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Chapter P2: Assessment for PIP

Contents
P2001:Daily Living and mobility components
P2002:Limited and severely limited ability
P2026:Information requirements
P2046:Assessment consultations
P2056:Failure to comply
P2058:Good reason
P2061:Duration of award
P2064:Re-determination
P2076:Terminal illness
P2080:Third party claims
Appendices
Personal Independence Payment Assessment.................................. Appendix 1
Daily living and mobility activities ....................................................... Appendix 2

Chapter P2: Assessment for PIP

P2001 Daily living and mobility components

The activities to satisfy the Daily Living and/or Mobility components are prescribed (1).
These can be found in the Appendices to this Chapter.
1 SS (PIP) Regs, Sch 1

P2002 Limited and severely limited ability

Entitlement to PIP is based on whether a claimant has limited or severely limited
ability to carry out daily living and/or mobility activities (1). This will be determined by a
DM using the information gathered during the PIP assessment (see P2004 -
P2006).

1 SS (PIP) Regs, reg 4

P2003

In addition the required period condition, consisting of
1. the qualifying period of 3 months and
2. the prospective test of 9 months
has to be satisfied (1). The HP will advise the DM if these conditions are likely to have
been met (see P1031).

1 SS (PIP) Reg, reg 12 & 13

P2004 P2002

The PIP assessment is used to determine a claimant's ability to carry out
1. daily living activities or
2. mobility activities or
3. a mixture of both.

P2005

The assessment will determine whether a claimant's ability is limited or severely
limited by their physical or mental condition, and if the claimant meets the required
period condition (1) (see ADM Chapter P1 - Conditions of Entitlement).

1 SS (PIP) Regs, reg 4 & reg 12 to 15

P2006 P2002 P2046

The assessment will be in the form of either (1)
1. a face-to-face consultation or
2. a telephone consultation or
3. a paper based assessment or
4. fast track if under the special rules for terminally ill persons or
5. a combination of any of 1. - 4.
Once all the evidence is gathered the DM will also assess the claimant using the
same criteria as the HP. The DM at this point may also ask the HP for additional
information if required, to help the DM make their decision.

1 SS (PIP) Regs, reg 9(1)

P2007

The HP is specially trained to assess and evaluate the impact of disability on a
claimant's ability to carry out activities of daily living and mobility. This includes the
affects of variable conditions.

P2008

The HP has appropriate knowledge of clinical aspects of a wide range of medical
conditions and is skilled in assessing people with physical and mental health
conditions.

P2009

A HP will be one of the following
1. An occupational therapist
2. Nurse (level 1)
3. Physiotherapist
4. Paramedic
5. Doctor (GMC registered)

P2010

The HP provides advice to the DM on the limitation to carry out daily living and/or
mobility activities and advises on which descriptors are appropriate for the claimant.
The advice the HP provides is based on the daily living/mobility needs arising from a
condition or conditions and not the condition(s) itself.

P2011 P2080

The claimant will be assessed as having limited ability if the daily living activities or
mobility activities achieve a score of at least 8 points (1) in each component. This will
then lead to an award of the relevant component or components at the standard rate
of PIP (see P2014).

1 SS (PIP) Regs, reg 5(3)(a); reg 6(3)(a)

P2012

The claimant will be assessed as having severely limited ability if the daily living
activities or mobility activities achieve a score of at least 12 points (1) in each
component. This will then lead to an award of the relevant component or
components at the enhanced rate of PIP (see P2014).

1 SS (PIP) Regs, reg 5(3)(b ): reg 6(3)(b)

P2013

The score in relation to the daily living and mobility activities is determined (1) by
adding together, in relation to each activity, the points awarded against the selected
descriptors.

1 SS (PIP) Regs, reg 5(1); reg 6(1)

P2014 P2011 P2012 P2080

The applicable descriptor for the claimant for each activity is
1. where one descriptor is satisfied for over 50% of the days, that descriptor (1) or
2. where two or more descriptors are satisfied for over 50% of the days, the
descriptor which scores the highest number of points (2) or
3. where no descriptor is satisfied for over 50% of the days but two or more
scoring descriptors are satisfied for periods of more than 50% of the days
when added together, the descriptor to be applied is the one which
3.1 is satisfied for the greatest proportion of the days or
3.2 scores the higher or highest number of points where both or all
descriptors are satisfied for the same period (3).
1 PIP Regs, reg 7(1)(a)); 2 reg 7(1)(b); 3 reg 7(1)(c)

Example 1

Phil has long term problems with rheumatoid arthritis and has very limited walking
ability. He needs to use a wheelchair for more than 50% of the days when outdoors,
and can only walk a few metres before being in pain and discomfort. He is assessed as
"Can stand and move more than 1 metre but no more than 20 metres, either
aided or unaided"
and scores 12 points on the assessment. He is therefore awarded the enhanced rate
of the PIP mobility component.

Example 2

Mary has learning difficulties and
"Needs supervision or assistance to either prepare or cook a simple meal"
scoring 4 points.
"Needs supervision, prompting or assistance to be able to manage therapy
that takes no more than 3.5 hours a week" - scoring 2 points.
"Needs supervision or prompting to be able to wash or bathe" - scoring 2
points.
"Cannot read or understand signs, symbols or words at all" - scoring 8 points.
"Cannot make any budgeting decisions at all - scoring 6 points.
"Cannot plan the route of a journey" - scoring 8 points.
Mary is therefore awarded the daily living component at the enhanced rate as she
has scored 22 points, and the mobility component at the standard rate as she has
scored 8 points.

Example 3

John has arthritis in his hands and for approximately 1 to 2 weeks a month he cannot
"Cannot prepare and cook food" which would score 8 points.
He also has Multiple Sclerosis which is not controlled well and for about 16 weeks of
the year, which do not overlap with the arthritis, he
"Needs supervision or assistance to either prepare or cook a simple meal"
which would score 4 points.
Neither descriptor is satisfied for more than 50% of the time on their own, but in
aggregate cover more than 50% of the time. John is awarded the standard rate of
the daily living component as the descriptor awarding 8 points applies for the
greatest amount of the time.

P2015

When assessing the claimant's ability to carry out an activity, the claimant is to be
assessed as if wearing or using any aid or appliance (1) which
1. the claimant normally wears or uses or
2. the claimant could reasonably be expected to wear or use.

