Overview of the Personal Independence Payment

Transcription

1 Overview of the Personal Independence Payment September 2015 Contents page What is Personal Independence Payment? 2 The key rules 3 The activities test 4 How will I be assessed? 5 Moving from DLA to PIP 6 PIP and other help 7 Further information 9 Timetable for the introduction of PIP 10 Useful contacts 11 Appendix I: activities and descriptors 12 Appendix II: DWP definitions for activities and descriptors 18 1

2 What is Personal Independence Payment? Disability Living Allowance (DLA) will be replaced by Personal Independence Payment (PIP) for people of working age. PIP was introduced in April 2013 and will be phased in over several years. PIP has similarities to DLA but it will be a pointsbased test and people will now be measured against descriptors to see if they score enough points to qualify for support. PIP has two components: 1. Daily living component, which consists of nine activities (see p 4). This is paid at either: the standard rate if you have a limited ability to carry out daily living activities OR the enhanced rate if you have a severely limited ability to carry out daily living activities 2. Mobility component, which consist of two activities (see p 4). This is paid at either: the standard rate if you have a limited mobility OR the enhanced rate if you have a severely limited mobility If you have a terminal illness (that is if you are suffering from a progressive disease where death can be expected within six months) you will automatically receive the daily living component enhanced rate. You will also be able to apply for the mobility component and receive it immediately if you qualify. 2

3 The key rules To claim PIP you need to be aged between 16 and 64 years. Those aged 65 and over (on 8 April 2013, which is the date PIP is due to be introduced on) will be able to remain on DLA if they are already getting it and will not have to be reassessed for PIP. Children under the age of 16 will also remain on DLA. Once a child reaches the age of 16 they will have to claim PIP. There is a possibility that people over 65 and children may be moved to PIP at some time in the future but there are no plans for this yet. If you have made a successful claim for PIP before you were 65 you can continue to get it after you are 65. In order to claim personal independence normally you must: have been present in Great Britain for 104 weeks out of the 156 weeks before claiming (ie. two out of the last three years) be habitually resident. Benefit rules define being 'present' as meaning physically present in the UK. There are particular rules that may allow you to be treated as present during a temporary absence. The habitual residence test is a test to see if you normally live in the United Kingdom, the Channel Islands, the Republic of Ireland or the Isle of Man. The test will be applied if you have been living abroad. There is no legal definition of 'habitual residence.' Relevant factors are where you normally live, where you expect to live in the future, your reasons for coming to this country, the length of time spent abroad before you came here, and any ties you still have with the country where you have come from. People claiming will need to satisfy the daily living and/or mobility activities test for three months prior to claiming and be likely to continue to satisfy this test for a period of at least nine months after claiming. The qualifying period starts from when the eligible needs arise. So it may not be necessary to wait for three months from the date of claim before payment can be made. Like DLA, PIP: is not means-tested and not taxable can be paid whether someone is in or out or work. If you qualify for PIP you will be able to spend the money in the way that suits you. 3

4 The activities test The form asks you questions about 12 activities 1. Preparing food 2. Eating and drinking 3. Managing treatments 4. Washing and bathing 5. Managing toilet needs 6. Dressing and undressing 7. Communicating 8. Reading 9. Mixing with other people 10. Making decisions about money 11. Going out (used in the test for the mobility component) 12. Moving around (used in the test for the mobility component) Each activity has a set of descriptors and points are awarded according to the descriptor that you satisfy. If you can show that a descriptor applies to you for six months within a 12 month period, and this is accepted by the DWP, you should be awarded points for that descriptor. In the PIP Handbook published by the DWP, it states (on page 7 -see below for where to find the factsheets) that for a descriptor to apply the claimant must be able to reliably complete the activity as described in the descriptor. This means being able to do the activity: safely to an acceptable standard repeatedly and within a reasonable time period. There is other useful information about the assessment criteria available in the DWP s PIP Handbook which you can see at You can also view the PIP regulations on line at The PIP amendment regulations confirm that the legislation should be applied as outlined above. You can see these at The Government stated (in its response to the PIP consultation published in December 2012) that although pain, fatigue, breathlessness, nausea and motivation are not explicitly mentioned in the legislation and descriptors, these will be key factors to examine when considering whether people can complete the activities reliably. If you have a fluctuating condition such as M.E. the most appropriate descriptor will be the one which is likely to apply for the greatest proportion of the time. If a descriptor applies more than 50% of the time you should be awarded points for that 4

