Personal Independence Payment

To start a new claim for Personal Independence Payment yourself you can telephone The PIP Line on: 0800 917 2222 the lines are open between 8am and 6pm, Monday to Friday.

Personal Independence Payment (PIP) update for Re-assessment for those currently on Disability Living Allowance (DLA)

From 28 October 2013, Department for Work and Pensions started inviting individuals living in Wales, West Midlands, East Midlands and East Anglia to claim PIP and from 13 January 2014, they extended the areas to postcodes beginning DG (Dumfries and Galloway), EH (Edinburgh), TD (Galashiels) and ML (Motherwell).

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

So claimants who present the following will be invited.

  • The DWP receive information about a change in care or mobility needs on or after 28 October 2013
  • Receive information about a change in care or mobility needs on or after 28 October 2013;
  • Their fixed term award is due to expire on or after 17 March 2014;
  • Children turn 16 years old on or after 7 October 2013 (unless they have been awarded DLA under the Special Rules for terminally ill people); or
  • Claimant wants to claim PIP instead of their DLA.

You can check your area by looking on PIP Assessment map by clicking  here

Source DWP

For tips on how to complete PIP forms click here

Personal Independence Payment which we will use PIP throughout the rest of this article, is the new allowance that the government have introduced through the Welfare Reform Bill and after the biggest consultation that the DWP have carried out.

By 2017 everyone of working age who is disabled and entitled to claim disability benefits will be on it and by 2017 Disability Living Allowance will only be available to children under the age of 16 and also people over 65 who where already in receipt of DLA when PIP is introduced.

Click here for Audio description of PIP

British Sign language for those who would like to use instead of reading the text here

How Personal Independence Payment came into force.

All new claims for disability benefit from April 8th 2013 in the following area postcodes where told that they have to claim PIP and not DLA, anyone wishing to claim a disability allowance up to this date could do so, this would have continued to be DLA until 6pm Friday 5th April on the phone (as DWP don’t work weekends) however you can still download the form from the Gov website until midnight 7th April 2013. – This only applied for those who are within the postcodes listed.

So if you lived in the listed postcodes below then you would have been the first to claim PIP:

Postcodes: BL, CA, CH (except CH1, CH4, CH5, CH6, CH7 and CH8), CW, DH, DL (except DL6, DL7, DL8, DL9, DL10 and DL11), FY, L, LA (except LA2 7, LA2 8, LA6 2 and LA6 3), M, NE, PR, SR, TS (except TS9), WA and WN please remember if your postcode is not on this list then PIP will not be available in your area until June 2013.please remember if your postcode is not on this list then PIP will not be available in your area until June 2013.

Between 8th April 2013 and midnight 9th June 2013 the rest of the county would have continued to be able to claim DLA however as the 9th is a Sunday the last time a new claim for DLA can be booked over the phone would be 17.59 (5.59pm) Friday 7th June 2013 and over the weekend online until the 10th June 2013 when PIP will then be available for the rest of Great Britain.

7th October 2013 will see anyone who has a change in health condition or a DLA award coming to an end be reassessed and invited to claim PIP, we must stress that if you would like to continue to get disability allowances then PIP is a mandatory allowance and you will not have an option to stay on DLA after this date.

Spring 2015 everyone who is on DLA will be reassessed and invited to claim PIP and again this will be mandatory if you wish to continue to claim disability allowances.

The DWP expect by summer 2017 every one of working age who is entitled to PIP will be on it and that no one of working age will be on DLA.

Why Disability Living Allowance is being replaced.

Disability Living Allowance known as DLA was first introduced in 1992 for all people with disabilities of working age and it was a 2 booklet application and very complicated to complete.

DLA, to begin with, was self-assessment by completing the form – the DWP would assess the information that the claimant had provided and then paid out on the rates awarded.

