Personal Independence
Payment: assessment
thresholds and
consultation Pt(1)
This document provides more information on the second draft of the PIP
assessment criteria – particularly on entitlement thresholds, impact
modelling and case studies – and includes the consultation on the criteria.
January 2012 Personal Independence Payment: assessment thresholds and consultation
2
Contents 1. ................................................................................................ 3 Executive summary
2. Introduction............................................................................................................. 4
3. The proposed entitlement thresholds ..................................................................... 5
Case studies ........................................................................................................... 6
4. The impact of the second draft criteria ................................................................... 7
Our approach .......................................................................................................... 7
Methodology for analysis ........................................................................................ 8
The analysis............................................................................................................ 9
5. Consultation and next steps ................................................................................. 12
Consultation questions.......................................................................................... 12
Further PIP consultation activity............................................................................ 15
Annex A: Case studies ............................................................................................. 16
Annex B – About this consultation ............................................................................ 31
Purpose of the consultation................................................................................... 31
Who the consultation is aimed at .......................................................................... 31
Scope of the consultation...................................................................................... 31
Duration of the consultation .................................................................................. 31
How to respond to this consultation ...................................................................... 31
Other ways of getting involved .............................................................................. 32
Queries on this document ..................................................................................... 32
How we consult..................................................................................................... 33Personal Independence Payment: assessment thresholds and consultation
3
1. Executive summary
1.1 This document provides details of the proposed entitlement thresholds within
the Personal Independence Payment assessment and contains our consultation
questions on the second draft of the assessment criteria.
1.2 On 14 November 2011, the Department published a second draft of the
proposed assessment criteria for Personal Independence Payment, in the form
of revised draft regulations and an explanatory note. This draft was developed in
light of testing and feedback received on the initial proposals. The second draft
also included initial thoughts on possible relative weightings for the descriptors.
1.3 Following publication, we sought initial reactions from disabled people and their
organisations on the second draft criteria and the proposed descriptor
weightings. While the feedback we have received has been helpful, many
people told us that they could offer only limited comments in advance of seeing
the proposed entitlement thresholds. Given this limited feedback, we have not
made any changes to the descriptor weightings at this point.
1.4 Following further consideration, we are now able to propose entitlement
thresholds for the rates and components of the benefit, as follows:
Daily Living component
Standard rate: 8 points
Enhanced rate: 12 points
(from activities 1-9)
Mobility component
Standard rate: 8 points
Enhanced rate: 12 points
(from activities 10-11)
1.5 To help illustrate how the assessment criteria will work and how the weightings
and thresholds will determine entitlement, we have produced fifteen indicative
case studies.
1.6 Using the entitlement thresholds, we have now been able to model the likely
impact of the second draft assessment criteria on the projected Disability Living
Allowance caseload in 2015/16. This analysis was carried out using the detailed
information gathered from around 900 volunteers when we tested our proposals
during summer 2011.
1.7 The modelling suggests that the second draft would produce a 2015/16
caseload of 1.7 million people receiving Personal Independence Payment.
Without introducing the new benefit we would expect the number of 16-64 year
olds claiming Disability Living Allowance in 2015/16 to be 2.2 million.
1.8 We would like to take this opportunity to seek further views from disabled people
and their organisations, to ensure that we get the assessment criteria right. We
are therefore launching a formal consultation which will run for 15 weeks, from
16 January 2012 to 30 April 2012. Final draft regulations will be laid before
Parliament later this year.Personal Independence Payment: second draft assessment criteria and consultation document
4
2. Introduction 2.1 In May 2011, we published initial proposals for the assessment criteria for
Personal Independence Payment. Following an informal consultation we made
significant revisions to the criteria, reflecting many of the comments we received
from disabled people and their organisations, and published a second draft on
14 November 2011. Having tested both the initial and revised proposals, we
were able to determine that the second draft of the criteria identified individuals’
levels of need both more accurately and more consistently than the first.
2.2 The second draft of the criteria includes proposed descriptor weightings,
reflecting our initial views on how the criteria might work to prioritise relative
need. They were developed following consideration of the comments received
on the first draft, discussion with our Assessment Development Group and
qualitative and quantitative analysis of the reliability and validity findings from
testing the initial proposals.
