A Comprehensive Guide to Personal Independence Payment (PIP)

1. An introduction to Personal Independence Paymentfor support organisations

2. Aims and Objectives Introduction to Personal Independence Payment (PIP) Introduction to PIP Toolkit Assessment Criteria PIP Claim Form PIP Toolkit – About PIP

3. Personal Independence Payment (PIP) will replace Disability Living Allowance (DLA) for eligible claimants from 8 April 2013 DLA was introduced in 1992 and has not been reviewed since Complex and confusing to claim Little independent evidence/involvement No systematic process to review whether an award remains correct Financially unsustainable in the long term Current benefit not in step with the needs of a 21st century welfare system Introduction to Personal Independence Payment PIP Toolkit - Quick Guide

4. Similarities and Differences between DLA and PIP PIP Toolkit – Differences and Similarities

5. Daily Living Mobility Enhanced Enhanced 12points Standard Standard 8 points Not Entitled Not Entitled 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 PIP Toolkit – Conditions of Entitlement

6. Assessment Criteria Daily Living Components (activities 1-10) Mobility Components (activities 11-12) Standard rate = 8 points Enhanced rate = 12 points Standard rate = 8 points Enhanced rate = 12 points Activity 11.Planning and following journeys 12 Moving around Standard 0 - 12 0 - 12 Standard 0 - 8 0 - 10 0 - 8 0 - 8 0 - 8 0 - 8 0 - 12 0 - 8 0 - 8 0 - 6 • Activity • Preparing food • 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 PIP Toolkit – Assessment Criteria

7. Personal Independence Rates Daily Living Component: Standard Rate £53.00 Enhanced Rate £79.15 Mobility Component: Standard Rate £21.00 Enhanced Rate £55.25

8. Assessment principles Individual Considers the impact of a condition, not the condition itself Claimants with the same condition may get different outcomes Objective Based on independent evidence Independent Assessment providers are independent and provide impartial advice Consistent Criteria are more detailed and more clearly defined

9. WCAand PIP – they aren’t the same

10. 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

11. 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 not covered in Regulations, but will form an important part of the assessment. It will be in guidance for assessment providers and Case Managers.

12. Reliably - example Using a walking stick a claimant can walk up to 50 metres. However after doing so they cannot repeat it again the same day. You would reasonably expect someone to walk 50 metres more than once a day. Therefore the claimant does not reliably satisfy descriptor D. The individual can walk shorter distances up to 20 metres and repeat them in the same day. The individual therefore satisfies descriptor E. Example – Activity 12 – Moving around

13. 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. Example – Activity 4 – Washing and bathing

14. Fluctuating conditions – cont. 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 Example – Activity 4 – Washing and bathing

15. 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.

16. Assessment process

17. Health Professional & Case Manager roles Assessment providers advise, DWP Decision Makers make the decisions Health professionals provide an assessment report which will List the sources of evidence Summarise the discussion (if a face-to-face consultation) covering history, medication and treatment, social and occupational history, a typical day etc. Detail examination findings, if appropriate Advise on descriptors and prognosis Justify the advice DM’s should Consider the assessment report and all evidence Is the HP’s advice consistent with all the evidence? Are all issues addressed? Do they have the information they need to make and explain the decision? If not – refer back to the AP

18. 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 • 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 Case Manager to make a decision PIP Toolkit – Assessment Process and Providers

19. The Assessment Providers PIP Toolkit – Assessment Process and Providers

20. Passporting to other benefits and services Many DLA claimants are receiving other benefits, such as ESA Most DLA claimants receiving Incapacity Benefit will have already been reassessed for Employment and Support Allowance by the time they need to make a claim to PIP Claimants receiving DLA or PIP won’t be migrated to Universal Credit until later in the UC rollout Households where someone is in receipt of DLA/PIP are exempt from the new Benefit Cap Most existing passporting arrangements have been maintained for PIP receipt of the Daily Living component (either rate) means that their carer may be entitled to Carer’s Allowance Motability scheme will work with PIP in the same way as it does with DLA Changes in entitlement may affect other benefits or support that the claimant or carer receives PIP Toolkit – Passporting

