Factsheet Benefits

Personal Independence Payment (PIP) You’ll find this factsheet useful if you are deaf or have a hearing loss and want to know more about what Personal Independence Payment (PIP) is, and how to claim it for the first time.

Contents • What is Personal Independence Payment (PIP)? 2 • Who qualifies for PIP? 2 • What are the 12 activities that I’ll be assessed on?

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• How will I be assessed? 3 • How do I apply for PIP? 4 • How do I fill in the claim form? 4 • What happens after I submit my claim form? 10 • What happens at the face-to-face consultation? 10 • How will I find out about the decision on my claim?

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• What can I do if I’m not happy with the decision?

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• Appendix A 14 • Appendix B 17 • Where can I get further information? 18

If you’d like this factsheet in Braille, large print or audio format, please contact our Information Line – see last page for contact details.

What is Personal Independence Payment (PIP)? PIP is a new benefit for people who need help with the extra costs caused by long-term ill health or disability. It is gradually replacing Disability Living Allowance (DLA) for people aged 16-64. The government introduced PIP in April 2013, as part of a wider reform of the welfare system. However, the change is being rolled out in stages, and only affects new claimants to begin with. New claims for DLA were stopped in June 2013 for 16-64 year olds (however, new claims for children aged under 16 are still accepted). If you currently claim DLA, you don’t need to take any action now. The Department for Work and Pensions (DWP) will invite most people who receive DLA to apply for PIP between October 2015 and October 2017. If you currently claim DLA and want to know more about how PIP may affect you, visit www. actiononhearingloss.org.uk/PIP This information comes with British Sign Language translations.

What are the components of PIP? PIP has two components (parts): • a daily living component – money to help you take part in everyday life • a mobility component – money to help you get around. Whether you are awarded one or both of these components depends on how your health condition or disability affects your daily life.

How much is PIP? Each component is paid at two different rates: standard and enhanced (see table, above right). The rate you may be paid depends on your ability to carry out 12 activities related to your daily living needs and mobility (see page 3) – this is what you’ll be assessed on.

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Personal Independence Payment (PIP)

Daily living component

Weekly rate

Standard

£54.45

Enhanced

£81.30

Mobility component

Weekly rate

Standard

£21.55

Enhanced

£56.75

How is PIP paid? PIP is usually paid every four weeks into an account – for example, your bank account.

Who qualifies for PIP? To receive PIP, you must: • be aged 16-64 •h  ave a long-term health condition or disability that causes difficulties with activities related to ‘daily living’ and/or ‘mobility’ •h  ave had difficulties caused by ill health or disability for three months and expect them to last for at least nine months. However, if you are terminally ill (if you are not expected to live more than six months), you can claim PIP straight away •b  e in Great Britain when you claim (there are some exceptions; for example, members of the armed forces and their family members) •h  ave been resident in Great Britain for at least two of the last three years •n  ormally live in the UK, Ireland, Isle of Man or the Channel Islands •n  ot be subject to immigration control (unless you’re a sponsored immigrant). PIP is being introduced in Northern Ireland in spring 2014. The qualifying rules regarding residence will be different to what’s above. To find out more about PIP in Northern Ireland, visit www.nidirect.gov.uk/personalindependence-payment-introduction

Key facts about PIP • You can claim PIP whether you are in or out of work. • It’s paid regardless of any income or savings you have and is not subject to tax. • PIP has two different components (parts), which each have two rates of payment. • It’s likely that you’ll have a face-to-face medical consultation to see if you qualify for PIP (see page 10). • You’ll be assessed on your ability to carry out 12 activities (see below).

How will I be assessed? A case manager at the DWP will assess your ability to perform the 12 activities by looking at: • the information you provide on your claim form • any evidence you submit, such as medical notes • t he report from a face-to-face consultation with a medical professional, if you have one – see page 10. The case manager will award you a point score for your ability to carry out each activity. This will determine whether or not you are entitled to either component of PIP – and, if you are, at which rate.

• You can choose how to spend PIP.

How do I score points?

What are the 12 activities that I’ll be assessed on? You’ll be assessed on your ability to carry out: 10 daily living activities: • 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. Two mobility activities: • Planning and following (making) journeys. • Moving around.

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Personal Independence Payment (PIP)

The point scores are attached to a number of ‘descriptors’, which describe different levels of ability to carry out each activity. The case manager will decide which of these best describes your situation. The less able you are to carry out an activity, the more points you’ll score. If more than one descriptor applies in an activity, you’ll be awarded whichever descriptor gives you the most points. The highest score from each activity is then added together to work out your points for each component. The descriptors are not listed on the claim form, so refer to Appendices A and B at the end of this factsheet (pages 14-17) to see each descriptor and the points attached to it.

