Personal Independence Payment Current Position for PIP Statistics

Personal Independence Payment

Current Position for PIP – Statistics • Official Statistics on PIP published 15 th March 2017 • Between 8 th April 2013 and end of January 2017: – 2, 254, 100 new claims registered, of these 76, 300 (3%) special rules for terminally ill, and 920, 100 (36%) reassessed DLA claims – 2, 286, 700 new claims to PIP cleared, of these 82, 600 (4%) under special rules)for terminally ill, and 754, 600 (33%) were assessed DLA Claims – 1, 232, 700 claims in payment at January 2017 – 46% led to an award of PIP for New Claims (99% of special rules claims led to an award) – 73% led to an award of PIP for DLA Reassessments (100% of special rules claims led to an award) Department for Work & Pensions 2

Introduction to PIP • 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 PIP Toolkit - Quick Guide Department for Work & Pensions 3

Similarities and differences between DLA and PIP Similarities Differences • Extra-costs cash benefit • three month qualifying period and nine month prospective test • Not means-tested or taxable • New assessment criteria • Two components • Payable both in and out of work • Individual assessment and face-to-face consultation • Maintains links to passported benefits where possible • Planned interventions • Special rules for terminally ill people • Reconsiderations process PIP Toolkit – Differences and Similarities Department for Work & Pensions 4

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 Daily Living Mobility Enhanced 12 points Standard 8 points Not Entitled PIP Toolkit – Conditions of Entitlement Department for Work & Pensions 5

PIP – Personal Independence Payment PIP Rates April 2017 • Daily living component: Enhanced Standard £ 83. 10 £ 55. 65 • Mobility component: Enhanced Standard £ 58. 00 £ 22. 00

Assessment Criteria Daily living component (activities 1 -10) Standard rate = 8 points Enhanced rate = 12 points Activity Mobility component (activities 11 -12) Standard rate = 8 points Enhanced rate = 12 points 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-toface 0 -8 10. Making budgeting decisions 0 -6 Department for Work & Pensions PIP Toolkit – Assessment Criteria 7

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 Example: Activity 2 – Taking Nutrition 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; or iii. 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 Department for Work & Pensions 8

Reliably • In order to satisfy a descriptor, the claimant must be able to carry out the activity as described in the descriptor reliably. • ‘Reliably’ means whether they can do so: – Safely – in a fashion that is unlikely to cause harm to themselves or to another person. – To a necessary and appropriate standard – given the nature of the activity. – Repeatedly – as often as is reasonably required. – In a timely manner – in a reasonable time period. • This is now covered in Regulations and will form an important part of the assessment. It is in guidance for assessment providers and Case Managers. Department for Work & Pensions 9

Reliably - example • Using a walking stick a claimant can walk Example – Activity 12 – Moving around up to 50 metres. However after doing so they cannot repeat it again the same day. A Can stand then move more than 200 0 metres. • You would reasonably expect someone to walk 50 metres more than once a day. B Can stand then move more than 50 4 Therefore the claimant does not reliably metres but no more than 200 metres. satisfy descriptor D. C Can stand then move unaided more 8 • The individual can walk shorter distances than 20 metres but no more than 50 up to 20 metres and repeat them in the metres. same day. D Can stand then move using an aid or 10 • The individual therefore satisfies appliance more than 20 metres but no descriptor E. more than 50 metres. Department for Work & Pensions E Can stand then move more than 1 metres but no more than 20 metres. 12 F Cannot – i. stand; or ii. move at all; or iii. move more than 1 metre. 12 10

Fluctuating conditions Example – Activity 4 – Washing and bathing • For a descriptor to apply, it must be satisfied on the majority of days (over 50% A Can wash and bathe. 0 of days) in a one year period • If it is satisfied at any point on a given day, it is satisfied for that day 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 Needs assistance to be able to wash either their hair or their body below the waist. 2 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 • If two or more descriptors are satisfied for D over 50% of days, the highest scoring descriptor applies. • E. g. if D applies on 100% of days and E on E 70% of days, E is selected. Department for Work & Pensions 11

Fluctuating conditions – cont. Example – Activity 4 – Washing and bathing • If no scoring descriptors apply for the majority of the days, but, when taken together, two or more scoring descriptors are likely to be satisfied on more than 50% of days, the descriptor that applies for the highest proportion of time applies. • E. g. if B applies on 20% of days, D on 30% of days and E on 5% of days, D is selected Department for Work & Pensions 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 12

