A Basic Understanding of Personal Independence … or Capita you don’t get a choice Regional...
Transcript of A Basic Understanding of Personal Independence … or Capita you don’t get a choice Regional...
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PIP Presentation
A
Basic Understanding of
Personal Independence
Payments,
known as P.I.P.s
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Changing from DLA to PIPs
From June 2013 all
new claims from
anyone aged 16-64,
will be for PIPs
instead of DLA
throughout the whole
of Great Britain
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Time Line for Existing clients
From 7th October 2013 for the following groups DLA
will be replaced by PIPs:
• Children turning 16 when their existing fixed-term
award comes to an end.
• People with a fixed-term DLA award expiring from
the end of February 2014
• People reporting changes of circumstances such
as an improvement or deterioration in condition,
but NOT issues like going into a care home or hospital or changing address
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Existing clients from
October 2015 move to PIPs
This appears random and is NOT
dependent on age or where you live.
You can go to the Gov.UK website
and insert a date of birth which gives
an indication of possible change over
time.
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Insert date of birth on the website
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This is what you see
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When will change over from DLA to
PIPs be complete ?
• The transfer of claimants from DLA to PIP is expected to take 5 years.
Ending in March 2018.
• Note current clients with indefinite DLA awards will be the last to be assessed.
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What to do when you get a letter?
Stage 1:
• When selected for transfer by DWP there is 28 days to respond, and ask for a form by phone: 0800 917 2222. Skype is possible too
• text phone: 0800 917 7777
• They will collect basic information such as:
Contact details, age, nationality, details of main healthcare professional, bank info etc, plus questions for people who have terminal conditions
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Other questions they ask
• Do the following conditions apply?
• A mental health condition?
• A behavioural condition?
• A learning disability?
• A memory problem?
• A developmental disorder?
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If a claimant can’t use a phone
• Then ask for a PIP1 form using the
text number or respond by letter.
• The form must be completed and
returned within 28 days
• Other people can complete it on your
behalf (with permission), but the
claimant MUST sign it.
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Warning!!!!!!
• If claimants fail to contact the DWP either by
phone or letter within the 28 days, their DLA
payments will be suspended for 4 weeks or
more.
• BEWARE: when a letter from the DWP arrives
advising of benefit rises as in annual increases,
the PIP invitation to respond is at the end of
this letter. This could possibly be overlooked!!!
• That’s when someone might fall foul of the 28
day rule and see suspension of payments
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The PIP1 form in Stage 1
There are 18 pages to this
form. Right at the top is
a section where it will be
personalised with the
client’s name and post
code.
http://www.dwp.gov.uk/docs/pip1-claim-form.pdf
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Stage 2 of action
“How your Disability affects you”CCCC.
A tear off letter attached to a 36 page long
form, with 12 page information booklet.
The forms collects details about:
• The professionals best place to advise the
DWP on your circumstances
• Health conditions or disabilities
• Medication and treatment
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The next 28 days
There are 28 days again to respond and send in
this form.
The decision maker can extend the 28 day
period in certain circumstances, like going
into hospital.
If claims are not made within 28 days, DLA will
be suspended for another 4 weeks.
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Failure to make a PIP claim
Failing to make a claim for PIP at the end of the
8 weeks, will see the DLA award terminated
from the date it was suspended.
Whether PIP is awarded or not, the decision will
not take effect for 4 weeks after the next DLA
pay day, allowing time to adjust to a possible
loss of finances!
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Supporting Evidence
The more supporting evidence to
accompany a claim the better the
chance for a right decision.
The form is evidence, as is a report from a
GP or Consultant, and the report from the
Atos or Capita health professional, if a
medical is required.
The majority of claimants will have a face to
face assessment with a health professional
working for Atos or Capita.
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Atos or Capita you don’t get a choice
Regional contracts determined this. Hereford
appears to be under Capita contracts.
Capita will be using 80% general nurses and
20% mental health nurses for assessment centre
medicals The nurses will be permanent staff
For home assessments they will use 20%
permanent staff and 80% contracted staff.
65% will be general nurses,
25% mental health nurses and 10% GPs.
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Medical assessments
The DWP estimate 8% of claimants will medically require a home visit.
Capita say they anticipate the majority of claimants will prefer home visits and expect 60% will take them up.
Capita will also use Remploy offices, Assist UK Independent Living Centres, as well as their own offices.
(Capita contract worth £140 million over 5 years).
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How to help the claimant
Start now to
prepare and
collect evidence
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Suggestions of evidence to include
• A health diaryC.showing daily issues
• Medication diary. If no treatment is suitable
then say so!
