An introduction to Personal Independence Paymentfor support organisations

April 2013 Version V 2

2Department for Work & Pensions

What is Personal Independence Payment?

• Personal Independence Payment (PIP) is a new benefit to help disabled people live full, active and independent lives.

• It will replace Disability Living Allowance (DLA) from 8 April 2013.

• PIP will help towards some of the extra costs arising from having a long term condition (this means ill-health or disability expected to last 12 months or longer).

• It is based on how a person's condition affects them, not the condition they have. PIP has a 3 month qualifying period and 9 month prospective test

3Department for Work & Pensions

What is Personal Independence Payment? (continued)

• 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.

• PIP is a benefit people can get whether they are in or out of work.

• It is not affected by income or savings and is not taxed.

• PIP has links to passported benefits where possible

• Entitlement to PIP will be decided based on assessment criteria which consider the ability to carry out a range of everyday activities

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Assessment Criteria

Activity1. 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

Standard0 - 8

0 - 10

0 - 8

0 - 8

0 - 8

0 - 8

0 - 12

0 - 8

0 - 8

0 - 6

Activity

11.Planning and following journeys

12 Moving around

Standard

0 - 12

0 - 12

Daily Living Components (activities 1-10) Mobility Components (activities 11-12)Standard rate = 8 pointsEnhanced rate = 12 points

Standard rate = 8 pointsEnhanced rate = 12 points

PIP Toolkit – Assessment Criteria

Link to Assessment Criteria

5Department for Work & Pensions

Assessment criteria – the descriptors

• Multiple descriptors for each activity describing varying ability to carry out the activity

• Each descriptor has a point score

• Cumulative scores determine entitlement to the rates and components of the benefit

A Can take nutrition unaided. 0

B Needs – i. to use an aid or appliance to be able to take nutrition; or ii. supervision to be able to take nutrition; oriii. assistance to be able to cut up food.

2

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 so. 10

Example: Activity 2 – Taking Nutrition

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Fluctuating conditions

• For a descriptor to apply, it must be satisfied on the majority of days (over 50% of days) in a one year period

• If it is satisfied at any point on a given day, it is satisfied for that day

• If two or more descriptors are satisfied for over 50% of days, the highest scoring descriptor applies.

• E.g. if D applies on 100% of days and E on 70% of days, E is selected.

A Can wash and bathe. 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 their 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 waist.

4

G Cannot wash and bathe at all and needs another person to wash their entire body.

8

Example – Activity 4 – Washing and bathing

7Department for Work & Pensions

Who are the assessment providers?

The PIP assessment process will be managed by two assessment providers:

Atos Healthcare - Scotland, North East and North West of England, London and Southern England

Capita Business Services Ltd – Wales and Central England and Northern Ireland

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What is the Personal Independence Payment Assessment?

• The PIP assessment considers people as individuals, focussing on the impact their condition(s) has on their daily lives and over a range of different activities

• The PIP assessment is carried out by health professionals who consider evidence provided by the claimant, along with any further evidence they think is needed against a set of assessment criteria

• 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

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

• Home visits will be available when necessary

• The health professional will send a report to the DWP following the assessment, for the DWP Case Manager to make a decision.

9Department for Work & Pensions

New Claims start in April 2013

New Claims to PIP will be taken from people living in Cheshire, Cumbria, Merseyside, North East England and North West England

New claims national rollout

April 2013

June

2013

10Department for Work & Pensions

Reassessment starts in October 2013

DWP will start to reassess remaining DLA claimants who were aged between 16 and 64 on the day that PIP was introduced (8 April 2013)

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 is made

- if they don’t claim PIP then their DLA claim will end

DWP will start to invite some existing DLA recipients to claim PIP. DWP will write to those individuals who

- are reaching the end of a fixed period DLA award

- are about to turn 16

inviting them to claim PIP

Those existing DLA claimants who report a change in their condition will be invited to claim PIP

DLA recipients who contact DWP wishing to claim PIP will be able to do so (self selectors)

October 2013

October 2015

11Department for Work & Pensions

How is Personal Independence Payment claimed?

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.Special Rules claims will be dealt with more quickly

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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

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

DecisionA DWP Case Manager 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

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What happens after a decision is made about Personal Independence Payment?

Disallowance/reduced award phone call

• After the decision letter is issued, a DWP Case Manager will contact the claimant to explain the decision – where PIP has not been awarded or where the award is lower than the DLA award in reassessment cases

Awards and Reviews

• PIP awards will be based on the claimant’s circumstances and the impact of their disability/health condition; the length of award will be included in the decision letter along with when and how changes in circumstances need to be reported

• There will be fewer ongoing awards; more awards of shorter duration (eg 2, 5, 10 years)

• Awards will be reviewed at pre-determined intervals to see if the claimant’s needs have changed over time and to make sure their award is still correct

• 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

13Department for Work & Pensions

What happens after a decision is made about Personal Independence Payment? (continued)

Disputes

• PIP has a reconsideration process which claimants will have to follow before they can appeal against a decision

• From April 2013, disputes about PIP decisions will come under new arrangements DWP is introducing

• This means that if someone is not happy with their PIP decision:

- the first, mandatory step, is for the decision to be reconsidered by the DWP Case Manager - if the issue is not resolved at the reconsiderations stage, there is a right to appeal - appeals must be lodged directly with Her Majesty’s Courts and Tribunals Service (HMCTS)

• Appeals will only proceed after the claimant has had their decision reconsidered - this will be explained in the reconsideration notification

• Only those appeals that are validated will be sent to DWP for a response which will help to reduce nugatory appeals being heard

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PIP Toolkit list of Contents

Core Products Fact sheets

• Introduction to PIP Toolkit

• Quick Guide

• 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 • Introducing PIP for new claimants (from April 2013)• 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