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Administration of personal independence payments on Merseyside

Published Monday, March 25, 2019

This House of Commons Library landing page has been published in advance of a debate entitled “Administration of Personal Independence Payments on Merseyside”. This debate is sponsored by Maria Eagle MP and will take place in Westminster Hall on Tuesday 26th March, starting 2.30pm.

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This landing page provides an overview of the Personal Independence Payment, including background information, the latest relevant statistics relating to claimants on Merseyside (including an Excel file provided at the bottom of this page), in addition to some recent parliamentary questions and several press articles.  Further reading material is highlighted and linked to throughout.

 

What is PIP?

Personal Independence Payment (PIP) is replacing Disability Living Allowance (DLA) for people of working age. PIP was introduced for new claims from April 2013, and it was originally expected that by late 2017 remaining working age DLA claimants would have been “invited” to claim PIP, but the Department for Work and Pensions now expects that full roll-out of PIP will not be achieved until October 2020.

At January 2019 just over 2 million people in Great Britain were receiving PIP, of whom 1.1 million were former DLA claimants.

By October 2018, 1,227,000 DLA claimants had been reassessed for PIP. Of those:

  • 482,000 (39%) had their benefit increased
  • 169,000 (14%) received the same amount as before
  • 268,000 (22%) were awarded PIP but with a decreased award
  • 253,000 (21%) were not awarded PIP following an assessment
  • 49,000 (4%) were disallowed PIP before the assessment

In total therefore, 47% of DLA claimants who registered a claim for PIP received a lower level of award or no award. However, of those who registered a claim, 349,000 (28%) were awarded PIP at the highest rate (i.e. enhanced rate daily living and mobility components). This is a higher proportion than under DLA. Of the DLA claimants who were reassessed for PIP, 191,000 (16%) were receiving the highest rate (higher rate care and higher rate mobility).

Claimants whose main disabling conditions were psychiatric disorders accounted for 36 per cent of DLA reassessments (445,000) but around 50 per cent of disallowances (153,000). The overall disallowance rate for claimants with psychiatric disorders was around 34 per cent.

The Welfare Reform Act 2012 provides the legislative framework for Personal Independence Payment (PIP). The 2010 Government believed that Personal Independence Payment would have certain advantages over Disability Living Allowance:

  • It would target support more closely on those most in need of support
  • It would be more responsive as claimants’ circumstances change
  • It would be based on a fairer, more transparent and consistent assessment of need
  • It would be easier for claimants, DWP staff and disability organisations to understand.

From the outset the Government also made it clear that a key aim for the new benefit was the need to make savings and reduce the working age caseload for disability benefits.  In its latest January 2019 Welfare trends report, the Office for Budget Responsibility (OBR) observes however that while the Coalition Government assumed initially that PIP would ultimately cost 20% less than DLA would have done, by 2017-18 it was in fact costing around 15-20% more, with roll-out only around two-thirds complete.

Further information

Commons Library Debate Pack CDP-2018-0278, Backbench Business Debate: Impact of Changes to Disability Support, 18 December 2018

Commons Library Debate Pack CDP-2019-0005, Mental health and the benefits assessment process, 21 January 2019

Office for Budget Responsibility, Welfare trends report, January 2019

 

How is PIP assessed?

The Coalition Government said that the assessment for Personal Independence Payment was intended to provide “a more holistic assessment of the impact of a health condition on an individual’s ability to participate in everyday life.” It covers sensory impairments, developmental needs, cognitive impairments and mental conditions, as well as physical disabilities. There is no automatic entitlement to PIP for people with particular health conditions.

The Department for Work and Pensions is responsible for handling claims for PIP and making decisions on entitlement to benefit. Contracted assessment providers are, however, a key element in the claims process. Atos Healthcare holds the contracts for undertaking assessments in Northern England and Scotland; and in London and Southern England. Capita Business Services Ltd holds the contracts covering Wales and Central England; and Northern Ireland. These are separate from the DWP Medical Services contract, now held by Maximus.

The assessment looks at the person’s ability to undertake 12 different activities: 10 relate to the “daily living” component and 2 relate to the mobility component.

