Transcript PIP Presentation Dec 2013

An introduction to
Personal Independence
Payment
Introduction to PIP
• Personal Independence Payment (PIP) is a new disability benefit
• Personal Independence Payment has replaced Disability Living
Allowance (DLA) for new claims from adults aged 16-64
• DLA remains for children up to age 16; and DLA recipients aged 65
or over on 8 April 2013 (day that PIP was introduced)
• PIP helps towards some of extra costs arising from health condition
or disability
• PIP based on how person’s condition affects them, not condition
itself
• Same way as DLA, claimants can get PIP whether in or out of work
• Not means tested or taxed
PIP Toolkit - Quick Guide
Department for Work & Pensions
2
Similarities and differences between DLA
and PIP
Similarities
Differences
• Extra-costs cash benefit
• three month qualifying period
and nine month prospective test
• Not means-tested or taxable
• New assessment criteria
• Two components
• Payable both in and out of work
• Individual assessment and
face-to-face consultation
• Maintains links to passported
benefits where possible
• Planned interventions
• Special rules for terminally ill
people
• Reconsiderations process
PIP Toolkit – Differences and Similarities
Department for Work & Pensions
3
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
Daily
Living
Mobility
Enhanced
Enhanced
12 points
Standard
Standard
8 points
Not Entitled
Not Entitled
PIP Toolkit – Conditions of Entitlement
Department for Work & Pensions
4
Assessment Criteria
Daily living component (activities 1-10)
Standard rate = 8 points
Enhanced rate = 12 points
Activity
Mobility component (activities 11-12)
Standard rate = 8 points
Enhanced rate = 12 points
Possible
points
Activity
Possible
points
1. Preparing food
0-8
11. Planning and following journeys
0-12
2. Taking nutrition
0-10
12. Moving around
0-12
3. Managing therapy or monitoring a
health condition
0-8
4. Washing and bathing
0-8
5. Managing toilet needs or
incontinence
0-8
6. Dressing and undressing
0-8
7. Communicating verbally
0-12
8. Reading and understanding signs,
symbols and words
0-8
9. Engaging with other people face-toface
0-8
10. Making budgeting decisions
0-6
Department for Work & Pensions
PIP Toolkit – Assessment Criteria
5
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
PIP Toolkit – Assessment Process and Providers
Department for Work & Pensions
6
The new assessment
• 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
Decision Maker to make a decision
PIP Toolkit – Assessment Process and Providers
Department for Work & Pensions
7
PIP Assessment Providers
Atos Healthcare is Assessment
Provider in Scotland, North East
and North West England and in
London and Southern England
PIP Toolkit – Assessment Process and Providers
Department for Work & Pensions
8
Timetable for PIP replacing DLA
From 28 October, natural reassessment started in Wales,
West Midlands, East Midlands and East Anglia for
• those with fixed period DLA awards coming up for
renewal
• children who turn 16 years old on or after 7 October
2013 (unless they have been awarded DLA under the
Special Rules for terminal illness)
• those where there is a report of a change in the DLA
claimant’s health condition or disability
• existing DLA claimants aged 16-64 who wish to make a
PIP claim.
• From 13 January 2014, reassessment areas extend to
postcodes beginning: DG, EH, TD and ML in southern
Scotland and parts of the borders.
• From 3 February, areas further extend to include
postcodes beginning: CA, DL, HG, LA and YO in the
north of England.
October
2013
January
2014
PIP Toolkit – Reassessing existing DLA claimants
PIP Toolkit – Postcode Map
Department for Work & Pensions
9
Timetable for PIP replacing DLA
Further decisions on extending natural reassessment will be taken
and communicated to the rest of the country in due course and will
be informed by the experience of introducing reassessment in a
gradual way first.
• From October 2015
– DWP begin to invite remaining DLA
claimants to claim PIP who were
aged between 16 and 64 on the day
that PIP was introduced (8 April
2013
October
2015
• 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
PIP Toolkit – PIP checker
Department for Work & Pensions
10
Reassessment
Postcode
Map
PIP Toolkit – Postcode Map
Department for Work & Pensions
11
The claimant journey
There are five key stages to claiming
1
Thinking about claiming
2
Making a claim
3
How your disability affects you
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.
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.
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
5
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 Decision Maker 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
Department for Work & Pensions
12
PIP claim call: basic info needed

Claimant’s personal and contact details

Residency and presence details

Relevant periods spent in hospital or residential care

Payment (bank account) details
PIP Toolkit – How to claim
Department for Work & Pensions
13
PIP new claim process
• New claims line: 0800 917 2222
(textphone: 0800 917 7777)
• PIP enquiries: 0845 850 3322
(textphone: 0845 601 6677).
• Claimants sent ‘How your disability
affects you’ form – return with supporting
evidence already held
PIP Toolkit – How to claim
Department for Work & Pensions
14
‘How your disability affects
you’ form

Explains how condition affects claimants in own words

Include affect on ‘good and bad’ days
PIP Toolkit – Completing the form
Department for Work & Pensions
15
‘How your disability affects
you’ form

