount of PIP.

For more information: DWP advice for decision making

https://www.gov.uk/government/publications/pip-and-reporting-changes-in-circumstances

https://www.gov.uk/government/publications/pip-and-reporting-changes-in-circumstances

https://www.gov.uk/government/publications/advice-for-decision-making-staff-guide

https://www.gov.uk/government/publications/advice-for-decision-making-staff-guide



ISBN: 978-1-78153-651-3© Crown Copyright 2013 Published by the Department for Work and Pensions Version 4.0: October 2013 Page 1 of 4 gov.uk/dwp/pip-toolkit

Access to work

Information about practical and financial support to help overcome barriers to work because of a physical disability or mental health condition Contents

• Access to Work

• What help is available

• What are the qualifying conditions?

• How to apply

• Access to work experience under the Youth Contract

Key facts

• Access to Work can provide practical and financial support to help people to overcome barriers to starting or keeping a job because of a physical disability or mental health condition

• Access to Work will also work with the employer to provide advice on how they can best provide support in the workplace

• Help for young people is also available through the Youth Contract for those about to begin a work trial or start work experience

Access to Work

For more information: Access to Work

If someone has a disability or long term physical or mental health condition, Access to Work can provide practical and financial support to help them overcome barriers to starting or keeping a job.

Access to Work can also give practical advice and guidance to employers, to help them understand physical and mental ill health and how they can support employees.





What help is available?

Access to Work can help pay for the support someone may need because of their disability or long term health condition, for example:

• aids and equipment in the workplace;

• adapting equipment to make it easier to use;

• money towards any extra travel costs to and from work if the person can’t use available public transport, or if they need help to adapt a vehicle;

• an interpreter or other communication support at a job interview, or

• other practical help at work, such as a job coach or a sign language interpreter.

If someone has a mental health condition they will be offered assistance to develop a support plan. This plan may include steps to support them going in to, remaining in or returning to work, and suggestions for reasonable adjustments in the workplace, for example:

• flexible working patterns to accommodate changes in mood and impact of medication;

• providing a mentor to give additional support at work;

• giving additional time to complete certain tasks;

• providing additional training; or

• regular meetings between the employee and their manager to talk about concerns or a phased return to work such as reduced hours or fewer days.

Access to Work partners will also work with the employer to advise them how best they can provide support in the workplace.




What are the qualifying conditions?

Someone can apply for Access to Work if they have:

• A disability or long term health condition that has a negative effect on their ability to do their job (long term means lasting or likely to last for at least 12 months), or

• A mental health condition and need support in work, they are aged 16 or over and live in Great Britain (England, Scotland or Wales), and they:

o are already doing paid work;

o are about to start work or become self employed, have an interview for a job; or

For more information: Access to work experience under the youth contract

o are about to begin a work trial or start work experience under the Youth Contract arranged through Jobcentre Plus (see p4).

The person must also either need support:

• when starting work;

• to reduce absence from work; or

• to stay in work.

How to apply

For more information about the Access to Work programme, or to make an application, contact a DWP customer service team:

London

Telephone: 020 8426 3110

Textphone: 020 8426 3133

Email: [email protected]

mailto:[email protected]




Glasgow

Telephone: 0141 950 5327

Textphone: 0845 602 5850


Cardiff

Telephone: 02920 423 291

Textphone: 02920 644 886


Access to work experience under the Youth Contract

Young people who start a new work experience opportunity under the Youth Contract are able to apply for Access to Work support.

If eligible for Access to Work, support will be available for customers age 16 to 24 when carrying out a work experience opportunity as part of the Youth Contract.

How to apply For more information: Access to Work For further information about the Access to Work programme or to make

an application, contact DWP customer service team:

Glasgow

Telephone: 0141 249 4000

Textphone: 0845 602 5850









Personal Independence Payment (PIP) has special rules for people who are terminally ill and not expected to live for more than six months

Key facts

There are special rules that allow people who are terminally ill to get help quickly when they claim PIP

Claims made under the special rules for terminal illness criteria follow a different process than standard PIP claims

To claim under the special rules for terminal illness, telephone 0800 917 2222

If the claim is being made under these rules, the phone call can be made by someone supporting the claimant (such as a support organisation or family member) without the claimant needing to be present

It is important that the claimant or the person making the phone call has as much information ready before calling DWP or it may delay progress of the claim

The claimant will not be sent the form ‘How your disability affects you’ if they meet the criteria for an award under the special rules

Claimants who meet the criteria for claiming under the special rules will not need a face-to-face consultation

Claimants are encouraged to get a DS1500 medical report from their health professional to support the claim

DWP cannot treat a DS1500 as a claim to PIP. It is important that a claim to PIP is made in addition to providing the DS1500.

