Personal Independence Payment (PIP)
How to successfully fill in PIP and Welfare forms
To enhance the likelihood of being awarded benefits, a Personal Independence Payment (PIP) form needs to be detailed and peppered with extensive information. These forms can be up to 1600 words in length and have to address all the core issues at hand.
Supporting evidence needs to be clear, relevant, detailed and must address information that can be painful for the individual, but needs to be explained at length and in depth.
Jacob Lewis, Independent Living West Country’s PIP and benefits expert, takes his clients through the process, completing forms and ensuring that they get the benefits that they should be receiving.
Through his help Jacob has had many notable successes for his clients, including one case where he secured ten years of back-payments worth thousands of pounds. In another case one simple question enabled him to help a client recover £5,500 in back pay for PIP that he was entitled to but didn’t know how to access.
It’s not always that easy and Jacob always starts the process by asking clients what benefits they are currently on, and how much they receive, so that he can fill the gaps; be that for Employment Support Allowance (ESA), Personal Independence Payment (PIP), Disability Living Allowance (DLA) or Universal Credit.
“It’s a very complicated system, and much depends on when you first started receiving benefits,” says Jacob. “The future for new clients coming into the benefits system is Universal Credits, but many of the old benefits are still in place and so we need to be able to navigate these too ensuring, where we can, that our clients are on the most appropriate benefits for them.
“We need to know all the nuances. For example, if you have ESA and PIP, which replaced the Disability Living Allowance DLA, you’re entitled to Severe Disability Premium – which tops up your benefit by £80. Clients only receive this if they claim it themselves. 99% don’t get it, but with our help, we’re changing that,” says Jacob.
He adds: “If you are fortunate enough to be on ESA, the government does not currently require you to switch to Universal Credit, which is helpful if you have an ongoing condition and you’re on the correct level of benefit, as it is rare to need medical assessment. This removes the pain of regular reassessment which runs the risk of benefit adjustments that more often than not need to be appealed."
Examples include a gentleman suffering from severe autism who was unable to understand the full range of benefits to which he could apply. Living in a private house, his 80-year-old mother was paying half his rent, and he was claiming just £542 per month.
He’d been placed on basic Disability Living Allowance (DLA) for the past ten years, which meant that he was being paid just £23 per week. Had he been on a medium DLA he would have been owed a huge backdate, but he’d never been properly assessed and so simply didn’t have the correct benefits in place.
Following Jacob’s assistance, he now receives £1,155.60 per month and will do so for the next three years before review – a figure that he should have been on for the past seven years.
Among Independent Living West Country’s many clients, Jacob Lewis, Team Leader in charge of PIP and benefits, has helped dozens of individuals access the benefits to which they are eligible.
It’s shattering to hear some of the tales of hardship that our clients have been through,” says Jacob, “simply because the system is not suited to people that find it hard to complete forms in the depth that they require to release benefits correctly. It’s very sad, but it makes the difference that we are able to make to their lives all the more important. It plays a vital role in enabling their journey to independence possible.
Jacob Lewis, Personal Independence Payment (PIP) Team Leader
Appealing PIP decisions
In our experience, it is critical to act promptly and not to let things slip. You have 28 days to challenge the PIP decision and two weeks to appeal. This is a complex process that again requires detailed analysis of the medical assessment (always ask for a copy), extensive form filling and thorough evidence to create a cast iron case outlining why the decision was wrong. You must ask for Mandatory Reconsideration within one month, or you face the prospect of being forced to wait up to 13 months.
By addressing the issue promptly and professionally, using our many years of experience and understanding of how the appeal process works, the vast majority of cases that we have been involved with result in the correct levels of benefits being awarded following the Mandatory Consideration appeal.
However, this is not always the case and occasionally cases are taken to Tribunal Appeal, where once again we are with our clients every step of the way to gain justice in the level of benefits that they are awarded.
Despite being a tough process, it is without doubt essential to avoid underpayment of benefits.
It’s also why we step in to take that pain away from our clients by fighting their corner and completing forms that will help them on their journey to independence; with the minimum of stress and damage to their mental health.
Tackling PIP head on – reassessment and appeal
All too often, we find that individuals affected by mental health conditions have been placed on the lowest level of Personal Independence Payment (PIP) benefits. Even those that have been on higher levels of PIP often slip to a lower level when they are reassessed every three years; regardless of their condition, even if the individual has a brain injury that is not going to improve.