Aids and appliances • Assessment takes account of aids and appliances that individuals use, or could reasonably be expected to use • Definition is no longer limited to specialist aids and appliances. • Where individuals use aids and appliances that are not specially designed to assist disabled people, they must be out of necessity, not choice. • E. g. – If a claimant is reliant on a food processor because they are unable to chop food due to their disability, the points will be awarded. – If a claimant could chop food but chooses to use a food processor, no points will be awarded. Department for Work & Pensions 13

Assessment process Department for Work & Pensions 14

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 Department for Work & Pensions 15

Health Professionals Clinical Director Registered Nurses Mental Health Nurses Paramedics Learning Difficulties Nurses Occupational Therapists Physiotherapists Department for Work & Pensions 16

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 Toolkit – Assessment Process and Providers Department for Work & Pensions 17

Appointees and Advocates We encourage family members, carers, and support worker to accompany claimants to Assessments – this can often help to reduce anxiety. They may be there either as an “Appointee” or an “Advocate”. Appointees: Are legally appointed by DWP and can speak on behalf of the Claimant An Assessment cannot be conducted without the Appointee present If the claimant is not present the Appointee can still speak on their behalf Advocates: Can be support worker/carer/friend/family member or a paid person from a Support Group Is there to “support” or to “speak in support” of the Claimant but not to “speak on their behalf” Department for Work & Pensions 18

Appointees and Personal Independence Payment (PIP) Since December 2016: • representatives of corporate and individual appointees have been able to attend PIP consultation appointments with claimants. • Representatives need to bring the appointment letter, or, explain how they know the claimant, how they knew about the appointment and provide ID. The appointee must tell the representative straightaway, as PIP consultation appointments can be rearranged only once and the PIP Assessment Provider must be contacted before the current appointment takes place. • Not attending appointments may affect benefit entitlement. • Claimants with an appointee cannot attend consultation appointments on their own. Department for Work & Pensions 19

Reassessment from DLA to PIP • DWP have been inviting DLA working age claimants to claim PIP • Only claimants whose 65 th birthday was on or before 8 th April 2013 will remain on DLA. • They will also be invited if their fixed term DLA award was due to expire; • If they were approaching age 16 (unless they were awarded DLA under the special rules for terminally ill people); • If DWP received information about a change in care or mobility needs which meant their claim had to be renewed; or • If the claimant chose to claim PIP instead of DLA. • DLA will remain in payment while the PIP claim is being processed.

Reassessment from DLA to PIP Full Roll-Out • DLA claimants living in all areas of Great Britain are now being selected and chosen at random, but this does not mean that it is happening to everyone everywhere at the same time. The PIP checker on gov. uk has been updated. • We are keeping flexibility to be able to adjust the volume of invitations issued in any postcode to match assessment provider capacity. • This approach will ensure that backlogs do not build up. • We expect this process to be completed by September 2017

PIP – Personal Independence Payment Average PIP Claim Clearance Times In January 2017: • 12 weeks end to end • 7 weeks from the point of referral to the assessment providers to a decision being made. Source: Personal Independence Payment: Official Statistics to January 2017

Escalation Routes • If the delay is with DWP, the claimant should be advised to contact the PIP enquiry line on 0345 850 3322 • If the delay is with the assessment provider, the claimant should be advised to contact the assessment provider – contact details on their websites • In cases where DWP consider there is hardship or risk, cases can be escalated via the Complaints Resolution Manager (CRM) at the relevant Regional Benefit Centre (RBC) Department for Work & Pensions 23

Atos Claimant Champions are: Mary. Dunning@atos. net Maria. Monaghan@atos. net They are there as escalation points when you feel that you need somebody to look into a specific issue. You may feel that something has gone badly off process, or you need some special attention to a particular case. They are not there to replace the Complaints process or to sidestep the PIP process, but they are there to give you someone within Atos you can go to if you need help or advice Child Maintenance Service

The claimant journey There are five key stages to claiming 1 Thinking about claiming Information 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. 2 Making a claim 3 How your disability affects you 4 Assessment 5 Decision Claimants (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. Claimant 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. Claim 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. A 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. PIP Toolkit – Claimant Journey Department for Work & Pensions 25

PIP new claim process • New claims line: 0800 917 2222 (textphone: 0800 917 7777) • PIP enquiries: 0845 850 3322 (textphone: 0845 601 6677) • British Sign Language (BSL) video relay service wttps: //www. gov. uk/pip/how-to-claimhtps: //www. gov. uk/pip/how-toclaimhttps: //www. gov. uk/pip/how-to-claim PIP Toolkit – How to claim Department for Work & Pensions 26

PIP 2 and Evidence • PIP 2 How your disability affects you form must be returned within 40 days. • It is important that the claimant provides us with any supporting information they already have that explains how their condition affects them. • We don’t need to see general information about the condition – we need to know how the claimant is personally affected. • The supporting information does not need to be recent but should be within the last 2 years and relevant to the claimant’s current condition. • DLA claimants can request the use of previous evidence held on their existing/past DLA claims.