Contents

How to claim



The DS1500 report

Assessment process

PIP and existing DLA special rules claimants




Introduction

There are special rules that allow people who are terminally ill to get help quickly when they claim PIP.

Claims made under the special rules for terminal illness criteria follow a different process, so are dealt with more quickly than standard PIP claims.

Claimants who meet the criteria for claiming under the special rules:

will not have to complete the 'How your disability affects you’ form;

will not need a face to face consultation; and

if entitled, will receive an award of the enhanced rate of the daily living component of PIP without having to wait until they satisfy the usual qualifying period.

Both the daily living component and, providing the conditions are met, the mobility component will be paid straight away.

How to claim

PIP special rulesThe way to claim under the special rules for terminal illness is by claims – telephone:telephone on: 0800 917 2222

0800 917 2222If the claim is being made under these rules, the telephone call can be made by someone supporting the claimant (such as a support organisation or family member) without the claimant needing to be present.

However, the claimant should be told that a claim to PIP has been made because DWP may need to contact them to verify their details and DWP will send notifications and any payment to them.

The claimant does not need to know that the claim has been made under the special rules for terminal illness, and this will not be mentioned by DWP in any contact with the claimant.





It is important that the claimant or the person making the telephone call has as much information ready before calling DWP or it may delay progress of the claim.

The claim can be taken even if the caller doesn’t have all of the information but certain details are needed to register the claim. If the caller doesn’t know the answer to some of the questions the claim may be delayed because DWP will need to get the detail before the claim can be put into payment.

The claimant or the person supporting them needs to have the following information:

full name of the person claiming PIP;

National Insurance Number;

full address including postcode;

date of birth;

bank or building society account details (so we can quickly arrange any payments if the claimant qualifies for the benefit);

daytime contact number;

details of the health professional best placed to provide further evidence regarding the terminal illness (for example, their GP, hospital doctor/consultant or specialist nurse);

details of a second contact – a health or social care professional, a family member, carer or friend;

details of any recent stays in hospitals, care homes or hospices;

Nationality or Immigration status;

details of time spent abroad, if they have been abroad for more than four weeks at a time over the last three years;

details of any pensions or benefits that they or a family member may receive from another European Economic Area (EEA) state or Switzerland; and




details if they are working or paying insurance to another EEA state or Switzerland.

The claimant will not be sent the form ‘How your disability affects you’ if they meet the criteria for an award under the special rules; instead they, or the person claiming on their behalf, will be asked some extra questions whilst they are on the telephone about their condition and how it affects their ability to get around. These questions are:

Do you need someone else to plan any journey for you that you wish to take?

Do you have difficulties following the route of a familiar journey? For example do you need:

o another person with you;

o an assistance dog; or

o aids, such as a white stick?

Do you have difficulty walking short distances up to 50 metres?

Do you have difficulty walking short distances up to 20 metres?


At the beginning of the telephone call the DWP agent will ask the claimant a series of questions to verify their identity.

If you are claiming on someone else’s behalf you will also be asked for your name and address. The DWP agent will explain what the special rules for terminal illness mean and will confirm that they wish to claim under the special rules.

The call will be quicker if the caller has the postcode for each address they give.

DS1500 report

Claimants are asked to get and send in a DS1500 medical report to support the claim. The DS1500 is a report about their medical condition, not their prognosis, and the claimant can obtain one from their GP,

More information for health professionals:

PIP quick guide

what PIP means for the health sector

PIP editorial for the health professions


https://www.gov.uk/government/publications/pip-quick-guide-for-support-organisations

https://www.gov.uk/government/publications/what-pip-means-for-the-health-sector

https://www.gov.uk/government/publications/what-pip-means-for-the-health-sector

https://www.gov.uk/government/publications/pip-editorial-for-support-organisations

https://www.gov.uk/government/publications/pip-editorial-for-support-organisations



consultant or certain other professionals, including Macmillan nurses. The claimant will not have to pay for a DS1500.