How many points do I need? To get the standard rate of the daily living component, you need to score at least eight points across the 10 daily living activities. To get the enhanced rate, you need at least 12 points. Likewise, to be entitled to the standard rate of the mobility component, you need to score at least eight points across the two mobility activities, and at least 12 points to get the enhanced rate.

How do I apply for PIP? Step one: Contact the DWP To make a claim for PIP, you first need to contact the DWP new claims telephone service: Telephone 0800 917 2222 Textphone 0800 917 7777 The lines are open Monday-Friday, 8am-6pm. The call should take about 15 minutes. Calls are free from BT landlines and most mobiles; however, some mobile phone or non-BT landline providers may charge for the call. What will happen during the call? You’ll be asked for information such as: • contact details and date of birth • National Insurance number • bank or building society details • doctor’s or health worker’s name • details of any time you’ve spent abroad or in a care home or hospital It will speed up the call if you have all this information to hand before calling. What if I have difficulty using the phone? A relative, carer or friend can make the call for you if you find it hard to use the phone. However, you must be there so that you can confirm that the person supporting you has your permission to make the call. If this isn’t possible, you can write to the DWP to ask for a form so that you can send the above information by post: Personal Independence Payment New Claims Post Handling Site B Wolverhampton WV99 1AH Alternatively, you can request a home visit from a DWP officer to help you complete the form.

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Personal Independence Payment (PIP)

Step two: Complete the claim form Once the DWP has established that you meet the basic PIP entitlement conditions relating to age and residence, it will send you the ‘How your disability affects you’ claim form, along with notes to help you fill it in and a freepost envelope in which to return your completed claim form.

How do I fill in the claim form? The claim form asks about any health conditions or disabilities that you may have and how these affect you while you carry out 10 daily living and two mobility activities (see page 3). The following section of the factsheet gives you guidance on how to answer the questions and what further information is helpful to include. Many of the difficulties you are asked about may not apply to you. The most important question for people who are deaf is question 9, which focuses on communication needs. You don’t have to complete the form all in one go. Take your time to make sure that you can fully describe the difficulties you have and the help and support that you need.

The structure of the form •Q  uestions 1 and 2 ask you to list details of your health professionals, health conditions and medication. •Q  uestions 3 to 12 are about the 10 daily living activities (refer to Appendix A, page 14) • Questions 13 and 14 are about the two mobility activities (refer to Appendix B, page 17). •Question 15 asks you to provide any additional information. Each question from 3 to 14 takes up a couple of pages. At the start of the question, the activity and the relevant issues are explained.

Tick-box questions

Question 1: Your health professionals

For each activity, there are two or three tickbox questions about your abilities or your need for aids or help. In each case, you are offered one of three boxes to tick: ‘yes’, ‘no’ or ‘sometimes’. Choose ‘sometimes’ if your condition is variable.

The first question on the form asks for details of the professional(s) who are best placed to provide advice on your circumstances. This can be social workers, counsellors, support workers or medical professionals, such as your GP.

The extra information box The tick-box questions are followed by a page with space for you to explain how your health conditions or disabilities affect your ability to do the activity. Describe the difficulties you face in as much detail as possible. For example: •D  o you need help from another person to do the activity? • If you do need help, what kind of help do you need? Does someone physically help you, reassure you, encourage you, remind or explain to you how to do something? Or do they need to supervise you? •D  o you use aids and/or appliances to help you in an activity? If you do, say what they are and how useful they are.

Whoever you list will need to know about your daily living needs and any mobility problems you have. If possible, make an appointment with them to discuss your PIP claim.

Question 2: Your condition and medication The second question asks you to list your health conditions or disabilities and approximately when each of these started. Don’t explain in detail how your health conditions or disabilities affect you here – you’ll be asked about this later in the form. You are asked to list any tablets or medicines you are taking or treatments you are having. If you have a printed prescription list, you can attach that. If you have any side effects as a result of the medication, list these here.

•C  an you do some parts of the activity but not others?

Question 3: Preparing food – see activity 1 (Appendix A for questions 3-12)

•A  re you unable to do the activity at all? Explain why.

Write down if there is any aspect of preparing or cooking a simple meal that is a risk to you. List any incidents that may have happened in the past. Have you cut yourself mishandling knives or burnt yourself on hot pans? Let them know if you are not able to work out sell-by dates or read or understand cooking instructions on packets.

•C  an you do an activity but it takes you a long time? • If your needs vary, describe in what way and how often. Explain about good and bad days or how your needs vary throughout the day. • If you regularly have accidents – such as falls – or are at risk of having accidents, explain why and when they happen. •D  o you have any side effects from doing the activity? Do you experience pain, breathlessness, tiredness or stress and anxiety either during or after the activity?

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If you use any aids or appliances to cook, do you need some help even when you use them? Make a note if you have difficulty timing the cooking correctly. Let them know if you are so exhausted after cooking a meal that you could not do it again that day.