21. Implementing PIP Introducing PIP for new claimants from April 2013 Reassessing existing DLA claimants from October 2013 PIP Checker: www.gov.uk/pip-checker Use this tool to check: if PIP affects you when your Disability Living Allowance may be affected when you can make a new claim for PIP PIP Toolkit – Implementing PIP

22. Starting a Claim for PIP To start a claim for PIP telephone DWP on: 0800 917 2222 Textphone – 0800 917 7777 These numbers will be available from 8th April 2013. Lines will be open fro 8am to 6pm, Monday to Friday The phone call can also be made by someone supporting the claimant – the claimant will need to be present and give consent DWP will provide interpreters through Big Word – Language Line - for those whose first language is not English

23. New Claims start in April 2013 April 2013 June 2013 New claims to PIP will be taken including from people living in Cheshire, Cumbria, Merseyside, North East England and North West England New claims national rollout PIP Toolkit – Introducing PIP for new claimants

24. Reassessment starts in October 2013 October 2013 October 2015 • From this date, 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) • From this date, 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 claim is made. • If they don’t claim PIP then their DLA claim will end. PIP Toolkit – Reassessing existing DLA claimants

25. 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. Making a claim 2 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. How your disability affects you 3 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. 4 Assessment 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. The claimant journey There are five key stages to claiming 5 Decision A 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. PIP Toolkit – Claimant Journey

26. 1 Thinking about claiming New Claims Family & Friends Support Organisations Online Information is available that explains the eligibility criteria and helps the claimant decide if they want to make a claim. GPs and Healthcare Professionals Leaflets DWP Existing DLA claimants From October 2015 all the remaining claimants in receipt of a DLA award will be invited to make a claim to PIP. We will select those recipients of DLA in receipt of an indefinite award or fixed term award, and notify them about what they need to do to claim PIP. If they choose not to claim PIP then their DLA would end. From October 2013 there will be reassessment to PIP of fixed period DLA awards coming up for renewal, young people turning 16 or where DLA claimants with indefinite awards report a change in their condition Existing DLA claimants will be asked at some point after October 2013 if they want to claim PIP.

27. 2 Making a claim DWP will identify communication needs (such as alternative formats) and consider if the claimant needs additional support Claims are made via a telephone call (0800) to DWP The initial information required to make a claim to PIP will be basic information covering: DWP will explain what happens next • The claimant’s personal and contact details • Residency details (known as residency and presence) • Relevant periods spent in hospital, residential care • Claims under special rules for terminally ill people, and • Payment (bank account) details DWP checks basic eligibility conditions – if not met then a disallowance letter will be issued A form is posted to the claimant. It is individually addressed and barcoded to speed up processing PIP Toolkit – How to Claim

28. 3 How your disability affects you Claimants may ask someone, such as a family member or support organisation to help them complete the form The form allows the claimant to explain how their condition affects them in their own words Some disabled people have fluctuating conditions, that affect them in different ways on ‘good and bad’ days, so they can use the form to explain this Any additional evidence that may help support the claim can be returned with this form The form and any supporting evidence is returned to DWP in a freepost envelope PIP Toolkit – Completing the form

29. 4 Assessment The claim information, completed form and any additional evidence is passed over to the health professional Some assessments may be completed at this stage– such as if someone is claiming under the special rules for the terminally ill or where the written evidence is sufficient Most will be asked to attend a face-to-face consultation They will decide if there is a need for any further evidence and will make all the arrangements to get this PIP Toolkit – Assessment Process and Providers

30. 4 Assessment Face-to-face consultation notrequired Face-to-face consultation required Claimant will be contacted to invite them to a face-to-face consultation Claimants can contact the health professional to ask questions about the consultation or rearrange appointments Claimant attends face-to-face consultation with health professional The health professional reviews all the evidence against a set of everyday activities and clear descriptors to assess the challenges faced by the individual The health professional will ask the claimant to explain how their condition affects them on a day to day basis. The claimant may also be able to provide additional evidence The health professional sends a report back to the DWP to help inform their decision

