Read the answers to some frequently asked questions below about Personal Independence Payment (PIP) for people with a learning disability.
Your frequently asked questions
Over the last few years, PIP has replaced the Disability Living Allowance (DLA) for people aged between 16 and 64 living in England and Wales.
Getting your head around the benefits system can be confusing, so we've given answers below to some of your questions around PIP.
Click each question to reveal the answer.
What is Personal Independence Payment (PIP) made up of?
Like DLA, PIP has a Daily Living (Care under DLA) component and a Mobility component. Awards will be made up of one or both of these components. Each component has two rates – standard and enhanced. Unlike DLA which had three rates of care, PIP just has the two - there is no lower rate of care.
Weekly rates from April 2019
Daily Living (called ‘care’ under DLA):
- Standard rate: £58.70
- Enhanced rate: £87.65
- Standard rate: £23.20
- Enhanced rate: £61.20
The Daily Living enhanced rate of PIP is the same as the higher rate care component of DLA. The standard rate of the Daily Living component is set at the same level as middle rate DLA care component. The mobility rates of PIP are the same as the DLA rates.
As there is no longer a lower rate of care, many people who previously received the lower rate of care DLA are expected to lose their care component when assessed for PIP. However, they may still qualify for a mobility payment.
Is there automatic entitlement to PIP for people with certain conditions, like DLA?
No. Entitlement for PIP is based on how someone’s conditions or disabilities affect them, not the condition or disability itself.
The Department for Work and Pensions (DWP) has taken the approach that the only way to accurately decide who should receive PIP is to assess everyone individually, looking at their personal circumstances and barriers they may face.
The assessment for PIP aims to make greater use of evidence from the people who support an applicant (e.g. a GP, support worker or specialist nurse). The majority of people who make a claim will be assessed face-to-face. This is different to DLA claims, where there were no face-to-face assessments, and expert evidence was rarely requested
Exceptions will be made for claimants who are terminally ill and who are not expected to live for more than six months. These claims will be fast-tracked.
If I get DLA, am I entitled to PIP?
Not necessarily There is no automatic transfer from DLA to PIP.
If you currently receive DLA, and are of an eligible age for PIP (see questions below on children and pensioners), you you do not need to do anything until DWP contact you by letter, inviting you to apply for PIP. If you do not respond to the letter your DLA will stop and there may be a delay before you can get PIP.
Everyone is individually assessed against the PIP entitlement criteria. The DWP examines individual circumstances, and entitlement depends on how the ability to carry out daily tasks and/or mobility is affected by your condition or disability.
Unlike DLA, entitlement does not depend on what health condition or disability you have. It solely depends upon the effect that your condition or disability has on your daily living and/or mobility.
If I was found ineligible for DLA, will I also be ineligible for PIP?
The criteria and assessment for PIP are different to DLA. While it is likely that some people who were eligible for DLA may be ineligible for PIP, there's also the possibility that some people who were ineligible for DLA may be found eligible for PIP.
This is especially true for the mobility aspect of PIP, which is likely to better reflect the barriers faced by people with a learning disability in planning and making a journey.
If you're not receiving DLA, you can apply for PIP whenever you want to. However, if you are receiving DLA currently, applying for PIP before you are invited to carries the risk of a reduced award, or the claim being rejected.
How will my entitlement be assessed and decided?
The assessment for PIP focuses on health professionals considering your personal circumstances, to understand how your condition or disabilities affect you. These health professionals, from Atos or Capita (the companies contracted to conduct assessments), then make a recommendation to the DWP, which makes the final decision on entitlement and duration of award.
The health professional will consider additional evidence provided by you, evidence they source themselves, and evidence from any professionals that may support you on a regular basis (like a GP or consultant).
Crucially for people with a learning disability, they will also consider non-medical evidence such as a statement from your social worker or educational establishment, or a care plan. The health professional may seek this information out on your behalf, providing that you've written it on the claim form (see next question).