Question 4: Eating and drinking – see activity 2 Write down if you need someone to encourage you to eat the right portion sizes. If you can cut up some food, but can’t cut up tougher items, such as meat, make a note of this. If you need an appliance such as a feed pump to eat, let them know if you need any help to use it properly.

Question 5: Managing treatments – see activity 3 Write down if there have been any times in the past when you have forgotten to take your medication, or have taken too much. Let them know if you have taken a deliberate overdose, or if you self-harm. Make a note if you need someone to keep an eye on you because you are not aware that your condition is getting worse; sometimes this is the case with conditions such as diabetes or epilepsy. If you need supervision, prompting or assistance to be able to manage your treatment, let them know how many hours on average each week you need this.

Question 6: Washing and bathing – see activity 4 Write down any aids or adaptations you use to wash or bathe yourself. These could include a long-handled sponge, shower seat or bath rail. Let them know if there are any parts of your body that you cannot reach even using such aids (for example, your back).

If there’s an aid that could help but you don’t use it, explain why. For instance, you may not use a commode during the day because there’s no private space where you spend the day.

Question 8: Dressing and undressing – see activity 6 List any aids you use to dress, such as modified buttons, zips, front-fastening bras, trousers, Velcro fastenings and shoe aids. Write down if you still need assistance, despite using such aids, even if this doesn’t take long. Let them know if you need someone to choose clothing that is clean and appropriate (for example, if you have a visual impairment and cannot see stains or marks on your clothing).

Question 9: Communicating – see activity 7 This is the most important part of the form if you are deaf or have a hearing loss. It doesn’t matter if you don’t currently get communication support. What counts is the help you reasonably require, not the amount of help you actually get. You may need help with communication in a range of situations such as visiting the doctor, using public transport, while at work, at the shops, or for social and leisure activities. It helps if you can give examples of when and how often you need this help, and how long you need it for. Information to include In this section, you should include details of:

Question 7: Managing toilet needs – see activity 5 Write down if you need to use any aids or appliances, such as a commode, raised toilet seat, bottom wiper, bidet, incontinence pads or a stoma bag. Let them know if you need help even when you use an aid, or if you need help to use an appliance (for example, securing a stoma bag, or washing around it to prevent infection). 6

Personal Independence Payment (PIP)

•y  our preferred method of communication – for example, lipreading and speech •w  hether your first or preferred language is British Sign Language • if you have difficulties with lipreading •w  hether you have problems understanding written English • whether you have any speech difficulties.

In all of these cases, the reason has to be your communication disability. It’s not relevant if your communication difficulty is, for example, because English is not your first language. Communication support from friends and family Many people who are deaf or have a hearing loss use their friends and family to help with communication. It’s important that you describe the help you get or need. For example: • Do you find it difficult to hear what strangers are saying?

•D  o you need TV programmes explained to you even when they are subtitled? •C  an you follow TV programmes that don’t have subtitles? •D  o you need someone to explain radio programmes to you? • If you use hearing aids, do you find yourself in situations when you need help to understand what’s being said – for example, in crowded places when other people are speaking?

• Do you need help to communicate with strangers whom you do not understand?

• If you rely on lipreading, do you find yourself in situations where you are unable to see the face of the person speaking?

• Do you need someone to attract your attention before speaking to you – for example, by tapping you on the shoulder?

•D  o you find that, when you are lipreading, people use words and phrases that have to be explained to you?

•D  o you need someone to place themselves in a certain position before speaking to you – for example, close by and in clear light – so that you can see their lips move?

•E  ven though you may be able to lipread well, are there any reasons why you still can’t communicate in all situations?

•D  o you find it difficult to hear what friends or family are saying? •D  o you need someone to repeat what is said and explain it to you? •D  o you need general conversation explained to you, especially if there are several people speaking and you cannot see who is talking? • If you have some hearing, do you still need some sounds and some speech explained to you? •D  o you find it difficult to understand gestures or body language used by people who are hearing and need to have them explained? •D  o sounds such as traffic, alarms and announcements have to be brought to your notice and explained? • Do you need someone to explain what children are saying to you because they cannot sign or speak clearly enough for you to lipread them? •D  oes someone need to let you know when a child is crying or distressed?

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Personal Independence Payment (PIP)

•D  o you find you can only lipread a trained lipspeaker? • If you can’t lipread, do you need an interpreter or other communication support? Support from sign language interpreters If you use a sign language interpreter, they must have breaks (periods of rest). Say how often and for how long, because the breaks mean that communication can take much longer. It’s important to mention that there are no appropriate alternatives to interpreters, such as using handwritten notes, if full and proper communication is to take place. Don’t be shy about explaining your needs – give as much detail as you can.

Question 10: Reading – see activity 8 Write down if you need to use aids to help you read – for example, a magnifier or magnifying glass. If you can manage indoors, but can’t adequately read signs, symbols and words outdoors, let them know.

