Personal Independence Payment (PIP)

Personal Independence Payment (PIP) Training handbook Charlie Callanan, Advice Now Plus, July 2015 This training pack is for guidance only and is not...
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Personal Independence Payment (PIP) Training handbook Charlie Callanan, Advice Now Plus, July 2015

This training pack is for guidance only and is not a complete or authoritative statement of the law. Seek advice where necessary. This handbook was produced for advisers working the Royal Borough of Kensington and Chelsea. Some information may not be applicable elsewhere in the UK. Copyleft notice This document is released freely; you can redistribute it and/or modify it for noncommercial purposes as long as you credit Advice Now Plus and the Author of this work. This work is distributed in the hope that it will be useful, but without any warranty. Welfare Benefits Specialist Support Service For support with welfare rights casework and to refer complex cases to our specialist caseworker contact the Advice Now Plus project: [email protected] or call 020 7244 1741 (This service is normally available Monday, Wednesday and Thursday).

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Table of Contents Background - The Welfare Reform Act 2012................................................................... 4 Introducing PIP ................................................................................................................ 5 What is PIP? ............................................................................................................... 5 Important facts about PIP ............................................................................................ 5 Main qualifying conditions ........................................................................................... 5 The PIP components ....................................................................................................... 7 1. The Daily Living Component ................................................................................... 7 2. The Mobility Component ......................................................................................... 7 The PIP Activities ............................................................................................................ 8 1. The Daily Living Component Activities .................................................................... 8 2. The Mobility Component Activities .......................................................................... 8 The Disability Conditions: how the claimant is assessed ................................................ 9 Activity and descriptor examples: ................................................................................ 9 Overarching principles – completing an activity reliably ................................................ 10 Aids and appliances .................................................................................................. 10 Assistance, prompting and supervision ..................................................................... 11 Variable and fluctuating conditions ................................................................................ 11 The PIP assessment ..................................................................................................... 12 The Claim Form ........................................................................................................ 12 Evidence ................................................................................................................... 12 Independent Assessor .............................................................................................. 13 Face to face consultation .......................................................................................... 13 Rates of PIP compared with DLA .................................................................................. 13 Timeline of introduction and transfer from DLA ............................................................. 14 DLA Claimants: The Managed Reassessment Process ............................................ 15 PIP from age 65 years .............................................................................................. 15 Transition at age 16 years ......................................................................................... 15 The Dispute Process: Reconsiderations and Appeals.................................................. 16 Other PIP issues ........................................................................................................... 17 PIP and means-tested benefits and Tax Credits ....................................................... 17 PIP and Carer’s Allowance ....................................................................................... 17 PIP and the Motability Scheme ................................................................................. 17 PIP and transport related concessions ...................................................................... 17

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Appendix 1 DWP Guidance: The claimant journey ....................................................... 18 Thinking about claiming ............................................................................................ 18 Making a claim .......................................................................................................... 19 Telling your story ....................................................................................................... 19 Assessment .............................................................................................................. 20 Decision .................................................................................................................... 20

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Background - The Welfare Reform Act 2012 The Welfare Reform Act was passed on 8 March 2012. This Act legislated for the biggest changes to the welfare system in over 60 years. It introduced a wide range of reforms including providing the primary legislation for Personal Independence Payment (PIP). PIP was then rolled out from April 2013. The government has decided that reform is needed to make the welfare system more sustainable and transparent. Some reasons they cited include: ‘DLA expenditure has risen by 30% in the last 8 years’ and ‘People are unsure who qualifies’ What does this mean for Disability Living Allowance? The new benefit, PIP, is intended to be easier to understand than Disability Living Allowance (DLA); more efficient; and targeted at supporting those in most need to remain independent. The mission of PIP is ‘…to provide a contribution towards the extra costs of overcoming the challenges faced by disabled people in order to lead full and active, independent lives’. The effect of this change? The Government aims to save £2.1 billion. It had been estimated that by 2015/16 over half a million claimants would lose their entitlement altogether, although that deadline is unlikely to be reached due to delays in the timetable for transferring existing DLA claimants to PIP. Others will qualify for lower rates than they currently receive.