The length of the awards varied and some claimants getting what they thought was awards for life; however this was not made clear for some time and a lot of people thought the award was for the period of their own lifetime and in actual fact it meant the lifetime of the disability or illness.

So many people where on DLA for many years and where not reviewed or assed for their disability or illness.

The DWP says that around 70% of DLA claims have not actually been assessed by a medical professional for their claim.

Many governments had tried and failed to implement change to the welfare bill or stayed away from doing anything until the present coalition government came into power and the welfare reform bill 2011 was introduced sparking the biggest shake-up in British politics since welfare started and disability benefits have been affected by this – with Employment Support Allowance (albeit this was already in force by this time but the government signed a contract with Atos Healthcare to provide the Work Capability Assessments on behalf of Department for Work and Pensions DWP) – this has been met with anger from various disability rights groups and even MPs on both sides of the house have condemned the assessments, recently we had the Harrington enquiry and this shown many flaws in the WCA questionnaires and process it was only recently that the DWP issued a new WCA questionnaire.

So along with the welfare reform we have seen the new household benefit caps which currently stand at:

£350 per week for single people

£500 per week for couple or lone parents with children that are dependent on them.

The bedroom tax rules that will affect housing benefit, which is paid to less well-off tenants to help with rent. Typically claimants receive between £50 and £100 a week.

But from April 2013 families deemed to have too much living space by their local authorities will receive a reduced payment. Under the government’s so-called “size criteria”, families will be assessed for the number of bedrooms they actually need.

Only those of working age will see reduced payments. If tenants are deemed to have one spare room, the amount of rent eligible for housing benefit will be cut by 14%. If they have two or more spare rooms, the cut will be 25%.

The government says that will mean an average loss of about £14 a week for council tenants. Those who rent from housing associations are facing an average loss of about £16 a week.

Disabled tenants will be allowed a bedroom for over-night full-time carers that are from a care provider. The number of bedrooms in the property will be determined by the landlord’s tenancy agreement, so you cannot claim a bedroom is actually a living room.

We also have Universal Credit that is due to be implemented in October 2013 which is a new single payment for people who are looking for work or on a low income.

Universal Credit will help claimants and their families to become more independent and will simplify the benefits system by bringing together a range of working-age benefits into a single streamlined payment.

  • income-based Jobseeker’s Allowance
  • income-related Employment and Support Allowance
  • Income Support
  • Child Tax Credits
  • Working Tax Credits
  • Housing Benefit.

And then we have Personal Independence Payment known as PIP is the all new allowance that will be replacing Disability Living Allowance known as DLA for working age people who have a disability.

So what is PIP?

PIP is to help towards some of the extra costs arising from ill-health or disability. It is based on how a person’s condition affects them, not the condition they have, the award will be limited for instance 5 years and then you will have to make a new claim, in some circumstances it may be extended to 10 years but this is in very exceptional circumstances, however awards will be reviewed to ensure that the claimant is receiving the right support. (There will be no life or indefinite period awards for PIP) Reviews will be at appropriate intervals depending on how likely it is for the claimant’s condition or impairment to change.

PIP is for people aged 16 to 64 – DLA will remain for children up to the age of 16. Once PIP has been introduced, the Department of Work and Pensions (DWP) will contact them as they approach 16 to explain what will happen

DLA will remain available to those 65 or over on 8 April 2013 (the day that PIP is introduced) In the same way as DLA, claimants can receive PIP whether they are in or out of work. The benefit is not means tested or taxed.

The Claimants Journey

How the claimant will be able to claim PIP will start with a phone call to DWP who will first take certain information from the claimant over the telephone or their representatives providing the claimant is with them in the same room.

To start a new claim for PIP the claimant should telephone DWP on: 0800 917 2222 This number will be available from 8 April 2013 and the lines will be open between 8am and 6pm, Monday to Friday.

The information will be personal details, contact details, bank details, any periods abroad, if they are in care and if they claimant is claiming under the special rules.

We have detailed more information below regarding the questions.