Daily Living (10 activities):

  • preparing food
  • taking nutrition
  • managing therapy or monitoring a health condition
  • washing and bathing
  • managing toilet needs or incontinence
  • dressing and undressing
  • communicating verbally
  • reading and understanding signs, symbols and words
  • engaging with other people face to face
  • making budgeting decisions

Mobility (2 activities):

  • planning and following journeys
  • moving around

For each activity there is a series of “descriptors” which define increasing levels of difficulty carrying out the activity (and therefore higher levels of need).  Claimants will be allocated a descriptor (and score) for each activity in the assessment. In determining which descriptor is appropriate, consideration should be given to whether the person can complete the activity safely, repeatedly, within a reasonable time period; and whether the impact of their disability fluctuates.

The total scores for all of the activities related to each component are then added together to determine entitlement for that component. The entitlement threshold for each component is 8 points for the “standard” rate and 12 points for the “enhanced rate.”

Further information on the PIP assessment and how it should be applied is given in the DWP’s PIP assessment guide (updated November 2018).

 

How is PIP claimed?

A claim for PIP must usually be initiated by a phone call to DWP. The purpose is to collect basic information about the claimant, and for DWP to determine whether the person may require additional support through the claims process. Once it is established that the person meets the basic entitlement conditions relating to age and residence, they are sent form PIP2, “How your disability affects you,” with an accompanying information booklet. Claimants have one month to return the completed PIP2 form.

The completed PIP2 form and any accompanying evidence submitted by the claimant are forwarded to the assessment provider, who decides whether a face to face consultation is necessary. Following the face to face consultation (or on the basis of written information alone, if this is considered sufficient), the assessment provider completes a report, which is then forwarded to DWP. A DWP “Case Manager” reviews the report, along with all other evidence in the case, before making the decision on the claim. The decision on entitlement to PIP is made by the DWP, not the assessment provider’s health professional.

There is a special fast-track claims process for claimants who are terminally ill.

In September 2017, the Department for Work and Pensions announced new ruled for "switching off" reassessments for ESA claimants who have a severe, lifelong disability, illness or health condition, and are unlikely to ever be able to move into work. The Department is also introducing revised guidance to provide that PIP claimants awarded the highest level of benefit and whose needs are not expected to improve will receive “ongoing” awards with a “light touch review” every 10 years.

Further information can be found in Commons Library briefing CBP-7820, ESA and PIP reassessments, published on 13 July 2018.  The Minister of State for Disabled People, Health and Work also issued a Written Statement just before Christmas which included a link to updated guidance for DWP Case Managers (HCWS1224, 20 December 2018).

In a written statement to on Health and Disability on 5 March 2019 (HCWS1376), the Secretary of State for Work and Pensions, Amber Rudd, announced that, among other things, that DWP would “improve and simplify the customer experience by no longer undertaking regular reviews of Personal Independence Payment (PIP) awards for claimants at or above State Pension age unless they tell us their needs have changed.”

 

How can PIP decisions be challenged?

When the DWP Case Manager has made their decision on entitlement to PIP, the claimant is sent a letter which should set out the reasons for the decision, and the points awarded for each descriptor. The letter will also explain what the claimant needs to do if they are not happy with the decision.

Claimants seeking to challenge a PIP decision must first request that DWP undertakes a Mandatory Reconsideration (MR) of the decision. This must normally be within one calendar month of the decision date. Late requests may not be accepted.

Following receipt of the MR request, a separate DWP Case Manager will look at the decision, along with any additional evidence or information that has been provided, to decide if the decision is fair and consistent with the evidence.

The claimant is sent a Mandatory Reconsideration Notice (MRN) advising of the outcome, and of their right to appeal against the decision to an independent First-Tier Tribunal. If the claimant is still unhappy with the decision and wishes to challenge it further, they must lodge an appeal directly with HM Courts and Tribunals Service. An appeal can only be lodged once the Mandatory Reconsideration Notice has been received.

