'I've recently had my claim about my PIP benefit turned down and I don’t know what to do next. How do I get help?'
That's the question I'm hoping to tackle this week as latest figures show it now takes 22 weeks for a claim to be reviewed.
A Personal Independence Payment (PIP) is a vital resource for people who have a long-term mental health or physical condition and was created to help with extra living costs.
In order to qualify you must be diagnosed with a specific condition and have difficulty carrying out certain everyday tasks as a result of these circumstances.
This payment is an essential lifeline for anyone living in this set of circumstances and is something I feel very strongly about as a close relative of mine falls in to this category and I know from them and people in similar situations how frustrating the process can sometimes be.
Many people have reported problems with making a claim, saying the process was complex, bureaucratic and unsympathetic, also highlighting how difficult it can be to make your voice heard.
Because only one organisation – the Department of Work and Pensions (DWP) - processes the payment, this is sadly not a situation where you can vote with your feet and go elsewhere – but I will talk you through the process of taking things further.
You can get PIP even if you’re working, have savings or are getting most other benefits.
How does it work?
Firstly, there are two ‘qualifying’ parts to PIP claims:
- Daily living, which establishes if you need help with day-to-day tasks
- Mobility, which assess how you get around
It’s possible to get one or both parts of the benefit but – and here’s the frustrating bit for many – what you get is dependent on how you ‘score’ when being assessed. There is also carers allowance for anyone in your life acting in this capacity.
It makes sense to understand the process before applying so you know what you’re being assessed for. There’s a full list of criteria on the Gov.uk website here.
Though money is paid based on the assessment of the two main criteria, there are upper and lower limits. Find out more here.
What has been going wrong?
Because there’s a lot riding on getting the PIP payments – and a jump from lowest to highest amounts – many people have been in touch to seek help with PIP payments. Complaints cover a lot of ground but include:
- Claims being rejected
- Staff issues (unhelpful, unsympathetic)
- The assessment not being conducted or assessed correctly
- The assessment not being conducted in the home
- Incorrect assumptions about the nature and scope of the disability or condition
- Delays with payments and other administration errors
How to make a complaint
Firstly, contact the DWP by either writing to the address on your claim decision letter or calling them. You can ask a (free) third party to help you – like a friend, family member or an organisation like Citizens Advice.
The DWP will ask for full contact details and your National Insurance number. Make sure you explain in full what you’re unhappy with – including medical assessments of your condition if you have them. Make it clear what you want to sort things out too.
At Resolver, we’re currently speaking to organisations like the DWP about how we can help make this whole process easier, but for now, it makes sense to go direct to them. You can still use Resolver for making complaints for free about all other business sectors.
The DWP will then contact you to discuss the complaint. If you’re not happy, you go to the next level – the complaint resolution manager.
They should make contact and within 15 days contact you again to let you know the outcome or if they need more time. If you’re not happy then a senior DWP manager will also look at the case.
If no resolution is forthcoming then you can go to the Independent Case Examiner – kind of like and ombudsman for the DWP. You can find out how they work here. Like and Ombudsman, you must contact them withing 6 months of the date on their ‘final decision’ letter. It’s a free service.
Finally, if all else fails, you can go to the Parliamentary and Health Service Ombudsman (usually through an MP referral). Find out more about the Ombudsman here.
Ultimately, this very lengthy process could do with streamlining and being more accessible.
I understand how tough this can be for people appealing a decision or making a complaint – so speak to other people in your situation for help and support and use the local services in your area for people with similar conditions. It’s easier to fight back if you get support.
Martyn James represents free complaints website www.resolver.co.uk.