1 SS (PIP) Regs, reg 4(2)(a) & (b)

P2016

The descriptor will only be regarded as being satisfied if the claimant can be
assessed as carrying out that activity, in the manner described in the descriptor
1. safely - which means in a manner unlikely to cause harm to themselves or to
another person, either during or after completion of the activity and
2. to an acceptable standard - given the nature of the activity and
3. repeatedly - which means as often as the activity being assessed is
reasonably required to be completed and
4. in a reasonable time period (1), which means no more than twice as long as the
maximum period that a person without a physical or mental condition, which
limits that person's ability to carry out the activity in question, would normally
take to complete that activity.

P2017

In determining whether the activity can be carried out in this manner, consideration
should be given to
1. approach - what the individual needs to do; what assistance or aids are
required; how long it takes; and whether it is safe and
2. outcome - whether the activity can be successfully completed and the standard
that is achieved and
3. impact - the effects that reaching the outcome has on the individual and, where
relevant, other people; and whether the individual can repeat the activity within a
reasonable period of time and to the same standard (this includes consideration
of symptoms such as pain, discomfort, breathlessness, fatigue and anxiety) and
4. variability - how an individual's approach and outcomes change over time and
the impact this has on them.

Example 1

Henry is able to stand and move unaided. He can comfortably walk up to 150 metres
at a normal pace. After 150 metres he starts to become breathless and to
experience some mild pain. He can continue to walk but his pace slows. The pain
and breathlessness gradually increases and after 250 metres he needs to stop and
rest for about 5 minutes before starting to walk again. Henry can repeatedly walk
250 metres, with short 5-minute rests in between for around an hour. After an hour
of this, he needs a longer rest of about an hour before walking again. It takes Henry
around four minutes to walk 200 metres. The DM considers whether Henry can
stand and then move more than 200 metres (descriptor 2a) safely, to an acceptable
standard, repeatedly and a in a timely manner. The DM decides there is no evidence
that this activity poses any risk to Henry's safety; he has said he experiences some
pain and breathlessness and, while this may be uncomfortable, he knows when to
stop and rest and there is no indication that this causes him any harm. The DM
decides Henry can complete the activity more frequently than would reasonably be
expected and, although he takes a little longer than a non-disabled person, he can
complete the activity in a reasonable time period. As Henry can therefore stand and
then move more than 200 metres safely, repeatedly and in a timely manner (the
standard is not an issue in this instance), the DM selects descriptor 2a.

Example 2

Louise is able to stand and move with a walking stick. She can walk up to 50 metres
at a slightly slowed pace with some discomfort. After this distance she starts to
experience increasing hip pain. She can continue to walk, but her pace slows even
further and after 100 metres she needs to stop and rest. This takes a lot out of her
and for a few hours after Louise is unable to go more than a few steps without
experiencing further severe hip pain. The DM considers whether Louise can stand
and then move more than 50 metres but no more than 200 metres (descriptor 2b)
safely, to an acceptable standard, repeatedly, and in a timely manner. The DM
decides that there is no issue with the standard and that she can do so safely,
because, although she experiences pain, she knows when to stop and rest, and
there is no indication that this causes her any harm. However, after she has walked
100 metres, it is several hours before Louise can walk this distance again. The DM
decides this is less frequently than would be reasonably expected and therefore
concludes she cannot do so repeatedly. Louise can repeatedly manage a few
metres using her stick, which is less than 20 metres but more than 1 metre
(descriptor 2e). On this evidence the DM selects descriptor 2e.

Example 3

Julie can prepare and cook a simple meal. However she lacks a perception of
danger and occasionally cuts herself from mishandling knives or burns herself on
hot pans. She is also impatient and does not cook food for as long as it should be
cooked, as a result she prepares food that is lukewarm and meat that is not cooked
properly - for example, chicken that is pink in the middle. Her sister usually has to
be in the kitchen when she is cooking meals to make sure she does so safely and to
remind her to leave food to cook fully. The DM considers whether Julie can prepare
and cook a simple meal unaided (descriptor 1a), safely, to an acceptable standard,
repeatedly and in a timely manner. The DM decides Julie is able to do so repeatedly
and in a timely manner. Because she lacks a perception of danger, the DM decides
Julie needs supervision to be able to safely prepare or cook a simple meal
(descriptor 1e). Because she does not cook food for as long as she should, the DM
decides Julie needs prompting to prepare or cook a simple meal (descriptor 1d) to
an acceptable standard. In this case there are two possible descriptors - 1d and 1e,
but as descriptor 1d does not describe a manner in which Julie is able to carry out
the activity safely, the DM selects descriptor 1e.

P2018

Where the claimant is assessed as having severely limited ability to carry out the
daily living and/or mobility activities, they cannot also be assessed as having limited
ability in relation to that component (1).
1 SS (PIP) Regs, reg 4(3)

[P2019-P2025]

P2026 Information requirements

The claimant will be required to provide any information or evidence (1) that may be
requested by the DM to determine their ability to undertake either the daily living or
mobility activities specified.

1 SS (PIP) Regs, reg 8(1)

P2027

The information will take the form of
1. the claimant questionnaire, (How your disability affects you), if required
2. any other information as may be requested by the DM
3. any other additional information requested by a person approved by the
Secretary of State (e.g. a HP requesting further information by telephone).

P2028

Where information has been requested of the claimant, that information must be
provided within 1 month (1) of the request, or any longer period as the DM may
consider reasonable.
1 SS (PIP) Reg, reg 8(2)

[P2029-P2045]

P2046 Assessment consultations

If it is decided that a consultation (1) with the claimant is required to assess the
claimant's ability to undertake daily living and/or mobility activities the consultation (1)
will take the form of participation in a face-to-face consultation (but see P2006, a
consultation by telephone may be used to gather further information).
Note: A paper based assessment may be available for some claimants, and may be
made where there is sufficient evidence for the HP to advise on all aspects of the
claim.

1 SS (PIP) Regs, reg 9(1)

P2047

The claimant will be required to comply with the request for a consultation. Failure to
comply will result in the DM giving a negative determination (1), unless the claimant
shows good reason (2) not to participate in the consultation (see P2058).

