Review of existing PIP claims
The Department for Work and Pensions has changed its PIP assessment process in two areas: ‘safety and supervision when carrying out activities’ and ‘overwhelming psychological distress and journeys’. They are reviewing all current PIP claims to see if they should have awarded more money. They are also looking again at claims where they didn’t award PIP. This may mean some people will get more money, or be awarded PIP when they were previously rejected. To find out more and to see if your PIP case will be reviewed, visit the following pages at gov.uk:Overwhelming psychological distress and journeys: changes to PIP law from 28 November 2016
What is Personal Independence Payment (PIP) and how can I apply for it?
Personal Independence Payment (PIP) is a benefit which helps with some of the extra costs caused by long-term ill-health or disability. You must be between 16 and 64 to claim PIP. You can receive it whether you are in work or not. PIP is not means-tested and is tax-free.
The Department for Work and Pensions (DWP) has a series of videos explaining who PIP is for and how the claim process works.
What will I get?
You could get between £22 and £141.10 a week. How much you get is based on how your condition affects your ability to complete certain tasks, not on a particular condition.
PIP is made up of 2 components (parts). You can be paid either the daily living component, or the mobility component, or both components at the same time. Whether you get one component or both depends on how your condition affects you. Each component is paid at a standard or enhanced rate depending on whether your abilities are limited or severely limited.
Rates of PIP
Daily living component weekly rate
Mobility component weekly rate
These amounts were correct in November 2017.
You will need an assessment to work out the level of help you get. You score points according to how difficult it is for you to carry out a list of activities. You need to score at least 8 points to be entitled to the standard rate and at least 12 points to be entitled to the enhanced rate. This is the same for each component.
Can I get PIP?
To qualify for PIP you must be aged 16 to 64. You must have a long-term health condition or disability, and have difficulty with activities of daily living or with mobility. You must have had these difficulties for at least 3 months and expect them to last for at least 9 months.
Daily living difficulties
You may get the daily living component of PIP if you need help with things like:
- Preparing or eating food
- Washing, bathing and using the toilet
- Dressing and undressing
- Reading and communicating
- Managing your medicines or treatments
- Making decisions about money
- Engaging with other people
You may get the mobility component of PIP if you need help with going out or moving around.
The ‘50 per cent rule’
With a variable condition like epilepsy, you must need help at least 50% (half) of the time to qualify for PIP. This will be considered over a 12-month period, looking back 3 months and forward 9 months.
You can find more information about eligibility for PIP on the government website.
Until recently the DWP have interpreted the 50 per cent rule as you being affected by your epilepsy more than half the time. When they have looked at issues around safety and supervision, they have said that in carrying out an activity (such as cooking) it needs to be more likely than not that you would have a seizure 50 per cent of the time. A court ruling in March 2017 (called an Upper Tribunal Ruling) disagreed with the DWP’s interpretation. It said that the PIP assessor should consider these 2 things:
- How likely it is that you would come to harm and
- How great the harm could be
The greater the possible harm, the less attention they will need to pay to how likely it is that it would happen.
For people with uncontrolled epilepsy there is always the risk of having a seizure. The level of harm you could come to would depend on what type of seizures you have and how unpredictable they are.
I am under 16 or over 65. What can I claim instead of PIP?
If you are under 16, you can apply for Disability Living Allowance (DLA).
If you are aged 65 or over and not currently claiming DLA, you can apply for Attendance Allowance.
I currently get DLA. How will PIP affect me?
DLA is ending for people who were born after 8 April 1948 and are 16 or over. If you are in this age group and are currently claiming DLA, you will continue to get it until the Department for Work and Pensions (DWP) writes to you to:
- Tell you when your DLA claim will end and
- Invite you to apply for PIP
To find out when you’ll be invited to apply for PIP you can use the Benefits and Work PIP self-test.
How do I claim PIP?
View a diagram showing the claim process, or read on to find out more about each stage.
DWP have made some videos to explain more about the PIP assessment process.
To start your claim call the DWP on 0800 917 2222. Someone can make the call on your behalf, but you need to be with them when they call.
You can also apply by post by writing to the address below and asking for a form. Bear in mind this can delay the decision on your claim.
Personal Independence Payment New Claims
Post Handling Site B
For more information on how to claim, including what information you’ll need to provide, visit the government website.
To claim in Northern Ireland you can ring the PIP Centre on 0800 012 1573.
Completing the form
Once you have told the DWP you want to claim PIP, they will send you a form called ‘How your condition affects you’. You need to complete and return the form within one calendar month.
You can see an example of the form on the government website.
There are 15 questions on the form. For all the questions bear in mind the information above about the Upper Tribunal ruling and stressing the likelihood of you coming to harm if you were to have a seizure, and how great that harm might be. You could put this information in the ‘Extra Information’ box.
Questions 1 and 2 ask for details of your health professionals, health conditions and medicines, including any side-effects you get. Whoever you put down in this section, they need to know about how you manage your daily activities. If necessary, make an appointment to see them. This gives you the opportunity to make sure they have all the information they need about you.
Questions 3 to 14 are about your ability to carry out daily activities. Each question has tick boxes, and space to describe how your health condition or disability affects your ability to carry out that task. Points are scored if you are not able to carry out a task reliably. ‘Reliably’ here means safely, to an acceptable standard, repeatedly and in a reasonable time.