2.3 As we have said previously, we view the development of the draft criteria as an
iterative process. Before we reached firm views on the entitlement thresholds for
the rates and components of Personal Independence Payment, we therefore
wanted to take the opportunity to hear initial reactions to the proposed
descriptor weightings included in the second draft.
2.4 Towards the end of 2011, we met with a variety of disabled people and their
organisations to discuss the revised proposals. We also received a number of
written comments. Although this engagement has been helpful, a common
theme was that, without the entitlement thresholds, people felt it difficult to
comment on the proposed descriptor weightings in any detail. Given this limited
feedback, at this stage we have not changed the weightings or made any further
amendments to the criteria. We have, however, now finished our consideration
on the proposed entitlement thresholds – which, in turn, have enabled us to
model the likely impact of the draft criteria on the Disability Living Allowance
caseload.
2.5 This document needs to be read in conjunction with the second draft
assessment regulations and the explanatory note for the second draft of the
assessment criteria, both published on 14 November 2011 and available at
www.dwp.gov.uk/pip. Personal Independence Payment: second draft assessment criteria and consultation document
3. The proposed entitlement thresholds 5
3.1 Each descriptor in the assessment criteria will have a relative weighting
attached to it, reflecting both the level of ability the descriptor represents and the
overall importance of that activity within the criteria as a whole. An individual’s
entitlement to Personal Independence Payment will be determined by the
cumulative weightings which apply to that individual. For both the Daily Living
and Mobility components, it will be possible for an individual to be entitled to the
standard rate; the enhanced rate; or neither.
3.2 The second draft of the criteria included our initial thoughts on these weightings.
In light of the preliminary comments we have received on these, further detailed
consideration of the written reports from the summer 2011 testing and more
discussion with our Assessment Development Group, we propose that the
entitlement thresholds should be as follows:
Daily Living component Standard rate: 8 points
Enhanced rate: 12 points
(from activities 1-9)
Mobility component
Standard rate: 8 points
Enhanced rate: 12 points
(from activities 10-11)
3.3 We feel that these thresholds for the rates and components of Personal
Independence Payment are reasonable and enable individuals to be accurately
prioritised on the basis of need.
3.4 For the Daily Living component, thresholds at these levels enable an individual
who requires aids, appliances or prompting to successfully carry out a number
of the daily living activities to receive the component at the standard rate. This
recognises the additional costs incurred through use of such support and the
barriers that the individual is likely to face. Equally, for all but one of the daily
living activities, the highest descriptor in that activity on its own ensures
entitlement to the standard rate.
3.5 The proposed thresholds allow the highest scoring descriptor for activity 7
(Communicating) to provide entitlement to the enhanced rate of the Daily Living
component, recognising both the significant barriers and costs faced by
individuals who are unable to communicate. This high relative priority
demonstrates our desire to develop an assessment which better reflects the
impact of impairments on speech, hearing, communication and language
comprehension than the current Disability Living Allowance criteria.
3.6 For the Mobility component, the proposed thresholds reflect and differentiate
between the extra costs incurred by an individual requiring support to get
around. They also ensure that individuals whose ability to get around is severely
impacted by impairments affecting either physical or non-physical ability can
receive the Mobility component at the enhanced rate – reflecting our key
principle of developing an assessment which considers the impact of
impairments equally, regardless of their nature. Personal Independence Payment: second draft assessment criteria and consultation document
6
3.7 For activity 11 (Moving around), individuals who use aids and appliances to
move very short distances can receive the standard rate, reflecting the extra
costs incurred; while those who need wheelchair to do so will receive the
enhanced rate, reflecting the additional extra costs, barriers and overall level of
need which often accompany wheelchair use. Meanwhile, two descriptors from
activity 10 (Planning and following a journey) entitle an individual to the Mobility
component at the standard rate on their own; while the bottom descriptor
provides entitlement at the enhanced rate.
3.8 We recognise that there are likely to be strong views on the entitlement
thresholds and how these relate to the descriptor weightings previously
proposed. We have now begun a further consultation on the second draft of the
assessment criteria, including the weightings and entitlement thresholds, and
would welcome any views that people and organisations have.