The DS1500 report can be sent to DWP either by the health professional or by the person requesting it but it is important that it is sent in quickly to support the PIP claim. The claimant (or the person making the claim on their behalf) will be given the freepost address below for the DS1500 when they make the claim over the phone.

It is important that the DS1500 is sent in quickly to support the PIP claim.

The address to send the DS1500 to is:

Freepost RTEU-HXBG-YTST Personal Independence Payment 10 Mail Handling Site A Wolverhampton WV98 1AE

It’s important to use the full address, including the ‘10’, to avoid unnecessary delay in processing the claim.

DWP cannot treat a DS1500 as a claim to PIP. It is important that a claim to PIP is made in addition to providing the DS1500.

Assessment process

The claim information and the DS1500 will be sent to an assessment More information: provider – either Atos Healthcare or Capita Health & Wellbeing – who assessment provider work in partnership with DWP. and process

A health professional working for the assessment provider will be able to complete the assessment using the information provided during the claims process, the DS1500 and any further evidence gathered.

Claimants who are deemed to qualify under the special rules will not need a face-to-face consultation.

The health professional may need to contact the person who has completed the DS1500 for more information.






PIP and existing DLA special rules claimants

Those claimants who are already in receipt of DLA under the special rules More information: will only be invited to claim PIP when their DLA award expires. This reassessing existingincludes children reaching age 16 who would otherwise have to claim PIP. DLA claimants for PIP

If an existing DLA claimant living in Wales, West Midlands, East Midlands or East Anglia contacts DWP after 28 October 2013 to say that their condition has deteriorated and they are now terminally ill, they will be invited to claim PIP under the special rules for terminal illness.

From 13 January 2014, the areas where this applies extend to postcodes beginning: DG, EH, TD and ML in southern Scotland and parts of the borders.

From 3 February 2014, the areas further extend to postcodes beginning: CA, DL, HG, LA and YO in the north of England.






Supporting young people to claim PIP

How DWP will invite young people, who are approaching the age of 16 and receiving DLA, to claim PIP

Contents

What reassessment means for young people approaching age 16

Preparing young people for PIP

DLA ends on or after 7 October 2013

DLA special rules

Claim to PIP is made

Appointees

Key facts

DLA will remain for children under 16

Young people will not be invited to claim PIP instead of their DLA until they are 16 years of age

From 28 October 2013, DWP started to invite young people about to turn 16 to claim PIP only if they live in Wales, West Midlands, East Midlands or East Anglia

From 13 January 2014, reassessment areas extend to postcodes beginning: DG, EH, TD and ML in southern Scotland and parts of the borders

From 3 February, areas further extend to include postcodes beginning: CA, DL, HG, LA and YO in the north of England

Young people who get DLA under the special rules for terminal illness will not be asked to claim PIP

DWP will write to the parent or guardian of young people before they turn 16 to tell them what they need to do next



Introduction

DLA will remain for children under 16. Young people will not be invited to claim PIP until they are at least 16 years of age.

What reassessment means for young people approaching 16

From October 2013 onwards, DWP started to invite some existing DLA claimants living in Wales, West Midlands, East Midlands and East Anglia to claim PIP. This will include people who are turning age 16 and are in receipt of DLA (except for those receiving DLA under the special rules for terminal illness).

DWP have already begun to notify parents or guardians of children approaching the age of 16 who have an existing award of DLA to inform them that that their child will be invited to claim on or shortly after their 16th birthday.

Children living in Wales, West Midlands, East Midlands and East Anglia will be invited to claim PIP when they reach age 16.

From 13 January 2014, children living in postcodes beginning DG, EH, TD or ML in southern Scotland and parts of the borders will be invited to claim PIP when they reach age 16.

From 3 February 2014, children living in postcodes beginning CA, DL, HG, LA or YO in the north of England will be invited to claim PIP when they reach age 16.

Children reaching age 16 and who live elsewhere in Great Britain will continue to receive DLA but will have their eligibility for adult DLA checked if their award is due to expire on or around their 16th birthday.

For more information: reassessing existing DLA claimants for PIP





Preparing young people living in reassessment areas for claiming PIP

DWP will write to parents or guardians of young people, who are currently in receipt of DLA and are living in reassessment areas as they approach age 16.

