Transcript An introduction to Personal Independence Payment for

An introduction to
Personal Independence
Payment
for support organisations
Aims and Objectives
• Introduction to Personal Independence Payment (PIP)
• Introduction to PIP Toolkit
• Assessment Criteria
• PIP Claim Form
PIP Toolkit – About PIP
Department for Work & Pensions
2
Introduction to Personal Independence Payment
• 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
PIP Toolkit - Quick Guide
Department for Work & Pensions
3
Similarities and Differences between DLA and PIP
Similarities
Differences
• Extra-costs cash benefit
• 3 month qualifying period
and 9 month prospective
test
• Not means-tested or
taxable
• Two components
• New assessment criteria
• Payable both in and out of
• Individual assessment
work
and face-to-face
• Maintains links to
consultation
passported benefits where
possible
• Planned interventions
• Special rules for
terminally ill people
Department for Work & Pensions
• Reconsiderations process
PIP Toolkit – Differences and Similarities
4
Components and Eligibility
•
•
•
PIP will be made up of two components – daily
living and mobility
Daily
Living
Mobility
Each can be paid at standard rate, or enhanced
rate for those with the greatest needs
Enhanced
Enhanced
The PIP assessment criteria will consider the
individuals’ ability to carry out a range of
everyday activities
Standard
12 points
Standard
8 points
Not Entitled
Not Entitled
•
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
Department for Work & Pensions
5
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
1.
Preparing food
2.
Taking Nutrition
Standard
0-8
0 - 10
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 to face
0-8
10.
Making budgeting decisions
0-6
Activity
Standard
11.Planning and following journeys
0 - 12
12 Moving around
0 - 12
PIP Toolkit – Assessment Criteria
Department for Work & Pensions
6
Personal Independence Rates
Daily Living Component:
Standard Rate £53.00
Enhanced Rate £79.15
Mobility Component:
Standard Rate £21.00
Enhanced Rate £55.25
Department for Work & Pensions
7
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
Department for Work & Pensions
8
WCA and PIP – they aren’t the same
Similarities with DLA
– Points-based assessment
– Face-to-face consultation main
means of gathering evidence
– Regular reviews
Method
Department for Work & Pensions
Differences
– WCA tests capability to work, PIP
is about ability to carry out
everyday activities
– WCA is a functional assessment,
PIP assessment focuses on
support needed
Content and principle
9
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
A
Can take nutrition unaided.
0
B
Needs –
i. to use an aid or appliance to be able to take nutrition; or
ii. supervision to be able to take nutrition; or
iii. assistance to be able to cut up food.
2
C
Needs a therapeutic source to be able to take nutrition.
2
D
Needs prompting to be able to take nutrition.
4
E
Needs assistance to be able to manage a therapeutic source to take nutrition.
6
F
Cannot convey food and drink to their mouth and needs another person to do so.
10
Department for Work & Pensions
10
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.
Department for Work & Pensions
11
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.
Department for Work & Pensions
Example – Activity 12 – Moving around
A
Can stand and then move more than 200
metres.
0
B
Can stand and then move more than 50
metres but no more than 200 metres.
4
C
Can stand and then move unaided more
than 20 metres but no more than 50
metres.
8
D
Can stand and then move using an aid or
appliance more than 20 metres but no
more than 50 metres.
10
E
Can stand and then move more than 1
metres but no more than 20 metres.
12
F
Cannot –
i. stand; or
ii. move at all; or
iii. move more than 1 metre.
12
12
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.
Department for Work & Pensions
Example – Activity 4 – Washing and bathing
A
Can wash and bathe.
0
B
Needs to use an aid or appliance to be
able to wash or bathe.
2
C
Needs supervision or prompting to be
able to wash or bathe.
2
D
Needs assistance to be able to wash
either their hair or their body below
the waist.
2
E
Needs assistance to be able to get in
or out of a bath or shower.
3
F
Needs assistance to be able to wash
their body between the shoulders
and waist.
4
G
Cannot wash and bathe at all and
needs another person to wash
their entire body.
8
13
Fluctuating conditions – cont.
Example – Activity 4 – Washing and bathing
• 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
Department for Work & Pensions
A
Can wash and bathe.
0
B
Needs to use an aid or appliance to be
able to wash or bathe.
2
C
Needs supervision or prompting to be
able to wash or bathe.
2
D
Needs assistance to be able to wash
either their hair or their body below
the waist.
2
E
Needs assistance to be able to get in
or out of a bath or shower.