Case studies 3.9 In order to provide further context to how we envisage the revised criteria being
applied, we have produced 15 case studies which are set out in Annex A. Each
case study is intended to be illustrative only, demonstrating the descriptors
which may apply to a variety of individuals. They do not show how all individuals
with particular conditions or impairments are likely to fare under Personal
Independence Payment, as entitlement will always be based on individual
circumstances.
3.10 Please note that these cases are not based on real individuals. Personal Independence Payment: second draft assessment criteria and consultation document
7
4. The impact of the second draft criteria
Our approach 4.1 Chapter 5 of the explanatory note to the second draft of the Personal
Independence Payment assessment criteria (
www.dwp.gov.uk/pip) explains the
approach we took when testing the first draft of the criteria in summer 2011.
During this exercise it was important to gather as much information about the
impact of impairments on volunteers’ lives as possible. This enabled us to
qualitatively analyse the findings from the initial testing, helping to sense-check
the quantitative data and challenging our initial proposals where it became
apparent that revisions to the criteria were necessary.
4.2 Participation in the assessment testing involved face-to-face appointments
being carried out between May and September 2011. We were keen not to
require the same volunteers to take part in another appointment, or to seek
further volunteers, in order to test the changes made to produce a second draft
or to analyse the impact of the proposals. For this reason, we ensured that the
initial data collected was broad enough to enable us to reconsider the same
volunteers against the second draft criteria on the basis of assessing the original
written report only.
4.3 As a result, we were able to test the impact of the second draft of the criteria by
re-assessing the original sample of around 900 volunteers on a paper basis.
Trained health professionals used the information provided in each report to
choose appropriate descriptors from the second draft criteria. We have now
been able to analyse the impact of the second draft by considering this data in
light of the proposed entitlement thresholds.
4.4 As our reliability and validity analysis of the first draft demonstrated that the
initial proposals were neither valid nor reliable, we have not included information
on the impact of the first draft criteria as the findings would not be meaningful. In
addition, the second draft of the criteria is substantially different from the first
and has been shown to be an improvement on the first in terms of both reliability
and validity. Our modelling therefore focuses on the analysis of the impact of the
second draft criteria.
4.5 For further information on the sample used to test the impact of the second draft
criteria, please refer to Annex C of the explanatory note to the second draft
assessment criteria (
www.dwp.gov.uk/pip). Personal Independence Payment: second draft assessment criteria and consultation document
8
Methodology for analysis 4.6 To assess the impact of the second draft assessment criteria, the Disability
Living Allowance awards of the 900 testing volunteers were compared with their
projected Personal Independence Payment award.
4.7 The results from the 900 person sample were used to analyse what would
happen to the 16-64 caseload in 2015/16. Results from the volunteer sample
were scaled up to make them representative, as far as possible, of the projected
Disability Living Allowance caseload. This adjusted the sample so that it
replicated the relative proportions of impairments affecting physical and mental
function and the rate combinations seen in the Disability Living Allowance
caseload. It also took account of the over-representation of the additional
specific impairment groups in the sample.
4.8 The sample was designed to be as representative as possible of the Disability
Living Allowance caseload. Weighting of the data helps to ensure this. The fact
that the participants were volunteers may have introduced bias which we cannot
eliminate.
4.9 In addition, two groups of Disability Living Allowance claimants were not
included in the sample: claimants who transitioned to Disability Living Allowance
from its preceding benefit in 1992, where the administrative data does not have
the level of detail used in the sampling (for example, on disabling condition); and
‘Special Rules’ cases who currently have automatic entitlement to Disability
Living Allowance. In the analysis we have assumed that these cases would
receive the Personal Independence Payment rate combination equivalent to
their current Disability Living Allowance rate combination (standard Daily Living
for those on Disability Living Allowance middle rate Care). In practice this may
not necessarily be the case, as there is no direct read across between awards
under Disability Living Allowance and Personal Independence Payment.
However, as these groups make up a relatively small proportion of the Disability
Living Allowance caseload (around 100,000 claimants) the impact on the overall
estimates will be limited.