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Introducing PIP What is PIP? It is for people of working age who have a physical and/or mental disability, and who need help with getting around and/or with participating in everyday life. It is intended to help with the extra costs of having a disability. It replaced DLA for new claimants from April 2013. Eventually most DLA claimants of working age will be invited to claim PIP PIP is administered by the Department for Work and Pensions (DWP). Important facts about PIP    

Non-means-tested – it can be paid on top of any other benefits or tax credits ‘Non-contributory’ – national insurance contributions not required Non-taxable Claimant can qualify whether in or out of work

The claim assessment involves a medically-based points system. There are some similarities to DLA, but also many major differences. Main qualifying conditions To qualify for PIP the claimant must meet qualifying conditions 1. Age The claimant must be aged between 16 and 64 years old when making a claim. NB Children aged under 16 years old can still claim DLA (but will have to claim PIP from age 16), and disabled people aged over 65 who already get DLA are not affected. You cannot claim PIP once you are aged 65 years old, but claimants are able to stay on PIP if they claimed or received it before they reached the age of 65, as long as they continue to meet the qualifying conditions. NB Attendance Allowance – the disability benefit for older people who become disabled after their 65th birthday – is not affected by the introduction of PIP.

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2. Residence and presence The claimant must satisfy the residence and presence tests: ‘Past presence test’ This is a measure of how long the claimant has been in Great Britain (GB). To qualify for PIP a claimant must have been in GB for two out of the last three years. (For DLA it was 26 weeks out of 52 weeks.) ‘Habitual residence test’ The claimant must show residence has been for an ‘appreciable period of time’ and the claimant must demonstrate a settled intention to remain in GB. An appreciable period of time is not defined in law or guidance, but a claimant might expect to need to be habitually resident for at least 3 months, although the length of time will depend upon individual circumstances. 3. Required period The claimant must satisfy the required period condition: The claimant must normally satisfy the daily living and/or mobility activities test for three months prior to a PIP claim (the backwards test); and be likely to continue to satisfy the test/s for a period of at least nine months after claiming (called the prospective test). NB the client can make a claim for PIP before the three month period has elapsed. Linking period If the claimant reclaims for the same condition within one year of a previous claim, they will not need to meet the backwards test again. Terminally ill people The required period condition does not apply to either component for claimants who are terminally ill. They qualify ‘automatically’ for the daily living component at the enhanced rate. But they have to pass the main PIP assessment to get the mobility component. 4. Disability The claimant must satisfy the disability conditions i.e. the claimant must pass the daily living and/or mobility activities test – see details below.

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The PIP components PIP has two components: the daily living component and the mobility component. Each component has two rates: a standard rate and an enhanced rate. 1. The Daily Living Component  

Standard rate: awarded to people whose ability to carry out daily living activities is limited by their physical or mental condition Enhanced rate: payable to people whose ability to carry out daily living activities is severely limited by their physical or mental condition.

If you have a terminal illness you are automatically entitled to receive the daily living component at the enhanced rate. Unlike within DLA care component and Attendance Allowance, there is no differentiation between activities carried out during the day or the night. So a claimant may qualify for the enhanced rate of the daily living component even if they have no night time needs. The daily living component is not payable to a claimant while living in a care home, unless she is completely self-funding. Payments will stop after 28 days. For hospital inpatients the daily living component is not payable after 28 days of the stay (but it remains payable if the treatment and stay is entirely private). 2. The Mobility Component  

Standard rate: payable to people whose ability to carry out mobility activities is limited by their physical or mental condition Enhanced rate: awarded to people whose ability to carry out mobility activities is severely limited by their physical or mental condition.

A claimant who has a terminal illness will be able, if they meet the qualifying conditions, to get the mobility component without having to serve the three months backwards period condition. For hospital in-patients the mobility component isn’t payable after 28 days (but it remains payable if the treatment and stay are entirely private). This includes payments of the mobility component under an existing Motability contract. Please see the separate handout for the complete list of activities and descriptors with guidance.