1 SS (PIP) Regs, reg 9(2); 2 reg 10

P2048

The claimant must be notified in writing (1) of the
1. date and
2. time and
3. place
of the consultation at least 7 days in advance.
Note:
The claimant can agree to accept a shorter period of notice, whether given in
writing or otherwise.

1 SS (PIP) Regs, reg 9(3)

P2049

The written notice may be issued electronically (1) where the claimant has agreed to
correspondence being sent in this manner.
Note This facility will not be available until a future date.
1 SS (PIP) Regs, reg 9(4)

[P2050-P2055]

P2056 Failure to comply

Failure to comply with the request for information without good reason shall result in
a negative determination (1) of the component(s) to which the failure is related (see P2056).

1 SS (PIP) Regs, reg (8)(3) & 9(2)

P2057

A negative determination (1) means a determination that a person does not meet the
requirements of the daily living component or the mobility component.
1 WR Act 12, s 80(6)

Example

Amanda made a telephone claim to PIP and was sent out a part 2 questionnaire,
`How does your disability affect you'. She was asked to return the form within one
month of the date of the request. After 19 days she had not returned the form so she
was sent a postal reminder but she also failed to respond to this. As she did not
comply with returning the information required, and she hadn't been identified as
needing additional support, a negative determination was made on her claim.

P2058 Good reason P2047

To determine if the claimant has good reason (1) for non compliance to either provide
the information required or participate in a consultation, then the DM should consider
1. the state of the claimant's health at the relevant time and
2. the nature of any disability the claimant has.
These circumstances for considering good reason are not exhaustive, but see ADM
Chapter P6 - Good Reason for more guidance.
1 SS (PIP) Regs, reg 10

Example 1

Joe did not attend for a consultation with the HP and did not notify them that he
could not attend. However, after a follow-up enquiry had been sent out the DWP was
notified that he had been unexpectedly taken into hospital after a heart attack, and
did not receive the notification until after he was discharged. The DM decided that
this was good reason, and a negative determination was not given on his claim.

Example 2

Tracey has schizophrenia, but did not give this information at the initial claim stage,
and when asked for more information did not comply. Further enquiries established
that Tracey could be a vulnerable claimant. It was then established she was not able
to complete the information required without help. Her social worker visited and
found the request and helped her to complete and send in. The DM decided not to
make a negative determination.

Example 3

Bill did not attend for a consultation and enquiries were made as to the reason. Bill
stated he `slept in', and could not supply any medical reason or evidence that would
support this as a reasonable excuse. Therefore the DM made a negative
determination.

[P2059-P2060]

P2061 Duration of award

When deciding the duration of an award (1) of PIP the DM should look at all the
evidence and facts of the case, including the advice from the HP. There will be three
types of awards
1. short fixed term awards, which will be for a minimum of 9 months and a
maximum of 2 years or
2. longer fixed term awards, where the DM will set an expiry date 12 months
after the date on which the claimant is due to be referred to the HP for a
review or
3. ongoing awards where it would be inappropriate to give a fixed term award
where any change is highly unlikely.
Note: DMs will also have a role in deciding the review date which will be detailed in
the DM's procedural guidance.

1 WR Act 12, s 88(2) & (3)

P2062

When deciding the length of the award the DM will have regard to
1. the advice from the HP, within the PIP assessment report and
2. any further evidence gathered by the HP and
3. the evidence given by the claimant in the questionnaire (How your disability
affects you), and any additional information supplied by the claimant.
Note:
DMs should refer to the procedural guidance on Award Periods and Reviews
(within the Decision Making Process Guidance), when deciding the length of the
award and setting review periods.

P2063

The advice on prognosis from the HP advising when they wish to see the claimant
again in accordance with P2064 - P2065, will have had consideration as to
1. whether there is likely to be an improvement or deterioration in the disability or
its functional effects and
2. whether further treatment is required and
3. the time any improvement or deterioration is likely to be expected and
4. the natural progress of the underlying condition and
5. any adjustments and adaptations.

Example 1

Joan sent in her questionnaire for her claim to PIP and attended for a consultation
with an HP. On the evidence before them the HP provided a report to the DM for
their consideration, with a recommendation that the claim should be reviewed in 3
years. This took into account the likely prognosis by the HP of improvement in
Joan's disability condition and the daily living/mobility needs arising. The DM
considered all the evidence and made their decision on the length of the award,
decided on a review date of 3 years and an award for PIP of 4 years. This ensures
that the award does not run out before the new decision is made.

Example 2

Richard submitted his questionnaire in relation to his claim for PIP, and the HP
considered the information and called him for a consultation. At the consultation
Richard brought a letter from his GP and handed it to the HP. The HP looked at all
the evidence, including the consultation, and advised that Richard's claim should be
reviewed after two years. The DM considered all the evidence and decided that a
formal review would not be appropriate, and made an award of PIP for two years, as
it is expected that he will have improved by the end of the award. Richard will receive
a letter before the end of his award to advise him about claiming again, should his
needs not have improved.

Example 3

Agnes has had a long term disability and made a claim for PIP. She submitted her
questionnaire, and the HP decided to seek further advice from her hospital
consultant. On this evidence the HP made an assessment and advised the DM that
Agnes' prognosis was that her needs would be unlikely to change. On this evidence
from the HP the DM made a decision to make an ongoing award for PIP, with a
review date after 10 years, to check if the level of benefit is still appropriate.

P2064 Re-determination P2063

Where a claimant has been determined to have a limited or severely limited ability to
carry out activities, the DM may re-determine (1) whether a claimant still has limited or
severely limited ability to carry out the required activities.

1 SS(PIP) Regs, reg 11

P2065 P2063

The re-determination can be performed when
1. a period of award is coming to an end or
2. a claimant reports a change of circumstances or
3. the DM wishes to review the claimant's award, at any time or for any reason.
Note 1: When the DM initiates a review this is referred to as a planned intervention
(except, for instance where information is received from a third party which initiates
an investigation).
Note
2: For more information on any time reviews please see ADM Chapter A3.