Question 13 and 14 talk about going out and moving around. The government decided that DWP did not have to consider possible ’psychological distress’ involved in this. But the issue of risk described in the Upper Tribunal information above is the same for moving around as for other activities.
For more advice about how to answer these questions and how to describe how your condition affects you, see pages 15-21 of the Disability Rights UK PIP factsheet. Also see our section below on explaining your epilepsy.
Question 15 asks for any extra information about your health condition or disability and how it affects you.
As well as completing the form, the DWP encourages you to send copies of any supporting evidence you have. Getting clear supporting evidence can make a real difference to how successful your claim is. This could include:
- Prescription lists
- Care plans
- Seizure diaries
- Reports from healthcare professionals
- Letter from your social worker or carer, or a relative or friend who helps you and knows about your difficulties
If the way your epilepsy affects you varies over time, you could send a diary to show the difficulties you have over a number of days or weeks. You can find more information about keeping a diary to support your claim in Appendix D of the Disability Rights UK PIP factsheet.
Help completing the form
We recommend that you use our information together with the Citizens Advice guide to completing the PIP form.
If possible, make an appointment with a welfare rights unit such as Citizens Advice, to help you complete the form. To make the most of your appointment time, make a rough draft of your answers to take with you.
Returning the form
You need to return the form within one calendar month of receiving it. Always keep at least one copy of it.
The PIP assessment
Once the DWP has received your form, you will be invited for an assessment with a healthcare professional. They may also contact your doctor, consultant or other healthcare professionals treating you, for more information before your assessment. The assessment takes place in an examination centre, or in your home, depending on which area of the country you live in. If you have to go to them, you can claim travel expenses. You should be given 7 days notice of an assessment.
Taking someone with you
You can take someone with you to the assessment. Ideally this will be someone who can help you feel as relaxed as possible. They will not be able to answer the questions for you, but they are allowed to add information, if you want them to. They could also remind you to look at your notes, if there are things you don’t remember.
Make notes beforehand
A lot of people understandably get anxious about the PIP assessment. And a lot of people with epilepsy have problems with their memory. This can make it really difficult to get all your information across. Making notes beforehand of the things you think will be most important to say can really help once you are in the assessment. Take your notes with you to the interview, along with anything else you think might help.
Ask to make a recording
You can ask to make a recording of the face-to-face PIP assessment. You need to do this well before the day of your assessment. And you need your own equipment. You can do this by calling the Enquiry Centre on 0808 1788 114.
For more information visit the Capita website.
The interview will be with a healthcare professional, but they might only have a basic understanding of epilepsy. Make sure you can explain clearly about your epilepsy and how it affects you. Don’t just talk about your seizure frequency. They need to know about all possible impact on your life, including such things as anxiety and memory problems.
You could use the list below to make notes about your situation. You can then take your notes with you to the interview. If you have a seizure diary, you could take this to the interview to help you explain your seizure pattern.
Here is a list of the sorts of things that a person with epilepsy may need to mention in their PIP interview:
- If there is a particular cause for your epilepsy – for example a brain tumour
- What happens to you before a seizure. If you get a warning or ‘aura’ before a tonic-clonic seizure, this is actually a specific type of seizure itself. It’s important to describe it as a seizure to the assessor
- What happens to you during a seizure
- How often you lose control of your bladder or bowel and any anxiety that may cause
- How likely it is that you would come to harm if you had a seizure
- How much harm you might come to if you had a seizure
- What your seizure recovery is like – for example whether you need to go to sleep, or if your awareness is affected and how much help you need afterwards
- How long it takes you to recover from a seizure
- Whether you have had to go to hospital because of a seizure
- Whether you have recently been injured during a seizure – for example cut your head
- Whether rescue medicine has been given to you by a carer or health professional after a seizure
- Any side-effects you get from your medicines
- Any support you are given by a partner or carer
- Whether your memory and/or concentration are affected
- Any other impact your epilepsy may have on your life
- Any relevant information about other health conditions
Answering the questions
The healthcare professional will ask you questions about your day-to-day life, your home, how you manage at work if you have a job, and about any social activities you do (or have had to give up). They may ask you to describe a typical day in your life. When answering, try to explain your difficulties as fully as you can. Tell them about any pain or tiredness you feel, or would feel, while carrying out tasks, both on the day of the examination and over time. Consider how you would feel if you had to do the same task repeatedly. Tell them if you need reminding or encouraging to complete the tasks.
Don’t overestimate your ability to do things
Make sure you are honest about how these activities would feel on a bad day, rather than a good day. Sounding positive about your condition is really useful in general life, but will not help to get you the financial support you may need.
The healthcare professional may, with your consent, give you a brief medical examination. But mostly they will observe how you are during the interview, including how you got there.
At the end of the interview
At the end of the interview the healthcare professional should give you an overview of how they see your situation. And you should get an opportunity to ask questions and add any final information.
The healthcare professional sends a report to the Department for Work and Pensions (DWP) case manager. They make the final decision.
You will be sent a letter giving the decision and explaining how the decision was made. If you are entitled to PIP, you will be told at what rate and for how long you will be entitled to it.
Your needs will be regularly reassessed to make sure you’re getting the right support. If there’s a change in how your condition affects you, you need to tell the DWP straight away.
Getting PIP may mean your other benefits increase. Make sure you check this out with a welfare rights worker. For example if anyone in your household is getting PIP you won’t be subject to the benefits cap.
This information has been produced under the terms of The Information Standard.
- Updated November 2017To be reviewed November 2018