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The PIP Activities 1. The Daily Living Component Activities 1. Preparing food 2. Taking nutrition 3. Managing therapy or monitoring a health condition 4. Washing and bathing 5. Managing toilet needs or incontinence 6. Dressing and undressing 7. Communicating verbally 8. Reading and understanding signs, symbols and words 9. Engaging with other people face to face 10. Making budgeting decisions 2. The Mobility Component Activities 1. Planning and following journeys 2. Moving around

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The Disability Conditions: how the claimant is assessed The claimant’s ability to carry out the activities for daily living and mobility is assessed via a points-based test. This looks at how her physical and/or mental health condition/s affects her ability to undertake the activities listed above. Under each activity there is a list of statements – the descriptors – that describe different types and levels of help needed with each activity.

Activity and descriptor examples: Activity: Washing and bathing Descriptor C: needs supervision or prompting to be able to wash or bathe (2 points) Descriptor F: needs assistance to be able to wash their body between the shoulders and the waist (4 points) Activity: Communicating verbally Descriptor B: needs to use an aid or appliance to be able to speak or hear (2 points) Descriptor D: needs communication support to express or understand verbal information (8 points) Points are awarded on the basis of limitations with respect to each activity. In order to qualify for the standard rate you have to score at least eight points in one or more of twelve activities of daily living, or eight points from one or both mobility activities. To qualify for the enhanced rate the claimant must score a total of at least twelve points across the activities of each component. The claimant gets points only for the highest scoring descriptor that applies to her within an activity i.e. she cannot score multiple points within one activity.

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Overarching principles – completing an activity reliably In order to satisfy being able to undertake an activity at a level described by a descriptor, the claimant must be able to carry out the activity ‘reliably’. The term 'reliably' is the key test to the assessment process and most likely will be the issue that determines the outcome of the assessment. Reliably means that the claimant can complete the activity:    

Safely To an acceptable standard Repeatedly In a reasonable time period

‘Safely’ – means in a fashion that is unlikely to cause harm to the individual, either directly or through vulnerability to the actions of others, or to another person. The risk of an adverse event happening must be likely to occur rather than it may happen. 'To an acceptable standard' – means in a manner that would be deemed satisfactory or adequate. ‘Repeatedly’ – means completed as often during the day as the individual activity requires. Consideration needs to be given to the cumulative effects of symptoms such as pain and fatigue. Does completing the activity adversely affect the individual’s ability to subsequently complete other activities? ‘In a reasonable time period’ – means doing something in no more than twice the time it would take for an individual without any disability would normally take.

Aids and appliances There is more acknowledgement of aids and appliances in the descriptors, and the need for them can lead to increased points. Aids and appliances can include those which are normally used as well as those which can ‘reasonably be expected’ to be worn or used. Aids are devices that help a performance of a function for example, walking sticks or glasses. Appliances are devices that provide or replace a missing function, for example artificial limbs, collecting devices (stomas) and wheelchairs.

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Assistance, prompting and supervision Many of the descriptors refer to assistance or prompting. While assistance is defined in the regulations as ‘physical intervention by another person’, prompting means ‘remind or encourage… by another person’. Unlike within the DLA regulations there is no reference in PIP law to prompting having to be ‘in the presence of’ the claimant. The fact that prompting does not require the presence of another person is highlighted in DWP’s explanatory notes. This means that prompting could be provided over the telephone. ‘Assistance’ is support that requires the presence and physical intervention of another person. This means someone actually doing some or all of the task in question. This specifically excludes non-physical intervention such as prompting or supervision. To apply this only need to be required for part of the activity. ‘Prompting’ is support provided by reminding or encouraging an individual to undertake or complete a task but not physically helping them. To apply this only needs to be required for part of the activity. ‘Supervision’ is a need for the continuous presence of another person to avoid a serious adverse event from occurring to the individual. There must be evidence that any risk would be likely to occur in the absence of such supervision. To apply this must be required for the full duration of the activity. ‘Unaided’ means without either the use of aids or appliances or without assistance, prompting or supervision.

Variable and fluctuating conditions In the assessment a descriptor will be deemed to apply to the claimant if it reflects her ability for the majority of days i.e. more than 50% of days over a 12 month period. This reflects the three month plus nine months in the required period condition. If the descriptor is satisfied at any point on a given day, it is satisfied for that day. The assessment takes account of changes in the claimant’s condition.   