At age 15 years and 7 months a letter will be sent to the parent or guardian to explain that:

PIP replaces DLA as the correct benefit for anybody over 16 years old

the young person will need to claim PIP at 16 years of age

DWP will write to the young person about this to explain how to claim PIP, when they are 16

if the young person makes a claim for PIP when they reach 16, DWP will make sure their DLA continues to be paid until DWP makes a decision about their PIP claim

they need to let DWP know who to pay DLA to once the young person turns 16 and if they make a claim for PIP, while DWP makes a decision about their claim

they should discuss the letter with the young person.

The letter will also ask whether the young person will need an appointee when they turn 16.

At age 15 years and 10 months a letter will be sent to the parent or guardian to explain that the young person will shortly be invited to claim PIP at 16. A variant of the letter also repeats the questions in the previous letter if an answer has not been received.

At age 16 a letter will be sent to the young person, or their appointee, to invite them to claim PIP, it will explain:

how to claim PIP and when by

For more information: how to claim PIP

For more information: appointees




that if they don’t claim PIP by the date given on their letter, their DLA will stop

that their DLA will continue to be paid (even if their DLA award was due to expire) as long as they send DWP any information they ask for and go to an assessment consultation, if required.

Young Person’s DLA award ends on or after 7 October 2013

From May 2013, DWP started to write to the parent or guardians or representatives of young DLA claimants who were due to turn 16 on or after 7 October 2013. This was to tell them that the young person would soon be invited to claim PIP.

From 28 October 2013, only those young people who turn 16 on or after 7 October 2013 and who live in Wales, West Midlands, East Midlands or East Anglia will be invited to claim PIP.

From 13 January 2014, children living in postcodes beginning DG, EH, TD or ML in southern Scotland and parts of the borders will also be invited to claim PIP when they reach age 16.

From 3 February 2014, children living in postcodes beginning CA, DL, HG, LA or YO in the north of England will also be invited to claim PIP when they reach age 16.

DLA Special Rules

Those who are being paid DLA under the Special Rules for the terminally ill will be invited to claim PIP at the end of their existing DLA award; if that date is after October 2015, they will be invited to claim PIP when DWP invite the bulk of DLA claimants to claim PIP from October 2015.

Claim to PIP is made

If a young person makes a claim to PIP, their DLA will continue to be paid until DWP makes a decision on their PIP claim; when the decision on their PIP claim is made their DLA will end even if they currently have a long term or indefinite award. If the young person is awarded PIP it may be the same amount or more or less than their current DLA. This could affect

For more information: reassessing existing DLA claimants for PIP

For more information: access to other benefits and services




https://www.gov.uk/government/publications/procedures-for-dealing-with-agents-appointees-attorneys-deputies-and-third-parties




other benefits that the young person, or others in their household, may receive.

Appointees

If a young person can’t do things like tell us if their condition gets better or worse, or about changes in address or bank details and so on, another person may need to act on their behalf, as their ‘Appointee’. This must be because of their illness or disability and not just because they are still a young person.

An appointee is fully responsible for acting on the young person’s behalf in all their dealings with DWP. These responsibilities include:

claiming, managing and spending benefits in a way that best serves the young person’s interests (including things like fees for social care services)

completing and signing any forms

reporting any changes such as if the help that they need increases or decreases, or if their address or bank details change.

Acting as an appointee is a position of trust and an appointee must be For more information:

aged 18 or over. DWP will visit both the young person and the appointee gov.uk website

to make sure they need an appointee and that the appointee understands their responsibilities.





People approaching age 65 and over

How people approaching age 65 will be affected by Personal Independence Payment (PIP) Contents

• Eligibility for PIP

• Linking rules for DLA

• Linking rules for PIP

• In receipt of DLA and under age 65 on 8 April 13

• In receipt of Attendance Allowance

• PIP claimants reaching age 65

Key facts

• People who were 65 and over on 8 April 2013 are not eligible to claim PIP

• Existing Disablity Living Allowance (DLA) claimants who were 65 or over on 8 April 2013 will continue receiving DLA for as long as they continue to meet the entitlement conditions

• There are linking rules for both DLA and PIP

• All DLA claimants who were aged between 16 and 64 on 8 April 2013 will at some point be invited to claim PIP.

