An introduction to Personal Independence Payment

2Department for Work & Pensions

• Personal Independence Payment (PIP) is a new disability benefit

• Personal Independence Payment has replaced Disability Living Allowance (DLA) for new claims from adults aged 16-64

• DLA remains for children up to age 16; and DLA recipients aged 65 or over on 8 April 2013 (day that PIP was introduced)

• PIP helps towards some of extra costs arising from health condition or disability

• PIP based on how person’s condition affects them, not condition itself

• Same way as DLA, claimants can get PIP whether in or out of work

• Not means tested or taxed

Introduction to PIP

PIP Toolkit - Quick Guide


Similarities Differences

• Extra-costs cash benefit

• Not means-tested or taxable

• Two components

• Payable both in and out of work

• Maintains links to passported benefits where possible

• Special rules for terminally ill people

• three month qualifying period and nine month prospective test

• New assessment criteria

• Individual assessment and face-to-face consultation

• Planned interventions

• Reconsiderations process

Similarities and differences between DLA and PIP

PIP Toolkit – Differences and Similarities


Components and Eligibility• PIP will be made up of two components –

daily living and mobility• Each can be paid at standard rate, or

enhanced rate for those with the greatest needs

• The PIP assessment criteria will consider the

individuals’ ability to carry out a range of everyday activities

• 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 them

• The total scores for each component determine whether a component is payable, and if so, whether at the standard or enhanced rate

Enhanced

Standard

Enhanced

Standard

Daily Living Mobility

8 points

12 points

Not Entitled Not Entitled

PIP Toolkit – Conditions of Entitlement


Assessment Criteria

PIP Toolkit – Assessment Criteria

Daily living component (activities 1-10) Mobility component (activities 11-12)

Standard rate = 8 pointsEnhanced rate = 12 points

Standard rate = 8 pointsEnhanced rate = 12 points

Activity Possible points

Activity Possible points

1. Preparing food 0-8 11. Planning and following journeys 0-12

2. Taking nutrition 0-10 12. Moving around 0-12

3. Managing therapy or monitoring a health condition

0-8

4. Washing and bathing 0-8

5. Managing toilet needs or incontinence

0-8

6. Dressing and undressing 0-8

7. Communicating verbally 0-12

8. Reading and understanding signs, symbols and words

0-8

9. Engaging with other people face-to-face

0-8

10. Making budgeting decisions 0-6


The new assessment

• The PIP assessment will involve health professionals who consider the evidence provided by the claimant, along with any further evidence they think is needed

• The health professionals will be employed by independent providers

• People will be assessed as individuals, and the focus is on the impact their condition has on their daily lives and over a range of different activities

PIP Toolkit – Assessment Process and Providers


The new assessment

• Most people will be asked to a face-to-face consultation with a health professional as part of the assessment process - claimants will be encouraged to take somebody with them to the consultation

• Home visits will be available when necessary

• Face-to-face consultations may not be necessary for everyone – for example, those who are terminally ill may not have to have them

• The assessment provider will send a report back to the DWP Decision Maker to make a decision



PIP Assessment Providers

Atos Healthcare is Assessment Provider in Scotland, North East and North West England and in London and Southern England



Timetable for PIP replacing DLAFrom 28 October, natural reassessment started in Wales,

West Midlands, East Midlands and East Anglia for• those with fixed period DLA awards coming up for

renewal• children who turn 16 years old on or after 7 October

2013 (unless they have been awarded DLA under the Special Rules for terminal illness)

• those where there is a report of a change in the DLA claimant’s health condition or disability

• existing DLA claimants aged 16-64 who wish to make a PIP claim.

• 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.

October2013

PIP Toolkit – Reassessing existing DLA claimants

PIP Toolkit – Postcode Map

January 2014


Timetable for PIP replacing DLA

• From October 2015

– DWP begin to invite remaining DLA claimants to claim PIP who were aged between 16 and 64 on the day that PIP was introduced (8 April 2013

PIP Toolkit – Reassessing existing DLA claimants

PIP Toolkit – PIP checker

• Once selected for reassessment, claimants will be asked to claim PIP

– If they do, then their DLA award will normally continue until a decision on the PIP claim is made

– If they don’t claim PIP then their DLA claim will end

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.