They will be asked how long they have had the disability and how long they expect to have it, the time scale is had it for longer than 3 months and to have it for longer than 9 months. – This is called the “required period condition” the reason for this is to establish that the claimant shows continuing needs for a specified period.

Claimant will be asked if they have been resident in Great Britain for the last 2 years out of the past 3 years and not subject to any immigration controls, the maximum period of absence UK is 13 weeks or 26 weeks if the claimant is receiving medical treatment abroad, this is part of the condition is called “Residence and Presence”

Care and Custody

Where a claimant is in care or in custody the conditions for PIP are as follows:

Both components of PIP cease to be payable 28 days after the recipient has been admitted to an NHS hospital however those who are privately funding their treatment are unaffected by these rules and can continue to be paid either component of PIP. Please be aware that 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.

Similar to hospital stays; apart from PIP Daily Living component ceases to be payable after 28 days of care home residency where the costs of the accommodation are met from public funds. i.e. paid for by local authority, However PIP mobility component can continue to be paid. As with private hospital treatment those claimants who are fully self-funding their stay in care are unaffected by these rules. Again please be aware that if a claimant is in a care home at the date of entitlement, PIP Daily Living component is not payable until they leave.

PIP is NOT payable after 28 days (and is suspended) where someone is being detained in legal custody, whether the offence is civil or criminal and whether they have been convicted or are on remand. Please note that suspended payments of benefit are not refunded regardless of the outcome of proceedings against the individual.

Claimants who are claiming under the special rules and are deemed as terminally ill (having a progressive condition where they are not expected to live for more than 6 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 also be exempt from face-to-face consultation.

PIP will include an assessment of the individuals needs by a health professional. Most people will have a face to face consultation as part of their claim.

So here is the process of claiming PIP

Thinking about claiming

Information about PIP will be available from a range of sources, including online, via leaflets and through support organisations. This will explain the eligibility criteria and help the claimant decide if they want to claim PIP. – You must have had the condition for more than 3 months before claiming PIP and to have it more than period of 9 months. – The phone call will in essence establish if the claimant will be entitled to claim PIP and the qualify under the rules (see above)

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

Draft Letter – PIP and Uprating

Making a claim

So you want to make a claim for PIP… you will (or your representative will) make the call to the claim line which will be an 0800 number which will be free from most mobiles and landline (check with provider) as already explained the first call will establish whether the claimant can claim PIP and if they do not qualify they will get an letter explaining this (you cannot appeal this first decision however you can re-apply, if the claimant has mental health issues and gets anxious over the phone and starts to talk about stuff that is not relevant to their claim this can be seen as good enough reason to re-apply) if your eligible to claim PIP you will be sent a unique form which will be relevant to you the claimer only have a barcode on the form.

During the phone call the DWP will establish any communications needs, this can be done with your support worker / representative explaining to the DWP why you’re not able to use the phone; “for instance Deafness, speech problems”.

The date of the claim will start at the point of the phone call, similar to DLA / AA when you call them for a claim pack the claim starts that day if you’re successful.

Existing DLA claimants will be asked from October 2013 to March 2016 will be contacted and asked if they would like to claim PIP by DWP. However if the claimant reports a change in condition or their DLA is due to end / review then the DWP will inform them of PIP – remember if your over 65 at the time when PIP is introduced then you will NOT affected. Also children will not be affected until they reach 16 years of age.

You can self-refer for PIP at any time from October 2013 whether you’re on DLA or not.

The Form otherwise known as “telling your story”

You will have 30 days to return the form to DWP if you do not return it within this period you may have to start from the beginning, the DWP will not be moved on this time period and will only accept late forms with a good and reasonable reason and will not accept for instance you couldn’t get an advisor or organisation to get it done in time, if you want help it’s important that you get this from the start and you have organisations or individual help that are able to offer you the time (try and pre-book an appointment with an organisation like Disability Online as soon as you have done the phone call to DWP this will save time and enable you to get the form off in time); you can also get a DWP visiting officer to call you and arrange an home visit to help you complete the form if you wish.