Eligibility for PIP

People who were aged 65 and over on 8 April 2013 (the day PIP was introduced) are not eligible to claim PIP. Anyone of this age who tries to make a new claim to PIP will be signposted instead to claim Attendance Allowance (AA).

Existing DLA claimants, who were aged 65 or over on 8 April 2013, will continue to receive DLA for as long as they meet the entitlement conditions.



Linking rules for DLA

Recent recipients of DLA who were 65 or over on 8 April 2013 can reclaim the benefit as long as they were in receipt of an award which ended less than twelve months earlier.

Someone who was 65 or over on 8 April 2013, and hasn’t received DLA in the previous 12 months would normally claim AA.

Linking rules for PIP

PIP has similar ‘linking rules’ to those used for DLA. These rules allow for a one-year linking rule for those over 65.

The linking rule means that the qualifying period will not have to be met for any component previously received, as long as the individual has substantially the same condition that gave rise to the previous entitlement. Entitlement can continue after the age of 65 if a claimant is already in receipt of PIP when they turn 65, providing they continue to satisfy the conditions of entitlement.

In receipt of DLA and under age 65 on 8 April 2013

All DLA claimants aged 64 or under on 8 April 2013 will be invited to claim PIP, even if they have reached age 65 by the time they are invited. Anyone invited to claim PIP aged 65 or over will be assessed for entitlement to PIP as if they were under age 65.

This means the claimant will have access to all components and rates that apply to claimants between16 and 64.

In receipt of Attendance Allowance (AA)

If someone is getting AA they will not be affected by the introduction of PIP.




PIP claimants reaching age 65

For more information: conditions of entitlement and assessment criteria

Individuals in receipt of PIP will be able to continue receiving the benefit past the upper age limit of 65, provided they continue to meet the eligibility criteria.

Rules exist to prevent a new entitlement to the mobility component after age 65 and there are other restrictions on moving between rates of the mobility component after age 65.







Supporting Personal Independence Payment (PIP) claimants who are in a vulnerable situation

How DWP will support claimants who are in a vulnerable situation Contents

• Introduction

• Additional support for claimants in a vulnerable situation

• DWP Visiting

Key facts

• DWP have a range of processes in place to identify claimants who are in a vulnerable situation

• Additional help and support is available when it is needed

• For the most vulnerable claimants DWP visiting will be available to provide a face to face service as they do now

Introduction

DWP recognise that some claimants may be in a vulnerable situation and may need some additional support to access their service.

For more information: how to make a claim

When DWP refer to claimants in a vulnerable situation they mean someone who may have difficulty in dealing with the demands of DWP processes at the time they need to access a service.

Some claimants may have active support mechanisms in place and be able to make their claim without further support, but others may not.





Additional support for claimants in a vulnerable situation

DWP has worked with a range of external support organisations to make sure they and other external organisations have sufficient information about PIP, so that they can provide advice and assistance to claimants who may have difficulty when making their claim to PIP.

DWP will make full use of alternative formats, for example TexBox or Braille to support deaf, speech impaired or blind people.

Claimants may be in a vulnerable situation at any point or at all points during their claim, for instance someone may be in a temporarily vulnerable situation because of a recent bereavement.

DWP have put a range of processes in place to make sure that they can identify when a claimant is in a vulnerable situation whenever a claimant contacts DWP. This may be during the initial phone call to make a claim, during the assessment or when the decision is communicated to the claimant.

DWP staff are fully trained to identify and support a claimant in a vulnerable situation whenever they are in contact with the claimant.

DWP will mark their PIP computer systems to show that claimants in a vulnerable situation may require additional help and support for them to complete their claim.

DWP provide help and support when it is needed. For example, where it is identified at the new claim stage that a claimant has mental health, learning needs or cognitive impairment and they do not return their 'How your disability affects you' form, DWP will arrange for the claimant to be referred directly to the assessment provider for their medical assessment, without the need for them to complete the form.

For more information: 'How your disability affects you' form

In addition, PIP has learned from rare cases across DWP when a claimant has threatened self harm or suicide. DWP have introduced a role to support claimants in these circumstances.

It is expected that these instances will continue to be rare, but every Benefit Centre will have a ‘champion’ in place to provide any additional help as required.