5 descriptor. You can look at a list of all the activities and descriptors in Appendix I (p 12) and DWP definitions for these in Appendix II (see p 18) of this factsheet. How will I be assessed? New claims will initially be made by telephone, although eventually people will also be able to claim online. It may in rare cases be possible to get a paper claim form sent out. The initial claim will only require basic information such as your contact details, payment information, details of any stays in hospital etc. Someone else can make the call on your behalf but you will need to be present so the DWP can confirm that you are happy with them advocating for you. This call will usually take about 20 minutes. The telephone number to call to make a claim for PIP is Following completion of this first form (done mainly over the phone) and its receipt at the DWP, a questionnaire will be sent out asking for details about your medical condition and how it affects you. This questionnaire will be considered by an independent health care professional (HCP). Companies that have been awarded contracts to carry out these assessments are Atos and Capita. You may also send in medical evidence (from your own GP or consultant or someone else involved in your care) to support your claim and this should also be taken into consideration. The HCP may decide to request further medical evidence from your GP or consultant. They might also ask you to attend a face-to-face consultation. If you have made a claim for Employment and Support Allowance (ESA) they may have a copy of your Work Capability Assessment (WCA) report. In the Government response to the House of Commons Work and Pensions Select Committee report on ESA (published November 2014) it says that while PIP and ESA are separate benefits designed to meet different purposes, they could do more to share information. It states that they are testing sharing WCA reports with PIP assessment providers to inform their assessments and help us make decisions faster. On the 25 November 2014 the Minister for Disabled People confirmed that this was happening and said that the report from the WCA would be put with a claimants PIP form. They seem to be hoping to make more decisions based on paper and without the need for a face-to-face assessment. It is likely that your PIP assessment report could be used in future ESA claims too. It is therefore even more important to ensure that you request copies of these reports and write to the DWP to correct any inaccuracies. The HCP will then send a report to the Department for Work and Pensions (DWP) and a Decision Maker there will decide on your entitlement. They will decide whether or not you are awarded PIP, at which rate and also the length of the award. 5

6 The claim form You claim PIP using two claim forms: Personal Independence claim form (PIP1) this is your initial claim. It asks you to supply your name, address, contact details, payment details etc. It also asks you questions about your nationality, whether you are in hospital or residential care or if are terminally ill. How your disability affects you (PIP2) this asks you questions on the activities tests. You will need to make your claim by calling the claims line (see above) and use the forms that they send out. You can download sample claim forms at Moving from DLA to PIP If you currently receive DLA, the DWP will contact you to see if you wish to make a claim for PIP. The timetable for moving people onto PIP has altered. Please see the timetable on page 9 for a complete list of postcodes affected and for how the changes will affect you. When you are due to be reassessed you will be contacted and invited to make a claim for PIP. If you choose not to claim PIP, your DLA will end. You are given 28 days from when you are notified to make your claim. The process will be much the same as for people making a new claim for PIP. There is no automatic transfer from DLA to PIP: you will have to make a claim. We have produced a detailed factsheet called PIP: filling in the form, which you can read/download at our Online M.E. Centre at or request a paper copy by phone on This includes detailed information about DLA claimants being reassessed for PIP. 6