• If not seeing a Consultant explain why. It may
be they have signed you off as there is
nothing further they can do, and state when
this stopped with a copy of their letter
• Give examples of your medical condition/
issues
• A GP medical report, but this might cost!
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Examples of medical condition issues
• If you have Arthritis and find it difficult to get
dressed, that is not enough evidence
• E.g. Explain that pain in your hands/ legs/
shoulders means getting dressed/ undressed
takes 30 minutes. The result of this action
leaves you fatigued for another hour (say)
• If with MS, fatigue is more of an issue when
the weather is hot, during illness or after
exercise, then this should be stressed,
personal to your circumstances
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Scoring Points
Points are scored to gain awards in two
ways:
1. Daily Living Component (care)
2. Mobility Component
There are 2 rates for each component
• Standard rate (8 points)
• Enhanced rate (12 points)
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Rates of payment
Daily Living:
• Standard: £53 a week
• Enhanced: £79.15 a week
Mobility:
• Standard: £21 a week
• Enhanced: £55.25 a week
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Daily Living Activities
1. Preparation of Food
2. Taking nutrition
3. Managing therapy or monitoring a health condition
4. Washing & bathing
5. Dressing & Undressing
6. Managing toilet needs or incontinence
7. Communicating Verbally
8. Reading & understanding signs, symbols & words
9. Engaging with other people face to face
10. Making budgeting decisions
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Mobility Activities
1. Planning & following journeys:
This now includes a section for maximum points:
“Cannot follow the route of a familiar journey
without another person, an assistance dog or an
orientation aid”
2. Moving around:
This section is purely about the physical ability
to get around
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New shock changes in Mobility
New rule:
50 metres rule has changed to 20 metres
For maximum points (12), and to qualify for a Motability vehicle, these are the pointers:
a. Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided.
b. Can’t either aided or unaided stand or move than 1 metre
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PIPs and Motability Cars
• If you are an existing DLA recipient who is
awarded the Enhanced Rate of the Mobility
Component of PIP, then your Motability lease
will continue as you move from DLA to PIP.
• If you are an existing DLA recipient who has
not received the Enhanced Rate of the
Mobility Component of PIP, you will not be
eligible to use the Motability Scheme.
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Not now eligible for Motability
• The leasing agreement will end
• Motability will arrange for the vehicle to be returned
• Motability refunds any Advance Payment on a pro-rata basis e.g. if the agreement ended after one year of a three year lease two-thirds of the Advance Payment would be refunded
• Subject to terms and conditions, Motability may in some cases be able to offer the vehicle for sale to you
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Appealing the decision
Customers will be able to appeal to the DWP if
they disagree with the decision.
However, DWP will NOT continue to make DLA
payments while an appeal is being processed,
and so Motability will not be able to leave the
vehicle with you.
If the appeal is successful, you will of course be
eligible to re-join the Scheme.
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Length of PIP awards
Awards are for fixed periods not indefinite
• Short term is up to 2 years, when the DWP
expects conditions to improve.
• Awards for 5- 10 years are made when
conditions are less likely to change
• On-going awards will only be given in a very
small minority of cases, where claimants are
unlikely to get either better or worse
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• PIPS are payable to residents of the UK between the ages of 16-64 years.
• From 2018, this will change as the pension age for men rises.
• The condition must have existed for 3 months and likely to be there for another 9 months
• It is a non means tested benefit
• If living abroad for more than 2 years , a resident must wait another two years before being eligible
Qualifying for PIPs
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Reliably….the new PIP word!
Guidance by DWP uses the word Reliably, and
refers to all activities in the tests.
Reliably means :
• Safely, in a fashion unlikely to cause harm to
clients or another person.
• To a necessary and appropriate standard.
• Repeatedly, as often as reasonably required.
• In a timely manner, in a reasonable time period
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Reliably also means
Consider these thoughts when answering:
• Does pain constrict activities?
• Is motivation require to achieve?
• Will breathlessness curtail success?
• Is nausea an issue?
• Is fatigue part of the reason why there
are such difficulties in managing daily
activities?
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Consider these things!
• Keep a copy of everything you submit
• Non medical evidence from a carer,
friend or neighbour can be submitted
• If you are asked to attend a medical
then make sure the date you are offered
suits. If not ask for another
• Take someone with you for any
interviews/ medicals
• Ask for an overview of findings
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Current information
The information in this guide to PIPs, has been produced to assist in understanding the changes
from DLA. However, for up to date accuracy you should look at the DWP website, as Herefordshire Disability United are not official representatives, and have produced these slides as part of an Open Meeting event.
Copyright Herefordshire Disability United 2013