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Check how to fill in your claim form

This advice applies to Wales

Help filling in your PIP form

When you apply for PIP, you’ll need to fill in a form called ‘How your disability affects you’. You can use our guidance to help you. There is advice for each question, including: 

  • what the questions mean 
  • what to write about in your answers 
  • examples of answers people might give
  • help explaining how your illness or disability affects you 

PIP is based on how your condition affects you. It's not based on your particular illness or disability, or your medication.

It’s very important to think about each question. Our help pages will help you to decide if you need to answer each question.

Help with question 1: listing your condition, medication and treatments

This question has 3 parts:

1a. You’ll need to tell them what condition or disability you have and the year it started.

1b. You’ll need to list any medication you’re taking - and include the dosage.

1c. You’ll need to list any treatments, therapies or operations.

Help with question 2: listing your health professionals

This question has one part. You’ll need to list any health professional you’ve seen about your condition - including their contact details and the date you last saw them.

Help with question 3: preparing and cooking food

This question has 2 parts: 

1a. This is a tick box. You'll need to tell them if it's difficult for you to prepare a simple meal. 

1b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 4: eating and drinking

This question has 3 parts:

4a. This is a tick box. You’ll need to tell them if eating and drinking is difficult for you.

4b. This is a tick box. You’ll need to tell them if you use a feeding tube to eat or drink.

4c. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 5: managing treatments

This question has 3 parts:

5a. This is a tick box question. You’ll need to tell them if it’s difficult for you to manage your treatments, including taking your medication.

5b. You'll need to explain the difficulties you have and give examples of the help you need.

5c. You’ll need to tell them about therapies you have at home where another person helps you.

Help with question 6: washing and bathing

This question has 2 parts:

6a. This is a tick box question. You’ll need to tell them if it’s difficult for you to wash or bathe.

6b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 7: managing toilet needs

This question has 2 parts:

7a. This is a tick box question. You’ll need to tell them if it’s difficult for you to use the toilet.

7b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 8: dressing and undressing

This question has 2 parts:

8a. This is a tick box question. You’ll need to tell them if it’s difficult for you to dress and undress.

8b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 9: communicating

This question has 2 parts:

9a. This is a tick box question. You’ll need to tell them if it’s difficult for you to talk, listen and understand others.

9b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 10: reading

This question has 2 parts:

10a. This is a tick box question. You’ll need to tell them if it’s difficult for you to read words and symbols.

10b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 11: mixing with other people

This question has 2 parts:

11a. This is a tick box question. You’ll need to tell them if it’s difficult for you to meet and mix with other people.

11b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 12: making decisions about money

This question has 2 parts:

12a. This is a tick box question. You’ll need to tell them if it’s difficult for you to manage your money or make decisions about money.

12b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 13: going out

This question has 2 parts:

13a. This is a tick box question. You’ll need to tell them if it’s difficult for you to cope with both long and short journeys.

13b. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 14: moving around

This question has 3 parts:

14a. This is a tick box question. You’ll need to tell them if it’s difficult for you to walk and move around.

14b. This is a tick box question. You’ll need to tell them how far you can walk using any aids you need.

14c. You'll need to explain the difficulties you have and give examples of the help you need.

Help with question 15: additional information

This is a blank page where you can add extra information if you want - for example, medical evidence or comments from other people like a carer or friend.

If you run out of space on the form

It's okay to write your extra information on a separate sheet - use our template [ 0.78 kb]

Always attach this sheet to your claim form and include your name, National Insurance number and the question number.

If you need more help with the form 

If you’re having problems with the form, your local Citizens Advice might be able to help you or find somewhere that can - get help from an adviser.

You might also be able to get help from a local disability or mental health support agency. You can:

Sending the form

You can find out more about how to send the form.

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