The forms are less confusing and not as big as the DLA forms and the DWP say that the forms lead better towards claimants with mental health issues which is great as mental health is always left behind and not represented well on forms like ESA and DLA.

You will complete the forms or your support worker / representative will do this with you and return to PIP / DWP within the timeframe given to you… We as an organisation do have an issue with this – if you are a claimer who has mental health issues and doesn’t open mail due to fear or have the “brown letter syndrome”, how will this be accommodated?

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

If you fail to return your form in time you will NOT be able to appeal.

The forms will ask you for information on the following questions:

Daily Living Activities:

  1. Preparing Food
  2. Taking Nutrition
  3. Managing therapy or monitoring a health condition
  4. Washing and bathing
  5. Managing toilet needs or incontinence
  6. Dressing and Undressing
  7. Communicating Verbally
  8. Reading and understanding signs, symbols and words
  9. Engaging with other people face to face

10. Making budgeting decisions

Mobility Activities

  1. Planning and following journeys
  2. Moving around

You need to answer the questions that are relevant to you condition, a bit like the DLA form and there is a box under each section where you can write extra information.

We have listed some of the questions regarding activities below.

PIP Activities

You need to score between 8 and 12 for each daily living and mobility activities to be able to qualify for the allowance “anything below 8 is not accepted and you will not get the allowance and you can appeal and unlike DLA where you can get low, middle or high for Care component and low or high for the mobility component, with PIP you get will only be entitled to standard or enhanced for either daily living or mobility or both

Qualifying Rates

Daily Living

Mobility

Enhanced Rate 12 points +

Enhanced Rate 12 points +

Standard Rate 8 points +

Standard Rate 8 points +

No Rate 7 points -

No Rate 7 points -

 

Payment rates

Daily living component

Mobility component

Enhanced £79.15 per week

Enhanced £55.25 per week

Standard £53.00 per week

Standard £21.00 per week

Once your form as been received at PIP / DWP then this is sent to the health professionals which are Atos Healthcare or Capita Business Services Ltd depending on your area click here to see who your provider is.

80% of claimants will be required to undergo a face to face assessment with the health care professional at one of the many centres or have an home visit; this will again depend on the health care provider, the other 20% will not have to undergo this assessment – these will be terminally ill claimants and those who are claiming under special rules.

Depending where you are you will be sent a letter or receive a call to go for your assessment, it is said that the DWP are in favour of phoning claimants because this has a better result than sending out letter, however if they cannot contact you by phone then a letter will be sent.

Special Rules

If you’re claiming under the special rules this will not apply after the first phone call, you will be told to get DS1500 as you already do with DLA and send this to DWP – Claimants are encouraged to get a DS1500 medical report from their doctor to support the claim.

The DS1500 is a report about their medical condition, not their prognosis, and the claimant can obtain one from their doctor’s receptionist, nurse, Macmillan nurse or social worker. The claimant will not have to pay for a DS1500.

The DS1500 report can be sent to DWP either by the doctor or by the person requesting it but it is important that it is sent in quickly to support the PIP claim PIP offices that will be dealing with your claim.

Assessment

Unlike the ESA assessment this will not take place on DWP grounds and could be with another organisation or partner or even at your local NHS hospital however the assessment will be carried out by Atos or Capita.

The claimant can contact the health care assessor beforehand to ask questions about the assessment or to rearrange appointments – it is important to say that if you rearrange the appointment this will delay your claim.

The big difference with this assessment is that the claimant will be in control and see the report made by the assessor before it is sent to DWP and also the claimant can ask for information to be edited before it sent; however this does not mean you can remove factual evidence that the DWP would need to make their decision.

They are also saying that the assessment will be more personal and on more casual feel, gone is the barrier of the desks and counters, the assessor will sit next to you and talk to you about your claim and how you’re affected.