However, most people will also be invited to a face-to-face consultation with this health professional as part of the claim process. You are encouraged to bring a companion/advocate with you to this meeting. The health professional will provide a report to a benefit decision maker at the DWP. The benefit decision maker will then use all of this information to decide whether you're entitled to PIP, at what rate and how long the award is for.
You can ask to record the assessment if you wish. You will need to contact the Centre for Health and Disability Assessments to arrange this before you go to the assessment - there are certain requirements you need to follow. You can find more details about the CHDA on their website, or by calling 0800 288 8777.
The claim process, from application to decision, was originally envisioned to take 12-16 weeks. If you start your PIP claim within four weeks of being invited to, your DLA will keep being paid until your PIP claim has been decided. If you do not start your PIP claim within four weeks, your DLA payments will stop. However, once PIP is awarded, the DWP will backdate your PIP payments to the date of application, meaning that you will receive all PIP payments that you were eligible for from the date that you applied.
Mencap has produced an easy read guide explaining what PIP is and how its introduction might affect people.
An in-depth booklet discussing the entire claim process, including the descriptors used to assess your needs across different categories, is available from Disability Rights UK.
How long do I have to return the main claim form once I've received it (called the PIP2 form, ‘How your disability affects you')?
You have 28 days to return the form, from the date that the PIP2 form is created.
It's best to assume that you have 28 days to return the form from the date that the initial claim phone call is made. As the form will be returned using second class post, we advise you to allow four working days for the form to be returned. It can take up to 10 days from the date of the phone call to receive the form.
This is a small window to complete and return the form, especially when taking into account the fact that many people will need to make advice appointments.
Extensions to the deadline are available on request for people who need them – reasons accepted by the DWP include:
- waiting for an advice appointment
- an inability to complete the form alone
- illness resulting in an inability to complete the form
It is advised that you request an extension as soon as you can if you believe that you may not make the initial deadline.
What is additional evidence?
Additional evidence (or "further medical evidence") is really important when claiming PIP. A GP is often the first person people will ask when gathering evidence for PIP, but they are not the only source of information. Non-medical professionals often know much more about the daily life of someone they support. Therefore you should list both medical and non-medical professionals as sources of evidence on the claim form. Providing enough evidence will support your claim, and may mean you don’t need to have a face-to-face assessment - as the health professional may be able to make a recommendation based upon the evidence alone.
While the assessment providers will gather their own evidence, they often do not receive the evidence they ask for from professionals in time. They also do not have to contact everyone you suggest on the claim form. That’s why it's important that you gather and submit as much additional evidence as possible (see examples below).
Official guidance states that you should only submit evidence that you currently have available. However, you may be able to ask people like a support worker, teacher or nurse, to simply write a brief letter to submit with your claim. If possible, it's recommended that you start collecting your additional evidence as early as possible.
Most evidence will be free for you to access, but some professionals may charge. The DWP will not reimburse any costs you pay when collecting evidence. To avoid paying for evidence you should list those charging for evidence on the claim form for the DWP to contact themselves, instead of you contacting them directly.
If you have previously received DLA, it's likely that you will already have evidence in your existing file. To reuse this evidence, you must tell the DWP you want to do so when making the initial claim. The DWP do not always ask about this, so you should remember to ask them about it yourself.
You can send in any evidence you think will be useful for the claim. Here are some examples of useful evidence:
- care plan
- diary sheets
- supporting statement/information from family or friends
- information from a social worker
- educational records
- statement from a teacher/headteacher
- consultant’s report
- community nurse statement
- GP letters.
What if I'm unhappy with the PIP decision?
You have the right to ask the DWP to reconsider their PIP decision. This is called a ‘mandatory reconsideration’.
This must be requested within one calendar month of the decision being made (meaning one month after the date on the DWP decision letter). In exceptional circumstances you may be able to request an extension to this deadline from the DWP.
If you're not satisfied with the decision of your mandatory reconsideration, you can make an appeal to a first-tier tribunal – but you must complete the mandatory reconsideration first. If the mandatory reconsideration is not requested within the time period given, then an appeal will not be possible. If you have any questions about this or need help with an appeal, please contact Mencap Direct on 0808 808 1111 or email@example.com.