DWP are experienced at dealing with customers in a vulnerable situation but have recognised that staff need support to make sure they provide the best possible service for a customer in a vulnerable situation.






DWP provides the required support to staff by developing new learning and development packages and by ensuring their learning is refreshed on a regular basis.

DWP Visiting

For more information: completing the 'How your disability affects you' form

For the most vulnerable claimants DWP Visiting is available to provide a face-to-face service, as they do now.

DWP Visiting is able to make a home visit to claimants who are having difficulty with either making a claim or completing the ‘How your disability affects you’ form.

There is no need for organisations to refer claimants directly to DWP Visiting to make a claim for PIP as the initial call can be made by someone on the claimants behalf, providing the claimant is with them. At any point of the process, should DWP feel that the claimant needs face to face services, this will be arranged.







Disputes Process

Details of the mandatory reconsideration and appeal process for Personal Independence Payment (PIP) Contents

• Introduction

• PIP disputes process

Key facts

• DWP has introduced mandatory reconsideration and direct lodgement of appeals for PIP from April 2013

• PIP decision notifications will tell claimants what they need to do if they dispute the decision

• Where a PIP decision is disallowed, or the level of award is reduced, a DWP decision maker will telephone the claimant to disuss the decision

• Claimants have one calendar month from the date on their decision letter to request a mandatory reconsideration

• An appeal cannot be lodged with HMCTS until after DWP have reconsidered the decision.

Introduction

The Welfare Reform Act 2012 includes the introduction of changes to the appeals process to ensure more disputes against DWP decisions are resolved without being referred to Her Majesty’s Court and Tribunals Service (HMCTS).

The change to the appeals process for DWP are:

• mandatory reconsideration of decisions prior to appeal;

• direct lodgement of appeals with HMCTS; and

• time limits for DWP to return appeal responses to HMCTS.




DWP has introduced mandatory reconsideration and direct lodgement for PIP from April 2013.

PIP Disputes Process

This means that for PIP the disputes process will be as follows: For a pictorial view of the disputes process for PIP: PIP disputes journey

Once a decision has been made on a claim, a decision notification will be issued to the claimant advising them of their award or disallowance, giving the reasons for the decision and advising what steps the claimant needs to take if they dispute the decision.

Claimants have one calendar month from the date on their decision letter to request a mandatory reconsideration.

If a claimant isn’t entitled to PIP or if they are awarded a lesser amount of PIP than their previous Disability Living Allowance (DLA) award either because of reassessment or a review of their claim, the DWP Decision Maker will telephone them so that they can discuss the decision and answer any questions the claimant or someone acting on their behalf may have.

If after the Decision Maker has discussed the decision, the claimant still disputes the decision and would like DWP to look at the decision again, they can request a mandatory reconsideration. The claimant will be asked to be specific about the points at issue or descriptors they are unhappy with and will be encouraged to send in any further evidence or information they may have to DWP at this point.

DWP expects that if the decision is communicated confidently and effectively there will be a reduction in the number of disputes.

When a mandatory reconsideration request is received, a second DWP Decision Maker will look at the decision, including any additional evidence or information that has been provided to decide if the original decision is fair and consistent with the evidence.

Examples of letters about PIP disputes can be found in the decision and disputes section of: PIP forms and letters

A letter called the Mandatory Reconsideration Notice will be issued to the claimant responding to any issues that they had about the decision and advising them of the outcome of their mandatory reconsideration request. It will also contain the claimant’s right of appeal against the decision and advise them how to make an appeal to HMCTS and where they can get an appeal form (SSCS1).








If, after DWP have reconsidered the decision, the claimant still disputes the decision, they can lodge an appeal directly with HMCTS. When lodging an appeal the claimant has one calendar month from the date on the Mandatory Reconsideration Notice to appeal direct to HMCTS.

For more information or to download an appeal form: HMCTS website or gov.uk website If the claimant sends the appeal in error to DWP, DWP will not forward the

appeal request to HMCTS. DWP will first check that a mandatory reconsideration has been carried out, and if not will treat any appeals they receive as a request for a mandatory reconsideration. If the claimant has had a mandatory reconsideration DWP will return the appeal to the claimant.

An appeal cannot be lodged with HMCTS until after DWP have reconsidered the decision. The claimant will need to include a copy of the Mandatory Reconsideration notice from DWP with their appeal.