Question 11: Mixing with other people – see activity 9 If you avoid mixing with other people because you have nobody to help you, write this down. How would you feel mixing with others without any support? Let them know if you would get panicky, angry or paranoid. Do you have difficulty understanding the behaviour of others?

Question 12: Making decisions about money – see activity 10 Write down if you would have problems buying a few items from your local shop. Would you be able to give the shop assistant the right amount of money? Would you know if the change was correct? If going to the local shop would pose no problems but you would have problems with more complex budgeting decisions, such as working out the monthly household budget or sorting out a gas bill, note this down. Let them know if you can do most of the task by yourself but would still need some support to finish it properly.

Question 13: Going out – see activity 1 (Appendix B for questions 13 and 14) This activity assesses your ability to work out and follow a route safely and reliably. Two types of route are considered: familiar and unfamiliar. You should only be considered able to travel to an unfamiliar destination if you are able to use public transport such as a bus or train. The tick-box questions These ask whether you need help from another person, a guide dog or a specialist aid to plan a route or get to a location. Point scores range from 0, if you can plan and follow a route unaided, to 12, if you can’t follow a familiar route without help or an aid. The questions also ask whether you are unable to go out because of severe anxiety or distress.

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The extra information box If you are deaf or have a severe hearing loss, you may need someone to guide or supervise you when you are travelling on unfamiliar or familiar outdoor routes. Explain why you need someone with you in these situations. For example: • Do you know when traffic is approaching? Can you hear warning sounds, such as car horns or sirens? Decision-makers often say that you should be able to rely on your eyesight to stay safe, so explain if this is not the case – for example, when you can’t see traffic well enough. Try to give examples of dangerous situations you have been in. • Do you need someone to explain loudspeaker announcements to you? • Do you avoid travelling by yourself in places you don’t know well? • Can you understand and follow street maps or do you need someone to help you follow directions to where you are going? • Can you understand and follow written directions? • Can you read and understand street signs, bus numbers and timetables, or destination boards? • Can strangers understand your speech when you ask for directions? • If a person who is hearing gives you directions, do you have difficulty understanding them? • Can you lipread strangers if they are explaining directions to you? • Do you have balance problems, Ménière’s disease or vertigo, which makes you unable to walk safely without help? Even if you don’t actually go out every day, you should say whether you would need help if you did go out. Remember, it’s about the help you need, not just the help you currently get.

Question 14: Moving around – see activity 2 This activity focuses on your physical ability to ‘stand’ and then ‘move around’. The tick-box questions These questions give you the opportunity to identify how far you can walk or move around using, if necessary, any aids such as a walking stick, frame, crutches, prostheses or a wheelchair. It’s important that you identify how far you can walk ‘safely’, in a ‘reasonable time period’ and without severe discomfort (such as breathlessness, pain or tiredness). If you could walk 50 metres (m), but would be in severe discomfort over the last 30m, then your walking ability will be considered to be limited to 20m. You are given a number of boxes stating different distances to tick as well as a box for ‘it varies’. Only tick the box ‘it varies’ if none of the other boxes apply for at least 50% of the time. The extra information box Use this space to list any symptoms that you feel when walking, such as pain, fatigue or breathlessness. Once the symptoms come on, how long do they last? Write down if you are at risk of falling – for example, due to balance problems or Ménière’s disease. Give examples of falls you have had outdoors in the past. Were you injured? Were you able to get up again? Describe the way you walk – for example, do you find it hard to balance, or do you limp or often lose balance? Give an idea of your speed. If you walk slowly and were to cover 20m, what distance would someone without a disability or health condition cover in that time? If your condition is worse on some days, give details. It may be helpful to keep a diary over a week, to show your walking limit on each day. You can send a copy of a diary with your form.

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Question 15: Additional information The box here gives you more space to explain your difficulties. If you run out of space, you can use extra sheets of paper. You need to write your name, address and National Insurance number at the top of each one.

What other evidence could I provide? The DWP encourages you to send supporting evidence with your completed form, such as: •p  rescription lists, care plans and information from health professionals, such as a letter from your GP or consultant outlining your condition, a report from your audiologist (hearing specialist) and/or a certificate of visual impairment •e  vidence from other people, such as a letter from a carer, relative or friend who helps you or knows your difficulties well •a  diary, to help the DWP understand how your condition affects you over a number of days or varies over time (include your name, address and National Insurance number at the top of every page). Read your claim form and look at the activities where you filled in information. Your diary should record how you are managing in each of those areas.

How long do I have to complete the form? You have one month to return the form from the date it was sent out. If you don’t return the form within the month without good reason (taking into account your state of health and the nature of any disability), your claim will be disallowed. If you’re not able to return the form within one month – for example, because you need help to complete it but can’t get an appointment with an advice centre in time – contact the DWP to explain this. It can extend the one-month time limit for you if there is a good reason to do so.

