Personal Independence Payment (PIP)

1 Personal Independence Payment (PIP) This factsheet was written by Tameside MBC Welfare Rights Service in January 2015. It is a guide and does not cover every circumstance. Though we have tried to ensure its accuracy at the time of publication, it may become inaccurate over time, for example because of changes to the law. If you are already getting Disability Living Allowance (DLA), please seek advice before applying for PIP. What is Personal Independence Payment (PIP)? Personal Independence Payment (PIP) is a benefit for people with a long-term health condition or disability. It is administered by the Department for Work and Pensions (DWP). PIP is gradually replacing DLA for most working-age people between 2013 and 2017: - If you are aged 16-64, and are not already getting DLA, you now have to claim PIP instead of DLA. - If you are aged 16-64 and already getting DLA, please see page 10. - If you are aged 15 or under, you can still make a new claim for DLA. - If you are aged 65 or over, you cannot make a new claim for PIP or DLA, and you will have to claim Attendance Allowance (AA) instead. The DWP does not look at your income, savings or National Insurance contributions when deciding whether you can get PIP. It can be paid alongside most other benefits, including Employment and Support Allowance (ESA). Who can get PIP? You will only get PIP if, because of a disability or a health condition, your ability to carry out certain daily living or mobility activities is limited or severely limited. You find out more about these activities on pages 3 and 12-15. It does not matter whether you have a physical or mental health condition or disability. The DWP will look at how your condition affects you, not just at the condition itself. Your condition needs to have affected you for at least 3 months, and must be expected to continue for at least a further 9 months (unless you are terminally ill). 1

2 If you are in hospital, residential care or prison there are special rules, so please seek advice (see page 11). You cannot usually get PIP if you are a person subject to immigration control, if you are not habitually resident, if you are not physically present in Great Britain, or if you have not been present in Great Britain for 104 weeks out of the past 156 weeks (2 out of the past 3 years). If you are unsure about this, please seek advice before claiming (see page 11). Terminal Illness If you are terminally ill, you can apply for PIP under special rules, providing you have a completed DS1500 from a medical professional. You will still have to meet the basic conditions for PIP (see pages 1-2, but the DWP will not take into account how long your disability or health condition has affected you for. If your claim is accepted under special rules, you will automatically get the enhanced rate daily living component of PIP when you ring to claim, and you will be only be asked questions about your mobility. You will not have to complete the how your disability affects you form or go to a face-to-face assessment, and your claim will be fast-tracked. How can I claim? The claim process is usually done in two stages. To start the claim, ring 0800 9172222 (textphone 0800 9177777). Someone can ring on your behalf providing you are there with them. If you are terminally ill, someone can ring on your behalf without you having to be present. During the phonecall, you will be asked questions to confirm your identity and to check you meet the basic conditions for getting PIP (see pages 1-2). If you cannot use the phone, you can request a PIP1 claim form by textphone or letter. Letters should be addressed to: Personal Independence Payment New Claims, Post Handling Site B, Wolverhampton, WV99 1AH. You will need to explain why you cannot claim by phone. 2

3 What happens after I claim? After your phonecall, if you meet the basic conditions for PIP, the DWP will post you a copy of their PIP2 How Your Disability Affects You Form. If you do not meet the basic conditions for PIP, the DWP should write to say so. You can challenge their decision by following the process on pages 7-8. Tips for the how your disability affects you form Most of the form is taken up with questions relating to 10 daily living activities (e.g. washing and bathing), and 2 mobility activities (e.g. moving around). Each of the activities has 4-7 descriptors. For example, for the washing and bathing activity, one of the seven descriptors is can wash and bathe unaided. When assessing your claim, the DWP will look at which descriptor for each of the activities best describes you most of the time. Each descriptor comes with 0-12 points. The table below shows how many points you need for each component and rate of PIP: PIP Daily Living Component At least 8 points from the daily living questions to get the standard rate At least 12 points from the daily living questions to get the enhanced rate PIP Mobility Component At least 8 points from the mobility questions to get the standard rate At least 12 points from the mobility questions to get the enhanced rate A full list of the descriptors, and the points, are included on pages 12-15. Refer to these pages when you are filling out the form. You can also show them to GPs and other professionals if you need to ask for additional medical evidence to support your claim or to challenge a decision. 3

