Guidance

Personal Independence Payment (PIP) assessment guide for assessment providers

Guidance for health professionals carrying out PIP assessment activity and for those responsible for the quality of PIP assessments.

Documents

Details

Each part of the guide focuses on a different part of the process.

The guidance is intended to supplement the contract documents agreed with assessment providers as part of the commercial process.

If you currently get PIP or would like to apply for it, read the PIP guide for claimants.

Published 8 April 2013
Last updated 3 April 2023 + show all updates
  1. Parts 1 and 3 updated. Part 1: The section on Special Rules for End of Life (SREL) claims has been updated in line with the legislative change for SREL claims for PIP. This means that SREL claims can now be accepted where death from a progressive disease is expected within the next 12 months – increasing from 6 months. Further changes in Part 1 & 3 to ensure the SREL processes are up-to-date. Part 3: The Quality Audit section has been updated to include the new audit requirement relating to the justifications of the initial review decision for assessment channel allocation.

  2. Parts 1, 2 and 3 updated. Terminology changed throughout to reflect the Departmental change from Special Rules for terminally Ill (SRTI) to Special Rules for End of Life (SREL). Incorporation of the Benefits Assessment under Special Rules in Scotland (BASRiS) form as an acceptable form of evidence for PIP Special Rules claims to support claimants completing a cross border move from Scotland to England/Wales. Adding the consideration of other assessment types when deciding if a home consultation is appropriate, to reflect the increased options now available. Removal of ‘severe’ in the examples of which health conditions might require claimants to receive additional support, relating to ADHD and Autism. An update to the section on ‘Health Professional Competencies’ in Part 3 to incorporate other registered health professionals (HPs) not listed, by individual prior written agreement with the Department.

  3. Parts 1, 2 and 3 updated. Part 1: Wording amended to reflect that claimants will be assessed by a Healthcare Professional (HP) when this is required but not in all cases. An update to the HP Role regarding the recording of concerns related to a claimant’s vulnerability. Updated guidance around the consideration of mental health medication as an indication of the severity of a condition. An update to include the capability of assessment providers to record face to face and telephone assessments, and also changes in the section on covert recordings. Wording of the section on ‘Award Review Dates’ has been improved for greater clarity and the ‘Review Period’ examples updated. Section on Consent and Confidentiality updated to better reflect GDPR legislation. Part 2: Correction of error within ‘Worked example 3’. Part 3: Inclusion of a brief overview of the Clinical Governance Quality Standards Framework (CGQSF) which Assessment Providers (APs) will implement. An update to the audit grading guidance so that award length recommendations deemed too long no longer receive a U grade, to improve consistency.

  4. The main change to this edition of the Personal Independence Payment Assessment Guide (PIPAG) is in part 2, to include guidance on the circumstances where a hearing impaired claimant may not be able to wash or bathe safely and in Daily Living Activity 4, if they cannot hear a standard fire alarm. This is following an Upper Tribunal decision (KT and SH), which was handed down on 21 August 2020. There are also a number of minor changes - in all 3 parts the phrase ‘face to face’ has been removed to reflect the addition of other assessment channels. There is a change to Part 3 to clarify maintenance of approval for health professionals.

  5. There are two changes to this edition of the Personal Independence Payment Assessment Guide (PIPAG). The amendment in part 1 concerns DWP’s use of Additional Support Markers to increase protection for the most vulnerable claimants. The amendment to part 2 follows a Supreme Court judgement (MM) which was handed down on 18 July 2019 and relates to the interpretation and timing of social support in activity 9 of the PIP regulations (engaging with other people face to face).