For more information: HMCTS website

When HMCTS receive the appeal, they will validate it and send it to DWP for a response. DWP will send their response back to HMCTS within 28 days of receipt of the appeal response request.

HMCTS will administer and process the appeal, advising all parties of hearing dates if an oral hearing is to be held.

http://www.justice.gov.uk/about/hmcts


https://www.gov.uk/pip/appeals

https://www.gov.uk/pip/appeals





Changes in circumstance

Changes DWP needs to know about Contents

• Introduction

• How to report a change

• Changes the claimant does not need to report to PIP

• Changes to report

Key facts

• DWP needs to know if the claimant’s condition or the amount of help they need changes

• Other changes in the claimant’s circumstance may change how much PIP they get

• It is important that claimant’s tell DWP straightaway about any changes in their life that could affect their benefit

• Personal Independence Payment (PIP) is not means tested and can be paid whether the claimant is working or not

Introduction

The PIP award letter gives details of how and when the claimant needs to tell DWP about any changes in circumstance.

DWP needs to know if the claimant’s condition, the amount of help they need or their circumstances change. This is because it may change how much PIP they can get.

For details of changes claimants should tell us about: Page 2

For more information: conditions of entitlement

It is important the claimant tells DWP straightaway about any changes in their life that could affect their benefit. Based on these changes their benefit may go up, go down, stay the same or it may stop. If the claimant is overpaid, they will normally have to repay the money. Failure to tell the Department about any of these changes may result in prosecution.

http://www.dwp.gov.uk/docs/pip-toolkit-factsheet-001-conditions-of-entitlement.pdf

http://www.dwp.gov.uk/docs/pip-toolkit-factsheet-001-conditions-of-entitlement.pdf




How to report a change

The claimant can report a change by:

Telephone: 0845 850 3322

Textphone: 0845 601 6677

By post: To the address at the top of their award notification.

Changes the claimant does not need to report to PIP

PIP is not means tested and can be paid whether the claimant is working or not. There is no need to report that the claimant has started or finished work or if the nature of their current employment has changed, unless the amount of help that they need has changed.

The table below outlines the changes the claimant should tell us about but there may be other changes that the claimant wants to tell DWP about.

Changes to report

Change to report Further details

Changes to daily living or mobility needs.

For example, more or less help or support is needed or the condition will last for a longer or shorter time than the claimant has previously told the Department about

This change may affect entitlement to PIP. The amount and the period of the PIP award may change.

PIP enquiry line: telephone 0845 850 3322

Information for claimants: gov.uk website

https://www.gov.uk/pip/what-youll-get

https://www.gov.uk/pip/what-youll-get





• Admission to a hospital, care home or hospice

• Entry into a residential school or college

• Entry into foster care, local authority care, sheltered housing or Social Care Trust care

This change may affect the amount of PIP that can be paid to the claimant.

DWP need to know the name and address of the place the claimant has gone into, and the date they went in. DWP need this information as soon as they go in. Failure to tell us this straight away could result in an overpayment. DWP also needs to know if the claimant spends any nights at home and the date the claimant comes out of this place as soon as this happens. This is because we may be able to pay PIP for any nights spent at home and as soon as they come out of this place.

Imprisonment or claimant held in legal custody

This change may affect the amount of PIP that can be paid to the claimant.

DWP need to know the date the claimant was taken into prison or legal custody and the length of time they are expected to be there if known.

Leaving the country or planning to leave the country for a period of more than four weeks even if this is a holiday

This change may affect the claimant’s entitlement to PIP. DWP will need to know the date the claimant is leaving the country, how long they are planning to be out of the country, which country they are going to and why they are going abroad.

Change of name This change will not affect payment or eligibility for PIP, but it is important that DWP have the most up to date details for the claimant.

This change needs to be reported in writing – if the claimant phones to give these details, DWP officials will ask for these details to be put in writing. The written notification must contain full details of their previous name, their new name, details of any changes made to the bank or building society account into which PIP is paid such as the name of the account or the account number and the letter must be signed by the claimant.

Change of account PIP is paid into

DWP need full details of the of the name and address of the new bank or building society along with details of the new account including the name of the account, the account number and the sort code or roll number.





Change of person acting for the claimant, by this we mean an appointee or someone with power of attorney for the claimant.

