PIP assessment and misunderstanding the 50% rule.

[Deaconblues]

I received a text last week informing me that my PIP reassessment had begun. I haven't had one for a few years. My wife noticed a few months ago that there has been a local recruitment drive for assessors, so perhaps many of us will be going through the process again soon. At first I got that feeling of dread that I'm sure most of us get. However, I now welcome the reassessment because I understand the rules better now and think that I'm entitled to the higher level for daily living and not the lower level that I've been getting.

In this post I want to write about the 50% rule and how it's misunderstood. In 2015 there was a court case between a PIP claimant and the DWP in which the judge ruled that for a descriptor to be counted and accepted for a points score it had to occur for a "significant" amount of time on more than 50% of days. The key word was "significant" which was deemed to mean "more than trivial". So, for example, if stiffness and joint pain on a morning means you can't shower or dress for the first couple of hours, then that's a significant amount of time, because it's more than trivial. If you told an assessor that later in the day you can shower and dress, they would, I am sure, wrongly mark you down as being able to do those tasks. Perhaps they don't understand the relevance of the court case. They should, because they are supposed to be professional and fair to us. You'd hope that their training would cover this issue.

Let's say that you can't perform a task for on average about 4 hours on 50% of days. 4 hours is one sixth of a day and is a significant amount of time (not trivial). 50% of one sixth is one twelfth, which is about 8%. This means that you can't perform that task for only about 8% of the time. This might not seem a lot, however, as long as you can't perform that task on at least 50% of days, that descriptor would have to be scored.

I think that when being questioned by an assessor, we have to be insistent. Don't let them put down a low scoring descriptor when it should be a higher one. Don't assume that the assessor fully understands the rules, or applies them correctly.

I don't think that many of us who struggle with rheumatoid arthritis understand this. I didn't for a long time and pre-arthritis I used to be a maths teacher!

[Bootoo]

I recently had my pip review and on my form I said as RA is incurable could they give me a paper based review and an ongoing award (10 years ) I got both and my award remained the same. If you don't ask you don't get, they can only say no.

[Deaconblues in reply to Bootoo]

Thanks for that advice. I didn't know that we could ask for a paper based review and an ongoing award. The thought of going through another 2 hour phone call assessment is quite stress inducing.

[Bootoo in reply to Deaconblues]

I have had 2 paper based assessments now. If you put enough information in your forms they shouldn't need to speak to you. Keep reminding them RA is incurable, you are never going to get any better, and the concoction of drugs we take do not make us better but only serve to 'try' to slow down the progression of the disease.

It angers me that they don't understand the 'incurable' bit. The assessors should read up on RA but seldom do so ram it down their throats it isn't simply arthritis.

Good luck with your assessment 👍

[medway-lady in reply to Bootoo]

The problem is it’s a one size fits all so it can’t take into account all circumstances and regarding RA it is not the condition that enables the benefit but how it affects a claimant. I’ve had RA for many years and had a career and never claimed any benefit as I didn’t need any. It’s a dreadfully complex situation.

[Happy5 in reply to medway-lady]

Quite we all have RA , then each of us have other conditions, we're different ages, family circumstances etc etc all of which effects our difficulties.

[Lizard28 in reply to Bootoo]

I wouldn’t get too excited about the 10 year ongoing award. My late husband also had that but a few years later he was getting assessed again. They tried to lower his claim but this time he appealed and won. It was a phone call assessment and they said he sounded very confident on the phone, honestly he was actually sick when he came off the call. Are you supposed to whimper and cry on the phone. The whole system is a farce.

[Tonkie in reply to Lizard28]

When I was going through my claim comments like this really scared me. I just want to add my assessor was really nice, I got enhanced for both and I found out 10 minutes after the call so no awful wait either. I’m sorry for the people who had bad experiences though.

[OSTEOARTHRITISRA]

If you can't do a descriptor once a day it's counts as unable to do it for the whole day even if you can do that descriptor later in the day it counts as unable to do it for that day and counts as majority of time, Another point if more than 1 descriptor applys I.e

B and d or b c e

B 30 % d 23 % then you get points on b with 30 %

B 20 % c 10 % d 30 % then you get points for D on 30 %

[medway-lady]

Please don’t take this the wrong way, but the words ‘reasonable’ ‘ likely ‘may feature too so it won’t be simple I’d suggest you read the latest gov.uk PIP awards process’. In my experience although long retired now rarely it was a case of substantial but more of reasonable. I’d like to read the judgement because case law interests me. If a time frame was specified like in the morning it may just relate to that claimant. I don’t know but gov.uk is from 2024 and it may be a later decision has changed things since 2015.It is very interesting.

[Tonkie]

this is really helpful thankyou. I was lucky and got enhanced for both on my first assessment but I dread the renewal. Thankyou for explaining it in such a clear manner. I’m sure this will help lots of people with their claim.

[BoneyC]

... sent to me by a CAB Solicitor after an NRAS meeting some years ago:-

'Whether a person is entitled to PIP is decided by the difficulties they experience and the help they need with very specific tasks. They may not get, or indeed want, such help - many people 'manage' - but entitlement to this benefit is based on the help a reasonable person would think someone in the persons situation ought to have.

If a person could do a particular task sometimes, but not on at least 50% of days it counts as being unable to do it.

Also, if a person could sometimes do a particular task, but not

reliably

safely

repeatedly or

in a timely fashion,

it counts as being unable to do it (REGULATION 4a)

For example, if they can stand and walk for 200 metres, but only on 3 days a week on average, or they can only do it a few times in a day, it may hurt them, they might sometimes fall, or it takes them twice as long as someone else, the law sees this as not being able to walk for 200 metres.'

[Kati66 in reply to BoneyC]

That’s really useful thanks 👍🏻

[OSTEOARTHRITISRA in reply to Kati66]

upto 200 metres does not get you an award ,unless you have mental health ,

Metres

0 upto 1 metres award

1 to upto 20 metres award

21 upto 50 metres award

51 upto 200 metres, (4points)no award unless points on mental health planning a journey as well

Know that was an example ,exsamples for above

[Happy5]

Good shout 👍