For anybody familiar with the welfare system PIP is notorious for being an incredibly difficult award to secure. That is for both physical and mental disabilities. The threshold and process through which eligibility is determined is so perplexing that many claimants discontinue their claims at the first refusal. It is not the fault of claimants that they are unsuccessful but the result of an unfair and complicated framework that does not broadly reflect individual circumstances.
I would like to explain below how the bureaucracy and contractual structure of the PIP process generates unfair outcomes for mental health claimants specifically.
Daily Living Element
The Daily Living section of PIP is incredibly broad and encompasses activities that might not be relevant to mental health claimants. The threshold for standard daily living is 8 points. The threshold for enhanced is 12.
A typical outcome in mental health–related claims is an award of the standard rate of the Daily Living component. An enhanced award is achievable in the right circumstances, but it is less common, as it requires clear and consistent evidence of a higher level of functional impairment.
The Daily Living component has 10 activities. These are:
- 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
Mental health claimants typically only experience difficulty in the activities highlighted in bold above. Other activities are possible but the burden of proof is much higher and would often require additional physical or developmental impairments.
The activity ‘Engaging with other people face to face’ is often an area of focus in mental health cases. This is because claimants are more likely to have medical evidence that directly supports this. It is reasonable to suggest that conditions such as depression, anxiety, mood disorders, personality disorders would have a marked impact on face to face engagements. There is a maximum of 8 points for this activity which will depend on the severity of the symptoms. The threshold for scoring 8 points is rather high and the maximum score on this activity alone would only allow a claimant to achieve standard daily living.
Key terminology to understand when applying for PIP is ‘Safely, reliably, repeatedly.’ This is the standard at which claimants are expected to be able to complete an activity for no support to be required. Anything less than that standard will attract supporting descriptors. It is vital that in the PIP2 application and during the assessment descriptions of the claimants abilities are described on the worst day and what is relevant the majority of the time. This approach allows descriptors to be satisfied more readily.
GP evidence is often extremely useful. For a mental health claim to be successful, GP evidence should directly link to activity descriptors clearly and unambiguously. Specialist evidence is also valuable but in most cases NHS evidence, including Mental Health Teams and subsequent referrals are viewed with more weight than other specialist services.
Mobility Element
In terms of the mobility element of PIP only one activity applies this is Planning and Following Journeys. Descriptor E is – Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant. This descriptor is highly prevalent in mental health cases because it captures the main difficulty regarding mobility associated with travel.
Descriptor E also brings with it further entitlements once awarded. This includes eligibility for a blue badge which for claimants with agoraphobia, panic disorder for instance, helps considerably in obtaining suitable parking spaces on uncomfortable but necessary journeys.
Please note…..
Throughout the application process it is crucial to recognise that objectivity is essential. The PIP process and DWP are entirely procedural and do not have emotion. As distressing and inequitable as the process may feel, emotional behaviour, verbal or written will have little bearing on the final decision.
If you feel discouraged or demoralised at any point, try not to disengage. Take a breath, revisit the legal framework, and remind yourself that the underlying entitlement does not change simply because an initial decision is negative.
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