Making a PIP Application

Questions about making a Personal Independence Payment Application? Mick Laffey, Legal Director in our Medical Negligence and Serious Injury team, advises…

Following an accident, or because of illness or injury, a lot of our clients find themselves in the position of having to apply for “State Help” for the first time.

Personal Independence Payment, or PIP for short, is The State’s first line of assistance for those who require help to live their daily lives, or simply to get around. It is a benefit to help with the extra costs associated with disability.

It is non means tested – which means that it is not taken into account for taxation purposes. You can work whilst receiving PIP without penalty or additional taxation.

It is a benefit designed to cover all kinds of problems, illnesses, and injuries, both physical and mental. It is therefore, by definition, somewhat unwieldy as it is a “one size fits all” situation.

That being said, it can provide very valuable, welcome and necessary assistance to those who find themselves needing to apply for it.

The main starting point to think about when making an application for PIP is that it is designed to look at the problems and issues caused by the applicant’s condition – not the actual condition itself.

People with terrible sounding ailments may fail to qualify if said ailments don’t really have that much of an effect upon them. If the condition deteriorates, they can apply later. A failure in a PIP application does not mean the applicant can never apply again. Far from it. Deterioration is a standard reason for re-applying and should not dissuade an applicant from trying again if they are worse now than in an earlier application.

It is often said to be quite difficult to qualify for PIP – but so it should be. This benefit, by its very nature, exists to assist disabled applicants. That being said, if you feel you would qualify you should apply.

The benefit is split into two distinct areas. The first component covers “Daily Living” including the applicant’s ability to look after themselves by cooking, dressing, washing, toileting and budgeting for example.

The second covers the applicant’s ability to get around – be that because of physical problems reducing their ability to walk or because of mental health issues significantly prohibiting their ability to get around.

This second component is certainly the better-known side of PIP applications as an award of the mobility component at the higher rate, with at least 12 months left, entitles to applicant to apply for a mobility car. This is a vehicle which is taxed, tested, MOT’d, serviced and insured. A deposit can be given to secure a better vehicle if desired.

Motability cars such as this account for the largest fleet of vehicles in the UK – at around (a breath-taking) 630,000 vehicles at any one time. Given that leases last for three years (which can be extended to up to five years) this presumably means that around 200,000 brand new cars roll off the forecourts each year supported by Motability. It certainly gives mobility and freedom to the most disabled in the country and is a benefit well worth having for recipients.

To succeed in either the Daily Living and/or Mobility component of PIP an applicant must attract a certain number of points to each part of the claim. If one obtains eight points for either, that benefit will be paid at the Standard Rate. If the applicant can get to 12 or more points, then the enhanced rate is payable.

To be quite clear then, to “get the car on Motability” as outlined above, the applicant would have to qualify for at least 12 points which could be broken down in several different ways. For example :-

• An applicant would get 12 points for “moving around” IF they are able to convince the DWP that they are so physically disabled that they cannot stand and walk more than 20 metres, either with a stick or sticks or not, reliably, repeatedly, and safely. That is a very short distance indeed and implies a very significant restriction.
• Or the Applicant would get 12 points for “planning and following journeys” IF they are able to convince the DWP that they are unable to follow the route of a familiar journey without another person, an assistance dog or an orientation aid. This could include visual difficulties or those with such overwhelming psychological issues as to make such a journey – even a familiar one – unmanageable.
• Or possibly a hybrid situation where an applicant is only able to walk for 50-200 metres reliably, repeatedly and safely under the “moving around” section, and is awarded four points AND ALSO shows that at the same time they qualify for eight points under the “planning and following journeys” section because they simply could not plan the route of a journey.

If you are awarded 12 points or more for the Mobility component as detailed above, then you would receive the “enhanced award” for that component – which can be used to apply for a car.

If you received the enhanced award for Daily Living only, then you cannot convert that enhanced award into the car – it only counts for the mobility component.

So what advice can we give to someone applying for PIP?

Be Accurate, Tell the truth and don’t exaggerate!

This may sound obvious, but nothing looks worse than a massive over exaggeration of symptoms or effects. The health care professionals who examine you are trained to look out for exaggerated claims. Your whole claim can be undermined by credibility issues if you exaggerate. The scheme is designed to pay benefits only to those considered to be significantly disabled.