The time limit for lodging an appeal is one month from the date of the MRN. Late appeals may be accepted if the Tribunal considers it would be fair and just to do so, but there is an absolute time limit of 12 months from the end of the normal one-month time limit.

HM Courts and Tribunals Service booklet SSCS1A, How to Appeal Against a Decision Made by the Department for Work and Pensions gives an overview of the appeals process and what happens at each stage.

 

What did a recent Work and Pensions Committee inquiry find?

Evidence to the Work and Pensions Select Committee’s 2017-18 inquiry on Personal Independence Payments (PIP) and Employment and Support Allowance (ESA) revealed claimants encountered various difficulties during the application and assessment processes for both benefits.

In its report on PIP and ESA assessments published on 7 February 2018, the Work and Pensions Committee said that failings in the assessment and decision-making processes for PIP and for ESA had resulted in the “pervasive lack of trust” that risked undermining the entire operation of both benefits. It set out a series of recommendations including:

  • recording face to face assessments and providing a record and a copy of the assessor's report to claimants;
  • measures to improve understanding about what constitutes good evidence to support PIP and ESA claim, and ensuring assessors use evidence effectively;
  • improving the accessibility of the process at every stage, from the application form, to information about home visits and about accessing reconsiderations and appeals; and
  • improving contractor performance through more effective use of contractual “levers” and ensuring assessors are given feedback, including from the appeals process.

In its response to the Committee’s report issued on 23 April, the Government made a number of commitments including:

  • Producing an Easy Read version of the notes which accompany the PIP “How your disability affects you” form.
  • Launching a series of videos which outline the PIP claim process in a simple and clear way, and explain the types of relevant information that are useful in support of a claim, in order to better prepare claimants for an assessment. The PIP assessment providers also supply information to claimants ahead of their assessment appointment via their websites and direct mail sent to the claimant.
  • Addressing improvements to application forms by commissioning external research to identify whether, how and what aspects of the PIP (and ESA) claim forms could have the potential to cause distress; revising and amending the forms in light of these findings; and testing the revised forms with applicants to determine if improvements made result in the forms being more claimant-friendly and less likely to cause distress. This work would commence in summer 2018.
  • Working closely with the PIP assessment providers around requests for home visits to ensure their processes align with guidance and claimant needs are being met.
  • Working with PIP providers to enhance GP engagement – all providers to foster a greater level of engagement and source information from a broader range of health and social care professionals.
  • Pilot enhancements to the PIP telephony script to remind claimants to submit medical evidence and the types of evidence that are useful.
  • The Department recognises that the complexity and potential costs of recording makes it difficult for claimants—of PIP.

For more information on the evidence submitted to the Committee for this inquiry, see Section 6 of the Commons Library’s debate pack CDP-2019-0006 Mental health and the benefits assessment process, published on 21 January 2019.

In her written statement to on Health and Disability on 5 March 2019 (HCWS1376), the Secretary of State for Work and Pensions, Amber Rudd, said that her Department would be “transforming the delivery of assessment services.”  She announced:

I have established the Health Transformation Programme to undertake the significant task of transitioning the currently separate Work Capability Assessment (WCA) for Employment and Support Allowance and Universal Credit (UC), and the PIP assessment services into one unified, integrated service from 2021. To support this, we are developing a single digital platform. An integrated approach will allow for a more joined-up claimant experience across these benefits, which takes account of the multiple interactions an individual may have with DWP. We hope that developing our own digital platform will also enable a greater range of assessment providers to compete to help us deliver this important service in the future.

To enable an integrated service, we are extending the contract for the Health and Disability Assessment Service (HDAS), which includes the delivery of the WCA, and aligning it to the duration of the extended PIP contracts. This will allow for a safe and stable service now, and as we transition to the new integrated service.

This strategic transformation will also open up new opportunities to improve our functional assessments in the future. For example, we will test whether it is beneficial to claimants requiring face-to-face assessments to offer a single assessment for UC and PIP to capture all the information required for both claims in one appointment, reducing the need for claimants of both benefits to attend multiple appointments.

