Reg 15 and the 2 year rule

I’m confused by how Reg 15 of the PIP regs will be applied.

Reg 15 suggests that if a new claim is made less than 2 years after a previous entitlement (for a related condition) to PIP ends that the new claim uses for the ‘required period’ both the 3 months preceding the end of the previous claim and the 9 months after the date the new claim was made.

Any ideas how this might work? Would this mean 2 assessments are made- one based on the claimant’s condition that previously scored insufficient points and one for the new claim where they may score 8 or more points.

I’m wondering whether a decision maker would bother looking at the forward 9 month ‘required period’ when they already have the information they need to determine a nil entitlement decision under the 3 month ‘required period’.

For example, a claimant with mild depression whose award was ended and then became severely depressed 18 months later and made a new claim would find that a decision maker would simply decide they were not entitled again and rubber stamp the same score from the ended claim.

In effect does this mean that irrespective of how severe their needs become, in most circumstances claimants will have to wait 2 years from the end of one claim before putting a new one in.

I don’t see why the DM would decide that there was no entitlement for the last three months of the previous award, unless there was some evidence to show that the award wasn’t correct at that point. This would presumably mean a supersession decision to remove part of the entitlement under the old award, and so the ‘prescribed date’ would then be the last day of the award as superseded. Reg 15 only applies to a component that the claimant was entitled to in a previous award as well.

I think that the rule just straightforwardly waives the 3 month qualifying period if you re-claim the same component within two years (one year if over 65) on the basis of the same condition(s), or new ones that have developed as a result of the original one(s).

I had wondered whether this would cause problems if the claimant’s needs were greater at the point of the new claim, but I have come roundto the view that actually the splitting of the required period condition for the rates of the components in Regs 12 and 13 means that it is technically possible for the DM to award the enhanced rate of a component on the new claim if convinced that the claimant’s needs were greater during the last three months of the old (standard rate) award. The best example I could think of would be where the claimant’s mental health deteriorates to the point that they should get the enhanced rate of a component, but also that they don’t make a new claim when their award is about to end, so leaving a gap. Any corrections or views on that are very welcome…

For me, the real issue with the required period condition is going to be Reg 14(b). How on earth will claimants manage to report the change that their daily living and/or mobility needs are no longer expected to last nine months?

Jon