4.10 The sample data provided the results of an assessment based on the draft
criteria. The final impact on claimants, however, will be influenced by other
elements in the decision-making process. Decision makers will use information
from the claimant and professionals who support them, as well as advice from
the independent assessor, to make decisions on awards. Some claimants will
ask for a reconsideration or may appeal this decision. Evidence from
Employment and Support Allowance as well as Disability Living Allowance has
been used to take into account the impact of these on likely Personal
Independence Payment awards. The results presented in this paper include
these effects, but inevitably the adjustments are subject to uncertainty until it is
possible to observe how the assessment process operates in practice. Personal Independence Payment: second draft assessment criteria and consultation document
9 The analysis 4.11 To assess the extent to which the introduction of Personal Independence
Payment will affect the caseload, the Disability Living Allowance awards among
the 900 person sample were compared with their projected Personal
Independence Payment award under the second draft of the assessment
criteria. The modelling suggests that the second draft would produce a 2015/16
16-64 caseload of 1.7 million people receiving Personal Independence
Payment. Without introducing the new benefit, we would expect the number of
16-64 year olds claiming Disability Living Allowance to be 2.2 million.
4.12 Like Disability Living Allowance, Personal Independence Payment will have two
separate components – a Daily Living component and a Mobility component.
Both components of the new benefit will be payable at either a standard or
enhanced rate.
4.13 Table 1 below gives a breakdown of the modelled eligible Personal
Independence Payment caseload. We estimate that under the second draft
criteria:
• Around 340,000 people would receive the enhanced rate of both
components of Personal Independence Payment.
• In total, around 540,000 people would receive the enhanced rate of the
Daily Living component and around 760,000 would receive the enhanced
rate of the Mobility component.
• Around 690,000 claimants would receive the standard rate of the Daily
Living component; and 560,000 would be in payment of the standard rate
of the Mobility component.
Table 1: Breakdown of eligible Personal Independence Payment (PIP)
caseload by Daily Living and Mobility component combination
2015/16 PIP rate combination Second draft criteria
Enhanced Mobility, Enhanced Daily Living 340,000
Enhanced Mobility, Standard Daily Living 190,000
Enhanced Mobility, No Daily Living 230,000
Standard Mobility, Enhanced Daily Living 110,000
Standard Mobility, Standard Daily Living 250,000
Standard Mobility, No Daily Living 190,000
No Mobility, Enhanced Daily Living 90,000
No Mobility, Standard Daily Living 250,000
Total 1,700,000
Note: data may not sum due to rounding
4.14 The estimates above do not include the potential impact on individuals who are
not currently entitled to Disability Living Allowance. Analysis of the small sample
of unsuccessful claimants suggests that a small number of such people could Personal Independence Payment: second draft assessment criteria and consultation document
10
be entitled to receive Personal Independence Payment but it is not possible to
quantify this reliably from the sample used in testing.
4.15 For comparison, the numbers of people projected to be on each of the Disability
Living Allowance rate combinations in 2015/16 are given in Table 2 below.
Table 2: Breakdown of forecasted Disability Living Allowance (DLA)
caseload by rate combination
2015/16 16-64 age DLA rate combination Caseload
Higher Mobility, Higher Care 350,000
Higher Mobility, Middle Care 290,000
Higher Mobility, Lowest Care 270,000
Higher Mobility, No Care 130,000
Lower Mobility, Higher Care 170,000
Lower Mobility, Middle Care 450,000
Lower Mobility, Lowest Care 230,000
Lower Mobility, No Care 50,000
No Mobility, Higher Care 10,000
No Mobility, Middle Care 40,000
No Mobility, Lowest Care 190,000
Total 2,200,000
Note: data may not sum due to rounding
4.16 Tables 3 and 4 below break down the projected Personal Independence
Payment caseload by age and gender and compare it to the current Disability
Living Allowance caseload. The proportion of the 2015/16 16-64 Personal
Independence Payment caseload that is female is slightly higher than in the
current 16-64 DLA caseload, but this difference is not statistically significant.
Similarly, differences in the breakdown by age are not statistically significant.
Table 3: Personal Independence Payment eligible caseload
Age....... Male......Female....Total
16 to 24...5%...........4%.......9%
25-34......5%...........7%......12%
35-44......6%...........9%......15%
45-54.....13%.........15%.....28%
55-64.....17%.........19%.....36%
Total
16-64.....46%.........54%....100%
Personal Independence Payment: second draft assessment criteria and consultation document
11
Table 4: Current Disability Living Allowance caseload
Sex Age
Male Female
Total
16 to 24 6% 4% 10%
25-34 5% 5% 10%
35-44 8% 9% 18%
45-54 12% 14% 26%
55-64 17% 19% 36%
Total 16-64 49% 51% 100%
4.17 Two thirds of the current Disability Living Allowance caseload is made up of
physical function conditions and one third mental function conditions. The 1.7m
modelled Personal Independence Payment eligible caseload has a similar split
between physical and mental function conditions.