The Secretary of State also announced that the DWP would be “exploring whether we can enhance the mandatory reconsideration process to gather further evidence from claimants and make more accurate decisions sooner.”  She continued:

These improvements will make significant progress in better supporting those with health conditions and disabilities, but this is only the start, we can, and should, go further.

My ambition is to continue this important conversation around the future of support and I will, alongside the Minister for Disabled People, be regularly engaging with stakeholders to enable on-going conversations on the future of the health and disability agenda. This includes exploring how the welfare system can better meet the needs of claimants with disabilities and health conditions.

I am also committing to looking at whether the incentives we provide for and the expectations we have of employers are right. We will consult on proposals to encourage and support employers to play their part in helping disabled people and people with health conditions get into work and remain in work, and to improve access to occupational health. We will be seeking stakeholder input, and that of employers and other partners, in to how we make a real difference to the working lives of people with health conditions and disabilities.

Commenting on the announcement, the Work and Pensions Committee Chair Frank Field said:

People claiming PIP and ESA should be able to trust that the assessments they must undergo will be fair, consistent and high quality. Time and time again we have heard they are none of these. Instead, claimants are let down by the repeated failings of an evidently shoddy, error-ridden process. 

These measures being announced today must be implemented with the key objective of making the whole process more manageable for disabled claimants, but changing the process alone will not fix the core problem. DWP must focus on bringing the quality of assessments up to scratch. And the lessons of Universal Credit should warn the Department against placing all its eggs in the “digital by default” basket, especially when - as the Committee heard from Scope last week - one in five disabled people does not or cannot access online forms.

Trust in PIP and ESA assessments is in desperately short supply. We wait to see if these announcements translate into the change that can begin to restore it.

 

Have there been recent developments concerning the PIP eligibility criteria?

In March 2017 the DWP introduced regulations to reverse the effect of two Upper Tribunal judgments relating to the PIP eligibility criteria – for background to these changes see Commons Library briefing CBP-7911, Changes to the Personal Independence Payment eligibility criteria. The most significant change made by the regulations was to tighten the rules on access to the mobility component for people unable to undertake journeys due to “overwhelming psychological distress.” This would potentially affect people with a wide range of conditions including learning disability. Disability organisations called on the Government not to proceed with the changes. Some questioned how the changes fit with the Government’s stated commitment to “parity of esteem” between physical and mental health issues.

In its judgment on 21 December 2017 in RF v the Secretary of State for Work and Pensions & Others, the High Court ruled that the regulations introducing the March 2017 changes were unlawful because they discriminate against people with disabilities in breach of Human Rights Act 1998 obligations, and declared that the Secretary of State did not have lawful power to make the regulations (i.e. they were “ultra vires’”) and should have consulted before making them.

In January 2018 the Government announced that it would not contest the High Court’s decision, and that it would also drop its appeal against the original Upper Tribunal decision that had prompted the change to the regulations (MH v Secretary of State for Work and Pensions [2016] UKUT 0531 (AAC)).  The Secretary of State for Work and Pensions said that the DWP “take all steps necessary to implement the judgment in MH in the best interests of our claimants, working closely with disabled people and key stakeholders over the coming months.”

The DWP is reviewing all 1.6 million existing PIP awards, and PIP claims submitted since the original Upper Tribunal judgment in November 2016, to see who could be affected.

The then DWP Minister Sarah Newton updated the House on progress reviewing cases affected by the Upper Tribunal decision in MH in a written statement on 20 December 2018 (HCWS1224):

My Written Statement of 25 June 2018 (HCWS793) informed the House that my Department had begun an exercise to identify anyone who may be entitled to more support under PIP as a result of the MH and RJ decisions of the Upper Tribunal. The MH decision broadened the interpretation about how symptoms of overwhelming psychological distress should be assessed for the purpose of mobility activity 1 in PIP. The RJ decision concerned how the Department considers a claimant to be carrying out an activity safely and whether they need supervision to do so. I committed to regularly updating the House of developments regarding this administrative exercise.