Example 1

Sarah has rheumatoid arthritis and is in receipt of the standard rate of mobility as her
walking had been affected after an exacerbation. She asks the DM to look at her
claim again as she has had a further flare up and it has left her in more pain and
swelling of her feet and more deformity of the joints in her arms and hands. After
more evidence being obtained, and consideration given to the qualifying period, the
HP advises that her needs have increased and refers to the DM for a decision. The
DM decides that Sarah:
Needs supervision or assistance to either prepare or cook a simple meal - 4 points
Needs - assistance to be able to cut up food - 2 points
Needs assistance to get in or out of the bath or shower - 3 points
Can stand and then move using an aid or appliance more than 20 metres but
no more than 50 metres - 10 points.
On these findings the DM makes an award for daily living activities at the standard
rate, and maintains the mobility component at the standard rate.

Example 2

Billy has been suffering with a heart problem and had been awarded the standard
rate of the daily living component and the enhanced rate of the mobility component.
12 months before his award was due to come to an end the DM instigated a planned
intervention and asked Billy to provide new information. He was invited by the HP to
a face-to-face consultation and medical evidence was obtained from his consultant.
It was found that although Billy had recently received a heart by-pass operation and
his needs had decreased, he was still recovering. He told the DM that he was going
to write in once he had see his GP again and was given the all clear. The DM, on the
evidence gathered, reduced his award to standard rate mobility component and no
rate of the daily living component for the remaining period of his previous award.

[P2066-P2075]

P2076 Terminal illness P2077 P2078

There are exceptions to the normal rules when the person who claims
1. is terminally ill and
2. has made a claim for PIP expressly on the ground of terminal illness (1).
Note:
Evidence from or on behalf of the disabled person of terminal illness will
amend the claim to one based on the Special Rules (see P2079).

1 WR Act 12, s 82

P2077 P5019

A person is regarded as being terminally ill (1) for the purposes of P2076 if
1. at any time the person suffers from a progressive disease and
2. the person's death in consequence of that disease can reasonably be
expected within 6 months.

1 WR Act 12, s 82(4)

P2078

When a claim is made under the circumstances in P2076 the claimant will
1. not be required to satisfy the required period condition for either component (1)
and
2. not be required to satisfy the past presence condition (2) and
3. be awarded the enhanced rate of the daily living component (3) and
4. be required to provide information on the mobility activities before either rate
of that component can be awarded.

1 WR Act 12, s 82(2) & (3); 2 SS (PIP) Regs, reg 22; 3 WR Act 12, s 82(2)

P2079 P2076

Claims for terminally ill people will usually be awarded for and limited to 3 years. A
reminder will be issued before the award expires to remind the claimant to re-claim
PIP.

P2080 Third party claims

A claim may be accepted from a third party (1) if the claim is made expressly on the
ground that this is on behalf of someone who is terminally ill. This has the effect that
the terminally ill person has made the claim (see ADM Chapter A2 - claims).
1 WR Act 12, s 82(5); SS (PIP) Regs, reg 21

[P2081-P2999]

