Personal Independence Payment

Personal Independence Payment d.doran@muscul… Tue, 05/18/2021 - 11:24

If you are currently on DLA, in time you will receive a letter from the Department for Work and Pensions (DWP) inviting you to apply for PIP. The letter will give the date of your last DLA payment and give you a deadline that you need to ensure your PIP application is done by.

PIP is a tax-free, non-means-tested payment – this means it is not affected by your earnings, other income or by any savings you may have.

If you receive PIP, you can spend it as you wish.  The money is there to help you with the added expense that living with a disability or long-term health condition can often bring.

The payment is awarded using a points-based system. You can be awarded PIP for a short period (up to two years) or a long period (five to 10 years), with ongoing awards provided where appropriate.

Towards the end of your award period, you are invited to undergo a review to see if your situation is still the same or has changed, which could mean your PIP award could alter. You will be sent a letter about this towards the end of your current award period.

PIP has two components, with two different payment rates. We’ll explain this in detail further on in the guide, but here’s how it looks in simple terms:

Daily Living Component

Mobility Component

Enhanced Rate Enhanced Rate
Standard Rate Standard Rate

How is payment awarded?

A really important thing to know about PIP is that payment is awarded with respect to how your condition affects you, not which condition you have.

Having a diagnosis of a muscle-wasting or associated condition doesn’t guarantee that you’ll be eligible for PIP.

In the application, you need to demonstrate the impact your condition has on your everyday life. This can feel daunting.

It may feel more natural to talk about the parts of daily life that are going well, but it is really important you share the everyday reality of living with your condition.

PIP is considered on a points-based system and rated on how your condition affects you. The more support you need, the higher your points score will be.

Dependent on how many points you score, you may be entitled to either the standard or enhanced rates under the daily living or mobility component.

You need to score:

  •  8 points for the standard rate
  •  12 points for the enhanced rate.

You could qualify for the enhanced rate of both the daily living and mobility components, the enhanced rate of one and standard of the other, or not qualify for one component but qualify for the other – or any combination of these.

On

Am I eligible for PIP

Am I eligible for PIP d.doran@muscul… Tue, 05/18/2021 - 11:50

You must:

  •  have had a health condition for three months before applying, and have the condition for a further nine months after applying
  •  have been in the UK for two of the past three years
  •  be aged between 16 and your state pension age
  •  There are exceptions and additional rules to the eligibility criteria if you have a terminal illness, if you live abroad or if you’re not a British Citizen. Please get in contact if you require further information.

Your needs are considered under the following areas, or ‘descriptors’:

Daily living

  •  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 people face to face 
  • Making budgeting decisions

Mobility

  •  Planning and following journeys
  •  Moving around

When you are being assessed, you will be given the score that best fits with your description of how your condition affects you. This is why it is vital to give as much detail as possible on your application.

SO, HOW DOES PIP GET CALCULATED?

PIP is made up of two separate components:

  •  daily living component – for help participating in everyday life
  •  mobility component – for help with getting around.

Each component is paid at one of two rates: the standard or enhanced rate. Which rate you receive will depend on how your condition affects you.

If successful, you could get one component at one rate, both components at the same rate, or both components at different rates. It is decided on a points system, explained further on in the guide.

The components will be added together to make a weekly rate, which is usually paid every four weeks in arrears directly into your chosen bank account.

Off

How to apply for PIP

How to apply for PIP d.doran@muscul… Tue, 05/18/2021 - 12:29

It’s usually quickest to phone, on 0800 917 2222, but you can also write or text the DWP.

Making a new claim to PIP: 0800 917 2222

General enquiry line for PIP (also for existing claims): 0800 121 4433

Find out more at www.gov.uk/pip

During the initial phone call, you will be asked for details including your full name, date of birth, national insurance number, bank details, address and contact information.

If you have difficulty providing this information over the phone, ask someone to call on your behalf; you will need to be present if someone does this.

Following the call, you will be sent the How your disability affects you form.

This is the PIP application form.

Please refer to the PDF Factsheet on the page titled - Personal Independence Payment for a detailed, stage by stage guide to filling in this form.

Off

Challenging a Decision

Challenging a Decision d.doran@muscul… Tue, 05/18/2021 - 12:36
  1. Initial application
  2. Decision    must send within one month of receiving decision letter
  3. Mandatory reconsideration
  4. Mandatory reconsideration notice  must send within one month of receiving mandatory reconsideration notice
  5. Request appeal
  6. Independent tribunal hearing

Mandatory reconsideration

If you do not agree with a decision, you can ask the DWP to look at this decision again.

