Personal Independence Payment (PIP)
If you have a long term illness or disability – physical and/or mental – and you are aged between 16 and 64 years old then you may be entitled to Personal Independence Payment (PIP)
PIP is gradually replacing Disability Living Allowance (DLA), so those receiving DLA will be asked whether they want to claim PIP at some point by 2017. DLA won’t be affected for children under 16 or people who were 65 or over on 8 April 2013. All new claims for people aged between 16 and 65 should be made for PIP.
Claiming these benefits can help you or the person you care for qualify for other benefits and or tax credits. If you are a carer who is disabled or ill you can continue to receive AA or DLA or make a new claim for PIP, even if you already get, or qualify for, Carer’s Allowance.
Who can claim?
To qualify for PIP you must meet all the following criteria:
- be aged 16-64
- satisfy the daily living and/or mobility activities test. You must satisfy this test for at least three months before you can be paid and be likely to continue to satisfy this test for at least nine months after the three month qualifying period (unless you have a terminal illness)
- have no immigration conditions attached to your stay in the UK (subject to some exceptions)
- pass the residence and presence tests (see below)
Claiming when you are over 64 years old
- You will not be able to make a new claim for PIP once you are 65 years old.
- However, people who are already claiming DLA who were aged between 16 and 64 on 8 April 2013 will at some point be invited to claim PIP.
- Existing DLA claimants who were 65 or over on 8 April 2013 will continue receiving DLA for as long as they continue to meet the entitlement conditions.
- You will be able to stay on PIP if you claimed or received it before you reached the age of 65.
- If you are over 65 and not getting PIP you can claim Attendance Allowance.
Residence and presence tests
There are three tests of residence and presence:
The presence test: You will need to show that you are present in Great Britain.
The habitual residence test: This is assessed by looking at a number of factors including reasons for coming to Great Britain, the length of your stay, future intentions, and previous links with the country. Members of Her Majesty’s Forces serving abroad and their families will be treated as habitually resident.
The past presence test: You will have had to be present in Great Britain for 104 out of the previous 156 weeks (two out of the last three years). You do not have to satisfy this past presence test if you have a terminal illness.
These rules are complicated so contact the Carers UK Adviceline if you think you may have difficulty passing these tests.back to top
How much is it worth?
There are two components of Personal Independence Payment (PIP):
- Daily Living Component
- Mobility component
Each component can be paid at either:
- Standard rate – where your ability to carry out daily living/mobility activities is limited by your physical or mental condition.
- Enhanced rate – where your ability to carry out daily living/mobility activities is severely limited by your physical or mental condition.
April 2014-March 2015 rates
|Daily Living component||£54.45||£81.30|
How to claim
Making an initial claim
The initial claim will generally be done by phone although paper claim forms are available in exceptional circumstances (form PIP1).
To start a new claim for PIP you should telephone the DWP on 0800 917 2222 (textphone 0800 917 7777). Lines will be open between 8am and 6pm Monday to Friday. The phone call can be made by someone else but they will need to be with you. The phone call sets the date of the claim.
This will be an administrative claim only and the information you will need is:
- your full name and date of birth
- your address and telephone number
- your National Insurance number
- your bank or building society account details
- your GP or other health professional’s details
- details of any recent stays in hospitals, care home or hospices
- details of any time you’ve spent out of the country
- nationality or immigration status
If you are terminally ill you will need to discuss your condition during this initial claim.
The DWP will then check basic eligibility conditions and if these are not met then a disallowance letter is sent. Otherwise an individually barcoded form is sent to you (‘How your disability affects you’ – form PIP2).
Note: If you are terminally ill you will not have to complete the ‘How your disability affects you’ form and will not need a face-to-face consultation. Instead, you or the person claiming on your behalf will be asked some extra questions whilst you are on the phone about your condition and how it affects your ability to get around.
How your disability affects you (PIP2)
The form sent to you will ask for information about how your condition affects you. Additional evidence can be sent in with this form. On the form there is a section for ‘additional information’. In this section, carers, friends or family could also provide information. It does not have to be filled in if you feel like you have included everything in the rest of the form.
You have one month to return the completed ‘How your disability affects you’ form. Failure to return the form without good cause can result in the claim being terminated. If you are unable to complete the form within the given timescales you should contact the DWP by phone to ask for an extension.
The form and any additional information are then sent to a health professional. If there is enough information the assessment can be completed at this stage but most people will be asked to attend a face-to-face consultation. The DWP says that claimants will be encouraged to take someone along with them to the consultation. Failure to attend the consultation without good cause can result in the claim being terminated.
The health professional then sends a report to the decision maker.
Tips for claiming
- Take your time to complete the claim form.