Appendix 1
PERSONAL INDEPENDENCE PAYMENT ASSESSMENT
Interpretation of terms
1
This Appendix gives guidance on the interpretation of terms (1) used for daily living and
mobility activities.
1 SS (PIP) Regs, Sch 1
Aided
2
Aided means with
1. the use of an aid or appliance or
2. supervision, prompting or assistance. Assistance
3
Assistance means physical intervention by another person and does not include
speech.
Assistance Dog
4
Assistance dog means a dog trained to guide or assist a person with a sensory
impairment.
Basic verbal information
5
Basic verbal information means information in the claimant's native language
conveyed in a simple sentence.
Basic written information
6
Basic written information means signs, symbols and dates written or printed in the
claimant's native language.
Bathe
7
Bathe includes getting into or out of an unadapted bath or shower.
Communication support
8
Communication support means support from a person trained or experienced in
communicating with people with specific communication needs including interpreting
verbal information into a non-verbal form and vice versa.
Complex budgeting decisions
9
Complex budgeting decisions means decisions involving
1. calculating household and personal budgets and
2. managing and paying bills and
planning future purchases
Complex verbal information
10
Complex verbal information means information in the claimant's native language
conveyed in either more than one sentence or one complicated sentence.
Complex written information
11
Complex written information means more than one sentence of written or printed
standard size text in the claimant's native language.
Cook
12
Cook means to heat food at or above waist height.
Dress and undress
13
Dress and undress includes putting on and taking off socks and shoes.
Engage socially
14
Engage socially means
1. interact with others in a contextually and socially appropriate manner and
2. understand body language and
3. establish relationships. Manage incontinence
15
Manage incontinence means manage involuntary evacuation of the bowel or bladder
including use of a collecting device or self-catheterisation and clean oneself
afterwards.
Manage medication or therapy
16
Manage medication or therapy means take medication or undertake therapy, where
a failure to do so is likely to result in a deterioration in the claimant's health.
Medication
17
Medication means medication to be taken at home which is prescribed or
recommended by a registered
1. doctor
2. nurse or
3. pharmacist.
Monitor health
18
Monitor health means
1. detect significant changes in the claimant's condition which are likely to lead to
a deterioration in their health and
2. take action advised by a
2.1 registered doctor
2.2 registered nurse or
2.3
health professional who is regulated by the Health Professions Council
without which the claimant's health is likely to deteriorate.
Orientation aid
19
Orientation aid means a specialist aid designed to assist disabled people to follow a
route safely.
Prepare
20
In the context of food prepare means to make food ready for cooking or eating.
Prompting
21
Prompting means reminding, encouraging or explaining by another person.
Psychological distress
22
Psychological distress means distress related to an enduring mental health condition
or an intellectual or cognitive impairment.
Read
23
Read includes reading signs, symbols and words but does not include reading
Braille.
Simple budgeting decisions
24
Simple budgeting decisions means decisions involving
1. calculating the cost of goods and
2. calculating change required after a purchase. Simple Meal
25
Simple meal means a cooked one-course meal for one using fresh ingredients.
Social Support
26
Social support means support from a person trained or experienced in assisting
people to engage in social situations.
Stand
27
Stand means stand upright with at least one biological foot on the ground.
Supervision
28
Supervision means the continuous presence of another person for the purpose of
ensuring the claimant's safety.
Take nutrition
29
Take nutrition means
1. to cut food into pieces and
2. convey food or drink to one's mouth and
3. chew and swallow food or drink or
4. take nutrition by using a therapeutic source. Therapeutic source
30
Therapeutic source means parenteral or enteral tube feeding, using a rate limiting
device such as a delivery system or feed pump.
Therapy
31
Therapy means therapy to be undertaken at home which is prescribed or
recommended by a
1. registered
1.1 doctor
1.2
nurse or
1.3 pharmacist
2. health professional regulated by the Health Professions Council.
Toilet needs
32
Toilet needs means
1. getting on and off an unadapted toilet and
2. evacuating the bladder and bowel and
3. cleaning oneself afterwards. Unaided
33
Unaided means without
1. the use of an aid or appliance or
2. supervision, prompting or assistance.
Appendix 2 See PIP Descriptor Log
Daily living and mobility activities
Note: See P2011- P2014
Daily Living Activities
Column 1
Column 2
Column 3
Activity
Descriptors
Points
1. Preparing food.
a. Can prepare and cook a simple meal
0
unaided.
b. Needs to use an aid or appliance to be
2
able to either prepare or cook a simple
meal.
c. Cannot cook a simple meal using a
2
conventional cooker but is able to do so
using a microwave.
d. Needs prompting to be able to either
2
prepare or cook a simple meal.
e. Needs supervision or assistance to
4
either prepare or cook a simple meal.
f. Cannot prepare and cook food.
8
2. Taking nutrition.
a. Can take nutrition unaided.
0
b. Needs -
2
(i) to use an aid or appliance to be able to
take nutrition; or
(ii) supervision to be able to take nutrition;
or
(ii) assistance to be able to cut up food.
c. Needs a therapeutic source to be able to
2
take nutrition.
d. Needs prompting to be able to take
4
nutrition.
e. Needs assistance to be able to manage a 6
therapeutic source to take nutrition.
f. Cannot convey food and drink to their
10 mouth and needs another person to do so.
3. Managing
a. Either -
0
therapy or
(i) does not receive medication or therapy
monitoring a health or need to monitor a health condition; or
condition.
(ii) can manage medication or therapy or
monitor a health condition unaided.
b. Needs either -
1
(i) to use an aid or appliance to be able to
manage medication; or
(ii) supervision, prompting or assistance to
be able to manage medication or monitor a
health condition.
c. Needs supervision, prompting or
2
assistance to be able to manage therapy
that takes no more than 3.5 hours a week.
d. Needs supervision, prompting or
4
assistance to be able to manage therapy
that takes more than 3.5 but no more than
7 hours a week.
e. Needs supervision, prompting or
6
assistance to be able to manage therapy
that takes more than 7 but no more than 14
hours a week.
f. Needs supervision, prompting or
8
assistance to be able to manage therapy
that takes more than 14 hours a week.
4.Washing and
a. Can wash and bathe unaided.
0
bathing
b. Needs to use an aid or appliance to be
2
able to wash or bathe.
c. Needs supervision or prompting to be
2
able to wash or bathe.
d. Needs assistance to be able to wash
2
either their hair or body below the waist.
e. Needs assistance to be able to get in or
3
out of a bath or shower.
f. Needs assistance to be able to wash
4
their body between the shoulders and
waist.
g. Cannot wash and bathe at all and needs
8
another person to wash their entire body.
5. Managing toilet
a. Can manage toilet needs or
0
needs or
incontinence unaided.
incontinence.
b. Needs to use an aid or appliance to be
2
able to manage toilet needs or
incontinence.
c. Needs supervision or prompting to be
2
able to manage toilet needs.
d. Needs assistance to be able to manage
4
toilet needs.
e. Needs assistance to be able to manage
6
incontinence of either bladder or bowel.
f. Needs assistance to be able to manage
8
incontinence of both bladder and bowel.
6. Dressing and
a. Can dress and undress unaided.
0
undressing.
b. Needs to use an aid or appliance to be
2
able to dress or undress.
c. Needs either
2
(i) prompting to be able to dress, undress
or determine appropriate circumstances
for remaining clothed; or
(ii) prompting or assistance to be able to
select appropriate clothing.
d. Needs assistance to be able to dress or
2
undress their lower body.
e. Needs assistance to be able to dress or
4
undress their upper body.
f. Cannot dress or undress at all.
8
7. Communicating
a. Can express and understand verbal
0
verbally.
information unaided.
b. Needs to use an aid or appliance to be