4 The following tips should also be of help when filling out the form: - If you cannot do a particular activity, or part of an activity, explain why - If you can only do a particular activity with prompting or assistance from someone else, say why - If you need supervision when doing an activity to reduce the risk of harm to yourself or others, say so - You only count as being able to do an activity if you can do it safely, repeatedly, to an acceptable standard, and in a reasonable time (i.e. in under twice the time it would take someone without a health condition or disability to do it) - If you experience pain, breathlessness, tiredness, stress or anxiety during or after an activity, say so - Say if you use aids or appliances when doing a particular activity - If you are unsure how far you can walk, or how long it takes you do an activity, measure it- or get someone to measure it for you - Say on the form about any medication you take, and any side effects - If your ability to do an activity varies, explain how. You could keep a diary, or get someone to do this for you. Attach photocopies of your diary to the completed form. When sending your completed form off, remember to: - Attach photocopies of supportive medical evidence, and write your name and National Insurance number on each page. - Get proof of postage. - Keep a photocopy of your completed form for yourself. Your completed form needs to be received by the DWP by the 1 month deadline given in the letter that came with it. You can get a 14 day extension of the deadline, or an even longer extension in exceptional circumstances, if you agree this with the DWP in advance. 4

5 Tips for the face-to-face assessment Most people who claim PIP will have to go for a face-to-face assessment. Currently, these assessments are carried out by a private provider called Atos (www.atoshealthcare.com/pip) on behalf of the DWP. For Tameside residents, the closest assessment centres are in Manchester and Stockport. Before the assessment, you should read through a copy of your completed how you disability affects you form. In general, the tips on page 4 on filling in this form are useful when preparing for your face-to-face assessment too. You can take photocopies of additional medical evidence to give to the Atos healthcare professional if you wish. You should get written confirmation of the time, date and location of your assessment at least 7 days in advance (unless you have agreed to attend a short-notice assessment). If you cannot attend your assessment, let Atos know in advance so it can be re-arranged. If you are refused PIP because you did not attend your assessment, you can challenge this by following the process on pages 6-8. You need to show you had a good reason for not attending your assessment. You can ask to have your assessment at home if you cannot travel to the assessment centre (e.g. if you have home visits from your GP), or if you are more than 90 minutes travelling time by public transport from your nearest assessment centre. You can claim back travel expenses, but if you intend to claim expenses for travelling by taxi, then this needs to be agreed in advance with Atos. You can take someone with you to your assessment. If you intend to audio record your assessment, you must let Atos know in advance, and supply them with a CD or tape recording at the end of the assessment. After your assessment, the Atos healthcare professional may contact your GP or other professionals working with you for more information. They will then produce a report for the DWP. It is the DWP who decide whether you will be awarded PIP, and at what rate. You should request a copy of this Atos report, as it may be helpful if you need to challenge the DWP decision later (see pages 7-8). 5

6 If PIP is awarded PIP is awarded for a set length of time, unless it is extremely unlikely your condition will ever change. The DWP will usually write to you 6 months before the end of your award asking you to renew your claim. Your award letter will tell you when your award is due to end. If there is a change in how your condition affects you, or if there is any other change in your circumstances, you should report this to the DWP by ringing 0845 8503322. It is a good idea to follow up your call with a letter, and keep a copy for your records. If you do not report a change and are paid too much PIP as a result, you may face a fine and possible prosecution for fraud, as well as having to repay the overpayment. 6

7 If you are unhappy with the DWP decision This information relates to challenging DWP benefits decisions made after 28 th October 2013. You can challenge a DWP decision to refuse you PIP, to award you a relatively low rate, or to award it for a relatively short length of time. You may feel that the evidence the DWP used to make its decision was incorrect or incomplete, or that it did not take your evidence fully into account when making its decision. However, when you challenge a DWP decision, be aware that your award may stay the same, increase or decrease. If you want to challenge a DWP decision to award you a relatively low rate of PIP, or to award you it for a relatively short length of time, always seek advice first. There is a clear process you must follow when challenging DWP benefits decisions: 1. Mandatory Reconsideration Once you have a letter from the DWP giving you their decision, you have 1 month from the date on this letter to ask them to look at their decision again. This is called mandatory reconsideration. It is best to ask for a mandatory reconsideration in writing: post your letter to the address given on the DWP letter, keep a photocopy of the letter you send, and get proof of postage. Your letter needs to get to the DWP before the 1 month deadline. You can also ask for a mandatory reconsideration by ringing the phone number given on the decision letter: record the date and time of your call, and the name of the person you spoke to. If you have missed the 1 month deadline for requesting a mandatory reconsideration, you may lose the right to appeal the decision, so get specialist advice as soon as possible (see page 11). You can post the DWP photocopies of any medical evidence that supports your case, such as letters, emails, medical reports and assessments, or a diary of how your condition affects you (see page 4). Remember to keep the originals yourself. 7

