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Chapter P1: Conditions of Entitlement

Contents
P1001:Introduction

Conditions of entitlement
P1011:The primary qualifying conditions
P1013:Age
P1014:The residence and presence and competency conditions

Daily Living and Mobility Components
P1021:The components
P1031:Required period condition
P1032:Prescribed date

Chapter P1: PIP - Conditions of Entitlement

P1001 Introduction

PIP was introduced for new claimants from 8.4.131 in certain areas only (see ADM
Chapter P5 Appendix 1 for the postcodes affected). It was introduced in all other
areas for new claimants only from 10.6.132. For existing DLA claimants PIP was
introduced after 27.10.13, but only where a relevant date has been specified. It
replaces DLA for working age claimants. PIP is an extra costs benefit for people who
have a limited or severely limited ability to carry out daily living or mobility activities.
Note: See ADM Chapter P5 for the definition of relevant date and for guidance on
transitional provisions.

1 WR Act 12 Commencement Order No. 8, Art 8; 2 WR Act 12 Commencement Order No.10, Art 2

P1002

The assessment process will identify the level of impact of a disabling condition on
both these areas, enabling both physical and mental disabilities to be assessed.

P1003

Those claimants already entitled to DLA on 8.4.13 will continue to retain that benefit
until a decision is made on their entitlement to PIP at a later date (see ADM Chapter
P5).

[P1004-P1010]

Conditions of entitlement

P1011 The primary qualifying conditions

The main qualifying conditions to PIP are
1. age (1) (see P1013) and
2. habitualresidency, presence and competency (2) (see ADM Chapter C2) and
3. meeting the relevant threshold (3) for entitlement under the daily living and/or
mobility component activities and
4. therequired period condition (4).
Although there is no formal order of consideration of these conditions, if either of the
first two is not satisfied, then the third and fourth need not be considered.

1 WR Act 12, s 83(1); 2 s.77(3); 3 SS (PIP) Regs, reg 4; 4 SS (PIP) Regs, reg 12 & 13

P1012

Claimants are entitled to PIP if they
1. make a claim (1) (see new ADM A2) and
2. satisfy the main qualifying conditions (see ADM P1) and
3. satisfy the NINO provisions (2) (see ADM A2).
1 SS UC,PIP, JSA & ESA(C&P) Regs, reg 11; 2 SSA Act 92, s 1(1A) & (1B)

P1013 Age P1011

To be entitled to PIP for the first time a claimant must be
1. age 16 or over and
2. the relevant age of
2.1
under age 651 or
2.2
underpensionable age, whichever is the higher and
3. not in receipt ofDLA.
Note: See ADM Chapter P4 for guidance on exceptions to entitlement for upper age
condition.
1 WR Act 12, s 83; Pensions Act 1995, Sch 4, para 1

P1014 The residence and presence and competency conditions

To be entitled to PIP a claimant must satisfy the habitual residency, presence and
competency conditions, under UK law (1) (see ADM Chapter C2).
1 SS (PIP) Regs; reg 16

[P1015-P1020]

P1021 Daily Living and Mobility Components

PIP consists of two components (1) which are
1. the daily living component and
2. the mobility component
and entitlement can be for either or both components.

1 WR Act 12, s 78 & 79

P1022

There are two rates of benefit for each component. They are
1. the standard rate (1) and
2. the enhanced rate (2)
and entitlement can be for either rate of one or both of the mobility and daily living
components.

1 WR Act 12, s 78(1) & 79(1); 2 s 78(2) & 79(2)

P1023

To be entitled to PIP a claimant will be assessed on their ability to carry out daily
living and/or mobility activities (1) (see ADM Chapter P2).
1 SS (PIP) Regs, reg 3 & 4; Sch 1, part 2 & 3

[P1024-P1030]

P1031 Required period condition P2003

To be entitled to PIP the claimant must also satisfy the required period condition (1)
which is met if
1. the claimant is assessed as having limited or severely limited ability to carry
out the
1.1
daily living activities and/or
1.2
mobility activities
for a period of 3 months (qualifying period) before the prescribed date and
2. is assessed as having limited or severely limited ability to carry out the
2.1
daily living activities and/or
2.2
mobility activities
for a period of 9 months (prospective test) beginning with the prescribed date.
1 WRA 12, s 81; SS (PIP) Regs, reg 12 & 13
Example 1
Deborah has a severe stroke and is admitted to hospital on 30.6.13. She is under
pensionable age and on leaving hospital on 13.8.13 she makes a claim for PIP. After
being assessed the DM decides she is entitled to the enhanced rate of the daily
living component and the enhanced rate of the mobility component for three years.
The benefit is awarded from 30.9.13 when the 3 months QP is satisfied.
Example 2
Andrew has a cycling accident on 17.8.13 and breaks his leg in two places. On
20.9.13, when he is still unable to go to work, he makes a claim for PIP. After being
assessed the DM makes the decision that although the first requirement of the 3
months QP will be satisfied on 17.11.13, he is unlikely to satisfy the second condition
of continuing for a further 9 months to 16.8.14, and therefore he does not satisfy the
conditions for an award of PIP.

P1032 Prescribed date

The prescribed date (1) is
1. the date on which a claim for PIP is made or
2. if later, the first date on which the required period condition (2) of 3 months is
met or is likely to be met or
3. if already in receipt of PIP, each day of that award (3).
1 SS (PIP) Regs, reg 14; 2 reg 12; reg 13; 3 reg 15(3)

P1033

Where
1. the claimant has previously been entitled to PIP and
2. the claim mentioned in 1. ended no more than 2 years before the new claim is
made or, where the claimant is over 65 (or pensionable age whichever is
later) no more than one year before the date of the new claim and
3. the previous entitlement was the same component as the one the claimant is
entitled to under the new claim and
4. the DM determines that the new claim results from
4.1
substantially the same mental or physical condition or conditions for
which the previous award was made or
4.2
a new condition which developed as a result of a condition for which the
previous award was made
then the prescribed date for the 3 month part of the required period condition is the
end of the previous claim and for the 9 month part is the date of the new claim. This
means that the 3 month part will be considered in relation to the previous claim and
does not need to be re-satisfied for the new claim.
1 SS (PIP) Regs, reg 15
Example
Judith has MS and has been receiving the standard rate of both PIP components for
3 years. On re-assessment she is found to be in remission and no longer has the
same level of needs. The DM decides that she is not entitled to PIP. 15 months later
Judith makes another claim for PIP as she has had another flare up of MS. When
assessed the DM decides that Judith is entitled to the same rates of the daily living
and mobility components as previously. As the claim is within 2 years, and she is
under pensionable age, she is entitled to payment of PIP from the date of claim, and
the qualifying period condition is deemed to be satisfied immediately.

[P1034-P1999]