An introduction to Personal Independence Payment for support organisations

1. An introduction to Personal Independence Paymentfor support organisations April 2013 Version V 2

2. What is Personal Independence Payment? • Personal Independence Payment (PIP) is a new benefit to help disabled people live full, active and independent lives. • It will replace Disability Living Allowance (DLA) from 8 April 2013. • PIP will help towards some of the extra costs arising from having a long term condition (this means ill-health or disability expected to last 12 months or longer). • It is based on how a person's condition affects them, not the condition they have. PIP has a 3 month qualifying period and 9 month prospective test

3. What is Personal Independence Payment? (continued) • 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. • PIP is a benefit people can get whether they are in or out of work. • It is not affected by income or savings and is not taxed. • PIP has links to passported benefits where possible • Entitlement to PIP will be decided based onassessment criteria which consider the ability to carry out a range of everyday activities

4. 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

5. 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

6. 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

7. Who are the assessment providers? The PIP assessment process will be managed by two assessment providers: Atos Healthcare - Scotland, North East and North West of England, London and Southern England Capita Business Services Ltd – Wales and Central England and Northern Ireland

8. What is the Personal Independence Payment Assessment? The PIP assessment considers people as individuals, focussing on the impact their condition(s) has on their daily lives and over a range of different activities The PIP assessment is carried out byhealth professionals who consider evidence provided by the claimant, along with any further evidence they think is needed against aset of assessment criteria 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 Face-to-face consultations may not be necessary for everyone – for example, those who are terminally ill may not have to have them Home visits will be available when necessary The health professional will send a report to the DWP following the assessment, for the DWP Case Manager to make a decision.

9. April 2013 June 2013 New Claims start in April 2013 New Claims to PIP will be taken from people living in Cheshire, Cumbria, Merseyside, North East England and North West England New claims national rollout

10. October 2013 October 2015 Reassessment starts in October 2013 • 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) 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 is made - if they don’t claim PIP then their DLA claim will end

11. 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. Special Rules claims will be dealt with more quickly 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 5 Assessment Decision 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 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. How is Personal Independence Payment claimed?

12. What happens after a decision is made about Personal Independence Payment? Disallowance/reduced award phone call After the decision letter is issued, a DWP Case Manager will contact the claimant to explain the decision – where PIP has not been awarded or where the award is lower than the DLA award in reassessment cases Awards and Reviews PIP awards will be based on the claimant’s circumstances and the impact of their disability/health condition; the length of award will be included in the decision letter along with when and how changes in circumstances need to be reported There will be fewer ongoing awards; more awards of shorter duration (eg 2, 5, 10 years) Awards will be reviewed at pre-determined intervals to see if the claimant’s needs have changed over time and to make sure their award is still correct 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

13. What happens after a decision is made about Personal Independence Payment? (continued) Disputes PIP has a reconsideration process which claimants will have to follow before they can appeal against a decision From April 2013, disputes about PIP decisions will come under new arrangements DWP is introducing This means that if someone is not happy with their PIP decision: - the first, mandatory step, is for the decision to be reconsidered by the DWP Case Manager - if the issue is not resolved at the reconsiderations stage, there is a right to appeal - appeals must be lodged directly with Her Majesty’s Courts and Tribunals Service (HMCTS) Appeals will only proceed after the claimant has had their decision reconsidered - this will be explained in the reconsideration notification Only those appeals that are validated will be sent to DWP for a response which will help to reduce nugatory appeals beingheard

14. PIP Toolkit list of Contents