This is the first step in the process and is called ‘mandatory reconsideration’. A mandatory reconsideration request needs to be made within one calendar month of the date on the decision letter.

If you have missed the one-month deadline, it is still possible to ask the DWP for a mandatory reconsideration. You would be expected to demonstrate the reasons for submitting a late request.

However, the DWP can refuse your request if submitted late.

Reasons to ask for a mandatory reconsideration would be:

  •  if you think that the level of benefit you have been awarded is incorrect (an example of this would be that you have been awarded the standard rate for the mobility component and you think you should be receiving the enhanced rate)
  •  if you disagree with the length of the award and feel it should be for a longer period.

Please be aware that the DWP will look at your whole application again.

This could go in your favour, but they also have the right to remove any rate of PIP that you were awarded in the DWP’s initial decision.

REQUESTING A MANDATORY RECONSIDERATION

You need to write to the address or call the number outlined at the end of your decision letter.

Calling is usually a quicker, more effective approach to get the process underway.

When you call, do the following:

request a mandatory reconsideration of the decision, and explain why you feel the decision is wrong. Keep it simple at this stage. An example of this would be that the decision does not acknowledge the extent of the support you require.

ask them to send you copies of their documents so you can review them. This will include the assessor report.

ask them for a deadline by which you can then send in additional evidence, and tell them they should not proceed with the reconsideration until they have received this evidence.

If you request the mandatory reconsideration in writing, make sure to keep a copy of the letter and proof of postage (sending recorded delivery where possible).

If you request the mandatory reconsideration by phone, take the full name of the person you spoke to and the date and time. We advise also following this up in writing.

You should hear from the DWP within a couple of weeks. If you haven’t, give the them a call.

When you get the reports, they will give you a wider understanding of why a decision has been made. There will normally be two parts to their documents: a copy of your form and the face-toface assessment report.

Once you have both of these in front of you, take a look at them side by side. Read the report in detail and see if any information about your condition has been missed or misunderstood.

Highlight these differences in your letter. Also try to get medical evidence to back up your claims. When you have gathered the evidence, make copies for your records and then send it to the DWP.

You can let the DWP know if you need additional time to collect evidence, especially if you are awaiting medical evidence.

Mathy, who has congenital myopathy, appealed against a PIP decision.

“I was awarded the standard rate of the mobility allowance. This meant I was no long eligible for my adapted Motability car.

“After an appeal, in which I submitted further evidence from my physiotherapist and a letter from MDUK, I was awarded the higher rate of the mobility component of PIP.

“I found the lack of understanding of my condition very difficult. I felt they didn’t refer to the medical letters I had provided. I had also requested they contact my GP and/ or physiotherapist directly. The effects of my condition are persistent and long-term, and as such are not going to change.”

Once all the information has been received, a case manager at the DWP will look at the original decision along with any new evidence. A decision will be made based on this.

The DWP will then write to you informing you of the outcome.

This letter is called a ‘mandatory reconsideration notice’. Keep this letter in a safe place, as you will need it if you choose to appeal to a tribunal.

INDEPENDENT TRIBUNAL

You must have been through the mandatory reconsideration process before you can appeal to an independent tribunal.

If you feel the mandatory reconsideration decision is incorrect, the next stage is to take the case to an independent tribunal.

An appeal needs to be made within one calendar month of the date on the mandatory reconsideration decision letter.

If you have missed the one-month deadline, it is still possible to appeal the DWP’s decision.

The tribunal service will review your appeal submission and make a decision on whether your appeal can go ahead. You would be expected to demonstrate the reasons for submitting a late request.

Her Majesty’s Courts and Tribunal Service (HMCTS) review appeals. This service is independent of the DWP. Any information must be submitted directly to the HMCTS.

Details will be on your mandatory reconsideration notice.

 

Off

Requesting an appeal

Requesting an appeal d.doran@muscul… Tue, 05/18/2021 - 13:24

 www.gov. uk/social-security-child-support-tribunal/appealtribunal (England, Scotland and Wales only).

Alternatively, call your local HMCTS and ask for an appeal form to be sent to you by post.

HMCTS CONTACT INFORMATION 

England and Wales: 0300 123 1142 (Monday to Friday, 8.30am to 5pm)

Scotland: 0141 354 8400 (Monday to Friday, 8.30am to 5pm)

Northern Ireland: 0300 200 7812

In Northern Ireland, use appeal form NOA1(SS), which you can download from:

www.nidirect.gov. uk/publications/appeals-form-noa1ss

The forms will ask for your name, address and, if you have one, details of your chosen representative.