PIP decision • DWP will write to claimant’s to explain for decisions in favour and not to award PIP • DWP tell claimants how and when to report change in circumstances • DLA will continue to be paid until 28 days after the next payday, until the PIP decision comes into force • Claims to PIP are currently taking longer than expected. The actual length of time a PIP claim will take will depend upon individual circumstances • We are taking steps to speed up the claims process and dealing with claims as quickly as we can. Any delays experienced by the claimant will not affect the date from which their benefit is paid. PIP Toolkit – Decision and Payment Department for Work & Pensions 28

PIP award • Once a report has been completed by the Assessment Provider the claim is passed back to the DWP. • The decision maker will look at all the evidence and make an award of PIP. The decision is based on the impact of the claimant’s health condition or disability on their daily life and their ability to live independently. • The length of award for PIP will be based upon each claimant’s individual circumstances. • The maximum award length is 10 years. • We will send the claimant a letter giving a decision on the PIP claim and an explanation of how that decision has been reached.

Award Reviews • When the Department makes an award of PIP we tell most customers that we will contact them whilst they’re getting PIP to review their award – to see if their needs have changed and to look at the amount they get. This information can be found in the decision notification. • An award review form will be issued • The form gives the claimant the opportunity to detail any changes in their ability to complete Daily Living and Mobility activities • If a Case Manager is able to make a decision they will, however if they don’t have enough information they will refer the case to the Assessment Provider

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 PIP Toolkit – Access to other benefits and services Department for Work & Pensions 31

Motability Scheme Transitional Support Package • In September 2013 the charity put in place a transitional support package for those DLA claimants who are invited to claim PIP and who are not entitled to the enhanced rate of the mobility component of PIP. • As a result, Motability has offered to enhance their DLA - PIP Transitional Support package. More information can be found on the Motability website www. Motability. co. uk • Motability Scheme customers will now be able to retain their car for up to 8 weeks after their DLA payments end, an increase from the current 3 weeks

Motability Scheme Transitional Support Package There is an additional option to the Transitional Support package for existing DLA claimants who go through the process of reconsideration and appeal following an unsuccessful PIP claim. Instead of receiving lump sum payments of £ 2, 000 these claimants may opt to extend their lease for 26 weeks after the DLA payments end and receive £ 500 support money (or £ 250 for those who joined the scheme during 2013. Those who choose this option cannot claim the £ 2, 000 support money as well – the choice is between the £ 2, 000 or the extended lease. • The changes were introduced from 24 th April 2017

Disputes • Claimants who wish to dispute a decision on their PIP claim are required to ask DWP to reconsider the decision before lodging an appeal with Her Majesty’s Courts and Tribunals Service. • The MR decision will be by a new Decision Maker. • A MR can be requested by phone or in writing. • If a Third Party wishes to request a MR we must hold consent from the claimant. PIP Toolkit – Disputes Department for Work & Pensions 34

Appeals • If the claimant still disagrees with the decision, they have the right to appeal to an independent tribunal so that a hearing can take place where a tribunal will look at the claim again. • The Tribunals Service is an executive agency of the Ministry of Justice and is a wholly separate organisation from the Department for Work and Pensions. • If the claimant wants to appeal, they have one month from the date of the Mandatory Reconsideration letter to do so. • 2. 1 million PIP claims have been decided since April 2013 to December 2016, of these only 7% of initial PIP decisions have been appealed against and only 3% have been overturned at an appeal hearing.

PIP Toolkit list of contents Core Products Fact sheets • Introduction to PIP Toolkit • Quick Guides • • • PIP Timeline 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 • Claimant Journey • External PIP white brand presentation and speaker notes • Sample forms and notifications • Leaflets • PIP Communications Products and Timeline • Sample Assessment Provider notifications Department for Work & Pensions • • • 36

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 Department for Work & Pensions 37