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Personal Independence Payment (PIP) - how your claim is assessed
If you meet the basic conditions for getting Personal Independence Payment (PIP), the Department for Work and Pensions (DWP) will send you a form to fill in about how your disability or health condition affects you. This is called the ’How your disability affects you’ form.
The DWP will send your completed form and any evidence you've provided to a health professional. In most cases the health professional will ask you to attend a face-to-face assessment. The health professional will assess your claim and write a report for the DWP. A DWP decision maker will then decide whether you're entitled to get PIP.
This page tells you how the assessment process works.
What's the purpose of the PIP assessment?
When you’ve returned the ‘How your disability affects you’ form, the DWP will ask a health professional to carry out an assessment to help them decide whether:
- you have a physical or mental condition that limits your ability to carry out certain activities. These are called the daily living activities and the mobility activities
- your abilities are limited or severely limited. This affects the rate of PIP you'll get
- your abilities are expected to last for at least a year. This includes three months before you become entitled to PIP and nine months afterwards. This is known as the required period condition.
Each activity has a list of descriptors. These describe a range of levels of ability to carry out the activities, including how much help you need.
The health professional will decide which descriptor applies to you for each activity. They will then send a report to the DWP decision maker who will make a decision on your claim.
Who will carry out the assessment?
Your claim will be assessed by a health professional working for a private company that carries out PIP assessments for the DWP. The company is known as an assessment provider.
The health professional could be an occupational therapist, nurse, physiotherapist, paramedic or doctor. The health professional writes a report for the DWP, but they don't make the decision on your claim.
Who are the assessment providers?
Atos Healthcare provides assessments in:
- North East England
- North West England
- Southern England.
Capita Business Services provides assessments in:
- Central England
- Northern Ireland.
What will the health professional do when they get your 'How your disability affects you' form?
The health professional will review the information you've given in your form, together with any other evidence you've provided.
They may ask for more evidence from the contacts you've included on your form. The DWP will pay any fees that may be charged for this evidence.
The health professional will then decide whether:
- they need more information from you
- you need to attend a face-to-face assessment, or
- they have enough information already.
Will you have to have a face-to-face assessment?
In most cases, the health professional will ask you to attend a face-to-face assessment. In some cases, they may decide they have enough evidence from the information you've provided to report back to the DWP. In other cases, they may phone you for more information.
If you're claiming because you're terminally ill, you won't be asked to attend a face-to-face assessment.
If you need to have a face-to-face assessment, the assessment provider will contact you to arrange an appointment.
How the health professional assesses your claim
The health professional will assess your claim against the 12 activities of daily living and mobility. For each activity, they will match your level of ability to the appropriate descriptor.
They will also look at all the written evidence you've provided and the outcome of the face-to-face assessment if you’ve had one. They will use all this information to prepare a report for the DWP.
Can you get a copy of the health professional's report?
The health professional who assessed you can't give you a copy of their report, but you can ask for a copy from the DWP.
How the decision on your claim is made
The DWP decision maker will review:
- all the information in your claim form
- the health professional's report
- any other information you've provided.
They won’t automatically consider evidence provided for a Work Capability Assessment for Employment and Support Allowance (ESA), but they could do so if they think it's useful for your PIP claim. If you think it would be helpful to you, ask them to look at it or send them a copy
The decision maker will decide which descriptors apply to you. Each descriptor carries a point score ranging from zero to 12. The points from the descriptors which apply to you are added up. Your total point score will determine whether you can get PIP and, if so, at what rate.
The decision maker will also decide how long you can get PIP for.
The DWP will send you a decision letter including reasons for the decision.
If you disagree with the decision
If you disagree with the decision, you can ask the DWP to look at it again. This is called a mandatory reconsideration. You must do this within one month of the date on the decision letter. The time limit can be extended in some circumstances. A reconsideration means that a different DWP decision maker will look at the evidence again and may decide to revise the decision.
If you're unhappy with the outcome of the reconsideration, you can appeal directly to HM Courts and Tribunals Service (HMCTS). However, you can't appeal until the DWP has reconsidered your claim and given you a written decision. The written decision is called a mandatory reconsideration notice.