4.18 The modelled Personal Independence Payment caseload cannot be broken
down further than this, for example by disabling condition, due to the
increasingly small sample sizes and the statistically insignificant figures in which
this would result. Personal Independence Payment: second draft assessment criteria and consultation document
12
5. Consultation and next steps
5.1 We have now published full details of the proposed assessment criteria for
Personal Independence Payment, including the weightings and entitlement
thresholds, and have shown the likely impact on the Disability Living Allowance
caseload. We would like to take this opportunity to seek further views from
disabled people and their organisations, to ensure that we get the assessment
criteria right. We are therefore launching a formal consultation which will run for
15 weeks, from 16 January 2012 to 30 April 2012.
5.2 For the consultation, this document should be considered alongside the second
draft assessment regulations and the explanatory note for the second draft of
the assessment criteria, both published on 14 November 2011.
1
Copies of all
three documents can be found at
www.dwp.gov.uk/pip. 5.3 The draft regulations will need to be updated to reflect the published entitlement
thresholds and, subject to the passage of the Welfare Reform Bill, the proposed
changes to the required period condition. These changes will be made in a later
iteration of the regulations.
Consultation questions
5.4 There are a number of specific areas where we are particularly seeking
feedback on the second draft:
• Q1 – What are your views on the latest draft Daily Living activities?
In the explanatory note we set out revised proposals for the activities
relating to entitlement to the Daily Living component (activities 1-9). These
include three new activities: Communicating, Engaging socially and Making
financial decisions. We would welcome your views on the activities. Are the
changes and the new activities an improvement? Do you think we need to
make any further changes?
• Q2 – What are your views on the weightings and entitlement
thresholds for the Daily Living activities?
In the explanatory note we set out proposals for the weightings of
descriptors in the activities relating to entitlement to the Daily Living
component (activities 1-9). In this document we have set out the
entitlement thresholds for the benefit. How well do you think they work to
distinguish between differing levels of ability in each activity? How well do
you think they work to prioritise individuals on the basis of their overall
need? Do you think we need to make any changes to weightings or
thresholds?
1
‘Personal Independence Payment: second draft of assessment criteria – an explanatory note to
support the second draft of the assessment regulations’ and ‘Personal Independence Payment:
second draft of assessment regulations’ Personal Independence Payment: second draft assessment criteria and consultation document
13
• Q3 – What are your views on the latest draft Mobility activities?
In the explanatory note we set out revised proposals for the activities
relating to entitlement to the Mobility component (activities 10-11). Are the
changes an improvement? Do you think we need to make any further
changes?
• Q4 – What are your views on the weightings and entitlement
thresholds for the Mobility activities?
In the explanatory note we set out proposals for the weightings of
descriptors in the activities relating to entitlement to the Mobility component
(activities 10-11). In this document we have set out the entitlement
thresholds for the benefit. How well do you think they work to distinguish
between differing levels of ability in each activity? How well do you think
they work to prioritise individuals on the basis of their overall need? Do you
think we need to make any changes to weightings or thresholds?
• Q5 – What are your views on how the regulations work regarding
benefit entitlement?
Draft Regulations 1 to 4 set out how the assessment will work to prioritise
individuals and determine entitlement to the benefit. How well do you think
the draft regulations achieve the intent of the assessment set out in the
explanatory note? Do we need to make any changes?
• Q6 – What are your views on how we are dealing with fluctuating
conditions?
Regulation 4(4)(c) of the draft regulations and paragraphs 7.13 to 7.15 of
the explanatory note set our how we are proposing to assign descriptors to
people who have fluctuating conditions. These are that:
- Scoring descriptors will apply to individuals where their impairment(s)
affects their ability to complete an activity on more than 50 per cent of
days in a 12 month period.
- If one descriptor in an activity applies on more than 50 per cent of the
days in the period – i.e. the activity cannot be completed in the way
described on more than 50 per cent of days – then that descriptor
should be chosen.