If your mandatory reconsideration or appeal is successful and the DWP find that you are eligible for PIP (or for a higher rate of your existing PIP), the DWP will backdate your claim to the date of your first application and you will receive all of the PIP payments that you were eligible for from the day that you first put in your claim.
If I'm awarded PIP will I need to undergo further assessments in the future?
This is quite likely.
All PIP awards are time-limited, and the maximum award length is 10 years. The majority of awards are much shorter than this, however.
The case manager working on your application decides how long your PIP award will last based on all the evidence they are presented with, and also decides whether a review or 'planned intervention' will apply, as well as when the review date should be set for.
What happens when my PIP award is reviewed?
The DWP might decide to review your PIP benefits at any time. In their review, they will decide if your PIP award should last longer, if the amount should change or if your claim should end. They will send you a letter with a PIP review form, and you must fill in the form and send it back within 4 weeks. If you need more time, you can phone the DWP and ask for an extension. If you don’t return the form within 4 weeks, the DWP will stop your PIP payments.
If a child is under 16 years old, will they be affected by the introduction of PIP?
Children with a disability who are under 16 years old do not receive PIP – they receive DLA until their 16th birthday. This is applied for by their parent or guardian, and payments start from the date you make the claim.
If you are approaching your 16th birthday, or supporting someone who is almost 16 years old, the DWP will contact you and advise what you need to do to change from claiming DLA to PIP.
Does the PIP system affect pensioners who receive DLA?
If you were over the age of 16 and under the age of 65 on the 8 April 2013, or if you reach the age of 16 after October 2013, the DWP will ask you to claim PIP instead of DLA.
If you were aged 65 or over on 8 April 2013, you will not be able to claim Personal Independence Payment and will continue to receive DLA for as long as you meet the entitlement conditions for that DLA. If your DLA award expires after turning 65, you may be able to apply for Attendance Allowance.
If you were aged 64 or under on 8 April 2013 and turn 65 once PIP has been introduced, you will need to be reassessed for PIP.
Are people on Attendance Allowance (AA) affected by PIP?
No. People on AA are not affected by PIP, as people on AA must be over 65 and therefore ineligible to apply for PIP as a new claimant. People who are receiving PIP when they turn 65 will continue to receive it for the duration of their award, as long as they remain eligible.
Will there be a break in benefit payments if someone moves from DLA to PIP?
If you apply for PIP when the DWP invites you to, and meet all the deadlines for sending in your forms, your DLA will continue to be paid until a decision is made on your PIP.
This is why it is important to be prepared for PIP, and to make sure that you start to gather evidence as soon as possible. The DWP will post several letters in the months before they officially invite you to claim PIP, so you should watch out for these.
It is important to note that PIP forms are not currently proactively being sent in accessible formats for people with a learning disability, and some people may find it difficult to understand them. Once DLA is stopped, it is very difficult to get it reinstated, so it’s important that people with a learning disability are supported throughout the process, notified to expect PIP letters and given all the help they need to fill out the forms.
If I currently have a Blue Badge and a carer who receives Carer’s Allowance because of my DLA, will PIP provide the same ‘gateway’ or ‘passport’ to that additional help and support?
For people already receiving DLA, if your award level stays the same under PIP, there should be no problems with keeping these benefits.
The daily living component of PIP will help carers qualify for Carer’s Allowance, while the enhanced rate of mobility allowance in PIP should help people to apply for a Blue Badge if they qualified under the mobility component.
However, if you only qualified for the enhanced mobility under the ‘planning and executing a journey’ category, you will not automatically be entitled to a Blue Badge, and whether you receive one will be down to the discretion of your local authority.
How to get the support you need
Phone or email the Learning Disability Helpline, which is our advice and support service, for guidance and information about what support we can offer you.
Or why not take a look at our online community? This is a place where parents and carers of people with a learning disability can share experiences, advice and support.