Claimants are encouraged to take a 3rd party member with them – this could be a support worker, representative, family member or friend to the assessment and the information that the 3rd party gives will be treated like it would be if the claimant gives it themselves.

Remember PIP is about what you can do and not want you can’t do or don’t want to do by choice.

After the assessment the health care professional will compile their report and reviews all the evidence against a set of everyday activities and the “descriptors” set out within the welfare bill to assess the challenges that the claimant faces and once this is done then they send everything back to DWP PIP office for the case manager who is dealing with the claim.

Existing claimants do not need to take any action now – If an existing DLA recipient makes a claim for PIP then their DLA would normally continue until a decision on their PIP claim is made. If PIP is not awarded or not claimed then DLA will stop and this will include there mobility if you have a car on mobility scheme.

The Decision

So now that the claimant has been assessed and all the evidence has been provided to the DWP office; all this is looked at by a “case manager” the case manager is new name for “decision maker” he or she will look at the form you completed, the assessment that you had and the information from the health care professional and any evidence that has been gathered.

The case manager dealing with the claim will call the claimant at least 3 times at different times of the day on different days; if they cannot get a hold of them on the first attempt to explain the award and why the rate of the award or non-award has been made, then the claimant will receive this in writing.

The decision will be one of three:

Decision one

An award of Personal Independence Payment has been made and you will be told the rate of the award for each activity so the award could be for instance:

Claimant has been awarded the following by using the information provided by the claimant in their form and other information from the assessment and evidence gathered – Enhanced rate for daily living and Standard rate for mobility.

You will also be told the length of the award which could be a minimum of 9 months and a maximum of 10 years, the longer of the length of the award does not mean that you will not be reviewed again during the period of your award. The DWP will have regular reviews throughout the award period and there is no indefinite/life period of an award.

If you’re on mobility and have a car under the mobility scheme then they will contact you with regards to your car, you need to be in receipt of the “enhanced” mobility to get a car or to keep an existing car you may have on scheme.

Mobility Scheme link here.

Decision two

No award of Personal Independence Payment has been made, the decision has been made by using the information provided by the claimant in their form and other information from the assessment and evidence gathered and used this against the descriptors set out and the claimant does not meet the required descriptors and therefore didn’t score the required points needed for PIP.

The claimant can ask then and there over the phone for a reconsideration and another case manager will look at the information and make a decision, or they can write to the DWP if they have received the decision in the post.

Decision three

This would be later-on if the claimant has already got PIP and is re-applying for it again and the decision has been down-rated from what the claimant was previously on.

The claimant or representatives can ask the case manager over the phone for a reconsideration and another case manager will look at the information and make a decision, or they can write to the DWP if they have received the decision in the post.

Reconsideration and Appealing

If the claimant has been refused PIP or down-rated from a previous claim and would like to appeal this, then they should be aware that it will be mandatory to ask for a reconsideration first, the claimant will not be able to go direct to appeal.

If after the reconsideration has been carried out and the outcome has not changed then the claimant or their representatives has to appeal direct to HM Courts & Tribunals Service and not to DWP.

It will be up to the claimant with the support of a representative to appeal the decision and do the necessary paperwork and gather further evidence – see our appeals page.

Carers Allowance

The claimants who are currently on middle or higher rate DLA and have a carer who is in receipt of carers allowance will still be able to have this providing they receive enhanced rate or standard rate for daily living on PIP.

Passporting to other benefits

As with all other benefits PIP has a passport element to so you will be able to claim other benefits. However this is subject to change when Universal Credit comes into force in October 2013.

The DWP has listed a full list of allowances that you may be able to claim, see below

Passporting Benefits from PIP

If you require more information about PIP on how it will affect you then please visit the DWP website here or to see how we will be able to help you from April 2013 then please contact us by going to our contact pages here or see our news page on PIP here

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