31. 5 Decision The DWP Case Manager reviews the evidence they’ve received – including the report from the health professional They make a reasoned decision on entitlement, level of award and the length of any award Claimants can call DWP to ask for more information about the decision A decision letter is posted to the claimant If a claim has been disallowed, or an existing award reduced, then the Case Manager will try to call the claimant to explain the decision PIP Toolkit – Decision and Payment

32. Additional Information Special Rules for Terminally Ill People Reviewing Awards Disputes Where to find more information about PIP PIP Toolkit list of contents

33. Special Rules for Terminally Ill People Claims for those who are found to meet the Special Rules for terminally ill people criteria will be dealt with more quickly than normal claims are guaranteed an award of the enhanced rate of the daily living component of PIP without having to wait until they satisfy the qualifying period or prospective test Both the daily living component and, providing the conditions are met, the mobility component will be paid straight away The claimant will not be sent the form ‘How your disability affects you’ they will be asked some extra questions whilst they are on the phone about their condition and how it affects their ability to get around PIP Toolkit – Special Rules

34. Awards of PIP will be based upon the claimant’s circumstances and will look at the impact of their disability or health condition on their daily lives If someone is awarded PIP we will tell them how long the award is for We will write to them to tell them how and when they need to tell us about any change in circumstances Claimants will have their award regularly reviewed 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. If someone is given a longer award we will contact them occasionally to see if their needs have changed over time. Reviewing Awards PIP Toolkit – Reviewing Awards

35. Disputes The change to the appeals process for DWP consists of the following key elements mandatory reconsideration of decisions prior to appeal direct lodgement of appeals with HMCTS time limits for DWP to return appeal responses to HMCTS. DWP will introduce mandatory reconsideration and direct lodgement for PIP from April 2013. PIP Toolkit – Disputes

36. Where to find more information • Information for support organisations and advisers is online at www.dwp.gov.uk/pip. 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 at www.gov.uk/pip. Please signpost to these pages from your own sites or materials. • Updated leaflets will be available too – generic information in existing leaflets from the Autumn, and PIP specific leaflet from early next year. • Talk to your local DWP Partner Manager

37. PIP Toolkit list of contents Key Black – Version 1 January 13 Red – Version 2 post January 13 Green – currently available on line

39. Toolkit for support organisations and advisers Toolkit for support organisations and advisers All about Personal Independence Payment [intro] Content >>Quick guide to PIP (pdf) >>Conditions of Entitlement(pdf) >>Assessment Criteria (pdf) >>Differences and Similarities between PIP and DLA(pdf) >>Passporting(pdf)

40. Toolkit for support organisations and advisers Toolkit for support organisations and advisers Implementing Personal Independence Payment [intro] Content >>PIP Timetable (pdf)>>Introducing PIP for new claimants from April 2013 (pdf) >>Reassessing existing DLA claimants for PIP from October 2013 (pdf) >>PIP calculator (pdf) >>When DWP forms and leaflets will be available

41. Toolkit for support organisations and advisers Toolkit for support organisations and advisers Personal Independence Payment Claimant Journey [intro] Content >>Claimant journey outline (pdf) >>How to Claim PIP (pdf) >>How to fill in the form ‘How your disability affects you’ (pdf) >>Assessment Process and Providers (pdf) >>Decision and Payment (pdf) >>Reviewing PIP awards (pdf)

43. Toolkit for support organisations and advisers Toolkit for support organisations and advisers Personal Independence Payment Specific Circumstances [intro] Content >>Special Rules for Terminally Ill People(pdf) >>Supporting young people(pdf) >>People approaching 65(pdf) >>Supporting people in vulnerable situations(pdf) >>Disputes(pdf)

46. Toolkit for support organisations and advisers Toolkit for support organisations and advisers Personal Independence Payment tools for you to use [Intro text] Editorial [Intro text] >>Introduction text – under 100 words (on page content) >>Short text – under 250 words (on page content) >>Medium text – about 600 words (on page content) >>Long text – about 1000 words (on page content) Presentations [Intro text] >>An introduction to PIP for support organisations and advisers (PowerPoint) Printable material [Intro text] >>Information posters (PowerPoint) >>A quick guide to PIP for support organisations and advisers (pdf) >>A quick guide to PIP for Local Authorities (pdf)