This change is important so that DWP can make payments to the right person at the right time. DWP need the full name, address and contact details of the new person who is acting for the claimant. If the person acting for the claimant has moved or has different contact details, PIP just need the new details.

Change of address This change, providing it is not a hospital or nursing home will not affect eligibility or payment of PIP. It is important that DWP hold the most up to date details for the claimant.

DWP need full details of the new address the claimant has moved to, including the postcode and the date that they moved.

Change of doctor of health care professional.

This change will not affect payment or eligibility for PIP and is not mandatory once a decision on the PIP claim has been made. However, if the change happens during the claiming stage it is essential that DWP has the most up-to-date information. This will make sure the assessment provider has the right contact details to gather any further details they may require. DWP will require the full name, address and contact details of the new doctor or health care professional.


Reassessment area includes CH1 , CH4, CHS, CHS, CH7, CHS

0

II

II

N, NW, E, EC, SE SW, WandWC

PIP reassessment areas from October 2013

PIP reassessment areas from January 2014

PIP reassessment areas from February 2014

xx Lot 1: Atos

xx Lot 2: Capita

xx Lot 3: Atos

xx Lot 4: Capita

ISBN: 978-1-78153-678-0 © Crown Copyright 2013 Published by the Department for Work and Pensions gov.uk/dwp/pip-toolkit - version 5.0: December 2013



Postcodes for PIP assessment providersand reassessment

Text to support the PIP postcode map

Atos cover postcode areas

Scotland, northeast and northwest England and in London and southern England

Lot 1 indicated in Black text

Lot 3 indicated in Red text on map

Postcodes beginning: AB, AL, BA, BB, BD, BH, BL, BN, BR, BS, CA, CB, CM, CO, CH (except CH1, CH4, CH5, CH6, CH7 and CH8), CR, CT, CW, DA, DD, DG, DH, DL, DN, DT, E, EC, EH, EN, EX, FK, FY, G, GL (except GL16), GU, HA, HD, HG, HP, HU, HX, IG, IP, IV, KA, KT, KW, KY, L, LA, LS, LU, M, ME, MK, ML, N, NE, NR, NW, OL, OX, PA, PH, PL, PO, PR, RG, RH, RM, S, SE, SG, SK, SL, SM, SN, SO, SP, SR, SS, SW, TA, TD, TN, TQ, TR, TS, TW, UB, W, WA, WC, WD, WF, WN, YO and ZE

Capita cover postcode areas

Wales and central England, and in Northern Ireland

Lot 2 indicated in white text

Lot 4 (Northern Ireland) indicated in purple text on map

Postcodes beginning: B, CF, CH1, CH4, CH5, CH6, CH7, CH8, CV, DE, DY, GL16, HR, LD, LE, LL, LN, NG, NN, NP, PE, SA, ST, SY, TF, WR, WS and WV

See page two for reassessment postcodes







From 28 October 2013: postcodes where we’ll ask existing DLA claimants to claim PIP instead

Wales, West Midlands, East Midlands and East Anglia

Visit the PIP toolkit for the circumstances under which we’ll ask existing Disability Living Allowance (DLA) claimants to claim PIP instead – this is known as reassessment.

Coloured in green on map

Postcodes beginning: B, CF, CH1, CH4, CH5, CH6, CH7, CH8, CV, DE, DY, GL16, HR, IP, LD, LE, LL, LN, NG, NN, NP, NR, PE, SA, ST, SY, TF, WR, WS and WV

From 13 January 2014: additional postcodes where we’ll ask existing DLA claimants to claim PIP instead

Postcodes around Dumfries and Galloway, Cumbria, Edinburgh, Galashiels, Berwick-upon Tweed and Motherwell

Coloured in blue on map

Postcodes beginning: DG, EH, ML and TD

From 3 February 2014: additional postcodes where we’ll ask existing DLA claimants to claim PIP instead

Postcodes around Carlisle, Darlington, Harrogate, Lancaster and York

Coloured in purple on map

Postcodes beginning: CA, DL, HG, LA and YO

Page 2 of 2 gov.uk/pip-toolkit






Personal Independence Payment - Advice York · Personal Independence Payment (PIP) toolkit Page 2...

Documents

Transcript of Personal Independence Payment - Advice York · Personal Independence Payment (PIP) toolkit Page 2...