We all know the anxiety inducing feeling of the dreaded brown envelope falling on your door mat. Being assessed, or reassessed for health and disability benefits, is both exhausting and scary. We are often made to feel we are faking it or exaggerating our symptoms. But when you are genuinely ill, you should not feel ashamed to apply for benefits you are entitled to.
You may have been discouraged from applying for the health benefit PIP after reading so many horror stories about the process. It can be challenging, but following a few practical tips can make the process easier and improve the chances of your application being successful.
Please note, although this article is based on a PIP application, the tips also apply to Employment and Support Allowance (ESA) applications.
What is PIP?
Let’s start with the basics; what is PIP? Personal Independence Payment (PIP) is a benefit that is designed to provide money for people who have extra care needs or mobility needs as a result of a disability.
There are two parts called “components”, the daily living component and the mobility component. You may qualify for one or both of them.
The amount of PIP that you get depends on how many points you score in the PIP test for daily-living and how many points you score in the PIP test for mobility.
PIP is not means-tested so your level of income will not affect your eligibility or the amount of money you receive.
So now we can move on to the application process. Over the years I have completed my fair share of benefit forms, and I’ve appealed and successfully had decisions overturned. I’ve picked up some tips along the way, which I will now share with you.
1. My biggest tip! Complete the form based on a “bad” day
The severity of symptoms with the majority of chronic illnesses fluctuate from day-to-day, and even hour-to-hour some days.
When you are asked if you are able to carry out a task DO NOT say “it varies” or “it depends” or “my symptoms fluctuate” – you will be penalised for that. ALWAYS complete the form based on a “bad” day. This applies to all health benefit forms.
2. Enlist help
Tip number two; ask a friend or family member to help you complete the form. Ask someone who knows you well and the restrictions your chronic illnesses places on your life. This person could complete the form with your guidance or just be a sounding board. Either way please don’t do this alone.
Having someone else to bounce questions off and give you reassurance will make the process a lot less stressful. They may also notice things you don’t. We often adapt tasks around our illnesses and disabilities without realising it, someone looking in from the outside is more likely to observe these things.
If you don’t have anyone that can help you, you may be able to find a local charity that can assist you.
You may also find some helpful tips online on charities for specific conditions. For example; Action for ME provides some great information and advice for people with ME/CFS, who are completing benefit forms.
3. Prepare, Prepare, Prepare
Don’t just dive into the form head first. Read through the whole form first and make notes. I tend to photocopy the form and complete a draft copy first.
Also, have your medical records, or at least the dates of diagnosis etc to hand. And compile a list of your medical conditions and symptoms, and all the ways they restrict your life and your ability to carry out tasks.
4. Take your time
Although there is a time limit for forms to be completed and returned, and you probably just want to get it over and done with, please don’t be tempted to rush the form. Complete a couple of sections each day, and read through the whole form before returning.
5. PEM (Post-exertional malaise) – “Payback”
This is an important point for people with ME/CFS but also for people with any other chronic illness that experience “payback” after increased activity.
If you are able to carry out a task but you spend the next few days in bed suffering with pain, fatigue or whatever delightful symptoms your illness throws at you, then DO NOT write on the form that you can complete the task. If doing a task causes you harm then you cannot safely carry out that task. Again, do not say your symptoms fluctuate.
5. Gather evidence
Send as much evidence to backup your statements as you can. This can include:
- A print-out of your patient summary record. My GP refused to write a letter supporting my PIP assessment but did offer to print off my patient summary. This record will have details of your medical conditions, test results, referrals etc. Mine also states that I require home visits
- Ask your GP or other health professional to provide a supporting letter. But please be aware, not all GPs are willing to provide this service, and sadly some health professionals may charge
- Any hospital appointment letters
- Test results
- Medication list
- Care plan or letter from your care agency
- A diary of your symptoms and how they affect your ability to carry out tasks
6. Photocopy everything!
Photocopy the form and covering letter for your records. Only send copies of your “evidence” unless the originals are requested. Also keep a record of any subsequent letters from the Department of Work and Pensions (DWP), and all phone calls. Note time of the call, the person you spoke to and what was discussed.
There have been mistakes made by the DWP on every application I have made, I have even been accused on lying on applications. But as I had photocopies for everything, I was able to prove the mistakes were not mine. By keeping your own record you can safeguard against these mistakes.
What happens next…
Your application will now be processed. You may be asked to provide additional evidence, and with the majority of applications, a medical assessment will be required.
7. Medical assessment tips
Once your benefits form has been processed, 95% of the time a medical assessment will be required. This will either be carried out at a local assessment centre or in your home.
My first tip here is; don’t be afraid to ask for a home assessment. If travelling to your local assessment centre, and sitting through an hour-long appointment will leave in so ill you are unable to function properly for weeks, then you should qualify for a home visit. You should not be expected to cause yourself this much harm. If your home visit request is denied please consider appealing – ask your GP if they would provide a letter in support.
More tips:
- Don’t assume the person carrying out the assessment knows anything about you or your medical conditions
- Plan your trip to the assessment centre
- Reread your application form to remind yourself of the questions and your answers, and take a copy with you
- Mobility aids. Use whatever mobility aids your need on a “bad” day
- Contact the assessment centre to ask about accessibility. Don’t just assume there is wheelchair access
- Make notes to take with you
- Attend with a friend or relative. Have someone present for support – they can also take notes. In stressful situation we don’t always take everything in
- Take any additional evidence
- Ask if you can make an audio recording of the assessment – but you must do this 3 days before your assessment and ask your provider about the rules for using recording equipment
- Remember; DO NOT say your ability to carry out tasks fluctuates – base all answers on a “bad” day
The Decision
You will then get a letter either stating you application has been declined, or stating the level of benefit you have qualified for. If you have been declined or have been accepted on a rate lower than you believe you are entitled to, please don’t be afraid to appeal the decision- it’s your right to do this.
8. The appeals process
The latest government statistics show that more than half of PIP decisions are changed after mandatory reconsideration or an appeal to a tribunal. So please don’t be afraid to appeal – it doesn’t cost any money.
I know it might seem a bit scary but there is a lot of helpful advice online and you may also have a charity local to you that could help you compile your appeal.
The first step in the appeals process is to ask the DWP to look at the decision again. This is called mandatory reconsideration.
If the DWP didn’t change their decision when you asked them to look at it again, you can appeal to an independent panel, called a tribunal.
The tribunal looks at the evidence from both sides, then makes a final decision. The tribunal is part of the court system – it’s not part of the DWP.
There are many guides online to help you through the appeals process. Citizens Advice and Advice Now have comprehensive but easy-to-follow guides.
9. Create a file for all your paperwork
My last tip is to create a file for all your paperwork. Keep all your photocopies, records of conversations, letters from the DWP and all evidence, in one file. This will mean you are more prepared for the next assessment but also means you have a “back-up” if the DWP question you about anything on your application.
In the past, I was accused of not recording an income from an insurance policy I was receiving, on a benefits assessment form. Basically, I was accused of lying (making a fraudulent claim) and ordered to pay back £1500 of benefit based on this. Thankfully I had a photocopy of the form which proved I had recorded it correctly, and the mistake was made by the DWP, not me. This happened 2 years after I initially completed the form, so safely storing all paperwork is essential.
I know the application process can seem very daunting, and its definitely exhausting. But hopefully these tips will help you get access the benefits you are entitled to.
Good Luck!
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