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DLA to PIP - who will be the losers and the winners?
Hello colleagues
I am ever hopeful! The govt doc responding to the consultation (below) estimated that as well as the 55% to lose some or all of their DLA to PIP, there would be 29% who will see their existing DLA awards increased (would this include newly entitled?). (Hope ive got that right)
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/181181/pip-assessment-thresholds-and-consultation-response.pdf - paragraphs 8.16 and 8.17. Thanks to Ken Butler of Disability Rights UK.
does anyone understand the kinds of needs/conditions that will be entitled to more and/or those who will be newly entitled?
Thank you
Clive
Hi Clive,
I too have been scratching my head to try and identify some possible PIP winners and came across two cases in the same week. Both are young men with severe learning disabilities who currently get middle rate care and lower rate mobility. Neither have sufficient nighttime care needs to qualify for the higher rate nor are they likely to meet the tough “severe mental impairment” threshold even though they have some behavioural issues.
However, on my assessment both would get at least 12 points or more and ought to get the Enhanced rate of PIP (Daily Living) based on a cumulative total of the 10 Daily Living Activities and would get the Enhanced rate of PIP (Mobility) under Activity 11 on the basis they would always have to be accompanied to either familiar or unfamiliar places. The big risk of course for existing DLA cases is whether ATOS would take the same view. Do you put in a PIP claim from this October (and potentially get a substantial increase in benefit income) or wait until their time comes up under the DWP’s managed reassessment programme?
Alaster Calder
I agree regarding the enhanced mobility.
PIP mob criteria 1(f) “cannot follow the route of a familiar journey without another person …..” gets you enhanced mobility which is a lot easier to satisfy than the SMI route to DLA high mob.
Many people with autism do always need someone with them to make any journey, but can’t quite meet the SMI rule.
It is going to be difficult to help clients decide whether to opt for early reassessment, particularly those currently on DLA high care, low mob.
Jane
Yes thanks!
Sorry - that was me being mean to my (much loved…) former colleague.
Some we have considered to date:
- those who have lower rate care or nil but who use aids and appliances over a range of activities. They also benefit from not having to show frequent or throughout the day
- those who score points across both mobility activities who would never have got higher rate mobility
- those with only day or night needs but who can nevertheless score 12 points on daily living component
As far as losers are concerned - anyone getting DLA on mainly supervision grounds relating to fluctuating mental health conditions I think is going to find it difficult. Bound to be others, will need to give it more thought.
As far as losers are concerned - anyone getting DLA on mainly supervision grounds relating to fluctuating mental health conditions I think is going to find it difficult. Bound to be others, will need to give it more thought.
Anyone would think they’d targetted the minority least likely to complain about it…
Another potential category of ‘winners’ is people who are visually impaired but don’t fit the criteria for DLA high rate mobility. If they need guidance from another person, dog or use an orientation aid in familiar areas they will qualify for enhanced PIP mobility.
I have to disagree re: visual impairment although my comments could just as equally apply to any sensory impairment.
The problem with VI is that most advisers think only in terms of VI being a loss of distance vision because anything else is very difficult to articulate. Even those things which involve that but which are predominantly something else tend to be thought of by advisers as loss of distance e.g. cataracts, glaucoma, AMD.
Unfortunately the battle re: DLA HR mobility component and VI also reflected that very limited approach to VI and I include those organisations representing people with VIs in that to a great extent also. This is a world in which you are either blind or partially sighted and the former means next to no distance vision whilst the latter means a loss of distance vision. There appears to be nothing else and yet VI also covers restrictions on visual field; issues with colour sensitivity; issues with light sensitivity and issues with movement.
PIP does no more than reflect the outmoded thinking on this and many people with a VI that don’t fit into the “loss of visual acuity” model will be big losers under PIP on both models.
The winning areas are potentially around Daily Living and the use of the 50% rule, which I suspect over time will be the single most productive area of PIP work.
As far as other conditions are concerned then epilepsy is an obvious one where the so called inconsistency of DLA becomes a mess under PIP. Unpredictable losses of consciousness would be a middle or higher rate care on supervision and lower rate mobility. Under PIP that becomes a massive 1 point under 3bii so no Daily Living. Mobility point in the direction of 1f and the higher rate.
[ Edited: 25 Jun 2013 at 03:33 pm by Mike Hughes ]I’m interested (and a little apprehensive) to see how the assessment deals with people with MH problems who experience anxiety in unfamiliar places to the extent that they need somebody to accompany them, but retain the ability to navigate effectively. Very common for people suffering from depression and/or anxiety who would have received DLA LRM.