8 A DWP decision-maker may contact you to discuss your request for a mandatory reconsideration. 2. Appeal Once the DWP have looked at their decision again, you will get two copies of a mandatory reconsideration notice letter telling you whether or not they have changed their decision. If you still disagree with the decision, you can now appeal directly to an independent tribunal, which has the power to change the DWP s decision. To appeal, you need to use form SSCS1, which is available at http://www.justice.gov.uk/downloads/forms/tribunals/sscs/sscs1.pdf. You need to send the completed form, along with the mandatory reconsideration notice letter, to HM Courts & Tribunals Service. This needs to be received by HM Courts & Tribunals Service within 30 days of the date on the mandatory reconsideration notice letter. A late request can be made in very exceptional circumstances, but seek specialist advice first (see page 11). It is best to get advice before filling out form SSCS1. If you tick the box on the form saying you want to attend your hearing, a specialist adviser may be able to come along with you to the hearing. An adviser may be able to help you prepare for the hearing, even if they cannot come to it with you. After the hearing, you can only appeal the tribunal s decision if it made a procedural error or a mistake in how it interpreted the law. You should always get specialist advice if you are thinking about appealing a tribunal s decision (see page 11). 8

9 PIP and other benefits An award of PIP will not reduce any of your existing benefits. In fact, an award may increase them, or make you eligible for a benefit for the first time (e.g. tax credit, housing benefit, or council tax support). If you or someone you live with is awarded PIP, tell the organisations that pay your benefits. You can use the Turn2Us benefit calculator (www.turn2us.org.uk) to estimate how a PIP award will affect your existing benefits, and to check if it may entitle you to anything else. The Turn2US website lists circumstances where their calculator will not be accurate. If this applies to you, seek advice. If your PIP stops, you should tell the organisations that pay your benefits. Your benefits may be reduced, but if you do not do this, you risk an overpayment of benefit and you could leave yourself open to accusations of benefit fraud. If you, your partner or a dependent child is awarded PIP, your household will be exempt from the Benefit Cap. If you are awarded either rate of the daily living component of PIP, someone who spends at least 35 hours a week caring for you may be able to claim Carers Allowance. However, this could have a negative effect on your benefits. Please use the Turn2Us benefit calculator to work out the best thing to do, or seek advice. If your carer is ill or disabled, they may be able to get PIP themselves, as well as Carers Allowance. If you are awarded 8 or more points for moving around under the mobility activities, you are automatically eligible for the Blue Badge parking scheme (www.tameside.gov.uk/bluebadge). You can get a concessionary public transport pass if you are awarded 8 or more points for either the moving around (mobility) activity or the communicating verbally (daily living) activity. You can get an application form from any Transport For Greater Manchester travelshop, or by writing to them (Travel Concessions, Customer Services, PO Box 429, Manchester, M60 1HX). If you are awarded the enhanced rate mobility component of PIP, you will be eligible for the Motability scheme (www.motability.co.uk) and you will be exempt from road tax. If you are awarded the standard rate mobility component of PIP, you can get a 50% reduction in your road tax. 9

10 What if I am currently getting DLA? From 2013 to 2017, working-age people who are claiming DLA will be told they have to claim PIP instead. To check if and when you will be affected, please go to www.gov.uk/pip-checker. If you were aged 65 or over on 8 th April 2013, and are getting DLA, you will not be told to claim PIP. You do not need to claim PIP until the DWP writes to you to tell you to do so. If the DWP tells you to claim PIP, you should do so within 28 days, as your DLA will eventually stop. Please seek advice if you are thinking about claiming PIP before the DWP tells you that you have to (see page 11). If you are on DLA and are told to claim PIP, please remember that you will not automatically get PIP, and that the amount of money you get may change. If you live in certain postcode areas and you are getting DLA, you will be told to claim PIP if you report a change in how your disability or health condition affects you, if your fixed-term award of DLA is coming to an end, if you are turning 16, or if you choose to claim PIP. Please go to www.gov.uk/pip-checker to find out if this applies to you. Most working-age people who are claiming DLA will not be told to claim PIP until October 2015 at the earliest. 10