The Department has today published an ad hoc release of Management Information on the administrative exercise: https://www.gov.uk/government/collections/dwp-ad-hoc-analyses#2018

As at 23 November 2018, 140,000 cases had been cleared, of which 1,000 had been paid arrears. The average payment made is approximately £4,500. We are monitoring the numbers of, and reasons for, revised awards closely and making regular quality checks in order to ensure that our decision making is accurate and fair.

Given the complexity of the exercise we have started at a relatively small scale to test our processes and ensure they are effective before ramping up. At the same time we have recruited over 250 additional staff to increase resources available for this exercise, with more to follow over the coming months.

In addition, we are redirecting resource from other areas of PIP. This means the administrative exercise will conclude in 2020. Some DLA to PIP reassessments that would have taken place in 2019/2020 will move to the following year. I believe that prioritising cases where claimants are entitled to arrears is the correct approach.

Further information on how the administrative exercise is being undertaken is set out in an updated Frequently Asked Questions. I will deposit a copy of this document in the Library.

Further details of the review process are given in the FAQs Deposited Paper – see DEP 2018-1299

 

Statistics for Merseyside

The supporting Excel file contains a range of PIP statistics for each Merseyside constituency and local authority (where available), and PIP appeal statistics for social security tribunal venues in Merseyside. Key figures are as follows:

People receiving PIP (table 1)

In Merseyside there are 75,292 recipients of PIP (January 2019) of whom 40,978 recipients (54%) were reassessed from DLA.

7.1% of 16- to 64-year-olds in Merseyside receive PIP. This PIP recipient rate is above the rate for Great Britain (4.4%) and the North West region (5.6%) as a whole.

Liverpool Walton (10.2%) has the highest 16-64 PIP recipient rate of all 632 constituencies in Great Britain. Other Merseyside constituencies with high PIP recipient rates include Birkenhead (9.4%, ranked 5th) and Knowsley (9.2%, ranked 7th).

PIP clearance outcomes (tables 2a and 2b)

A clearance is when a PIP application or reassessment has been fully processed by the DWP and an initial award decision reached where applicable.

In Merseyside between April 2013 and January 2019:

  • There were 89,660 cleared new claim applications for PIP (i.e. not reassessments of former DLA claimants), of which 46% resulted in an award of PIP and 53% were disallowed PIP. This is broadly in line with Great Britain as a whole;
  • There were 55,038 cleared DLA-to-PIP reassessments, of whom 73% were awarded PIP and 26% were disallowed PIP. Again, these percentages are similar to Great Britain as a whole (71% awarded, 28% disallowed).

Changes in awards from DLA to PIP (table 3)

Where DLA-to-PIP reassessments have resulted in a PIP award, in the large majority of cases this has led to a change in the amount received.

In Merseyside between April 2013 and October 2018, 45% of reassessed claimants who moved from DLA to PIP saw an increase in their award, 36% saw a decrease in their award, and 19% saw their award unchanged.

For Great Britain as a whole, there figures were 52% increased, 29% decreased and 18% unchanged.

Tribunal appeals – outcomes and clearance times (table 4)

Figures on PIP appeals and clearance times are available for tribunal venues in Merseyside. Claimants who appeal their award will generally see their case referred to the closest tribunal venue.

In the period October to December 2018, the proportion of PIP appeal hearings where the judgement was in favour of the appellant, and the average time to clear a PIP appeal, were as follows:

  • Great Britain: appeal success rate 73%; average clearance time 31 weeks;
  • Liverpool tribunal venue: appeal success rate 76%; average clearance time 38 weeks;
  • Birkenhead tribunal venue: appeal success rate 67%; average clearance time 33 weeks;
  • St Helens tribunal venue: appeal success rate 74%; average clearance time 38 weeks;

Success rates and clearance times have both trended upwards in recent years. See table 4 in the supporting tables.

 

Parliamentary material

Asked by: Eagle, Ms Angela

To ask the Secretary of State for Work and Pensions, what the waiting time from registration for personal independence payment to appeal was in (a) Wallasey, (b) Merseyside and (c) the North West in the most recent period for which figures are available.