Under the assessment criteria the there are two descriptors that refer to ‘psychological distress’. One refers to the claimant needing ‘prompting’ to complete any journey (4 points - a current DLA LRM recipient might not even satisfy this descriptor as they may be able to complete familiar journeys unprompted) . The other is where the claimant cannot undertake any journey whether accompanied or not (10 points). It seems to me that the other descriptors refer to the ability to navigate/“follow a route” (whether due to visual impairment, learning disability, cognitive impairment etc). I note that being unable to complete any journey unaccompanied due to this kind of problem gives entitlement to the Enhanced Rate whereas a situation whereby a claimant cannot complete any journey even if accompanied due to psychological distress will only give Standard Rate - if I have understood this correctly I am surprised that more has not been made of it (as far as I am aware).
If this is correct, I imagine that for many people in this kind of situation we are going to be arguing that their anxiety gets so out of control that they are unable to navigate effectively and become disorientated. However I think this is going to be difficult to demonstrate for many clients.
Would be interested to hear other’s thoughts on this - the PIP assessment guidance seems a bit more encouraging (for example it refers to consideration being given to the risks posed to other people despite this not being directly referred to in the regulations)
As far as other conditions are concerned then epilepsy is an obvious one where the so called inconsistency of DLA becomes a mess under PIP. Unpredictable losses of consciousness would be a middle or higher rate care on supervision and lower rate mobility. Under PIP that becomes a massive 1 point under 3bii so no Daily Living. Mobility point in the direction of 1f and the higher rate.
Time will tell obviously, but if someone has unpredictable epileptic seizures, then I would be arguing for Daily Living activities 1 (e) (4pts), and 4 (c) (2pts) as applicable in most cases, to give 6pts.
3 (b) (ii) should also apply but carrying just the 1pt would need to go with 4 (e) to be of any use as it’s the only other odd numbered point scoring descriptor. And I can’t see this applying in such circs.
But what about also arguing 2 (b) (ii) – 2pts for supervision to be able to take nutrition (i.e. cut food into pieces, convey food and drink to one’s mouth and chew and swallow food and drink).
That would give 8 and the standard rate.
Mind you, I think for Daily Living such claimants with epilepsy where incontinence follows the seizure, what about 5 (e) or even (f) where they need assistance to clean themselves after a seizure on most days?
The DWP in their previously released case studies awarded “Pete”, a claimant with unpredictable epilepsy with occasional incontinence the above 6 points, which would be a loss under PIP compared to most DLA cases, but they go on to award mobility activity 11 (f) which is 12 points, and is the enhanced rate of PIP – a gain over the common low rate mobility under DLA
As far as other conditions are concerned then epilepsy is an obvious one where the so called inconsistency of DLA becomes a mess under PIP. Unpredictable losses of consciousness would be a middle or higher rate care on supervision and lower rate mobility. Under PIP that becomes a massive 1 point under 3bii so no Daily Living. Mobility point in the direction of 1f and the higher rate.
Time will tell obviously, but if someone has unpredictable epileptic seizures, then I would be arguing for Daily Living activities 1 (e) (4pts), and 4 (c) (2pts) as applicable in most cases, to give 6pts.
3 (b) (ii) should also apply but carrying just the 1pt would need to go with 4 (e) to be of any use as it’s the only other odd numbered point scoring descriptor. And I can’t see this applying in such circs.
But what about also arguing 2 (b) (ii) – 2pts for supervision to be able to take nutrition (i.e. cut food into pieces, convey food and drink to one’s mouth and chew and swallow food and drink).
That would give 8 and the standard rate.
Mind you, I think for Daily Living such claimants with epilepsy where incontinence follows the seizure, what about 5 (e) or even (f) where they need assistance to clean themselves after a seizure on most days?
The DWP in their previously released case studies awarded “Pete”, a claimant with unpredictable epilepsy with occasional incontinence the above 6 points, which would be a loss under PIP compared to most DLA cases, but they go on to award mobility activity 11 (f) which is 12 points, and is the enhanced rate of PIP – a gain over the common low rate mobility under DLA
In your case I’d be awarding 7 points - I’d only be awarding 2 points for Activity 1 as I am unsure why somebody would be at extra risk from a seizure whilst using a microwave.
The case study is encouraging re the mobility component and the point I raised above - they seem to be thinking about supervision needs as well as navigation.
[quote author=“In your case I’d be awarding 7 points - I’d only be awarding 2 points for Activity 1 as I am unsure why somebody would be at extra risk from a seizure whilst using a microwave.
The case study is encouraging re the mobility component and the point I raised above - they seem to be thinking about supervision needs as well as navigation.
I’m thinking that 1 (e) would apply because supervision would be needed for the dangers in preparing a meal, rather than just simply the cooking of it in a microwave instead of a cooker.
[quote author=“In your case I’d be awarding 7 points - I’d only be awarding 2 points for Activity 1 as I am unsure why somebody would be at extra risk from a seizure whilst using a microwave.