11 Further information Advice Tameside www.advicetameside.org.uk/ Tameside MBC Welfare Rights www.tameside.gov.uk/benefits/welfarerights Turn2Us www.turn2us.org.uk PIP Checker www.gov.uk/pip-checker Citizens Advice Bureaux AdviceGuide www.adviceguide.org.uk/england Local advice Tameside Citizens Advice Bureau offers information and advice on a whole range of issues at their drop-in (09:30-12:30 every weekday) at Ashton Customer Services (Tameside MBC, Council Offices, Clarence Arcade Stamford Street, Ashton-Under-Lyne, OL6 7PT). Tameside MBC Welfare Rights Service offers telephone advice on benefits on 0800 0749985 (09:30-12:30, Mondays, Wednesdays and Thursdays). This is a specialist service, which can help you challenge benefit decisions, and provide assistance with tribunal hearings. If you are a New Charter tenant, you can get advice and help with your benefits by ringing New Charter on 0161 3312456. 11

12 These pages list the activities, descriptors and points (see page 3) that the DWP will use to assess your claim for PIP. Explanations of what some of these words and phrases mean can be found at www.benefitsandwork.co.uk/personal-independencepayment-pip/glossary Daily Living Activities 1. Preparing food 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 2 meal. c. Cannot cook a simple meal using a conventional cooker but is able to do so 2 using a microwave. d. Needs prompting to be able to either prepare or cook a simple meal. 2 e. Needs supervision or assistance to either prepare or cook a simple meal. 4 f. Cannot prepare and cook food. 8 2. Taking nutrition a. Can take nutrition unaided 0 b. Needs 2 (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 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 10 so 3. Managing therapy or monitoring a 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 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. c. Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week. 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. 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. f. Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week. 0 1 2 4 6 8 12

13 4. Washing and bathing a. Can wash and bathe unaided. 0 b. Needs to use an aid or appliance to be able to wash or bathe. 2 c. Needs supervision or prompting to be able to wash or bathe. 2 d. Needs assistance to be able to wash either their hair or body below the waist. 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 4 waist. g. Cannot wash and bathe at all and needs another person to wash their entire 8 body. 5. Managing toilet needs or incontinence 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 2 incontinence. c. Needs supervision or prompting to be able to manage toilet needs. 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 6 bowel. f. Needs assistance to be able to manage incontinence of both bladder and 8 bowel. 6. Dressing and undressing a. Can dress and undress unaided. 0 b. Needs to use an aid or appliance to be able to dress or undress. 2 c. Needs either - 2 (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. 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 7. Communicating verbally a. Can express and understand verbal information unaided. 0 b. Needs to use an aid or appliance to be able to speak or hear. 2 c. Needs communication support to be able to express or understand complex 4 verbal information. d. Needs communication support to be able to express or understand basic 8 verbal information. e. Cannot express or understand verbal information at all even with 12 communication support. 13

14 8. Reading and understanding signs, symbols and words a. Can read and understand basic and complex written information either 0 unaided or using spectacles or contact lenses. b. Needs to use an aid or appliance, other than spectacles or contact lenses, to 2 be able to read or understand either basic or complex written information. c. Needs prompting to be able to read or understand complex written 2 information. d. Needs prompting to be able to read or understand basic written information. 4 e. Cannot read or understand signs, symbols or words at all. 8 9. Engaging with other people face to face a. Can engage with other people unaided. 0 b. Needs prompting to be able to engage with other people. 2 c. Needs social support to be able to engage with other people. 4 d. Cannot engage with other people due to such engagement causing either 8 (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. 10. Making budgeting decisions a. Can manage complex budgeting decisions unaided. 0 b. Needs prompting or assistance to be able to make complex budgeting 2 decisions. c. Needs prompting or assistance to be able to make simple budgeting 4 decisions. d. Cannot make any budgeting decisions at all. 6 14

15 Mobility Activities 1. Planning and following journeys 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 4 psychological distress to the claimant. c. Cannot plan the route of a journey. 8 d. Cannot follow the route of an unfamiliar journey without another person, 10 assistance dog or orientation aid. e. Cannot undertake any journey because it would cause overwhelming 10 psychological distress to the claimant. f. Cannot follow the route of a familiar journey without another person, an 12 assistance dog or an orientation aid. 2. Moving around 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, 4 either aided or unaided c. Can stand and then move unaided more than 20 metres but no more than 50 8 metres. d. Can stand and then move using an aid or appliance more than 20 metres but 10 no more than 50 metres. e. Can stand and then move more than 1 metre but no more than 20 metres, 12 either aided or unaided. f. Cannot, either aided or unaided, 12 (i) stand; or (ii) move more than 1 metre. 15