3
F
Needs assistance to be able to wash
their body between the shoulders
and waist.
4
G
Cannot wash and bathe at all and
needs another person to wash
their entire body.
8
14
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.
Department for Work & Pensions
15
Assessment process
Department for Work & Pensions
16
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
Department for Work & Pensions
17
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
Department for Work & Pensions
18
The Assessment Providers
PIP Toolkit – Assessment Process and Providers
Department for Work & Pensions
19
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
Department for Work & Pensions
20
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
Department for Work & Pensions
21
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
Department for Work & Pensions
22
New Claims start in April 2013
April
2013
June
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
2013
PIP Toolkit – Introducing PIP for new claimants
Department for Work & Pensions
23
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
Department for Work & Pensions
24
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 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
Department for Work & Pensions
25
1
Thinking about claiming
New Claims
Information is available that
explains the eligibility criteria
and helps the claimant decide
if they want to make a claim.
Family &
Friends
Leaflets
Existing DLA claimants
Existing DLA claimants will
be asked at some point
after October 2013 if they
want to claim PIP.
Department for Work & Pensions
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
Online
DWP
Support
Organisations
GPs and
Healthcare
Professionals
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.
26
2
Making a claim
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:
• 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 will identify communication needs (such as alternative
formats) and consider if the claimant needs additional support
DWP will explain what happens next
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
Department for Work & Pensions
27
3
How your disability affects you
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
Claimants may ask someone,
such as a family member or
support organisation to help
them complete the form
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
Department for Work & Pensions
28
4
Assessment
The claim information,
completed form and any
additional evidence is
passed over
to the health professional
They will decide if there is a
need for any further evidence
and will make all the
arrangements to get this
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 faceto-face consultation
PIP Toolkit – Assessment Process and Providers
Department for Work & Pensions
29
4
Assessment
Face-to-face consultation required
Claimant will be contacted to invite them to a faceto-face consultation
Face-to-face
consultation not required
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 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 reviews all the evidence
against a set of everyday activities and clear descriptors
to assess the challenges faced by the individual
The health professional sends a
report back to the DWP to help
inform their decision
Department for Work & Pensions
30
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
Department for Work & Pensions
31
Additional Information
• Special Rules for Terminally Ill People
• Reviewing Awards
• Disputes
• Where to find more information about PIP
• PIP Toolkit list of contents
Department for Work & Pensions
32
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
Department for Work & Pensions
33
Reviewing Awards
• 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.
PIP Toolkit – Reviewing Awards
Department for Work & Pensions
34
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
35
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
Department for Work & Pensions
36
PIP Toolkit list of contents
Core Products
Fact sheets
•
Introduction to PIP Toolkit
•
Quick Guide
•
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
•
•
•
•
•
•
•
•
•
•
•
Conditions of Entitlement
Assessment Criteria
The difference between PIP and DLA
Introducing PIP for new claimants (from April 2013)
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
Key
Black – Version 1 January 13
Red – Version 2 post January 13
Green – currently available on line
Department for Work & Pensions
37
Department for Work & Pensions
38
Toolkit for support organisations and advisers
All about Personal Independence Payment
[intro]
Toolkit for support
organisations and advisers
Content
>> Quick guide to PIP (pdf)
>> Conditions of Entitlement (pdf)
>> Assessment Criteria (pdf)
>> Differences and Similarities between PIP and DLA (pdf)
>> Passporting (pdf)
Department for Work & Pensions
39
Toolkit for support organisations and advisers
Implementing Personal Independence Payment
[intro]
Toolkit for support
organisations and advisers
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
Department for Work & Pensions
40
Toolkit for support organisations and advisers
Personal Independence Payment Claimant Journey
[intro]
Toolkit for support
organisations and advisers
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)
Department for Work & Pensions
41
Department for Work & Pensions
42
Toolkit for support organisations and advisers
Personal Independence Payment
Specific Circumstances
[intro]
Toolkit for support
organisations and advisers
Content
>> Special Rules for Terminally Ill People (pdf)
>> Supporting young people (pdf)
>> People approaching 65 (pdf)
>> Supporting people in vulnerable situations (pdf)
>> Disputes (pdf)
Department for Work & Pensions
43
Department for Work & Pensions
44
Department for Work & Pensions
45
Toolkit for support organisations and advisers
Personal Independence Payment tools for you to use
[Intro text]
Toolkit for support
organisations and advisers
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)
Department for Work & Pensions
46