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Daily Record
Daily Record
Lifestyle
Linda Howard

People making new claim for PIP may not need to attend an assessment

Personal Independence Payment (PIP) is a benefit for people with a long-term health condition or impairment, which can be physical, sensory, mental, cognitive, intellectual, or any combination of these. It is paid by the Department for Work and Pensions (DWP) to make a contribution to the extra costs that disabled people may face, to help them lead full, active and independent lives.

The benefit is not means tested and is non-taxable and non-contributory. This means that entitlement to the benefit is not dependent on a person’s financial status or on whether they have paid National Insurance contribution s. PIP can be paid to those who are in full or part-time work as well as those out of work.

The final part of a new PIP claim involves an assessment, which looks at an individual’s ability to carry out a series of everyday activities. The assessment considers the overall impact of a claimant’s health condition or impairment on their functional ability, rather than focusing on a particular diagnosis.

Updated guidance on GOV.UK clarifies that PIP is “not a compensation payment for ill health / disability; it is to help people with the increased costs of daily living in cases of long-term ill health or disability”.

It adds: “PIP sits alongside support provided by the NHS and local authorities and is not meant to duplicate that support.”

The activities explored during the PIP assessment are:

Daily living (10 activities)

  • preparing and cooking a simple meal
  • taking nutrition
  • managing therapy or monitoring a health condition
  • washing and bathing
  • managing toilet needs or incontinence
  • dressing and undressing
  • communicating verbally
  • reading and understanding signs, symbols and words
  • engaging with other people face-to-face
  • making budgeting decisions

Mobility (2 activities)

  • planning and following journeys
  • moving around

Each activity contains a series of descriptors which describe increasing levels of difficulty with carrying out the activity.

The total scores for all of the activities related to each component determine entitlement for that component. The entitlement threshold for each component is 8 points for the standard rate and 12 points for the enhanced rate.

PIP payment rates 2022/23

Daily Living Component

  • Enhanced: £92.40
  • Standard: £61.85

Mobility Component

  • Enhanced: £64.50
  • Standard: £24.45

Cases that should not require a consultation

There are certain circumstances which may mean a new claimant may not require a consultation with a health professional.

DWP explains: “Although each case should be determined individually, the following types of cases should not normally require a consultation.”

  • The claimant questionnaire indicates a low level of disability, the information is consistent, medically reasonable and there is nothing to suggest under-reporting.
  • The health condition(s) is associated with a low level of functional impairment, the claimant is under GP care only and there is no record of hospital admission.
  • There is strong evidence on which to advise on the case and a consultation is likely to be stressful for the claimant - for example, claimants with autism, cognitive impairment or learning disability.
  • The claimant questionnaire indicates a high level of disability, the information is consistent, medically reasonable and there is nothing to suggest over-reporting - examples may include claimants with severe neurological conditions such as multiple sclerosis, motor neurone disease, dementia, Parkinson’s disease, severely disabling stroke.
  • There is sufficient detailed, consistent and medically reasonable information on function.

Cases that are likely to require a consultation

DWP guidance also states: “For cases where there is marked inconsistency, the claimed level of disability is unexpected based on the available evidence, or it has not been possible to gain sufficient further evidence, a consultation will be required.”

Health professionals are also encouraged to carry out assessments using a paper-based review in cases where they believe there is “sufficient evidence in the claim file, including supporting evidence, to provide robust advice to the DWP on how the assessment criteria relate to the claimant”.

It adds that it is “vital all advice is sufficiently evidenced”.

If you have an assessment coming up, we have a handy checklist to help you understand the process - find out more here.

To keep up to date with the latest benefits news, join our Money Saving Scotland Facebook group here, follow Record Money on Twitter here, or subscribe to our twice weekly newsletter here.

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