- If more than one descriptor in an activity applies on more than 50 per
cent of the days in the period, then the descriptor chosen should be
the one which applies for the greatest proportion of the time.
- Where one single descriptor in an activity is not satisfied on more than
50 per cent of days, but a number of different descriptors in that
activity together are satisfied on more than 50 per cent of days – for
example, descriptor ‘B’ is satisfied on 40 per cent of days and
descriptor ‘C’ on 30 per cent of different days – the descriptor satisfied
for the highest proportion of the time should be selected.
What are your views on this approach and how this is set out in the
regulations? Personal Independence Payment: second draft assessment criteria and consultation document
14
• Q7 – What are your views on the definitions of ‘safely’, ‘timely’,
‘repeatedly’ and ‘in a timely’ manner?
In the assessment an individual must be able to complete an activity
descriptor reliably, repeatedly, safely and in a timely manner. Otherwise
they should be considered unable to complete the activity described at that
level. In paragraph 7.4 of the explanatory note we set out draft definitions
for these as follows:
- Reliably means to a reasonable standard.
- In a timely fashion means in less than twice the time it would take for
an individual without any impairment.
- Repeatedly means completed as often during the day as the
individual activity requires. Consideration needs to be given to the
cumulative effects of symptoms such as pain and fatigue – i.e.
whether completing the activity adversely affects the individual’s
ability to subsequently complete other activities.
- Safely means in a fashion that is unlikely to cause harm to the
individual, either directly or through vulnerability to the actions of
others; or to another person.
What are your views on these? Some organisations have suggested that
these terms should be included within the regulations. Do you agree? If so,
do you have views on how we should do so – for example, as a general
provision or referring to them in the detail of activity descriptors?
• Q8 – What are your views on the definitions in the regulations?
The draft regulations contain a number of definitions in Regulation 1
(Interpretation) and Schedule 1. Do we need to make changes to any of
these?
• Q9 – Do you have any other comments on the draft regulations?
Regulations 5 to 10 of the draft regulations relate to elements of the
assessment process for Personal Independence Payment, around the
requirement to provide information and attend face-to-face consultations,
the consequences of failing to meet these requirements and when
individuals might have good reason for not meeting these. Do you have
any comments on these regulations?
5.5 Other comments on the second draft criteria – in particular on the changes
made in the November 2011 version, the proposed weightings and the
entitlement thresholds – are welcome. At this point in the development process
we do not envisage making significant changes to the broad principles or scope
of the assessment – i.e. to incorporate social and environmental factors. We are
therefore not seeking comments on these aspects of the second draft criteria.
We are also not seeking views at this stage on Regulations 11 to 13 of the draft
regulations relating to the required period conditions. These will be subject to
separate consultation at a later point.
5.6 We intend to further refine the draft assessment criteria once we have
considered all the responses to this consultation. Subject to Royal Assent of the Personal Independence Payment: second draft assessment criteria and consultation document
15
Welfare Reform Bill, the draft regulations will be laid before Parliament in the
second half of 2012, alongside a summary of consultation findings and a
government response. These regulations will be subject to Parliamentary
scrutiny through the affirmative procedure.
5.7 More information on the consultation process and how to respond is set out in
Annex B.
Further PIP consultation activity
5.8 Throughout the development of Personal Independence Payment we have
demonstrated our ongoing commitment to involve disabled people and their
organisations in the design of the benefit and how it can best be delivered.
Following the publication of our consultation document on 6 December 2010,
and our response published on 4 April 2011 (available at
www.dwp.gov.uk/pip), we have continued to engage with disabled people and their organisation to
further develop and refine our plans. That process has continued as the Welfare
Reform Bill, which will deliver the overall structure for Personal Independence
Payment, has progressed through Parliament.
5.9 As a result of this continued engagement we have made significant changes to
some of the design principles for Personal Independence Payment – for
example by announcing that we will remove the power in the Welfare Reform
Bill to exclude entitlement to the mobility component for care home residents
and that the qualifying period will be one of three months rather than six months.
These new arrangements will not be subject to a further period of consultation.