- Look at the 12 activities and work out which tests you satisfy before you fill in the form. It may be a good idea to get your carer to do the same, to make sure that you don’t miss anything out.
- What matters is whether you need the help, not whether you are already getting it.
- If you are not sure about how much help you need, or how long things take, keep a diary for a week or so. This would be particularly useful with fluctuating conditions.
- If you are applying for the ‘moving around’ activity (activity 12), do make a proper measurement of how far you can walk and how long it takes you to walk that far before you fill in the form.
- Evidence is important; therefore it is a good idea for you to collect evidence and submit it either with the claim pack or as soon as you can afterwards. Evidence might include a report from an occupational therapist or consultant, information from your doctor or a support worker, or a statement from a carer/friend/family member.
- Keep a copy of your form and any evidence you send.
The decision maker will review the report from the health professional and any other evidence and make a decision. Shorter term awards of up to two years could be given, or longer term awards of five or ten years could be given. On-going awards will be given in the minority of cases where needs are stable and changes are unlikely. However, all claimants will have their award periodically reviewed, regardless of the length of the award, to ensure that everyone continues to receive the most appropriate level of support.
The DWP will send you a letter giving a decision on the PIP claim and a clear reasoned explanation of how that decision has been reached. If you have been awarded PIP, the letter will detail the amount of the award, the length of the award and the reasons for making that decision. Specific details of PIP payments including the date payments will start and their frequency will also be included in the letter.
If you have not been awarded PIP, the letter will give all the same information as the award letter and will include a full statement of reasons for the decision. The letter will also explain what you need to do if you are not happy with the decision. After the decision letter has been issued, if a claim has been disallowed or an existing award reduced then the DWP decision maker will try to phone you to discuss the decision and explain the reasons for making that decision. If you are still not happy with the decision after discussing it with the decision maker, you can ask for a mandatory reconsideration.back to top
Challenging the decision
If you are unhappy with a decision about PIP you have the right to challenge it. This could be a decision about a new claim or a decision on PIP following the transfer from DLA.
If you disagree with the decision you must ask the Department for Work and Pensions (England, Wales and Scotland) or the Social Security Agency (Northern Ireland) to look at the decision again. This is called a mandatory reconsideration.
There is usually a strict one month deadline for asking for a mandatory reconsideration so it is important to act as soon as possible. If you have missed this deadline contact the Carers UK Adviceline for advice because this deadline can be extended in special circumstances.
If you disagree with the reconsidered decision you will need to lodge an appeal directly with HM Courts and Tribunals Service (England, Wales and Scotland) or the Appeals Service (Northern Ireland). Attach a copy of the mandatory reconsideration with the appeal.
There is a guide to challenging a benefit decision on the Carers UK website – visit www.carersuk.org/appealsguide or contact the Carers UK Adviceline.
Making a complaint
If you are unhappy with the way your claim has been dealt with, eg long delays or lost forms, you should first contact the Personal Independence Payment helpline on 0845 850 3322.
If you’re unhappy with their response you’ll be asked if you want your complaint sent to the Director General of Operations for the Department for Work and Pensions. They aim to deal with complaints within 15 working days.
If you’re still unhappy, you can then ask the Independent Case Examiner to investigate – they’ll be impartial and this is free.
If you’re unhappy with their response you can ask your MP to send your complaint to the Parliamentary and Health Service Ombudsman. Visit www.gov.uk/complain-disability for more information.
Change in circumstances
Any change in your daily living or mobility needs may affect your entitlement to PIP or the amount you receive. You should let the DWP know about the change as soon as you can so that they can review your PIP award and make sure you are receiving the right support.
You or someone acting on your behalf should also tell the DWP if you have been admitted to a hospital, a care home or a hospice, or have been imprisoned, as this may also affect your benefit.
Going into hospital, a care home, or a hospice
Both daily living and mobility components of PIP are not payable after 28 days in hospital. Payments will stop after 28 days including payments of the mobility component under an existing Motability contract. There is a 28 day linking rule which means that different periods spent in hospital separated by 28 days or less are linked together and treated as one period.
The daily living component of PIP is not payable after the first 28 days in a care home unless you are completely self-funding. Again, the 28 day linking rule applies, so different periods in a care home separated by 28 days or less are linked together and treated as one period. The mobility component of PIP can continue to be paid.
Periods spent in a care home also link with periods spent in hospital if they are less than 28 days apart.
PIP will generally still be payable if you are terminally ill and in a hospice.
Special Rules allow people who are terminally ill (where death can be expected within six months) to get help quickly. If you meet the criteria for claiming under these Special Rules you will not have to complete the ‘How your disability affects you’ form and will not need a face-to-face consultation. Instead, you or the person claiming on your behalf will be asked some extra questions whilst you are on the phone about your condition and how it affects your ability to get around.
