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.
What is Personal Independence Payment (PIP)
PIP is a benefit which helps with some of the extra costs caused by long-term ill-health or disability. You must be aged 16 or over and have not reached state pension age to claim PIP.
You can receive it whether you are in work or not. PIP is not means-tested and is tax-free.
What will I get?
You could get between £22.65 and £155.35 a week. How much you get is based on how your condition affects your ability to complete certain tasks, not on having 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 April 2019.
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 between 16 and your State Pension age. 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. You can get PIP whether or not you're working.
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
- Mobility difficulties
You may get the mobility component of PIP if you need help with going out or moving around.
I am under 16 or over 65. What can I claim instead of PIP?
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. The DWP says that this process is likely to continue until 2021.
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. Lines are open Monday to Friday 8am to 6pm. Making your claim by phone means your claim starts from the date of the phone call.
You can also write to the address below and ask for a form. Bear in mind this can delay the decision on your claim, as the form can take 2 weeks to arrive.
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 make a new claim in Northern Ireland you can phone the PIP Centre on 0800 012 1573. You can also write to the address below and ask for a form. Bear in mind this can delay the decision on your claim, as the form can take 2 weeks to arrive.
For an existing claim ring 0800 587 0932.
How is the PIP assessment made?
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 Citizens Advice website.
General guidance on answering the questions
It's not that easy to complete this form if you have a variable condition such as epilepsy. Hopefully this guidance will help you get across the important information about how your epilepsy affects you.
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. However an Upper Tribunal ruling in March 2017 instructed the DWP when considering safety and supervision for a person applying for PIP, to bear in mind 2 things. When carrying out an activity:
- How likely it is that you would come to harm
- How serious that harm could be
The greater the possible harm, the less attention the assessor 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.
If you are struggling to fit this information in the body of the form you could always add it in the Extra Information box at the end of the form.
You can find more information about eligibility for PIP on the government website.
Questions 1 and 2
These questions are about your health conditions and medicines, including any side-effects you get. They also ask for details of your healthcare professionals. 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 12
These questions 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 activity. Points are scored if you are not able to carry out an activity reliably. ‘Reliably' here means safely, to an acceptable standard, repeatedly and in a reasonable time.
Questions 13 and 14
These questions are about going out and moving around. An Upper Tribunal ruling of November 2016 decided that the DWP did not have to consider possible 'psychological distress' involved in this. But the issue of risk described in the March 2017 Upper Tribunal ruling above about likelihood and seriousness of harm is as relevant 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.
This question 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. Make it clear if you are estimating. Also say how you are on your good days and your bad days. And give an idea of how often you have bad days and how the way in which you're affected changes from day to day.
You can find more information about keeping a diary to support your claim in Appendix D of the Disability Rights UK PIP fact sheet.
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. And take our PIP and epilepsy information too. This will give you the best chance of making a successful claim.
Returning the form
You need to return the form within one calendar month of receiving it. Always keep at least one copy of it. If you need to include extra pages make sure each page has on it:
- Your name and
- Your National Insurance number and
- The question number that the information is related to
The PIP assessment
We want the government to make the assessment process fairer for people with epilepsy.
The face-to-face assessment
Once the DWP has received your form, you will be invited for an assessment with a healthcare professional. The DWP 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.
Don't expect the assessor to be ‘on your side'. They are there to ask questions, not make sure you get PIP.
Take 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 difficult to get all your information across. Go through your form and make notes beforehand of the things you think will be most important to say. This 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.
Also Citizens Advice has a good PIP assessment helpsheet.
Ask to make a recording
You can ask to make a recording of the face-to-face PIP assessment. You will need:
- Your own recording equipment. This does not include mobile phone or laptop
- To be able to create 2 identical copies
- To be able to give one to the healthcare professional at the end of the assessment
- To make your request well before the day of your assessment. You can do this by calling the Enquiry Centre on 0808 1788 114.
For more information visit the Capita website.
In June 2018 the government decided to make legal the introduction of video recording the assessment. This is partly in response to the lack of trust voiced by so many people about Capita and Atos. At the moment it is only being trialled in one centre. The DWP are assessing whether people would prefer a video or an audio recording.
BOX Explaining your epilepsy needs to go here. See word document
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 just answer yes or no. try to give them full information about your situation.
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.