7 PIP and other help Carers Allowance It is intended that both the daily living components of PIP will act as a passport to Carers Allowance, in the same way that the middle and high rate care of DLA acts as a passport. So if the person you care for gets either daily living component and you meet the other criteria for Carers Allowance you will be eligible. If the person being cared for gets the Severe Disability premium with a means-tested benefit like income-related ESA, they will lose this if someone is paid Carers Allowance for caring for them. Seek advice in this situation. Benefit cap An award of PIP means you are exempt from the benefit cap Blue Badge scheme In England, if you have been awarded eight points or more in the moving around activity of personal independence payment (PIP) you will be able to get a Blue Badge. In Scotland and Wales you can get the badge if you have been awarded eight points or more in the moving around activity or 12 points in the planning and following journeys activity. You can find out about the Blue Badge in Northern Ireland by searching for Blue Badge scheme at or calling If you do not qualify for a Blue Badge through the PIP route you may still be able to obtain one. See Action for M.E s factsheet, The Blue Badge parking scheme, for more information. Vehicle Excise Duty You will be exempt from road tax if you get the enhanced mobility element of PIP. You can also get a 50% discount on your road tax if you receive the standard mobility element of PIP. Motability Motability is an independent charity that exists to help disabled people use their PIP mobility award to improve their ability to get around, for example through leasing a car or having a vehicle adapted. You will be able to qualify for the Motability Scheme help if you are receiving the enhanced mobility (moving around) component of PIP. If you lose your Motability vehicle following a PIP reassessment and you were on the scheme prior to January 2013, you may be entitled to a 2,000 lump sum to help pay for a used car. If you lose your vehicle and you had entered into your first lease 7

8 agreement between January 2013 and December 2013 you may be eligible for a 1,000 grant. Contact Motability (see useful contacts on p 11) for more information about this. Premiums An award of PIP can also entitle you to premiums (extra amounts of money) that are paid with other benefits, for example income-related ESA and Housing Benefit. If you are awarded the standard or enhanced rate of the daily living component for PIP, this could entitle you to the Severe Disability or Enhanced Disability Premium. In practical terms, this means that you either become entitled to a means-tested benefit for the first time or you are entitled to more money through your existing award. For example, George gets contribution-based ESA and is in the Work Related Group. He has savings under 16,000 and lives alone. His income is equal to the amount that the law says he needs to live on so he does not get Income Related ESA. He makes a claim for PIP and is awarded the enhanced rate of the daily living component. He is now eligible for the Enhanced Disability Premium and the Severe disability premium and needs to make a claim for income-related ESA. You will still need to satisfy other rules to get the premiums but if you have savings under 16,000 and your partner works less than 24 hours a week you may qualify it will depend on how much your household income is. If you live alone with savings below this limit and no other income you are very likely to qualify. Seek advice if you are unsure. 8

9 Further information The DWP has produced briefing notes and answers frequently asked questions about PIP at It also offers an online diagram showing the process for claiming PIP at The Social Security (Personal Independence Payment) Regulations 2013 are available at The DWP have produced a guide for assessors that has lots of useful information about PIP and the approach that the assessors will take. You can see this at The government has an online PIP checker so you can find out how Personal Independence Payment affects you. You can try it out at This uses the claimant s date of birth to work out how and when they might be affected. You can also find out more about PIP and the Welfare Reform Act at 9

10 Timetable for the introduction of PIP You can view the online PIP checker at and the full timetable at See the map of postcodes affected at 10

11 Useful contacts Action for M.E. Information and support for people with M.E. and their carers General enquiries: (Mon-Fri 9am-5pm) Enquiries Welfare Advice and Support Service: (times vary) Online M.E. Centre: Citizens Advice Bureau Offers advice on a range of issues and may complete a benefits check for you Civil Legal Advice Help with some benefit appeals for eligible people. Disability Law Service Offers information and advice on a range of issues including Welfare rights fact sheets. Please note that they no longer give advice on welfare benefits. Tel: Disability Information and Advice Line (DIAL) To find your local DIAL office, contact Scope, 6 Market Road, London N7 9PW Tel: Disability Rights UK Factsheets on benefits, tax credits and independent living Local councils Some local councils employ welfare rights workers. The council may also have information about other services that offer welfare rights advice in your area. Motability For information on leasing a car, scooter or powered wheelchair using PIP Tel: If you have found the information in this factsheet helpful, please consider making a donation to Action for M.E. at or by calling Thank you. 11