2
able to speak or hear.
c. Needs communication support to be
4
able to express or understand complex
verbal information.
d. Needs communication support to be
8
able to express or understand basic verbal
information.
e. Cannot express or understand verbal
12 information at all even with
communication support.
8. Reading and
a. Can read and understand basic and
0
understanding
complex written information either unaided
signs, symbols and
or using spectacles or contact lenses.
words
b. Needs to use an aid or appliance, other
2
than spectacles or contact lenses, to be
able to read or understand either basic or
complex written information.
c. Needs prompting to be able to read or
2
understand complex written information.
d. Needs prompting to be able to read or
4
understand basic written information.
e. Cannot read or understand signs,
8
symbols or words at all.
9. Engaging with
a. Can engage with other people unaided.
0
other people face
b. Needs prompting to be able to engage
2
to-face
with other people.
c. Needs social support to be able to
4
engage with other people.
d. Cannot engage with other people due to
8
such engagement causing either -
(i) overwhelming psychological distress to
the claimant; or
(ii) the claimant to exhibit behaviour which
would result in a substantial risk of harm
to the claimant or another person.
10. Making
a. Can manage complex budgeting
0
budgeting
decisions unaided.
decisions
b. Needs prompting or assistance to be
2
able to make complex budgeting
decisions.
c. Needs prompting or assistance to be
4
able to make simple budgeting decisions.
d. Cannot make any budgeting decisions
6
at all.
1 SS (PIP) Regs, Sch 1
Mobility Activities
Column 1
Column 2
Column 3
Activity
Descriptors
Points
1. Planning and
a. Can plan and follow the route of a
0
following journeys.
journey unaided.
b. Needs prompting to be able to
4
undertake any journey to avoid
overwhelming psychological distress
to the claimant.
c. Cannot plan the route of a journey.
8
d. Cannot follow the route of an
10 unfamiliar journey without another
person, assistance dog or orientation
aid.
e. Cannot undertake any journey
10 because it would cause overwhelming
psychological distress to the claimant.
f. Cannot follow the route of a familiar
12 journey without another person, an
assistance dog or an orientation aid.
2. Moving around.
a. Can stand and then move more than
0
200 metres, either aided or unaided.
b. Can stand and then move more than
4
50 metres but no more than 200
metres, either aided or unaided.
c. Can stand and then move unaided
8
more than 20 metres but no more than
50 metres.
d. Can stand and then move using an
10 aid or appliance more than 20 metres
but no more than 50 metres.
e. Can stand and then move more than
12 1 metre but no more than 20 metres,
either aided or unaided.
f. Cannot, either aided or unaided,-
12 (i) stand; or
(ii) move more than 1 metre.
1 SS (PIP) Regs, Sch 1
Pip Descriptor log - Activity 1
Descriptor
Query
Line to take
All
What is the best method to
Start at the highest scoring descriptor and work up to
score descriptors?
the lowest scoring descriptor. Working from the lowest to the highest scoring descriptor can result in application of the incorrect descriptor - for example in relation to Activity 1 if someone needs prompting and supervision to prepare food, descriptor 1d may be incorrectly chosen. The aid must be necessary to help the Claimant overcome their disability. Everyone uses aids to some
All
What should be considered
extent. For example, many people use dosette boxes
when we propose the use
as they are useful to manage a pill regimen, but this
of aids?
does not necessarily mean they are overcoming a disability by using it. You must consider if the aid (or appliance) is affordable to the Claimant. You must consider if the aid (or appliance) is readily available or acquirable. You must consider whether the aid is practical for the Claimant to use, based both on their on their disability and domestic circumstances
1b
Are prechopped vegetables
No, but it may demonstrate an inability to prepare
an aid or appliance?
vegetables. If someone has difficulty chopping or peeling and uses pre-chopped vegetables as a proxy for an aid or appliance, then 1b may apply if they could prepare food using an aid/appliance. If their health condition/impairment prevents the claimant from preparing vegetables at all (even with an aid) then descriptor 1e may apply (if with assistance or supervision they could manage it). 1f may apply if even with assistance or supervision they could not prepare food.
1c
Does activity 1C
No. Activity 1C should only apply to someone with a
automatically apply to
condition that means that they cannot safely use a
someone who says they
conventional cooker but could use a microwave oven
use a microwave oven to
- for example this may apply to a person with
cook?
cognitive impairment who might leave a gas cooker on
1a, 1c, 1e
What descriptor should
1a, 1c or 1e. Someone with infrequent/ predictable
apply to someone with
fits should be able to use a conventional cooker.
epilepsy?
Somebody with unpredictable epilepsy might need to use a microwave due to the risk of burning themselves with a conventional cooker. Descriptor 1e should rarely apply and only in those people where there is good evidence that their fits are extremely frequent, i.e. several times a day and unpredictable.
1e
What descriptor should
1e. Preparation of a simple meal includes the ability
apply to someone who can't to peel and chop food. If someone can't do this then
chop and peel vegetables,
activity 1e will apply because it wouldn't be
even with the use of aids,
reasonable for someone to live on microwave 'ready'
but can use a microwave to
meals. Note, however, that a microwave can be used
prepare a 'ready' meal?
to cook vegetables and other fresh produce and therefore a whole simple meal can be cooked using one.
1
Can someone who is at risk
Yes, but it depends on the evidence. Somebody who
of self harm meet
is at high risk of suicide or self harm may need
descriptors under activity 1? supervision to prepare a meal in which case 1e may
apply. There should be evidence that the person is at high risk of harm, for example high level involvement of community mental health services, care plan approach... etc
1
What if reduced mobility
Mobility is not part of the activity but, as with any task,
means the person cannot
it must be completed 'safely' (in a manner unlikely to
move about the kitchen
cause harm to themselves or another person, either
area?
during or after the completion of it). A perching stool may be a reasonable aid to reduce risk in these circumstances. Carrying food from kitchen to eating area is not included in this activity.
1f
If a person never makes
If the lack of making meals is through choice, lack of
meals or never cooks do
knowledge of cooking or because someone else
they meet descriptor 1f?
always does it, 1a would apply. If it stems from their health condition then they may satisfy 1f.
1
Does the Claimant need to
They must gain an adequate level of nourishment
be able to make a variety of
from their diet. However, if someone chooses to eat
food, or make meals that
poorly or have a repetitive diet, but had the capacity
are of nutritional value?
to cook a variety of food such as to give them this adequate level of nourishment, then they would not score any points.
Activity 2
2b(i)
If someone needs an aid or
No. Somebody who has problems with manual
appliance to peel and chop
dexterity or grip strength to the extent that they have
food for Activity 1 can you
problems chopping and peeling raw vegetables may
automatically asssume that
have difficulties cutting cooked food into pieces but
they will need to use an aid
this is not inevitable as it may be easier to cut
or appliance to take
cooked food than raw vegetables.
nutrition for Activity 2 ?
2
Should someone with
In rare circumstances 2b may be appropriate but
epilepsy require supervision there must be evidence that the fits are without to avoid the risk of choking
warning and are poorly controlled, e.g. the person is
when eating?
likely to be on multiple antiepileptic medication, under the care of a neurologist and will not be able to drive. The vast majority of people with epilepsy do not require another person to supervise them when eating
2
What if the person conveys
All individuals spill some food and drink at times but
some food and drink to their regularly spilling food as a result of a medical mouth but also spills a