Family member or support organisation
can help

Additional evidence already available to
help support the claim returned included
PIP Toolkit – Completing the form
Department for Work & Pensions
16
How eligibility is assessed
• Assessment considers effect of health
condition or disability on daily life
• Information considered by Assessment
Provider
• They may request further evidence from a
relevant health professional or someone who
supports claimant
PIP Toolkit – Assessment process and providers
Department for Work & Pensions
17
How eligibility is assessed
Assessment Provider may arrange face-toface consultation with claimant who:
– can ask questions about the consultation
or rearrange appointment
– explains how condition affects them on a
day to day basis
– is able to provide additional evidence
PIP Toolkit – Assessment process and providers
Department for Work & Pensions
18
PIP decision
• DWP calls claimant to explain for decisions not to award PIP
• DWP tell claimants how and when to report change in
circumstances
PIP Toolkit – Decision and Payment
Department for Work & Pensions
19
Award reviews
• The length of award for PIP will be based
upon each claimant’s individual
circumstances
• DWP regularly reviews awards
• When awards ends, claimant can make new
claim
• DWP contact claimants with longer awards
occasionally to see if needs have changed
PIP Toolkit – Decisions and Payment
Department for Work & Pensions
20
Special rules for terminal illness
• Claims for those who are found to meet the special rules for
terminal illness 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
Department for Work & Pensions
21
Special rules for terminal illness
 Special rules claims line: 0800 917 2222
(text phone 0800 917 7777)
 DS1500 report needed to support claim
 Both the Daily Living and, providing conditions met, the Mobility
component paid straight away
 Don’t have to complete the ‘How your disability affects you’ form
 Don’t need a face-to-face consultation
PIP Toolkit – Special rules
Department for Work & Pensions
22
Rising 16s
• Children can continue to claim DLA until they are 16
• These changes do not affect children in receipt of Disability Living
Allowance
• They'll continue to receive it until they reach 16 when they become eligible
for Personal Independence Payment.
• DWP will write to children who turn 16 years old on or after 7 October 2013
(unless they have been awarded DLA under the Special Rules for terminal
illness), to invite them to claim PIP
• Existing DLA SRTI claimants, including young people reaching 16, will only
be invited to claim PIP when their DLA award expires.
• There are no plans to extend PIP to new or existing claims for children
Department for Work & Pensions
23
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
– Households where someone is in receipt of DLA/PIP are exempt
from the new Benefit Cap
PIP Toolkit – Access to other benefits and services
Department for Work & Pensions
24
Passporting to other benefits
and services
• 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 – Access to other benefits and services
Department for Work & Pensions
25
Motability, Blue Badge, Concessionary
travel and Vehicle Excise Duty
• If a claimant gets the enhanced rate of the mobility part of
Personal Independence Payment, they may be able to use all or
part of their allowance to lease a car, scooter or powered
wheelchair from the Motability scheme
• If a claimant gets the mobility part of Personal Independence
Payment they might be able to claim for a Blue Badge
• They may also be able to claim a pass to travel for free on public
transport
• If the claimant gets the enhanced rate of the mobility part of
Personal Independence Payment they won’t have to pay car tax
• If the claimant gets the standard rate of the mobility part of
Personal Independence Payment they will only have to pay half
the price of a car tax disc
PIP Toolkit – Access to other benefits and services
Department for Work & Pensions
26
Claimants in care homes
• PIP Daily Living component
will stop being paid after total
28 days in a care home
• Mobility component payment
not affected when claimant is
in care home
Claimants in hospitals
• Both components of PIP will stop 28
days after claimant admitted to NHS
hospitals
Department for Work & Pensions
27
Awards
• 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
PIP Toolkit – Disputes
Department for Work & Pensions
28
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
Department for Work & Pensions
29
Where to find more information
• Information for support organisations and advisers is online at
www.gov.uk/pip/toolkit. 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 on www.gov.uk. Please
signpost to these pages from your own sites or materials
• Updated leaflets are also available – generic information in existing
leaflets, and PIP specific leaflet
• Talk to your local DWP Partner Manager
Department for Work & Pensions
30
PIP Toolkit list of contents
Core Products
Fact sheets
•
Introduction to PIP Toolkit
•
Quick Guides
•
•
•
•
•
PIP Timeline
•
Claimant Journey
•
External PIP white brand presentation and
speaker notes
•
Sample forms and notifications
•
Leaflets
•
PIP Communications Products and Timeline
•
Sample Assessment Provider notifications
Department for Work & Pensions
•
•
•
•
•
•
•
•
•
•
•
•
Conditions of Entitlement
Assessment Criteria
The difference between PIP and DLA
Reassessing existing DLA claimants for PIP (from
Oct 2013)
How to Claim PIP
Completing the How your disability affects you
form
Assessment Process
Decision and Payment
Reviewing Awards
Special Rules for Terminally Ill People
Young People approaching age 16
People approaching age 65 and over
Passporting to other benefits
Vulnerable Claimants (includes signposting)
Disputes Process
Changes of Circumstances
31