Quick guide to PIP for health professionals
Updated 3 April 2023
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This publication is available at https://www.gov.uk/government/publications/what-pip-means-for-the-health-sector/quick-guide-to-pip-for-health-professionals
Overview
Personal Independence Payment (PIP) was introduced on 8 April 2013. It began to replace Disability Living Allowance (DLA) for new claims from people aged 16 to 64 (or the day before they reach State Pension from 6 December 2018 onwards). DLA remains for children up to the age of 16 and existing DLA recipients who were age 65 or over on 8 April 2013.
What this means for health professionals
The health professions play an important role in PIP, as they do in DLA.
What’s different for health professions
Claimants are only required to send in evidence they already hold, such as copies of clinic letters – they are not told to contact their GP or health professional to obtain further evidence.
There is no requirement for a statement from a GP or other health professional on the PIP claim form.
It may be necessary to provide factual information, but it will be the assessment providers who will contact you rather than your patient or DWP
What you might need to provide
It may be necessary to complete a factual report, which will be used by the assessment provider to inform the PIP Assessment – they will contact you when that is necessary. It’s very important to the patient that you reply within the requested time.
SR1 form – a report about a patient’s medical condition that health professionals complete to support a claim under special rules for end of life.
Read guidance on factual reports and SR1 forms.
When you may be contacted by phone
It may be necessary for a health professional to contact you by phone in relation to a:
- factual report – where requested and not returned or to clarify any points on the report
- patient who has been told they might have 12 months or less to live – if a SR1 is not available or there are questions about it, it may be necessary to contact you to progress the claim quickly
Who will contact you
In line with GMC guidelines, contact will only be made where the patient’s consent is held.
DWP will not contact any health professionals in relation to a PIP claim – instead it will be:
- Independent Assessment Services in London, southern England, Scotland and northern England
- Capita Health and Wellbeing in Wales and central England
See the map of the postcode areas covered.
More information for health professionals
Read the PIP toolkit.
Claiming and PIP eligibility
PIP contributes towards the extra costs associated with a health condition or disability. It is assessed on the claimant’s ability to undertake a range of activities rather than the condition they have.
People can claim and receive PIP whether they are in or out of work and it is not taxed or means tested. It can be useful in helping disabled people move into, or stay in work.
How people claim PIP
New claims are made by phoning 0800 917 2222 (textphone 0800 917 7777).
There are special rules that allow people who are nearing end of life to get help quickly when they claim PIP. This is when their doctor or a medical professional has said they might have 12 months or less to live. They or someone supporting them should call this number.
Claimants (other than those who are nearing end of life) are then sent a form ‘How your disability affects you’, which they complete and return with any supporting evidence they already hold.
How eligibility is assessed
Information on the form is considered by the assessment provider who may request further evidence from a relevant health professional or someone who supports the claimant. They may also arrange a face-to-face consultation with the claimant. DWP uses all this information to decide if PIP can be awarded, at what rate and for how long.
The PIP assessment considers the effect of a health condition or disability on daily life. This includes the individual’s ability to complete the following activities:
- prepare and eat food
- manage personal care needs
- communicate and engage with other people
- make decisions
- get around
Full list of activities in the PIP assessment guide for assessment providers.
Evidence
The only evidence the claimant needs to request from their health professional is a SR1 form. This is a end of life report form and is completed by the health professional confirming the individual’s medical condition (not their prognosis) and needs to be quickly sent to DWP by the health professional or by the claimant.
Read the PIP claimant guide.