Answering member: Sarah Newton | Department: Department for Work and Pensions

Information on the waiting time from registration of a Personal Independence Payment (PIP) claim to appeal in Wallasey, Merseyside and the North West could only be provided at disproportionate cost.

13 Feb 2019 | Written questions | Answered | House of Commons | 218761

Date tabled: 08 Feb 2019 | Date for answer: 13 Feb 2019 | Date answered: 13 Feb 2019

Asked by: McGinn, Conor

To ask the Secretary of State for Justice, how many applications for personal independence payments that were refused at mandatory consideration were subsequently overturned at tribunal in (a) St Helens North constituency and (b) Merseyside in (i) 2016-17 and (ii) 2017-18.

Answering member: Lucy Frazer | Department: Ministry of Justice

The information requested is not held centrally.

Latest figures indicate that since PIP was introduced, more than 3.1 million decisions have been made, and of these under 9% have been appealed and 4% have been overturned.

The statistical record produced by the HM Courts & Tribunal Service computer system records numbers of appeals according to the category of benefit awarded, or not awarded, and the type of issue in dispute, but it will not necessarily identify appeals made specifically because applications for benefit were “refused at mandatory reconsideration”. No such statistical category exists. When a person appeals a decision on a benefit award, that person must first undergo the mandatory reconsideration process of the initial decision with the DWP, before they can appeal to the Tribunal. But the fact that an appeal is made does not necessarily mean the appellant must have been refused at mandatory reconsideration. An award may be made at a rate of payment lower than the appellant had sought. For example, Personal Independence Payment can be awarded for daily living and/or mobility components, and those components can be paid at either the standard, or enhanced, rate.

Information about the number and outcomes of Social Security and Child Support appeals is published on gov.uk. The most recent statistics, for the period January to March 2018, published on 14 June, can be viewed at: https://www.gov.uk/government/statistics/tribunals-and-gender-recognitions-certificates-statistics-quarterly-january-to-march-2018 which include overturn rates for venues in (a) St Helens North constituency and (b) Merseyside for that period.

26 Jun 2018 | Written questions | Answered | House of Commons | 156467

Date tabled: 21 Jun 2018 | Date for answer: 26 Jun 2018 | Date answered: 26 Jun 2018

Asked by: Eagle, Ms Angela

To ask the Secretary of State for Work and Pensions, with reference to her Departments withdrawal of appeals in the cases Secretary of State for Work and Pensions v AN & JM CPIP/1882/2015 and CPIP/1159/2016, whether her department has made an estimate of the number of claimants of personal independence payment daily living allowance 3 that have been underpaid in (a) England, (b) the North West, (c) Merseyside and (d) Wallasey constituency.

Answering member: Sarah Newton | Department: Department for Work and Pensions

We have withdrawn appeals in the cases Secretary of State for Work and Pensions v AN & JM CPIP/1882/2015 and CPIP/1159/2016 to provide certainty to the claimants in question. The decision to withdraw from these appeals affects only the two claimants in the appeals, as outlined in the statement given by the Secretary of State, 4 June 2018, Official Report, Columns 29-30.

11 Jun 2018 | Written questions | Answered | House of Commons | 149940

Date tabled: 05 Jun 2018 | Date for answer: 11 Jun 2018 | Date answered: 11 Jun 2018

 

Press articles

Strip DWP of responsibility for ill and disabled people, urges thinktank

The Guardian, 25 March 2019

 

DWP document refers to benefit claimant as 'lying bitch'

The Guardian, 22 March 2019

 

Disabled people waiting three and a half MONTHS on average for vital PIP benefit

The Mirror, 21 March 2019

 

Disabled pensioners freed from 'unnecessary' benefits checks

BBC News, 5 March 2019

 

Amber Rudd to end repeat PIP assessments for disabled pensioners

ITV News, 4 March 2019

 

PIP appeal delays: 'I had to sell my belongings to live'

BBC News, 21 February 2019

Commons Debate packs CDP-2019-0071

Authors: Andrew Mackley; Roderick McInnes; Steven Kennedy; Alexander Bellis

Topics: Benefits administration, Benefits policy, Sickness, disability and carers' benefits

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