If only one descriptor applies from more than 50% of the days in the period, that descriptor is used If two or more descriptors are satisfied for more than 50% of days, the highest scoring descriptor applies If no single descriptor is satisfied on over half of the days, but two or more descriptors when added together are satisfied for more than 50% of the days, the descriptor that is satisfied for the longest period of time will apply.

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The PIP assessment The Claim Form The PIP claim consists of two claim forms. It is expected by DWP that Part 1 of the claim is completed over the phone with a DWP employee. Paper formats for Part 1 are available on request in exceptional circumstances, for example for claimants with hearing loss. Basic information required for this initial call includes:     

National Insurance Number Bank or building society details A health professional’s details Nationality and details of time spent abroad Details regarding any terminal illness.

A claimant’s claim may fail at this stage if they do not meet the basic eligibility conditions e.g. regarding the residence/presence test. They are not sent any further forms but will be sent a ‘disallowance letter’. Upon successful completion of Part 1 the claimant is sent Part 2 (known as 'telling your story'). This form is bar-coded and unique to the claimant. Part 2 is pre-populated with information from Part 1. Evidence For all claims, decisions on entitlement will involve consideration of evidence from a range of sources, including:    

The claimant herself (via the claim form) Independent Health Care Professional GP Consultant

Evidence is a key part of the assessment process. Ideally the claimant / adviser should collate as much evidence as possible and submit it either with the claim pack or as soon as they can after. Other evidence that might be considered to be important to a claim may include reports from a rehabilitation officer, Social Services and carers etc. Given the qualifying conditions for PIP - especially around the requirement for satisfying a descriptor/s on a majority of days in a period the use of a care and mobility diary may be particularly important.

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Independent Assessor Individuals' claims and supporting evidence are considered by an independent assessor who is a health care professional working on behalf of a third party supplier. The assessor will provide advice to a DWP decision maker who will make the final decision on entitlement to PIP, using all the available evidence. Both the assessor and the DWP decision maker will have appropriate training, guidance and support to carry out their roles.

Face to face consultation The vast majority of claimants are expected to have a face to face consultation with the assessor as part of their claim. This is supposed to provide individuals with an opportunity to explain how their impairment affects their everyday lives. Claimants are able to bring another person with them to the face to face consultation such as a family member, friend, carer or advocate. Failure to attend a consultation can result in a negative decision unless good cause is shown. Decisions on claimants for whom a face to face consultation would not be appropriate are made on a case by case basis. DWP says this is because impairments affect people in different ways.

Rates of PIP compared with DLA DLA

PIP

2014/15 weekly rates

Highest rate of Care component

=

Daily Living Enhanced rate

£81.30

Middle rate of Care component

=

Daily Living Standard rate

£54.45

Lowest rate of Care component

=

No equivalent

Highest rate of Mobility component

=

Mobility Enhanced rate

£56.75

Lowest rate of Mobility component

=

Mobility Standard rate

£21.55

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Timeline of introduction and transfer from DLA From April 2013 New claims to PIP from anyone aged 16 to 64 were taken in the controlled start area in postcodes in the North West and part of the North East of England. During this time DWP did not invite any existing DLA claimants to claim PIP. From June 2013 From 10 June new PIP claims were also taken in all remaining areas of Great Britain. DWP no longer accepts new claims for DLA from anyone aged 16 to 64. From October 2013 Since 28 October 2013 reassessment of some existing DLA claimants started on various dates in selected post code areas. The final post code areas were announced earlier this year. These included London SW post codes from 27 June, and London W post codes from 27 July. DWP has been inviting the following current DLA recipients only living within those areas to claim PIP:  those with fixed period DLA awards ending on or after 17 March 2014 (reassessment activity starts approximately 20 weeks before existing DLA awards end);  young people turning 16;  those where there is a report of a change in the DLA claimant’s health condition or disability; and  existing DLA claimants aged 16-64 who wish to make a PIP claim. From 13 July 2015 DWP has announced that from 13 July 2015 it will start inviting people who currently have a long-term or indefinite award of DLA to claim PIP. This is will be done gradually over a period of around two years starting with people living in various postcodes in the Midlands and the North of England. The DWP states that, by late 2017, all existing DLA claimants (aged 16 to 64 on 8 April 2013) will have been invited to claim PIP.