condition to the extent, say, that an individual has to
great deal
change their clothes after eating is not acceptable.
Activity 3
3b
Is a needle an aid or
No - An injecting needle is not an aid or appliance
appliance?
(there is no impaired function that is improved or replaced by the use of the needle). It is the duration of the assistance/prompting/supervision. So for example
3c-f
The hours - Is it the therapy
somebody who needs supervision with haemodialysis
or is it the supervision/
that takes 5 hours 3 times a week - 3f would apply.
prompting/assistance that
However, if someone only needs assistance for 30
must last this long?
minutes with a therapy that lasts 5 hours, then that should only count as 30 minutes towards the weekly hourly total.
3b
Is a blood sugar monitor for
No - It is not an aid or appliance (there is no impaired
a diabetic an aid/appliance? function that is improved or replaced by the use of the
monitor). However, if supervision, assistance or prompting is required in its use then descriptor 3b(ii) might apply.
3
Therapy is defined as being
Home' means their domestic setting. If they reside in
administered at 'home'.
some form of nursing home, this is their domestic
What if they are in a setting
nursing home?
3
Would someone at risk of
Potentially - if the medication they take is of a type
suicide need supervision to
that an overdose could lead to harm and there is
manage medication?
good evidence that the person is at high risk, for example high level involvement of community mental health services, care plan approach... etc.
3b
Is an asthma inhaler an
No - it's medication. An individual who uses an inhaler
aid/appliance?
without aids or assistance would meet descriptor 3a(ii).
3
Is a dosette box an aid or
Yes - As long as the person uses one because of
appliance?
their mental/physical impairment or health condition.
3
Does 'keeping an eye' on
Only if there is a medically advised intervention that
how a person is count as
the person doing the monitoring must implement in
monitoring?
order to prevent deterioration in the claimant. Asking relatives or friends how they are or checking on their feelings or wellbeing as part of normal social interaction would not meet this criteria unless there was a medical reason for expecting a change, a defined sign of deterioration and an advised action plan.
3a-b
If a person with learning
No. If a person is not on long term medication only 3a
difficulties or cognitive
can be chosen. The descriptors reflect their current
impairment, for example
needs as assessed as being present for the 12 month
Alzheimer's disease, is not
period. Any short term medications would not meet
on medication, could 3b be
the scope of 3b and we are not being asked to
scored as they might need
predict possible future changes. If the claimant did
help or monitoring to
develop a condition requiring long term medications
assess if they need some
they could apply for a change of circumstances in the
medication in the future?
usual manner.
What descriptor should
Compression hosiery and compression bandaging
apply to people who use
can count as therapy as long as its use is to actually
3
support stockings /
treat an existing condition (that is to improve, alleviate
compression bandaging?
or prevent deterioration) rather than to prevent a condition arising. If there is assistance/prompting needed to use the compression stockings/bandaging then this could score under 3c-3f but note that it is the time spent on the asssistance/prompting that should be considered, not the time spent actually undertaking the therapy. For example, if someone needs 15 minutes of assistance to put on their compression hosiery, which they keep on for 6 hours a day, it is the 15 minutes of time which goes towards the weekly totals in 3c-3f, not the 6 hours Yes, it could replace/improve the memory function. However, everyone uses alarms to some extent. It
3b
would have to be shown that there was a medical condition that meant the use of the alarm was necessary.
Activity 4
4
Which descriptor should
4a could apply if they have a shower in the house or
apply to someone with
4b could apply if they need a shower attachment for
epilepsy for washing and
the bath. Even if they don't have a shower they can
bathing?
use a shower attachment for their bath taps. A shower attachment can be as effective as a conventional shower so there is no question that use of this would not be to the same standard as a bath / ordinary shower.
4f
Does between shoulders
Yes - Read 4f as if to say "Needs assistance to wash
and waist mean whole
any part of their body between shoulders and waist".
torso?
4
Is there a definition of
There is no legal definition. The ordinary meaning, to
'wash'?
clean oneself to an acceptable standard with water, should be used
Activity 5
5b
Is a bidet an aid or
.Potentially, but the vast majority of people use one
appliance?
out of choice. If someone claims to need a bidet to clean themselves after using the toilet, 5b may apply if there is evidence that they cannot clean themselves by conventional means and that this is consistent with their medical condition. If the Claimant is not incontinent then no. This Activity only refers to the ability to get on and off the toilet, to
5b
Does activity 5b apply to
clean afterwards and to manage evacuation of the
someone who has to use a
bladder and bowel - it does not include problems with
commode/bottle because
mobilising or the ability to climb stairs.
they are unable to get to the However, if the Claimant is incontinent then a toilet quickly enough?
commode or water bottle could be an aid. Their ability to get to the toilet is hampered not by their inability to mobilise but rather by their inability to properly control evacuation.
Activity 7
7
Does writing things down
No. This activity relates to verbal communication. If a
count as communication?
person has a hearing problem such that they need to communicate by writing then 7d would likely apply.
7b
How should I score
If someone claims that they can't use a hearing aid
someone who has been
that they have been prescribed, the reason given
prescribed a hearing aid but must be checked to ensure that it is reasonable. So choses not to use it?
for example if someone says they don't like using it for cosmetic reasons, this wouldn't be reasonable. However if it was because of a chronic ear infection, this is likely to be reasonable
Activity 8
8
Is dyslexia considered
Potentially they could satisfy a descriptor but it
under activity 8?
depends on the severity of their dyslexia; there should be good supporting evidence to support your choice of descriptor
8
How should illiteracy be
In order to be taken into account illiteracy must be as
addressed?
a direct result of a health condition or impairment and not due to a lack of education.
8
If someone can only "read"
8e. The use of braille does not count. As per the PIP
using braille what descriptor guide, the person must be able to physically see the should be used?
"written or printed information".
Activity 9
9
Is vulnerability to the
Yes. If someone is unable to engage with others
actions of others
safely as a result of vulnerability because of a defined
considered in activity 9?
medical condition and to the extent that they need social support (9c) this should be taken into account. So, for example, someone with Downs Syndrome or autism may be less risk aware and vulnerable to manipulation or abuse.
9
What is the difference
9b "prompting" applies to people who need someone
between "prompting" in
present for part of the time to help them socially
descriptor 9b and "social
engage, for example somebody with depression who
support" in 9c?
might need intermittent encouragement; 9C "social support" applies to someone who can only engage with another person in the presence of a third party, so in effect they need someone with them all of the time, for example someone with a severe behavioural disorder or autism
9
Can a violent person satisfy
Yes, but the violent behaviour must be due to an
9d(ii)?
inability to control their behaviour and as a result of an underlying health condition. Violence relating to alcohol would not meet descriptors unless that person had alcohol dependency, and for the majority of time they were under the influence and a risk to others which is supported by a documented past history of violent behaviour . Violence relating to being provoked would only be considered if the low threshold for reacting was related to an underlying medical condition.