12 Appendix I: activities and descriptors The activities, descriptors and points listed below are the legal test as laid out in the Social Security (Personal Independence Payment) Regulations You can see these at In order to qualify for the daily living component (activities 1 to 10 in the table below) of PIP you need to score: at least eight points to be awarded the standard rate at least 12 points to be awarded the enhanced rate In order to qualify for the mobility component (activities 11 and 12 in the table below) of PIP you need to score: at least eight points to be awarded the standard rate at least 12 points to be awarded the enhanced rate To get both the daily living and mobility component you would need to score at least eight points in both sections (ie. a total of 16 points.) You can only score once in each activity so only the descriptor with the highest points that applies to you will be awarded. Daily living component activities 1. Preparing food a. Can prepare and cook a simple meal unaided 0 points b. Needs to use an aid or appliance to either prepare or cook a simple meal 2 points c. Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave 2 points d. Needs prompting to be able to either prepare or cook a simple meal 2 points e. Needs supervision or assistance to either prepare or cook a simple meal 4 points g. Cannot prepare and cook food 8 points 2. Taking nutrition a. Can take nutrition unaided 0 points 12

13 b. Needs either (i) to use an aid or appliance to be able to take nutrition OR (ii) supervision to be able to take nutrition OR (iii) assistance to be able to cut up food 2 points c. Needs a therapeutic source to be able to take nutrition 2 points d. Needs prompting to be able to take nutrition 4 points e. Needs assistance to be able to manage a therapeutic source to take nutrition 6 points f. Cannot convey food and drink to their mouth and needs another person to do so 10 points 3. Managing therapy or monitoring a health condition a. Either: (i) does not receive medication or therapy or need to monitor a health condition OR (ii) can manage medication or therapy or monitor a health condition unaided 0 points b. Needs either: (i) to use an aid or appliance to be able to manage medication OR (ii) supervision, prompting or assistance to be able to manage medication or monitor a health condition 1 point c. Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week 2 points d. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week 4 points e. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 7 but no more than 14 hours a week 6 points f. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week 8 points 13

14 4. Washing and bathing a. Can wash and bathe unaided 0 points b. Needs to use an aid or appliance to be able to wash or bathe 2 points c. Needs supervision or prompting to be able to wash or bathe 2 points d. Needs assistance to be able to wash either their hair or body below the waist 2 points e. Needs assistance to be able to get in or out of a bath or shower 3 points f. Needs assistance to be able to wash their body between the shoulders and waist 4 points g. Cannot wash and bathe at all and needs another person to wash their entire body 8 points 5. Managing toilet needs or incontinence a. Can manage toilet needs or incontinence unaided 0 points b. Needs to use an aid or appliance to manage toilet needs or incontinence 2 points c. Needs supervision or prompting to be able to manage toilet needs 2 points d. Needs assistance to be able to manage toilet needs 4 points e. Needs assistance to be able to manage incontinence of either bladder or bowel 6 points f. Needs assistance to manage incontinence of both bladder and bowel 8 points 6. Dressing and undressing a. Can dress and undress unaided 0 points b. Needs to use an aid or appliance to be able to dress or undress 2 points 14

15 c. Needs either: (i) prompting to be able to dress, undress or determine appropriate circumstances for remaining clothed OR (ii) prompting or assistance to be able to select appropriate clothing 2 points d. Needs assistance to be able to dress or undress their lower body 2 points e. Needs assistance to be able to dress or undress their upper body 4 points f. Cannot dress or undress at all 8 points 7. Communicating verbally a. Can express and understand verbal information unaided 0 points b. Needs to use an aid or appliance to be able to speak or hear 2 points c. Needs communication support to be able to express or understand complex verbal information 4 points d. Needs communication support to be able to express or understand basic verbal information 8 points e. Cannot express or understand verbal information at all even with communication support 12 points 8. Reading and understanding signs, symbols and words. a. Can read and understand basic and complex written information either unaided or using spectacles or contact lenses 0 points b. Needs to use an aid or appliance, other than spectacles or contact lenses, to be able to read or understand either basic or complex written information. 2 points c. Needs prompting to be able to read or understand complex written information 2 points d. Needs prompting to be able to read or understand basic written information 4 points 15