If you are claiming under Special Rules you do not have to satisfy the required period condition (satisfying the test for at least three months before you can be paid, and be likely to continue to satisfy the test for nine months after the three month qualifying period). You also do not need to satisfy the past presence test (being present in Great Britain for 2 out of the last 3 years).
If you are claiming under these Special Rules you are guaranteed an award of the enhanced rate of the daily living component of PIP, however payment of the mobility component will depend on whether you need help to get around, and if you do how much help you need.
The way to claim under the Special Rules for terminally ill people is by telephone on 0800 917 2222. The phone call can be made by someone supporting you without you needing to be present. However, you should be told about the claim because the DWP may need to contact you to verify your details and the DWP will send notifications and any payment to you.
People claiming under Special Rules are encouraged to get a DS1500 medical report from their doctor to support the claim. The DS1500 is a report about your medical condition, not your prognosis, and you can obtain one from your doctor, nurse, Macmillan nurse or social worker. You will not have to pay for a DS1500. The DS1500 report can be sent to the 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. You (or the person making the claim on your behalf) will be given a freepost address for the DS1500 when you make the claim over the phone.back to top
If you receive PIP, you may become entitled to various other types of help.
If you are already receiving means-tested benefits (such as Income Support, income related Employment and Support Allowance, income based Jobseekers Allowance, Pension Credit and Housing Benefit) getting PIP may mean that you become entitled to an increase in your benefit. An award of PIP can also mean that you become eligible for a means-tested benefit for the first time. So if you are awarded PIP it is a good idea to get a benefit check.
If you are getting Child Tax Credits or Working Tax Credits you may also be entitled to an increase in benefit if you are awarded PIP.
However, PIP in itself will not automatically entitle you to any increase in benefit under Universal Credit.
Exemption from the benefit cap
The benefit cap is being introduced gradually from April 2013 and it means that the amount of benefits a household can receive will be limited to £350 a week for single people who do not have children or whose children don’t live with them, and £500 a week for single people whose children live with them, and couples with or without children.
Households will be exempt from the benefit cap where you, your partner or a qualifying young person is entitled to PIP.
Help with transport costs
Motability Scheme: You will be able to qualify for Motability Scheme help if you are receiving the enhanced mobility component of PIP.
Road Tax (vehicle excise duty): You can get a free tax disc if you get the enhanced mobility component of PIP. You can also get a 50% discount on your road tax if you receive the standard mobility component of PIP.
Blue Badge Scheme without further assessment
In England, if you have been awarded eight points or more in the ‘moving around’ activity of PIP you can get a Blue Badge.
In Scotland you can get the badge if you have been awarded eight points or more in the ‘moving around’ activity or 12 points in the ‘planning and following journeys’ activity.
In Wales you can get the badge if you have been awarded eight points or more in the ‘moving around’ activity or 12 points in the ‘planning and following journeys’ activity.
Eligibility for the Scheme in Northern Ireland has not yet been decided.
If you do not meet these conditions, you may still qualify for a blue badge if you meet certain other conditions. The scheme is run through your local council or trust and you should contact them for further information.
Public transport concessions
You may be eligible for other transport concessions such as free travel on public transport. In England, if you score eight points or more under the ‘moving around’ activity or under the ‘communicating verbally’ activity you may be eligible for transport concessions. You should contact your local authority for further information or visit www.gov.uk/apply-for-disabled-bus-pass for more information on the England National Concession, or www.wales.gov.uk/topics/transport/public/concessionary for more information on the Welsh National Concession (at the time of writing, Wales had not yet confirmed their public transport concessions scheme).
In Scotland, if you receive the daily living or mobility component of PIP you will be eligible for the Scottish National Concessionary Travel Scheme.
Companion Entitlement (for Scotland only): If you receive the standard or enhanced rate of the daily living component of PIP, you will be eligible for a Companion Card, allowing a companion to travel with you for free. You should contact your local authority or visit Transport Scotland for further information.
Armed Forces Independence Payment
The Ministry of Defence is introducing a new benefit that will provide financial support for injured service or ex-service personnel. It will be called the Armed Forces Independence Payment (AFIP) and is being introduced from 8 April 2013. AFIP claimants will receive a flat-rate benefit which for passporting purposes is the equivalent of the enhanced rates of the daily living and mobility components of PIP.
Claimants who choose to claim AFIP will not be eligible for PIP, DLA or AA. Claimants who choose not to apply for AFIP will be treated as PIP, DLA or AA applicants in the usual way.