October2015


ReassessmentPostcodeMap

PIP Toolkit – Postcode Map


Making a claimClaimants (or those supporting them) phone DWP to make a claim to PIP. Paper claims won’t normally be used, and online claims will not be available before 2014.

DWP will send claimants a form where they can explain how their disability affects them.2

AssessmentClaim details, form and supporting evidence are passed to the health professional.

Most people will be asked to attend a face to face consultation The health professional reviews the claim against a set of clear descriptors to assess the challenges faced by the individual.

4

Thinking about claimingInformation about PIP will be available from a range of sources, including online, via leaflets and through support organisations.

Existing DLA claimants will be contacted individually to ask if they want to claim PIP.

1

DecisionA DWP Decision Maker will use all the information in the claim form, from the health professional and anything else that has been provided. They will make a reasoned decision on entitlement, including the level and length of award.

5

The claimant journey There are five key stages to claiming

How your disability affects youClaimant completes the ‘How your disability affects you’ form to explain how their condition affects their daily life, both on good and bad days and over a range of activities.

Supporting evidence can be sent with this form, which they return to DWP by post.

3

PIP Toolkit – Claimant Journey


PIP claim call: basic info needed

Claimant’s personal and contact details

Residency and presence details

Relevant periods spent in hospital or residential care

Payment (bank account) details

PIP Toolkit – How to claim


PIP new claim process

• New claims line: 0800 917 2222 (textphone: 0800 917 7777)

• PIP enquiries: 0845 850 3322 (textphone: 0845 601 6677).

• Claimants sent ‘How your disability affects you’ form – return with supporting evidence already held

PIP Toolkit – How to claim


‘How your disability affectsyou’ form

Explains how condition affects claimants in own words

Include affect on ‘good and bad’ days

PIP Toolkit – Completing the form


‘How your disability affectsyou’ form

Family member or support organisation can help

Additional evidence already available to help support the claim returned included

PIP Toolkit – Completing the form


How eligibility is assessed

• Assessment considers effect of health condition or disability on daily life

• Information considered by Assessment Provider

• They may request further evidence from a relevant health professional or someone who supports claimant

PIP Toolkit – Assessment process and providers


How eligibility is assessed

Assessment Provider may arrange face-to-face consultation with claimant who:

– can ask questions about the consultation or rearrange appointment

– explains how condition affects them on a day to day basis

– is able to provide additional evidence

PIP Toolkit – Assessment process and providers


PIP decision

• DWP calls claimant to explain for decisions not to award PIP

• DWP tell claimants how and when to report change in circumstances

PIP Toolkit – Decision and Payment


Award reviews

• The length of award for PIP will be based upon each claimant’s individual circumstances

• DWP regularly reviews awards

• When awards ends, claimant can make new claim

• DWP contact claimants with longer awards occasionally to see if needs have changed

PIP Toolkit – Decisions and Payment


Special rules for terminal illness• Claims for those who are found to meet the special rules for

terminal illness criteria – will be dealt with more quickly than normal claims– are guaranteed an award of the enhanced rate of the daily

living component of PIP without having to wait until they satisfy the qualifying period or prospective test

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

• The claimant will not be sent the form ‘How your disability affects you’– they will be asked some extra questions whilst they are on

the phone about their condition and how it affects their ability to get around

PIP Toolkit – Special rules


Special rules for terminal illness

Special rules claims line: 0800 917 2222 (text phone 0800 917 7777)

DS1500 report needed to support claim

Both the Daily Living and, providing conditions met, the Mobility component paid straight away

Don’t have to complete the ‘How your disability affects you’ form

Don’t need a face-to-face consultation

PIP Toolkit – Special rules


Rising 16s• Children can continue to claim DLA until they are 16

• These changes do not affect children in receipt of Disability Living Allowance

• They'll continue to receive it until they reach 16 when they become eligible for Personal Independence Payment.