Take your time
Don't let the examiner rush you. The way to get the fairest decision is to be able to get relevant information across to them.
The healthcare professional may, with your consent, give you a brief medical examination.
But mostly they will observe how you are during the interview. They may also ask how you got to the interview.
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 their 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.
Getting a PIP award can make a real difference to how you manage financially. So it can be really upsetting to be told you are not entitled to PIP, especially if you have had this (or Disability Living Allowance) before. This can be especially true if the letter does not seem to reflect what you said in the assessment. Try to be prepared for this and for what you might want to do next. This can make the decision feel a little less difficult.
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. Or if you lose PIP, if someone was getting carer's allowance for you, they may no longer be entitled to it.
We want the government to make the assessment process fairer for people with epilepsy. Ask your MP to take the PIP Pledge
What can I do if I've been refused PIP?
If you're not happy with the decision because you have scored no points or not as many as you feel you should have, you can ask the DWP to look at your case again. This is called a mandatory reconsideration. You have one calendar month from the date of your decision letter to request this.
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:
Once the DWP has made its decision about whether you are entitled to PIP, there are 3 aspects you could challenge. You may want to challenge the actual decision (if they have refused you PIP) or the rate or the length of time of the benefit award.
Bear in mind that if you are challenging the rate or length of time, the DWP will look at your whole claim again. This could result in you being awarded less than with the first decision.
You can also ask for a reconsideration if your condition worsens. But be aware your benefit could go down as well as up. It's always good to get advice before you do this. One of the useful organisations listed below may be able to help you with this.
How to ask for a mandatory reconsideration
You have one month from the date on the decision letter to ask for a mandatory reconsideration.
You can either:
Use the form CRMRI to ask for a mandatory reconsideration. You can complete it online and then print it out. There are notes to help you with this process or
Phone the number on the decision letter. It is a quicker process to make the phone call. When you speak to them you should:
- Ask for a reconsideration of the decision and explain why you want it and
- Ask for copies of any evidence they used to make their decision and
- Ask them not to take any further action until you've had a chance to respond to their evidence
As well as the phone call, write them a letter asking for the evidence, and keep a copy. If you haven't heard anything in 2 weeks, phone them again.
Once you have received the evidence you should have a better idea of why the decision was made and how to challenge it. For example, you might have said on the form that you need help with a certain task, but the healthcare professional who carried out the face-to-face interview disagrees. If possible, you could collect medical evidence to show that what you said on the form was correct, for example a letter from your healthcare professional confirming your difficulties.
Once you have gathered evidence to support your case, send it to the address on the decision letter. A case manager will look at the further evidence you send. They will then write back to you with their decision.
If the DWP don't change their mind they will send you a mandatory reconsideration notice which proves that you have asked for a reconsideration. You will need this if you want to lodge an appeal.
If you still want to challenge the decision, you now have one calendar month from the date of the mandatory reconsideration notice to lodge an appeal to an independent tribunal.
According to the DWP's own data, of the new PIP claims made where epilepsy was the main condition, 66 per cent (about two thirds) were refused. These are numbers for claims between April 2013 and March 2018. And out of the number of people who appealed these decisions, 66 per cent (about two thirds) were settled in favour of the claimant.
This is a lengthy process and can be quite draining. But try not to be put off if you think the decision is wrong.
In order to appeal, you must have asked for a mandatory reconsideration first. You will have to download a copy of the official notice of appeal form SSCS1. Alternatively, you can phone your local HM Courts and Tribunals Service (HMCTS) and ask to be sent the appeal form. The Tribunal is part of the court system and not part of the DWP.
HMCTS website: courttribunalfinder
When you fill out the form, it will ask if you waYou may be able to get a welfare rights benefits worker to help you with your appeal.Try your nearest Citizens Advice or Welfare Rights Unit.
When you appeal, you may find it helps your case to mention the Upper Tribunal ruling described above. It would be a good idea to get advice on this from a benefits law advice service, such as the Disability Law Service.
Your appeal will be heard by an independent appeal tribunal. Tribunals are informal, and you can take someone with you for support.
You will usually get the decision very soon afterwards.
For more information on appeals and reconsiderations see Disability Rights UK's appeals and reconsiderations factsheet.
Epilepsy Action has a list of useful organisations for help with benefits
This information has been produced under the terms of The Information Standard.
- Updated April 2019To be reviewed April 2020