  6. The main change to the Personal Independence Payment assessment guide is to align our guidance with general medical opinion that the dosage of analgesia is not necessarily indicative of the severity of condition(s). There are also a number of minor changes: In 'PIP assessment guide part 1: the assessment process', paragraph 1.6.2, wording has been added to clarify that the list of venues for home consultations is intended to be indicative and not definitive. In paragraph 1.10.2, additional bullet point added to ensure the health professional (HP) selects ‘no review required’ where in the HP’s assessment, the claimant’s levels of functional impairment are such that DWP is likely to decide that they do not meet the threshold for an award of PIP. In 'PIP assessment guide part 2: the assessment criteria', activity 5, added clarification on the use of incontinence pads under Descriptor B. In activity 6, the word ‘supervision’ has been removed to reflect the descriptors in legislation. In activity 12, added the word ‘with’ as it was omitted in error. In 'PIP assessment guide part 3: health professional performance,' paragraphs 3.10.16, 3.10.17 and 3.10.18, the examples have been changed to reflect the amendments in part 1 for analgesia as an indicator of severity.

  7. The main change to this edition of the Personal Independence Payment Assessment Guide (PIPAG) is to include guidance on the circumstances in which the extra help with the requirements of a special diet can constitute therapy. This is following an Upper Tribunal decision (LB) which was handed down in November 2016. There are also a number of minor changes; a change in the guidance for award duration - this is to ensure that people are not given short awards and reassessed unnecessarily. A change in the guidance on the number of companions at the assessment. A change in the guidance around mobility following engagement with MS Society. A number of minor amendments to give clearer definitions and to better reflect legal requirements.

  8. Various updates to part 1 of the guidance. HTML and PDF updated. Clarification in paragraph 1.4.3 on handling further evidence at a face-to-face consultation. Addition of 'audiologist’s report' to sources of evidence list in paragraph 1.4.5. Added paragraph 1.6.33 on assessment rooms representing an ideal environment. Removed hearing examination example from 1.6.36. Added paragraph 1.6.73 on evidence required to request home consultations. Removed paragraphs on further evidence due to duplication in paragraph 1.4.3. Various revisions and clarifications to 'Award review dates' to bring the assessment guide in line with revised DWP operational guidance.

  9. Part 1 - added section 1.5.2. Part 2 - the term 'anxious' changed to 'panicked' in the illustrative example for descriptor B in activity 11 'planning and following journeys'. Both HTML and PDFs updated.

  10. Corrected guidance in part 2 of the assessment guide about activity 11 'Planning and following journeys'.

  11. Guidance update to reflect the Upper Tribunal MH judgment on mobility activity 1 (activity 11).

  12. Added HTML versions of the guidance (no changes to the information).

  13. Point 2.2.6 from previous edition of 'PIP assessment guide part 2: the assessment criteria' removed. Removal done to provide clarity to health professionals. The numbering of points within section 2.2 of this edition (from 2.2.6 onwards) therefore affected.

  14. Guidance split into 3 PDFs: the assessment process, the assessment criteria, and health professional performance. Guidance updated to reflect recent case law on our interpretation of 'safely'. Also updates on how to assess claimants with sensory impairments under activity 9 (engaging with other people face to face) and activity 11 (planning and following a journey). Clarified how to assess claimants with mental health issues under activity 11.

  15. Updated the guide with revised sections on Award Reviews, Additional Support, Appointees and Claims from those living outside the UK. The update also includes small amendments to Daily Living Activity 4 (Washing and bathing) and Daily Living Activity 6 (Dressing and undressing).

  16. Updated the guide with revised guidance for health professional and providers on the processes they must put into place for auditing PIP assessments.

  17. Added revised guide that has been clarified using feedback from users.

  18. Clarified the guidance in part 3.4 about daily living activities 1, 2, 3, 4, 5, 7, 8 and 9 and part 3.5 about mobility activity 11.

  19. Updated assessment guide: 2.2 clarification of definition of 'vulnerable claimant's; 2.5 revised 'paper-based reviews' processing guidance; 2.10 clarification of claimants with additional support needs which relates to a defined range of health conditions; 3.3 further guidance on 'reliability'; 3.4 updates about 'administration of medication'; 3.5 further guidance for planning and following journeys; 4.5 and 5.4 updates about the audit criteria.

  20. Updated the to correct a few small errors in the previous version and to clarify where some of the text was unclear. New guidance at paragraphs 2.4.21a-2.4.21b and 2.13.22-2.13.23. Additional notes have been added to assist in the interpretation of activities 3 and 11 and there have been some changes to the quality audit criteria.

  21. First published.