Keep a copy of your form Don’t forget to keep a copy of your completed form and any diary or other supporting evidence you send back with it. This is both for your own future reference or in case the DWP loses any documents. A copy will also be useful if you later wish to seek advice from an advice agency in relation to the decision made on your PIP claim.

What happens after I submit my claim form? Once you’ve returned your claim form (and any supporting evidence) to the DWP, your case will be passed to one of the two companies contracted to carry out the PIP assessments: Atos or Capita. Although the decision on your claim will be made by the DWP, Atos or Capita will receive your claim form, assess you against the PIP criteria and use this to decide the next steps for you. A healthcare professional working for the company assessing your claim may initially contact your doctor, consultant or other medically qualified person treating you for further information. They may just talk to them on the phone or they may ask them to produce a factual report. It’s then likely that you will be asked to see a healthcare professional at a ‘face-to-face consultation’. Where consultations are delivered by Atos Healthcare, they normally take place in an examination centre. Capita aims to deal with the majority of consultations in claimants’ homes. A home visit should be arranged if you are unable to travel on health grounds. If you do need to travel to an assessment centre, you can claim travel expenses.

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What happens at the face-to-face consultation? To identify the descriptors that apply to you for each activity, the healthcare professional will ask you questions about: • your day-to-day life • your home • how you manage at work if you have a job •a  bout any social or leisure activities that you engage in (or have had to give up). They will often ask you to describe a typical day in your life. When answering, explain your difficulties as fully as you can: • t ell them about any pain or tiredness you feel, or would feel, while carrying out tasks, both on the day of the examination and over time. •c  onsider how you would feel if you had to do the same task repeatedly. • t ell them if you need reminding or encouraging to complete the tasks.

Will there be a medical examination? At the consultation, the healthcare professional will be able to observe your ability to stand, sit and move around. They may watch you getting on and off the examination couch and bending down to pick up your belongings. They will check whether you have any aids or appliances, and the extent to which you use them. They will also be able to assess your levels of concentration and your ability to understand them and how well you express yourself. The healthcare professional may also carry out a brief physical examination. They should explain each stage of the examination and ask your permission before carrying it out. You should not be asked to do anything that will cause you pain or discomfort either during or after the consultation.

Will the healthcare professional tell me if I qualify for PIP? No, you won’t receive a formal indication at the face-to-face consultation of whether you’ll be awarded PIP. However, before the consultation ends, they should give you an overview of their findings, and invite you to ask questions and add or clarify anything you wish. When you leave your face-to-face consultation, the healthcare professional will complete their report. Once they have done this, they will send it to a DWP case manager, who will decide whether or not to award you PIP and, if it is awarded, at what rate and for how long.

How will I find out about the decision on my claim? Successful claims If the case manager decides to award you PIP, you will be sent a letter telling you about this decision. Your award will usually be for a set period of time. This might be for a short time, such as one or two years, or a longer period of five or 10 years (if significant changes in your condition are less likely). You will only be awarded PIP for an indefinite period if the case manager feels it’s unlikely that your condition will improve in the future, so your needs will remain broadly the same. However, the DWP will review awards from time to time, regardless of their length. If you’ve been awarded PIP but think you should have been awarded a higher rate, you can ask for a reconsideration (see ‘What can I do if I’m not happy with the decision?’, right).

After receiving your notification letter, you should get a telephone or textphone call from the DWP decision-maker, who will explain why you’ve not been awarded PIP. They should tell you that if you’re not happy with the decision, you can ask for a reconsideration. If you do disagree with their decision, tell them during this call (see page 12 for more on what to say).

What can I do if I’m not happy with the decision? If your claim is turned down, you have one calendar month from the date of the decision in which to ask the DWP to look at their decision again. This is called a reconsideration. You need to go through this process before you can lodge an appeal. You can also ask for a reconsideration if you are unhappy with: • t he level of the benefit that you’ve been awarded (for example, if you are awarded the standard rate of the daily living component but believe you are entitled to the enhanced rate) • the period for which it has been granted. Be careful when you ask for a reconsideration, as the DWP will look at your whole award and they can take away any rate of PIP that you have already been granted. If you are in doubt, seek advice from a local advice centre, such as a Citizens Advice Bureau (see page 18 for contact details).

How do I ask for a reconsideration?

Claims that are turned down

You’ll have the opportunity to ask for a reconsideration when the DWP contacts you to explain the decision to disallow your claim. If you don’t get a call, use the contact number on the decision letter. During the call:

If the case manager decides to disallow your claim, they will write to you to tell you. The letter should tell you why they have chosen the descriptors that they think apply to you.

• r equest a reconsideration of the decision. Explain why you disagree with the decision simply at this stage – for example, ‘I believe that you have underestimated the effect of

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my disability and, consequently, underestimated the extent of my mobility problems and/or the difficulties I have in carrying out daily living activities.’ •a  sk for copies of all the evidence that was used in making their decision. •a  sk them not to take any further action until you have had the chance to respond to that evidence. Put your request in writing as well and send it to the address on the decision letter. Keep a copy for yourself. If you’ve not received the evidence after two weeks, contact the DWP again to ask for it. When you do receive the evidence, you should have a better idea of why the decision was made.