Consider the Activities and the various descriptors and see how your issues fit into them, and accurately and honestly state the same.

That being said - make sure you explain the effect your problems have upon you clearly and succinctly. That is to say, don’t forget or be afraid to accurately notify the DWP of your problems – however embarrassing or personal.

There are a number of ways you can attract points and applicants sometimes forget to point out the effects upon them.

Daily Living, for example, being the first of ten activities listed in this component, relates to the applicants ability to “prepare food” for themselves. The word “cook” in this context is generally accepted to mean “the ability to heat food at or above waist height”. This is, as always, within the caveats of safely, to an acceptable standard, repeatedly and within a reasonable time period.

An applicant who is physically unable to stand up for more than a few minutes would usually qualify for two points as they may need an aid in the form of a perching stool to enable them to undertake this task. At the other end of the spectrum for this activity, someone who is totally unable to prepare and cook food AT ALL would qualify for eight points for the “preparing food” activity alone. There are a number of other descriptors within this activity which could attract points. Someone who can show the effect of their issues means they cannot use a conventional cooker and can only cook a simple meal using a microwave would qualify for two points. Similarly, someone who requires prompting (ie reminding or encouraging or explaining by another person) would also receive two points. An applicant who requires supervision (i.e. the continuous presence of another person for the purpose of ensuring their safety) OR assistance (i.e. physical intervention by another person (not just verbal encouragement) would also receive four points.

As you can see there are a number of ways to obtain points in each of the activities and careful thought should be given within an application to provide an explanation as to how affected the applicant is in each of these areas.

Applicants often gloss over the issues they may have for Activity 5 – “managing toilet needs or incontinence” for example. If you have issues here don’t be too embarrassed to say it. This is not the time or place to be embarrassed!

This may mean that you have assistance filling in your form via a specialist solicitor or from an organisation such as the Citizens Advice Bureau or similar.

A specialist can help you to correctly identify your problems and log them on the form. This is simply to ensure nothing is missed by you. They will not add in anything inaccurate or misleading and an experienced representative can be a very useful check and balance to assist with your claim.

Back up what you say with medical evidence where possible.

This could be as simple as you providing copies of letters to you from a treating hospital. If you have something detailing your injuries and how they affect you that would be very useful to show to the DWP. Doctors often describe the problems and the effect they have upon patients when writing after appointments, and such a letter can be very useful in applications such as this.

This could include you obtaining your last few years’ GP records and associated documents (such as letters sent to your GP via a hospital) to bolster your application. The DWP will find medical evidence very useful in explaining and supporting your claim.

Don’t be afraid to appeal if you feel that all or part of your application is wrong.

Again, this is best made with some form of representation purely because of the difficulties involved in the system – but it is not essential if you are able to accurately and succinctly explain why you feel the DWP has got it wrong.

This is best done with reference to the exact activities and descriptors you feel you should have been awarded. Provide as much documentation as you can (see note re medical evidence above) for the appeal. Your first appeal will be on paper. If you disagree with that one too, the next appeal will be a hearing in front of an experienced, and independent, panel of three. This hearing could be face to face or possibly by telephone or even remotely. Please don’t feel too overwhelmed by this. The panel are trained to look at the case itself and you should not be dissuaded if you feel the wrong decision has been made.

Make sure your application is in time!

Apply as soon as you have been affected by a condition or problem for more than three months which you feel is likely to affect you for a year or more.

And if you feel that you want to appeal do so ASAP. Any notification of an award will explain the timescale within which you need to appeal and how to do so. Please act quickly.

Make sure your form is legible and use additional sheets of paper if necessary – but keep it succinct and readable!

An application for PIP is meant to be easy and straightforward – but it isn’t regrettably.

It consists of an application form and then an examination/assessment with a health care professional. That information, and any medical evidence you disclose, will be passed to a DWP decision maker who will consider your application as a whole and make a decision.

If you’re not happy with the decision – or feel it is wrong – you can appeal it. Be careful however as there is no guarantee that an award you have been given will be enhanced – and may possibly even be reduced.

At Burnetts we are used to dealing with clients who have had the most serious injuries following an accident or assault, who find themselves having to apply for this, and other, benefits for the first time.

As part of the claims process, it’s not a problem to help – it’s all part of the service to our clients’ following accidents at work, in RTA’s or elsewhere.