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DLA Claimants: The Managed Reassessment Process 1. The Administrative Claim - A letter is sent telling the claimant that their DLA is due to end and inviting them to claim PIP. They will have four weeks to make the claim - generally this will be done online or over the phone with paper format being the exception. 2. If they do not claim within four weeks DLA will be suspended and a letter sent out stating that the suspension will be lifted if they claim within the next four weeks. If no claim is made the DLA claim is terminated. 3. The Questionnaire - If the claim is made then a detailed questionnaire is sent out asking about their disability/impairment. Failure to return the form will result in the claim being rejected. 4. Assessment - An independent assessor determines whether further evidence is required and whether a face to face consultation is needed. The majority of claimants will have a face to face consultation on the first claim. If the questionnaire has not been received and it is identified that the claimant needs additional support they will be invited to a face to face consultation. 5. If the face to face consultation is missed without good cause the PIP claim will be rejected. 6. A decision maker will decide the claim. DLA ceases to be paid and PIP is paid if claim is successful. Note that claimants who were aged under 65 on 8 April 2013 will be invited to claim PIP, even if they are aged 65 or over at the time of the invitation to transfer. However it is planned that this group of claimants will be dealt with as early as possible during the transfer process. PIP from age 65 years All DLA claimants who are 65 before 8 April 2013 will not be re-assessed under PIP. They will continue to receive DLA as long as they meet the entitlement criteria. If someone is getting Attendance Allowance (AA) they will not be affected by the introduction of PIP. Transition at age 16 years PIP cannot be claimed by anyone under the age of 16. Children can claim DLA until they reach age 16. From their 16th birthday if a child lives in one of the post code areas in which DLA claims are being reassessed she will be invited to claim PIP. If they do not live in one of those areas – and that includes Kensington & Chelsea - they can continue to get DLA under the adult rules.

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The Dispute Process: Reconsiderations and Appeals Since October 2013 claimants have had to apply for a ‘mandatory reconsideration’ if they wish to challenge a decision regarding a claim for a benefit administered by DWP. This includes PIP claims. They cannot proceed straight to an appeal application following the initial decision on their claim. The dispute process is as follows. If the claimant disputes the decision made and would like DWP to look at the decision again the claimant can ask for a reconsideration. Claimants are advised to provide any additional evidence at this point. If a claimant is not entitled to PIP, or in the case of a claimant who used to get DLA if they are awarded a lesser amount of PIP than their previous DLA award, the DWP Case Manager will telephone her to discuss the reasons for the decision and answer any questions the claimant may have. If after DWP have reconsidered the decision the claimant still disputes it she can lodge an appeal with HM Courts & Tribunals Service (HMCTS). Appeals against DWP benefit decisions must now go directly to HMCTS, whereas previously they were sent to the office that had made the decision. To lodge the appeal the claimant should complete the appeal form SSCS1 (although a letter of appeal may be accepted instead). She must normally include a copy of the mandatory reconsideration notice sent by DWP with her appeal application. HMCTS will administer the appeal and make arrangements for the appeal hearing. NB if at any point during the dispute period the DWP decision-maker revises a decision only partly in the claimant’s favour (e.g. awarding the daily living component but not the mobility component) and she is not happy with the revised decision, she will have to start the dispute process again by asking for a reconsideration.

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Other PIP issues PIP and means-tested benefits and Tax Credits Where applicable certain awards of PIP may lead to entitlement to a means-tested benefit and tax credits, or an increased amount for means-tested benefits and tax credits. Any rate of either component of PIP gives entitlement to the disability premium. An award of either rate of the daily living component is required, along with other conditions, to get the severe disability premium. And the enhanced rate of the daily living component gives access to the enhanced disability premium. Any rate of PIP acts as a ‘qualifying benefit’ for the disability element in Working Tax Credit (WTC), and leads to a disabled child element in Child Tax Credit for any qualifying young person. The enhanced rate of the daily living component gives entitlement to the severe disability element for an adult in WTC, or the severely disabled child element in CTC for any qualifying young person. PIP and Carer’s Allowance Either rate of the daily living component of PIP acts as a passport to claiming Carer’s Allowance, in the same way as carers of the middle and highest rate care components of DLA have been able to claim Carer’s Allowance. PIP and the Motability Scheme Claimants are able to qualify for Motability Scheme help if they are receiving the enhanced mobility component of PIP. PIP and transport related concessions Passporting arrangements which exist under DLA have been generally maintained for PIP. Claimants who receive the mobility component of PIP may be eligible for: 1. a Blue Badge without further assessment. (As the arrangements for administering the Blue Badge scheme differ across the country, claimants in receipt of the mobility component of PIP who wish to apply for a Blue Badge should contact their local authority or apply online) 2. concessionary travel (free off-peak travel on local buses) 3. free road tax if getting the enhanced rate or 50% off if on the standard rate.