How do I build a case? When you receive the evidence from the DWP, you may see that the only information used to make the decision was the information you gave on your claim form. In most cases, there will also be a report produced by the healthcare professional at the face-to-face consultation. Compare their report with what you explained on your form. Look for where a difference of opinion arises. Where you find any differences, collect medical evidence showing that what you said on the form was correct – for example, a letter from your doctor or audiologist confirming your need for communication support to understand basic verbal information. Once you have gathered evidence to support your case, send it to the address on the decision letter. If you need more time, you must let the DWP know how long this is likely to take, so they don’t make a decision straight away. A case manager will look at the further evidence you send. They will then either change their decision in your favour or write back to you explaining that they have been unable to change the decision. They will send you a mandatory reconsideration notice, which proves that you 12

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have asked for a reconsideration (you will need this if you want to lodge an appeal). You now have one calendar month from the date of the new decision to lodge an appeal with an independent tribunal.

How do I lodge an appeal? You will have to download a copy of the official SSCS1 appeal form, or get in touch with your local HM Courts and Tribunals Service (HMCTS) (search online at https://courttribunalfinder. service.gov.uk) and ask to be sent the appeal form. You cannot make an appeal unless you’ve first asked for a reconsideration of your decision. State clearly why you disagree with the decision. Explain what rate of PIP you think you should have been awarded and your reasons for this. Make a copy of the completed appeal form and send it to your local HMCTS. You need to include a copy of your reconsideration notice to prove that you have first asked for a reconsideration of your decision.

What happens when I appeal? When the HMCTS receives your appeal form, it will send you an acknowledgment letter. A copy of your appeal will also be sent to the DWP for a response. The DWP should write a response to your appeal and return it to HMCTS along with all the documents relevant to the decision. You will also be sent a copy of everything. Getting a hearing The HMCTS will send you a pre-hearing enquiry form. This asks if you’d like your appeal to be decided with or without a tribunal hearing (a proceeding before a court). You must return the form within 14 days. If you choose to have a hearing, you’ll be invited to it. Having a hearing and attending can greatly improve your chances of a successful appeal. Your appeal will be heard by an independent appeal tribunal. These tribunals are informal; they are not like courts.

If you have a carer, they can attend the tribunal hearing as well, to provide their account of your needs. If you need to have communication support for the hearing, HMCTS will arrange it. Support or representation You can get in touch with a local advice centre, such as a Citizens Advice Bureau or Disability Information and Advice Line (DIAL – see page 18 for contact details) to see if they can give you any support with an appeal, and possibly provide you with a representative to present your case at the tribunal. The charity Turn2us can also help. Use their online ‘Find an adviser’ tool to search for local support to help you challenge or appeal benefits decisions (see page 18 for contact details).

When will I find out the appeal decision? You’ll get a decision notice on the day of the tribunal or very soon after. A copy of the decision notice will also be sent to the DWP, so it can put the decision into effect. If the decision is a positive one (that you are entitled to PIP), the DWP will start paying you, and pay you any benefit you are owed to cover the period you were appealing. If your appeal is unsuccessful, you can ask for a more detailed explanation of why. To find out more about appealing a decision, contact Disability Rights UK (see page 18 for details).

What happens if I choose not to have a hearing? A tribunal will study all of the appeal papers and come to a decision based on these papers alone. You can send extra evidence and comments for the tribunal to consider at any time, but do so as soon as possible as the tribunal won’t tell you when they’ll be meeting to decide your case.

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Personal Independence Payment (PIP)

Appendix A – Daily living activities and descriptors The activities, descriptors and points listed below are the legal test laid out in the Social Security (Personal Independence Payment) Regulations 2013. The entitlement thresholds (pass mark) for the daily living rates and components of PIP are 8 points for the standard rate and 12 for the enhanced rate.

Preparing food – Activity 1

d) Needs prompting to be able to take nutrition. Score 4 e) N  eeds assistance to be able to manage a therapeutic source to take nutrition. Score 6 f) Cannot convey food and drink to their mouth and needs another person to do so. Score 10

Managing therapy or monitoring a health condition – Activity 3 a) Either:

i) d  oes not receive medication or therapy or need to monitor a health condition; or

b) N  eeds to use an aid or appliance to be able to either prepare or cook a simple meal. Score 2



ii) c  an manage medication or therapy or monitor a health condition unaided. Score 0

c) C  annot cook a simple meal using a conventional cooker but is able to do so using a microwave. Score 2

b) Needs either:

a) C  an prepare and cook a simple meal unaided. Score 0

d) N  eeds prompting to be able to either prepare or cook a simple meal. Score 2 e) N  eeds supervision or assistance to either prepare or cook a simple meal. Score 4 f) Cannot prepare and cook food. Score 8