The case study is encouraging re the mobility component and the point I raised above - they seem to be thinking about supervision needs as well as navigation.
I’m thinking that 1 (e) would apply because supervision would be needed for the dangers in preparing a meal, rather than just simply the cooking of it in a microwave instead of a cooker.
I guess that is a potential argument but my own personal view (until we get any case-law on it) is that in preparing a meal, i.e. until heat is involved, the only danger comes from knives. A tribunal would have to decide whether the frequency of the seizures and the risk of injury in the event of a seizure mean that supervision is reasonably required, and even once that is established they would have to establish whether it is possible to prepare a simple meal without the use of sharp knives.
The PIP guidance is a little unclear on pre-chopped vegetables (and I guess by extension pre-cut meat), stating that they do not in themselves count as an aid/appliance but a need to use them may indicate a need for an aid/appliance (2 points) or assistance from another person (4 points) when chopping vegetables. The case study mentioned above gave 4 points for cooking in a case where the seizures were ‘most days’ but none for taking nutrition or managing a medical condition - IMHO the arguments for the latter two are actually stronger?!
So far as losers in comparison to DLA are concerned, here are some more possible:
1) As partly mentioned, those with supervision needs that are not continuous and/or extend to the needs to protect others (although note that the ‘safely’ factor in the PIP reliability regulation does refer to safety of others).
2) Those who need help to get to the toilet/medication/therapy (note that the PIP Assessment Guide no longer hints that the Mobility Component could help with those indoor journeys).
3) Those who do not only cook ‘from the waist up’
4) Those who depend on verbal assistance (‘prompting’ is a low scorer)
5) Those who will fall foul of the fluctuation conditions formula. The ‘majority of days’ requirement in the 12 month relevant period could present particular difficulties in relation to evidence, since may people do not keep their doctors up to date with their changing problems. In a related sense, how are doctors supposed to have the level of detail required in Regulation 7, when a person will have multiple descriptor needs on any particular day? I am sure ATOS etc will make be able to make that fine assessment…(!) sadly their ESA track record speaks for itself. The PIP2 questionnaire asks nothing about these issues, which says that will become ATOS territory - be warned.
6) Those with social needs and aspirations
7) Those with night time needs. I realise that Daily Living is supposed to be a 24 hour assessment, but look at the Activities - realistically, they are mostly nigh time gigs.
The prospect of mandatory revision delaying the reversal of poor decision making is also particularly worrying.
Steve
Returning to my earlier thoughts - I used to have some success getting people with a diagnosis of bipolar onto middle rate care on the ground of reasonably requiring continual supervision due to lack of insight at the stage of their condition deteriorating and therefore stopping medication or failing to seek help at the appropriate stage and their manic/depressive episode spiralling out of control. I can’t see how to get PIP in these circumstances where the claimant is reasonably stable for periods which make up more than 50% of the time. They should of course get the “almost pointless point”...
Also those who require prompting rather than assistance or to use an aid or appliance (for example those with depression) may struggle to get up to 8 points as prompting tends to score lower.
Going back to the issues around visual impairment and in reply to the points made by Mike Hughes above, I still maintain that some (obviously not all) people with a visual impairment will be better off under PIP mobility compared to DLA.
Anyone who would qualify for low rate DLA mobility because of a visual impairment will almost certainly satisfy PIP descriptor D, ‘cannot follow the route of an unfamiliar journey, without another person, assistance dog or orientation aid’. That will get them PIP standard rate mobility.
Some people with sight problems who didn’t qualify for DLA low mobility will have a chance of quailfying for PIP mobility:
- PIP descriptor D also includes the use of public transport (bus or train), which are not considered for DLA mobility
- it is possible to qualify for PIP mobility based on a need for a dog or orientation aid, which is not currently possible for DLA.
The criteria for DLA high rate mobility refer to visual acuity, while the criteria for PIP do not directly refer to visual acuity. For DLA, if a claimant has a visual impairment but no other health condition, they have NO chance of getting DLA high mobility if they don’t meet the visual acuity criteria. Under PIP they have a chance of getting enhanced mobility if they need another person / orientation aid / dog in familiar areas.
Most claimants who currently qualify for high rate DLA mobility under the visual acuity grounds are likely to be able to meet descriptor F to qualify for enhanced PIP mobility, either because they use a guide dog, cane or other aid, or require guidance from another person to be able to safely and reliably follow a journey. The PIP assessment guidance refers to the ability to cope with small disruptions and unexpected changes, such as roadworks and changed bus stops. On balance I think most people with sight problems are likely either receive the same amount of mobility, or a higher amount of mobility, under PIP compared to DLA (provided that they can navigate the hurdles of the PIP claims process).
The above comments are restricted to mobility component; daily living component is a different kettle of fish.