• DWP will write to children who turn 16 years old on or after 7 October 2013 (unless they have been awarded DLA under the Special Rules for terminal illness), to invite them to claim PIP

• Existing DLA SRTI claimants, including young people reaching 16, will only be invited to claim PIP when their DLA award expires.

• There are no plans to extend PIP to new or existing claims for children


Passporting to other benefits and services

• Many DLA claimants are receiving other benefits, such as ESA

– Most DLA claimants receiving Incapacity Benefit will have already been reassessed for Employment and Support Allowance by the time they need to make a claim to PIP

– Households where someone is in receipt of DLA/PIP are exempt from the new Benefit Cap

PIP Toolkit – Access to other benefits and services


Passporting to other benefits and services

• Most existing passporting arrangements have been maintained for PIP

– receipt of the Daily Living component (either rate) means that their carer may be entitled to Carer’s Allowance

– Motability scheme will work with PIP in the same way as it does with DLA

• Changes in entitlement may affect other benefits or support that the claimant or carer receives



Motability, Blue Badge, Concessionary travel and Vehicle Excise Duty• If a claimant gets the enhanced rate of the mobility part of

Personal Independence Payment, they may be able to use all or part of their allowance to lease a car, scooter or powered wheelchair from the Motability scheme

• If a claimant gets the mobility part of Personal Independence Payment they might be able to claim for a Blue Badge

• They may also be able to claim a pass to travel for free on public transport

• If the claimant gets the enhanced rate of the mobility part of Personal Independence Payment they won’t have to pay car tax

• If the claimant gets the standard rate of the mobility part of Personal Independence Payment they will only have to pay half the price of a car tax disc



Claimants in care homes

• PIP Daily Living component will stop being paid after total 28 days in a care home

• Mobility component payment not affected when claimant is in care home

Claimants in hospitals

• Both components of PIP will stop 28 days after claimant admitted to NHS hospitals


Awards• If someone is awarded PIP we will tell them how long the award

is for

• We will write to them to tell them how and when they need to tell us about any change in circumstances

• Claimants will have their award regularly reviewed

• 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

• If someone is given a longer award we will contact them occasionally to see if their needs have changed over time

PIP Toolkit – Disputes


Disputes

• The change to the appeals process for DWP consists of the following key elements

– mandatory reconsideration of decisions prior to appeal– direct lodgement of appeals with HMCTS– time limits for DWP to return appeal responses to HMCTS.

• DWP will introduce mandatory reconsideration and direct lodgement for PIP from April 2013

PIP Toolkit – Disputes


Where to find more information• Information for support organisations and advisers is online at

www.gov.uk/pip/toolkit. The site includes a quick guide to PIP for advisers, an overview of the claimant journey and frequently asked questions

• We’ll also include the latest news in the monthly Touchbase bulletin – sign up at the DWP website

• Information aimed at claimants is available on www.gov.uk. Please signpost to these pages from your own sites or materials

• Updated leaflets are also available – generic information in existing leaflets, and PIP specific leaflet

• Talk to your local DWP Partner Manager


PIP Toolkit list of contents

Core Products Fact sheets• Introduction to PIP Toolkit

• Quick Guides

• PIP Timeline

• Claimant Journey

• External PIP white brand presentation and speaker notes

• Sample forms and notifications

• Leaflets

• PIP Communications Products and Timeline

• Sample Assessment Provider notifications

• Conditions of Entitlement • Assessment Criteria • The difference between PIP and DLA • Reassessing existing DLA claimants for PIP (from

Oct 2013)• How to Claim PIP• Completing the How your disability affects you

form • Assessment Process • Decision and Payment • Reviewing Awards • Special Rules for Terminally Ill People • Young People approaching age 16• People approaching age 65 and over • Passporting to other benefits • Vulnerable Claimants (includes signposting) • Disputes Process • Changes of Circumstances

An introduction to Personal Independence Payment

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