Personal Independence Payment (PIP) is a benefit available to people from age 16 through to state pension age who are suffering an illness or disability, including a mental health condition. It provides extra money to help with everyday living expenses and eligibility is not affected by your income, savings or employment status. It can even be paid in addition to Employment and Support Allowance (ESA) and other benefits. There are two parts to PIP – Daily Living and Mobility – and you may qualify for one or both parts.
PIP for hidden disabilities
Eligibility is not based on the condition you have, but rather the amount of help you need as a result of how your condition affects you. So there is no reason why people suffering hidden disabilities such as Fibromyalgia, ME/CFS, chronic pain and other conditions of central sensitisation should not qualify for PIP.
In any event, last year, with cross-party support, Fibromylgia was finally recognised by parliament as a real and potentially disabling condition. Figures now show that people with Fibromyalgia account for 3.5% of all applications for PIP.
To be eligible for PIP, the rules say that as a result of your condition, you must:
- have had difficulties with daily living or getting around (or both) for 3 months; and
- expect these difficulties to continue for at least 9 months.
Although the assessment is based upon the level of help you require with specific activities, you can make a claim whether or not you receive help from someone else. The government website says:
How to claim PIP
The best guide to claiming PIP is provided by Citizens Advice, and it is advisable to consider their guidance carefully.
The final stage of the PIP application process is the PIP Assessment. As a result of COVID-19, the government has suspended all face-to-face assessments. Where possible, they are attempting telephone assessments, but this is not suitable for every person or condition. For that reason, some assessments are currently based on documents only, including any available medical evidence.
The assessment will be carried out by an “independent healthcare professional” who will then send a report to the DWP. In an earlier article, albeit in the context of ‘Work Capability Assessments”, we considered concerns which have been raised over the level of training and experience of many assessors.
Despite its recognition as a disability, there continues to be an abundance of anecdotal evidence that some assessors remain sceptical about Fibromyalgia. With this in mind, there is certainly a lot to be said for submitting as much evidence as possible with your application. This might include letters from your treating hospital consultant and/or your GP, as well as letters from anybody who has observed your limitations and difficulties, including, family, friends, neighbours and, if you are working, your employer. In respect of each observation made, you should ask them to be as specific as possible with regard to time, place, nature of the activity and what they actually witnessed. General comments are far less persuasive.
Challenging a PIP decision
If your application is refused, or you are otherwise unhappy with the decision, you can ask the Department for Work and Pensions (DWP) for a mandatory reconsideration. If they do not change their decision, you have the right to appeal to a tribunal. Nearly 75% of appeals are successful, nearly double the number a decade ago.