Your representative is someone who can speak about your condition at the tribunal. You do not have to have a representative. It may be that you are representing yourself. If this is the case you can bring along a friend or relative to support you.

There is a section where you can share why you feel you have grounds to appeal.

You will be asked the decision date, name of benefit and the outcome. This information can all be found on your mandatory reconsideration notice.

The next section will ask you to state why you feel the decision is incorrect.

Explain in your own words why you feel the decision is wrong. If possible, link back to any medical evidence you have provided to the DWP.

For example: ‘the report stated I could chop vegetables but my consultant letter stated I have a very weak grip and am unable to hold a knife safely’.

You will be asked if you wish to attend the hearing. There is no pressure to attend and it is completely down to you, but it can be helpful for the tribunal panel if you do go along.

If you choose not to or are unable to attend the tribunal, a decision will be made using the evidence you submit.

Make a copy of the form and return it to HMCTS at the address on the form. A copy of the mandatory reconsideration notice also needs to be included.

Once the tribunal service or HMCTS has received the form, you will receive an acknowledgement in the post. HMCTS will then send a letter to DWP informing them of your appeal.

The DWP will write to the HMCTS outlining why they made the decision they did. This will include your original application form and their assessment report. A copy will also be sent to you and, if you have one, your representative.

Your local MP may be able to offer you support, so do let them know your situation and why you are appealing.

You can find your MP here:

www.parliament.uk/get-involved/contact-your-mp

WAITING FOR THE HEARING

It can take some time to have your appeal heard. We know this wait can be stressful for many people.

The length of time depends on where you live and how busy your local service is.

It’s important that you let HMCTS know of any upcoming appointments or holidays you have booked. It can be quite time-consuming to get an appeal date moved so it’s good to avoid this if you can.

While you’re waiting for your hearing date to come through, think about any additional people you could approach who could provide additional evidence. You can send information through up until two weeks before the hearing date.

THE HEARING

If you have opted to attend the hearing you will receive a date in the post. Don’t worry; the independent tribunal is not like attending a formal court. The venue should be accessible and the clerk of the court will be there to assist you.

If you need support from a carer or family member, they can also attend the tribunal hearing. Please ensure that you arrive promptly and allow additional time to pass through security.

You can bring notes to help you remember everything. It can be helpful to read through the information and highlight key things you want to ensure you get across in the hearing.

Karan, who has Charcot-Marie-Tooth disease, went to a hearing.

“The date of my hearing arrived and I attended the magistrate’s court. “The clerk was there to help me. She talked me through the process and told me whom everyone was. There was a lady there who was to do with my daily living, and a judge and a doctor. 

“All of these people are completely independent. They are there to make their own minds up based on the information they have been given. They will all ask you questions about how your disability affects you daily.

“The DWP were there. They only asked me one question. I was also able to share my experience of living with this condition. We were then asked to leave the room whilst a decision was made.

This took around five to 10 minutes. We were called back in to receive their decision which I am happy to say went in my favour.”

The tribunal panel is usually made up of three independent people.

A solicitor will lead the tribunal. There will be a person with a medical background and a lay person who has some experience of disability. All will introduce themselves to you and your representative.

The DWP can send a presenting officer to put forward their position and challenge the points that you have made in the appeal document. This is standard practice and should not be anything to worry about.

The panel will then ask a series of questions based on what you have put on your form and any additional supporting information you have provided them with.

Take your time and don’t feel rushed – this is your chance to explain to them how your condition affects you. If you need to pause or take a moment for a drink of water, this is perfectly acceptable and most definitely understandable.

If a DWP presenting officer is there, they will have an opportunity to ask you a few questions. If you have chosen to have a representative, they will also have an opportunity to raise anything they feel may have been missed and challenge any points made by the DWP.

You will be then be asked to leave the room for the tribunal panel to discuss your case. You will either be informed that day of their decision or very soon after your hearing. You will receive a copy of the decision notice and a copy will be sent to the DWP.

If the outcome is in your favour, then the DWP will make the necessary changes and you will start to receive your award. Within a few weeks of the decision being changed, you will also receive any back payment, backdated from the date you made the claim.

If your appeal is unsuccessful, you can request (in writing) a detailed explanation of why this is.

 

Off