5.10 There remain a number of issues in relation to Personal Independence Payment
on which we intend to further consult to help inform the necessary regulations. It
is our intention to formally consult on these in the Spring, conducted in line with
the Cabinet Office Code of Practice on Consultation. At the same time we will
also set out some of the other details on Personal Independence Payment
which will not be subject to consultation to provide a fuller picture on the benefit
rules and how it will be delivered. Any future consultation will be published on
our website (
www.dwp.gov.uk/pip) and will be made available in alternative
formats. Personal Independence Payment: second draft assessment criteria and consultation document
16
Annex A: Case studies
Case study 1
Katie is 29 and lives with her partner and young daughter. She has not felt well since
2009 and is very easily exhausted. She was working as a primary school teacher
until she had a flu-like illness, since diagnosed as chronic fatigue syndrome. She can
have two or three good days, and then four or five bad ones. To help her manage her
condition, the main bedroom has been moved downstairs and a downstairs shower
room has been installed.
She is only able to carry out minimal daily tasks independently, such as brushing her
teeth and feeding herself, so her partner and daughter support her in most activities.
She needs assistance to get into the shower and then sits on a seat to wash herself;
afterwards, she usually has to lie down to rest. She can dress herself, but has to sit
down and take her time to do so and on most days she is too tired to dress in clothes
which she cannot pull on easily. She used to enjoy reading, but now cannot
concentrate on anything longer than a magazine article. Even on a good a day she
finds it difficult to help with the cooking. Her poor concentration and memory for
recent events make it difficult to manage her finances. She likes to visit friends and
go shopping but can only walk a few metres so she uses a wheelchair pushed by
another person if she goes out.
Likely descriptor choices
Activity Descriptor
1 F Needs assistance to either prepare or cook a simple meal. 4
2 A Can take nutrition unaided. 0
3 A
Either –
i. Does not receive medication, therapy or need to monitor a health condition; or
ii. Can manage medication, therapy and monitor a health condition unaided, or
with the use of an aid or appliance.
0
4 G Needs assistance to bathe. 4
5 A Can manage toilet needs or incontinence unaided. 0
6 E Needs assistance to dress or undress upper body. 4
7 A
Can communicate unaided and access written information unaided, or using
spectacles or contact lenses.
0
8 A Can engage socially unaided. 0
9 B Needs prompting to make complex financial decisions. 2
10 A Can plan and follow a journey unaided. 0
11 F
Cannot move up to 50 metres without using a wheelchair propelled by another
person or a motorised device.
15
Total points
Daily living activities = 14 (enhanced rate Daily Living component)
Mobility activities = 15 (enhanced rate Mobility component)
Explanation
Katie often needs assistance with a wide range of daily living activities, on account of
fatigue. Her condition does fluctuate and on some days she is more independent.
However, on the majority of days she requires a significant amount of support.Personal Independence Payment: second draft assessment criteria and consultation document
17
Case study 2
Rachel is 45 and gave up work as a clerk three years ago because she was suffering
from exhaustion. She lives alone. Since being diagnosed with chronic fatigue
syndrome she tries to manage her condition by pacing herself and her activities,
making sure she doesn’t overdo things. She enjoys painting watercolours and doing
needlework. She has on average three good days to each bad one, when she rests
for the day and does not get dressed or go out. She likes to cook, but finds standing
to prepare food tiring, so she sits on a stool to do so. She can wash herself without
assistance but she finds standing in the shower very tiring, so she uses a seat. She
does relaxation exercises every day. On a good day she can walk to the post office
half a mile away, as long as she takes her time, or can drive to the supermarket. She
has no problems planning a journey and hopes to visit a friend in France next year.
Likely descriptor choices
Activity Descriptor
1 B Needs to use an aid or appliance to either prepare or cook a simple meal. 2
2 A Can take nutrition unaided. 0
3 A
Either –
i. Does not receive medication, therapy or need to monitor a health condition;
or
ii. Can manage medication, therapy and monitor a health condition unaided,
or with the use of an aid or appliance.
0
4 F Needs to use an aid or appliance to bathe. 2
5 A Can manage toilet needs or incontinence unaided. 0
6 A Can dress and undress unaided. 0
7 A
Can communicate unaided and access written information unaided, or using
spectacles or contact lenses.
0
8 A Can engage socially unaided. 0
9 A Can manage complex financial decisions unaided. 0
10 A Can plan and follow a journey unaided. 0
11 A
Can move at least 200 metres either –
i. unaided; or
ii. using an aid or appliance, other than a wheelchair or a motorised device.