16 e. Cannot read or understand signs, symbols or words at all 8 points 9. Engaging with other people face to face. a. Can engage with other people unaided 0 points b. Needs prompting to be able to engage with other people 2 points c. Needs social support to be able to engage with other people 4 points d. Cannot engage with other people due to such engagement causing either: (i) overwhelming psychological distress to the claimant OR (ii) the claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person 8 points. 10. Making budgeting decisions. a. Can manage complex budgeting decisions unaided 0 points b. Needs prompting or assistance to be able to make complex budgeting decisions 2 points c. Needs prompting or assistance to be able to make simple budgeting decisions 4 points d. Cannot make any budgeting decisions at all 6 points Mobility component activities 11. Planning and following journeys. a. Can plan and follow the route of a journey unaided 0 points 16

17 b. Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant 4 points c. Cannot plan the route of a journey 8 points d. Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid 10 points e. Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant 10 points f. Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid 12 points 12. Moving around a. Can stand and then move more than 200 metres, either aided or unaided 0 points b. Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided 4 points c. Can stand and then move unaided more than 20 metres but no more than 50 metres 8 points d. Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres 10 points e. Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided 12 points f. Cannot, either aided or unaided: (i) stand OR (ii) move more than 1 metre 12 points 17

18 Appendix II: DWP definitions for activities and descriptors Note: The information below is based on draft regulations (and the explanatory notes). They may be subject to further development and consultation. These are available at aid or appliance A device to improve either a physical or mental function or both. It includes a prosthesis but does not include an aid or appliance ordinarily used by a person without a physical or mental condition which limits that person s ability to carry out daily living or mobility activities assistance Physical intervention by another person bathe To clean one s torso, face, hands and underarms cook To heat food at or above waist height communicate To convey and understand information in the claimant s native language communication support (a) support from a person trained to communicate with people with specific communication needs (b) support from someone experienced in communicating with the claimant; complex financial decisions (a) calculating household and personal budgets (b) managing and paying bills (c) planning future purchases dress and undress To put on and take off socks and slip-on shoes engage socially (a) to interact with others in a contextually and socially appropriate manner (b) to understand body language (c) to establish relationships 18

19 groom (a) to comb or brush one s hair (b) to wash one s hair (c) to clean one s teeth manage incontinence To manage evacuation of the bowel or bladder including using a collecting device or self-catheterisation; manage medication or therapy means take medication or undertake therapy, where a failure to do so is likely to result in a deterioration in the claimant s health; medication Medication prescribed or recommended by a registered doctor, nurse or pharmacist monitor health (a) to detect significant changes in the claimant s health condition (b) to take action advised by a healthcare professional, without which the claimant s health is likely to deteriorate overwhelming psychological distress Distress caused by an enduring mental health condition or an intellectual or cognitive impairment prepare In the context of food, means the activities required to make food ready for cooking or eating prompt To remind or encourage simple financial activities (i) calculating the cost of goods (ii) calculating change required after a purchase simple meal A cooked, one-course meal for one using fresh ingredients social support Support from a person trained or experienced in assisting people to engage in social situations supervision The continuous presence of another person for the purpose of ensuring the safety of the claimant support dog 19

20 A dog trained to guide or assist a person with a sensory impairment take nutrition (a) to cut food into pieces (b) to convey food or drink to one s mouth (c) to chew and swallow food or drink (d) to take nutrition by using a therapeutic source therapeutic source Parental or enteral tube feeding using a rate limiting device such as a delivery system or feed pump therapy Refers to long-term therapy which is (a) undertaken at home (b) prescribed or recommended by a registered doctor, nurse, pharmacist or healthcare professional regulated by the Health Professions Council [now Health and Care Professions Council] toilet needs (a) getting on and off the toilet (b) cleaning oneself after using the toilet unaided means without (a) without the use of an aid or appliance (b) without assistance, prompting or supervision Copyright Action for M.E. September Registered charity in England and Wales no Registered in Scotland no. SC Company limited by guarantee, registered in England no Disclaimer: Welfare benefits law is complex and subject to change and the information is correct at the time of writing. We are updating this factsheet as changes occur. Whilst every care has been taken to ensure accuracy at the time of writing, this fact sheet can only be a general guide as the process will vary depending on the severity of the claimant s condition. Action for M.E. cannot accept responsibility for any loss experienced as a result of this document. 20