The PIP process is managed online. For individuals with mental health and learning difficulties, this is a huge challenge and those that attempt to fill out the forms themselves often fail to do so in a way that unlocks the appropriate levels of benefits and support that they need.
Until recently individuals on PIP would get 12 months’ notice to reapply. Now you have just 6 months. The trouble is, even when forms are sent off on time, processing of those forms can and frequently are delayed, particularly if those forms fail to follow the process, or are hard to decipher. If that happens, and you do not pursue your case diligently, there is a very real danger that your current PIP benefit could expire before the reassessment process has been completed.
When this happens, individuals slip to the lowest level of PIP benefit and lose eligibility for Severe Disability Premium. That can mean a drop in benefits of nearly two thirds, all because the forms have not been processed. The process itself can take 6 months or longer, which lies at the heart of the problem, resulting in many receiving lower levels of benefit than they need, throwing them into poverty.
Now, while any underpayment will be paid back once the reassessment has been completed, it can leave many in a desperate situation particularly, if after processing the documentation, a medical review is demanded.
Experience shows that, following the medical review, individuals are all too frequently offered the lowest level of PIP, or below that which they should receive.
A recent report published by the Disability News Service (DNS), which you can read here, argues that many rejected claimants do not challenge the benefits decision handed down by the Department for Work and Pensions (DWP). In its view hundreds of thousands of claimants would have taken further steps to challenge the results of their claim if the system was less stressful and more accessible.
The one ray of light is that in the most recent quarter where stats are available (April-June 2019), 75 per cent of PIP claimants have seen their PIP appeal upheld by a tribunal. This goes to show that appealing is a necessary step in most cases.
The DNS views that a major contributor to the success of PIP appeals is the low standards of the assessments and the lack of proper consideration given to disabled peoples’ own oral and written evidence.
It believes that the DWP should take proper account of disabled people’s evidence at the mandatory reconsideration stage. It also argues that disabled people are having to wait several months or longer for justice at an independent tribunal, which is causing unnecessary stress as well as unjustified financial hardship.
Clearly, every step should be taken to avoid individuals - especially those suffering from mental health conditions - falling into the trap of accepting insufficient benefits. That is why it is essential to understand the process and challenge it where justified.
Falling through the net – overcoming PIP problems
Jacob Lewis, Independent Living West Country’s PIP and benefits expert, knows only too well the pain of going through benefit appeals with clients as well as his only family.
His sister, who suffers from fibromyalgia - a long-term condition that causes pain all over the body - was informed that she would receive the basic PIP award based on a medical report commissioned from an independent assessor by the Department for Work and Pensions (DWP).
Incensed by the decision and knowing full-well that his sister was incapable of work, Jacob took up her cause, following the tried and tested method of appeal that he has pursued time and again with Independent Living West Country’s clients.
Immediately on receiving the decision he sought mandatory reconsideration, building a case that examined the findings of the medical assessment, addressing the inconsistencies, inaccuracies and outlined in detail why his sister’s PIP decision should be reassessed.
With his help, Jacob’s sister was able to achieve the maximum care and the lower mobility element for her Personal Independence Payments (PIP), which helped her and her partner receive an extra £400 per month.
For another client, who had been working part-time to top up her PIP payments but was made redundant shortly before Christmas, Jacob came to the rescue to help her recover from the nightmare of losing virtually everything, to lift her out of poverty and put her back on her feet.
Due to the unfortunate combination of losing her job, and a delay in the processing of her PIP claim, she was forced to apply for Universal Credits. These were themselves delayed, leaving her to rely on a food bank for three months. From December to January she was left with nothing. In March her Universal Credits benefit payment paid out just £18 as a result of complications linked to her final pay slip.
Had her PIP form been processed on time, she would not have been put through the pain, indignity and stress that has done little to help her mental health.
Frustratingly, it took seven to eight weeks to process her PIP forms and then, at six months, the DWP demanded a medical review. Here Jacob led the appeal; successfully thankfully, as if it had gone to tribunal, that could have taken a further 6 months to get her benefits payed back.
Faced with debt collectors and bailiffs, it was a terrible time for his client, showing the worst aspects of PIP when the process breaks down. Today, her payments have been backdated, but it is a situation that should never have happened.