0
Total points
Daily living activities = 4 (no Daily Living component entitlement)
Mobility activities = 0 (no Mobility component entitlement)
Explanation
While Rachel sometimes requires aids and appliances to carry out daily activities, for
the majority of activities and on the majority of days she is able to do so
independently. Her mobility is restricted on bad days, but on the majority of days she
can mobilise in excess of 200 metres. Personal Independence Payment: second draft assessment criteria and consultation document
18
Case study 3
Victoria, 42, lives with her husband who has been supporting her for the last five
years and is now doing so full time. She spends most of her time in an electric
wheelchair because she can only walk about 10-15 steps. Although her multiple
sclerosis hasn’t changed much over the last 18 months, things are very different from
when she was first diagnosed.
Vicky likes to be as independent as possible and so she uses a variety of aids and
appliances to carry out everyday activities. Her husband sometimes assists her to get
in the shower, but usually she is able to do this independently. She has a big walk-in
shower cubicle with a seat and once in she can wash without support. However, it
does take a very long time on her own as she has poor manual co-ordination. She
also has an adapted toilet with a raised seat and grab rails. In the kitchen she can
use the microwave but finds if difficult to lift saucepans and needs assistance to cut
up her food. She has modified clothes, such as Velcro fastenings, so that she can
dress herself. Her neighbours often come around for company and she enjoys
chatting to them. When she and her husband want to go out they use an adapted car
which accommodates her wheelchair
Likely descriptor choices
Activity Descriptor
1 F Needs assistance to either prepare or cook a simple meal. 4
2 B
Needs either –
i. to use an aid or appliance to take nutrition; or
ii. assistance to cut up food.
2
3 A
Either –
i. Does not receive medication, therapy or need to monitor a health condition;
or
ii. Can manage medication, therapy and monitor a health condition unaided,
or with the use of an aid or appliance.
0
4 G Needs assistance to bathe. 4
5 B Needs to use an aid or appliance to manage toilet needs or incontinence. 2
6 B Needs to use an aid or appliance to dress or undress. 2
7 A
Can communicate unaided and access written information unaided, or using
spectacles or contact lenses.
0
8 A Can engage socially unaided. 0
9 A Can manage complex financial decisions unaided. 0
10 A Can plan and follow a journey unaided. 0
11 F
Cannot move up to 50 metres without using a wheelchair propelled by another
person or a motorised device.
15
Total points
Daily living activities = 14 (enhanced rate Daily Living component)
Mobility activities = 15 (enhanced rate Mobility component)
Explanation
Vicky’s impairment impacts on some aspects of daily living and so she uses several
aids and appliances. Her ability to move around is severely affected. Personal Independence Payment: second draft assessment criteria and consultation document
19
Case study 4
Pete is 19 and lives with his family. He does administrative work for his father’s
roofing business, working from home as he is not allowed to drive because of regular
epileptic fits. He loves to watch sports, particularly football, but is unable to take part
as he is worried about having a fit. These have been more frequent since puberty
and his neurologist keeps his treatment under constant review to try to reduce his fit
frequency; he is currently having a mix of either grand-mal or petit-mal fits most days
and sometimes more than once a day.
He is occasionally incontinent during a grand-mal fit and falls asleep for a while
afterwards. Between fits he is fairly independent though he only takes a shower if a
family member is in the house and he never cooks when alone – in the past he has
suffered injuries including scalds and burns in the kitchen. He has little or no warning
of a fit and previously he has received cuts and bruising from fits while outdoors. He
never goes out unaccompanied because of the risk and danger from traffic.
Likely descriptor choices
Activity Descriptor
1 E Needs supervision to either prepare or cook a simple meal. 4
2 A Can take nutrition unaided. 0
3 A
Either –
i. Does not receive medication, therapy or need to monitor a health condition;
or
ii. Can manage medication, therapy and monitor a health condition unaided,
or with the use of an aid or appliance.
0
4 E Needs supervision or prompting to bathe. 2
5 A Can manage toilet needs or incontinence unaided. 0
6 A Can dress and undress unaided. 0
7 A
Thu Feb 05, 2015 9:36 pm by 