9
'Social Support' is defined
This can mean a family member or friend - just
as support from a person
someone who is experienced in supporting the
trained or experienced in
person and can compensate for their limited ability to
assisting people to engage
engage socially.
in social situations. What does a person
'experienced' in assisting people mean?
9
Which descriptor would
It is unlikely that a blind person would require either
apply to a blind person
prompting or social support to engage with other
under activity 9?
people in which case descriptor 9a would apply. However, there may be individual cases where the person does require additional support for reasons unrelated to their visual impairment and the relevant descriptor should apply.
9
If a person is deaf and
No, communication is covered by Activity 7. In Activity
needs a sign language
9 the presence of another person as social support
translator, would this meet
must be due to their inability to understand and
descriptors under activity 9? respond to body language, other social cues and to
assist in social integration.
9
The person can engage
Consideration should be given to whether the
fully with people they know
Claimant can engage with people generally, not just
well, but cannot engage at
people they know well.
all with strangers? Do they satisfy any of the descriptors?
Activity 10
10
Does financial knowledge
No, The activity does not include the sort of decisions
come into 'complex
which require financial knowledge, such as
budgeting decisions'?
calculating interest rates or comparing mortgages.
When calculating
This is well beyond what is considered as complex.
household and personal
Complex budgeting involves making choices about
budgets, or planning future
what to spend money on, when to save, how to plan
purchases, does one not
future purchases etc.
need to understand mortgage rates, interest rates, or similar financial instruments? What if they need to take on debt?
10
If someone has a physical
10a because the activity only relates to the cognitive
condition that affects their
ability to make budgeting decisions
ability to make everyday budgeting conditions, which descriptor should apply?
The age of the person or whether they have ever done any household budgeting is irrelevant - it is their
10
ability to make budget decisions, for example their level of cognitive function, that is relevant.
The age of the person or whether they have ever done any household budgeting is irrelevant - it is their
10
ability to make budget decisions, for example their level of cognitive function, that is relevant.
Activity 11
11
Does Activity 11 apply to
Only if the condition results in either sensory or
people with physical
cognitive impairment or severe anxiety. Activity 11
conditions?
relates to the ability to plan and follow a journey but not the physical ability to move - this is covered under Activity 12. Someone with severe physical disability which then causes a mental health problem may need prompting to leave the house, or someone with them for encouragement in which case 11b could apply. For example, someone with Crohn's Disease has a physical condition, which leads to a severe anxiety about walking outdoors, which may lead to a score under Activity 11.
11
Does activity 11 apply to
In rare circumstances Activity 11 may apply but the
people who are violent?
violent behaviour must be due to an inability to control their behaviour and as a result of an underlying mental health condition; Also there must be good evidence that being accompanied by another person actually reduces the risk of the person committing a violent act.
11
What is 'overwhelming
A severe anxiety state in which the symptoms are so
psychological distress'?
severe that the person is unable to function. This may occur in conditions such as generalised anxiety disorder, panic disorder and agoraphobia
11
Under which activity is
Activity 11. If someone cannot safely follow a journey
awareness of danger
because of a condition affecting sensory or mental
considered?
health/intellectual/cognitive function then descriptors 11d or 11f should be considered
11
What descriptor applies if
if someone is actively suicidal they may require
someone is actively
another person to accompany them out of doors in
suicidal?
which case 11b would apply. There must be good evidence that the person is a high suicide risk by for example high level involvement of community mental health services, care plan approach etc
11b
When would descriptor 11b
This descriptor would most likely to apply to a person
apply?
with agoraphobia or panic disorder who is able to leave their home but requires someone else to be with them in order to do so. It may apply if someone has anxiety in relation to a physical condition - they don't have to have a formal mental health diagnosis but there must be good evidence to support the stated level of functional impairment.
11e
When would 11e apply?
This descriptor would most likely to apply to a person with agoraphobia or panic disorder who is unable to leave their home at all. So if someone is occasionally able to leave the home with another person, then 11b would apply.
11d and f
When would 11d and 11f
These descriptors would apply to a person with visual
apply?
or cognitive impairment. Cognitive impairment encompasses orientation (understanding of where, when and who the person is), attention and concentration and memory. Conditions that may impair cognitive function include physical conditions
(such as stroke, head injury, dementia), learning disabilities, and mental health conditions such as mood disorders ( e.g. moderate or severe depression, bipolar disorder) or psychotic illnesses
(e.g. schizophrenia). Example: A person with Downs Syndrome is left alone to walk home. If left in a familiar area can they be trusted to get home? If No they would satisfy 11f. If Yes - move onto the next descriptor in this category, 11d. If they were left in an unfamiliar area to get home could they manage this? If no, they could satisfy 11d. If yes, then they would not satisfy any descriptor.
11
Should the use of public
A person should only be considered able to follow an
transport be considered?
unfamiliar journey (11d) if they are capable of using public transport. The reason for not being able to use it must be because of their cognitive/intellectual impairment. A physical reason for not being able to use public transport, such as being unable to negotiate a high step, or an inability to speak English does not count. Small disruptions and unexpected changes, such as roadworks and changed bus stops, are commonplace and should be taken into account when considering if individuals can follow routes reliably
11f
Can activity 11f apply to
Rarely. Only if there is evidence of cognitive
someone with epilepsy?
impairment in that the person has uncontrolled epilepsy which results in fits on the majority of days and prolonged episodes of post fit confusion. There should be evidence that the fits are poorly controlled, e.g. the person is likely to be on multiple antiepileptic medication, under the care of a neurologist and will not be able to drive. The vast majority of people with epilepsy do not require another person to accompany them to navigate out of doors.
11
Where might epilepsy be
Those with well controlled epilepsy might safely go
relevant?
out alone in which case 11a should apply. A small minority of people with epilepsy might be so anxious about having a fit that they will not go out alone or might feel the need for reassurance when out - in which case 11b might apply. 11c, 11d and 11e are unlikely to apply. 11f might rarely apply in cases of uncontrolled epilepsy where there is confusion following the fit to the extent that the person would wander or not know their location and how to get home.
Activity 12
12
On what surface should the
It should be judged in relation to a flat surface
walking be judged?
normally expected out of doors such as pavement and includes the consideration of kerbs
12
Can moving in a wheelchair
No - people who require a wheelchair/vehicle to move
be considered?
a given distance should not be considered able to move that distance under this descriptor.
12
'Stand' is defined as being
Posture should be taken into account if it affects the
'upright' - what if the
person's ability to mobilise safely and to an
Claimant can only move in
acceptable standard (e.g. without severe discomfort).
a stooped position?