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Appendix 1 DWP Guidance: The claimant journey There are five main stages to claiming Personal Independence Payment: 1) Thinking about claiming 2) Making a claim 3) Telling your story 4) Assessment 5) Decision Thinking about claiming For new claims to PIP Step 1: Claimant can look at PIP information that explains eligibility criteria and helps the claimant decide if they want to make a claim. This information can be found from several sources:      

Online Support organisations Leaflets DWP GPs and healthcare professionals Family & Friends

For existing DLA claimants Step 1: After 7 October 2013, existing DLA claimants will be reassessed for PIP [in selected areas – see above] if they have fixed period DLA awards coming up for renewal; are young people turning 16; or have indefinite awards and report a change in their condition. Existing DLA claimants (between 16 and 64 on 8 April 2013) don’t need to do anything now – DWP will contact them in plenty of time if they need to take any action DWP will begin selecting existing DLA claimants and tell them what they need to do to claim PIP. They will prioritise DLA claimants who have turned 65 after 8 April 2013, when PIP was first introduced. If an existing DLA claimant makes a claim for PIP then their DLA payments would normally continue until their PIP claim is decided. If they choose not to claim PIP then their DLA would end.

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Making a claim Step 2: Claims can be made by calling DWP on 0800 917 2222. Paper claim forms will be by exception for those claimants that are unable to make a claim by phone. The initial information required to make a claim for 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 It can help speed up the claim if the caller has all this information ready before calling. The initial phone call can also be made by someone supporting the claimant, such as a support organisation or family member. They’ll need to be with the claimant when they call and the claimant will need to pass a quick identity check. Step 3: DWP will identify communication needs, such as alternative formats, and consider if the claimant needs additional support. The date of claim is set at the point of the phone call. DWP will explain what happens next to the claimant. Step 4: DWP checks basic eligibility conditions. If these are not met then a disallowance letter will be issued. Step 5: A 'How your disability affects you' form is posted to the claimant. It is individually addressed and bar-coded to speed up processing when it is returned. Telling your story Step 6: The form that DWP sends following the making the claim phone call 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. They can use the form to explain this. Information about how to complete the form will be included and also available online. Claimants may ask someone, such as a family member or support organisation to help them complete the form. DWP will provide advice and guidance for support organisations to help them help claimants. 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.

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Assessment Step 7: The claim information, completed form and any additional evidence is passed over to a health professional. Step 8: The health professional 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 face-to-face consultation. Face to face consultation required: Step 9: If the health professional thinks they need to speak to the claimant they will contact the claimant and invite them to a face to face consultation. Claimants can contact the health professional to ask questions about the consultation or rearrange appointments. Step 9a: When the claimant attends the face-to-face consultation with a health professional they 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. Claimants are encouraged to take someone along to the consultation for support. Anybody they bring can take an active part in the discussion where necessary. Face to face consultation not required: Step 9: If the health professional decides a face to face consultation is not needed they will review all the evidence against a set of everyday activities and clear descriptors to assess the challenges faced by the individual. For all claimants: Step 10: The health professional then sends a report back to the DWP to help inform their decision. Decision Step 11: 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.

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Step 12: A decision letter is posted to the claimant. This letter provides more information about the decision and how it’s been reached. It also explains other sources of support available. Claimants can call DWP to ask for more information about the decision. Step 12a: 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. If the claimant disagrees with the decision they can ask the Case Manager to look at it again – this is known as a reconsideration.

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