Taking nutrition – Activity 2 a) C  an take nutrition unaided. Score 0 b) Needs either:

i) t o use an aid or appliance to be able to take nutrition; or



ii) s upervision to be able to take nutrition; or



iii) a  ssistance to be able to cut up food. Score 2

c) N  eeds a therapeutic source to be able to take nutrition. Score 2

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Personal Independence Payment (PIP)



i) t o use an aid or appliance to be able to manage medication; or



ii) s upervision, prompting or assistance to be able to manage medication or monitor a health condition. Score 1

c) Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week. Score 2 d) Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week. Score 4 e) N  eeds supervision, prompting or assistance to be able to manage therapy that takes more than 7 but no more than 14 hours a week. Score 6 f) N  eeds supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week. Score 8

Washing and bathing – Activity 4

c) Needs either:

a) Can wash and bathe unaided. Score 0



i) p  rompting to be able to dress, undress or determine appropriate circumstances for remaining clothed; or



ii) p  rompting or assistance to be able to select appropriate clothing. Score 2

b) N  eeds to use an aid or appliance to be able to wash or bathe. Score 2 c) N  eeds supervision or prompting to be able to wash or bathe. Score 2 d) N  eeds assistance to be able to wash either their hair or body below the waist. Score 2 e) N  eeds assistance to be able to get in or out of a bath or shower. Score 3 f) Needs assistance to be able to wash their body between the shoulders and waist. Score 4 g) C  annot wash and bathe at all and needs another person to wash their entire body. Score 8

Managing toilet needs or incontinence – Activity 5 a) C  an manage toilet needs or incontinence unaided. Score 0 b) N  eeds to use an aid or appliance to be able to manage toilet needs or incontinence. Score 2 c) N  eeds supervision or prompting to be able to manage toilet needs. Score 2 d) N  eeds assistance to be able to manage toilet needs. Score 4 e) N  eeds assistance to be able to manage incontinence of either bladder or bowel. Score 6 f) Needs assistance to be able to manage incontinence of both bladder and bowel. Score 8

Dressing and undressing – Activity 6 a) Can dress and undress unaided. Score 0 b) N  eeds to use an aid or appliance to be able to dress or undress. Score 2

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Personal Independence Payment (PIP)

d) N  eeds assistance to be able to dress or undress their lower body. Score 2 e) N  eeds assistance to be able to dress or undress their upper body. Score 4 f) Cannot dress or undress at all. Score 8

Communicating verbally – Activity 7 a) C  an express and understand verbal information unaided. Score 0 b) N  eeds to use an aid or appliance to be able to speak or hear. Score 2 c) Needs communication support to be able to express or understand complex verbal information. Score 4 d) Needs communication support to be able to express or understand basic verbal information. Score 8 e) C  annot express or understand verbal information at all, even with communication support. Score 12

Reading and understanding signs, symbols and words – Activity 8 a) C  an read and understand basic and complex written information either unaided or using spectacles or contact lenses. Score 0 b) N  eeds to use an aid or appliance, other than spectacles or contact lenses, to be able to read or understand either basic or complex written information. Score 2 c) Needs prompting to be able to read or understand complex written information. Score 2

d) N  eeds prompting to be able to read or understand basic written information. Score 4 e) C  annot read or understand signs, symbols or words at all. Score 8

Engaging with other people face to face – Activity 9 a) C  an engage with other people unaided. Score 0 b) N  eeds prompting to be able to engage with other people. Score 2 c) N  eeds social support to be able to engage with other people. Score 4 d) C  annot engage with other people due to such engagement causing either

i) o  verwhelming psychological distress to the claimant; or



ii) t he claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person. Score 8

Making budgeting decisions – Activity 10 a) C  an manage complex budgeting decisions unaided. Score 0 b) N  eeds prompting or assistance to be able to make complex budgeting decisions. Score 2 c) N  eeds prompting or assistance to be able to make simple budgeting decisions. Score 4 d) C  annot make any budgeting decisions at all. Score 6

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Personal Independence Payment (PIP)

Appendix B – Mobility activities and descriptors The activities, descriptors and points listed below are the legal test laid out in the Social Security (Personal Independence Payment) Regulations 2013. The entitlement thresholds (pass mark) for the mobility rates and components of PIP are 8 points for the standard rate and 12 for the enhanced rate.

Planning and following journeys – Activity 1 a) C  an plan and follow the route of a journey unaided. Score 0 b) N  eeds prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant. Score 4 c) Cannot plan the route of a journey. Score 8 d) C  annot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid. Score 10 e) C  annot undertake any journey because it would cause overwhelming psychological distress to the claimant. Score 10 f) Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid. Score 12

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Personal Independence Payment (PIP)

Moving around – Activity 2 a) C  an stand and then move more than 200 metres, either aided or unaided. Score 0 b) C  an stand and then move more than 50 metres but no more than 200 metres, either aided or unaided. Score 4 c) Can stand and then move unaided more than 20 metres but no more than 50 metres. Score 8 d) C  an stand and then move using an aid or appliance more than 20 metres but no more than 50 metres. Score 10 e) C  an stand and then move more than 1 metre but no more than 20 metres, either aided or unaided. Score 12 f) Cannot, either aided or unaided:

i) stand; or



ii) move more than 1 metre. Score 12

Where can I get further information?

Disability Information and Advice Line services (DIAL)

Action on Hearing Loss

An independent network of local disability information and advice services, run by and for people who are disabled. Contact Scope to find your local DIAL.

We have a wide range of free information on many aspects of hearing loss. Our leaflets provide introductory information, while our factsheets go into more detail. You may be interested in the other factsheets in our Benefits range, including Employment and Support Allowance, How can social services help? and Universal Credit. For further details, and to order free copies, contact our Information Line (see last page). You can also download our publications for free at www.actiononhearingloss.org.uk/factsheets For information about PIP in BSL, visit www.actiononhearingloss.org.uk/PIP References All of our factsheets are based on up-to-date research and information. If you’d like a list of references for this factsheet, please email us at [email protected]

Other organisations Benefit Enquiry Line (Northern Ireland) Provides advice and information on disability and carers’ benefits. Telephone 0800 220 674 Textphone 028 9031 1092 Citizens Advice Provides free advice and information to help people resolve legal, financial and other problems – see your phonebook for your nearest bureau or do an online search at: www.citizensadvice.org.uk (England and Wales) www.cas.org.uk (Scotland) www.citizensadvice.co.uk (Northern Ireland) Alternatively, you can use the Citizens Advice online advice guide at www.adviceguide.org.uk 18

Personal Independence Payment (PIP)

Telephone 0808 800 3333 [email protected] www.scope.org.uk/services/local-groups/dial-uk Disability Rights UK Provides a range of information about benefits including free factsheets and the Disability Rights Handbook. It does not have a benefits advice line for individuals. Ground Floor, CAN Mezzanine, 49-51 East Road, London N1 6AH Telephone 020 7250 8181 [email protected] www.disabilityrightsuk.org

Acknowledgement We would like to thank Disability Rights UK for helping us to produce and review this factsheet.

Gov.uk A government website providing information on public services and welfare benefits, and so on. www.gov.uk Law Centres Provide free legal advice, casework and representation to individuals and groups. All Law Centres specialise in social welfare law. You can find details of your local Law Centre from the Law Centres Network. www.lawcentres.org.uk

NI Direct

We welcome your feedback

Northern Ireland’s government website providing information on public services and welfare benefits, and so on.

If you have any comments or suggestions relating to this factsheet, or if you’re interested in joining our Readers’ Review Panel, we’d love to hear from you. Your feedback will help us to improve our information.

www.nidirect.gov.uk PIP helpline A government advice line. Telephone 0845 850 3322 Textphone 0845 601 6677

To find out more, or to provide us with your comments, please email us at reviewpanel@ hearingloss.org.uk or write to Information and Publications, Action on Hearing Loss, 19-23 Featherstone Street, London EC1Y 8SL.

Turn2us Helps people in financial need to access welfare benefits, charitable grants and other financial help. Telephone 0808 802 2000 Fax 01443 827616 [email protected] www.turn2us.org.uk ‘Find an adviser’ search tool: http://advicefinder.turn2us.org.uk

Please help us support others We provide our leaflets, factsheets and Information Line service free of charge to anyone affected by hearing loss or tinnitus in the UK, but we rely on the generosity of our supporters to help us to do this. We would be very grateful if you would consider making a donation today – of as little or as much as you can afford. You can send a cheque/PO made payable to Action on Hearing Loss to: Action on Hearing Loss, FREEPOST LON13186, London EC1B 1AL. Or you can make a donation online using a credit card, debit card or CharityCard. Please visit www.actiononhearingloss.org.uk/icanhelp

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Personal Independence Payment (PIP)

We’re Action on Hearing Loss, the charity working for a world where hearing loss doesn’t limit or label people, where tinnitus is silenced – and where people value and look after their hearing. We can’t do this without your help. To find out more about what we do and how you can support us, go to www.actiononhearingloss.org.uk Action on Hearing Loss Information Line Telephone 0808 808 0123 Textphone 0808 808 9000 SMS 0780 000 0360 (standard text message rates apply) Email [email protected]

Personal Independence Payment, version 1, A0759/0414. PUBLISHED: APRIL 2014. REVIEW DATE: APRIL 2015.

Action on Hearing Loss is the trading name of The Royal National Institute for Deaf People. A registered charity in England and Wales (207720) and Scotland (SC038926)