The Personal Independence Payment (PIP) is a welfare benefit in the UK that helps with extra living costs for those with long-term physical or mental health conditions or disabilities. To qualify for PIP, you must undergo an assessment to determine your eligibility. Failing this assessment can be worrying, but it doesn’t necessarily mean you won’t get PIP.
Why do people fail PIP assessments?
There are a few common reasons why someone may fail their PIP assessment:
- Not meeting the PIP criteria – To qualify for PIP, your condition must impact your ability to carry out daily living and/or mobility activities. If the assessment determines your needs aren’t substantial enough, you may not meet the threshold for PIP.
- Inadequate evidence – The DWP decides your eligibility based largely on your PIP assessment. Without strong supporting evidence of your condition’s effects, such as a doctor’s letter, you may struggle to prove your needs.
- Assessor’s judgement – The health professional conducting your assessment must decide if your condition limits you enough to qualify. Their judgement may differ from your own view of your needs.
- Failing to attend or participate – If you miss your assessment without good reason, or don’t participate fully, it’s likely to result in a failed claim.
Can I ask for my PIP assessment to be reviewed?
Yes, you have the right to request a review if you fail your PIP assessment. There are two review options:
Mandatory Reconsideration
If your PIP claim is denied, you can challenge the decision by asking the DWP to look at it again. This ‘Mandatory Reconsideration’ gives them an opportunity to review the decision and change it if there were errors.
To request a Mandatory Reconsideration:
- Contact the DWP within one month of your decision letter. Explain you wish to dispute the decision.
- Provide any new evidence you have to support your claim.
- The DWP then reassesses the decision and informs you of the outcome within 14 days.
PIP Appeal
If Mandatory Reconsideration upholds the denied claim, you can take your case to a tribunal. A judge will consider your appeal and has the power to overturn the DWP’s decision.
To make a PIP appeal:
- Request an appeal pack from the DWP within one month of your Mandatory Reconsideration outcome.
- Complete the appeal form giving your reasons for appealing.
- A tribunal date will be set – you must attend and make your case.
- The tribunal will decide whether to uphold or overturn the DWP’s decision.
Around 70% of PIP appeals are successful, so it’s worth challenging if you believe the decision was wrong.
Can I claim PIP again if my appeal fails?
Yes, it’s possible to reapply for PIP if your appeal isn’t successful. However, you usually need to show that your condition or circumstances have changed significantly since your last claim.
Examples of changes that may warrant a new claim include:
- Your health deteriorating and your needs increasing.
- Being diagnosed with a new condition.
- Recovering from a temporary improvement that led to your previous rejection.
Without demonstrating a change, the DWP may simply refer back to the outcome of your last assessment. Seeking expert advice can help determine if reapplying may succeed.
What support can I access if my PIP claim fails?
Having your PIP claim rejected can be difficult, but support options include:
Challenge the decision
As outlined above, Mandatory Reconsideration and appeals give you routes to contest the outcome. Around 4 in 10 reconsiderations and 7 in 10 appeals are successful, so it’s worth exploring your options if you believe the decision was wrong.
Apply for other benefits
Alternative benefits like Employment Support Allowance or Universal Credit may offer financial support, depending on your circumstances. Speaking to a welfare rights adviser can help determine which benefits you may qualify for.
Seek local support
Your local council, charities and community organisations can suggest services to help with practical tasks, mobility, mental health, employment and disability rights. This support can be invaluable as you consider your next steps.
Get expert advice
Free advice from Citizens Advice, disability charities and benefits experts can help ensure you understand your rights. They can also assist with challenging decisions, navigating the system and exploring alternative options. You don’t need to handle this alone.
Can I claim PIP while challenging my decision?
You cannot continue claiming PIP payments while challenging the decision. However, you may be able to claim other benefits such as Universal Credit or Employment and Support Allowance in the interim, subject to eligibility criteria.
An ‘advocate’s discretionary payment’ may also be available if you’re facing financial hardship. Discuss your circumstances with the DWP or Citizens Advice to see if this temporary payment could assist you.
While challenging the decision, focus on gathering medical evidence and demonstrating how your condition affects you, ready to present a strong case if your appeal goes to a tribunal.
How long do I have to challenge a PIP decision?
Time limits apply for challenging a rejected PIP claim:
- One month to request Mandatory Reconsideration from the date on your decision letter.
- One month to appeal from the date of your Mandatory Reconsideration outcome letter.
It’s important to act quickly within these time frames or you risk losing your right to challenge the decision. If you’re unable to meet a deadline due to exceptional circumstances, contact the DWP as soon as possible to discuss your options.
Can I get PIP backdated if my appeal succeeds?
If your appeal overturns the decision, you can request PIP payments be backdated to cover any period you should rightfully have received them.
PIP can potentially be backdated to:
- The start date of your original claim.
- The date of your disagreement with a decision, eg rejection for Mandatory Reconsideration.
- The start of your appeal if you appealed within one month of your reconsideration outcome.
However, backdated payments are not guaranteed – factors like meeting notification deadlines will be considered.
How long do PIP awards last?
If awarded PIP following a successful claim, reconsideration or appeal, you will receive it for a set period before your needs are reviewed. This PIP award length can be:
- 2 years for most under 65s
- Up to 10 years for those over 65 unlikely to improve
- Ongoing award with light touch reviews every 10 years for severe conditions very unlikely to change
Towards the end of your award, you will be invited to reapply so your needs can be reassessed, and your entitlement reviewed. Your payment rates may change at this point based on any changes to your condition.
Conclusion
Failing your PIP assessment can be discouraging, but does not necessarily mean you won’t qualify if you seek a review or appeal. With the right evidence and expert support, many initially rejected claims successfully overturn the outcome.
If claiming PIP again, focus on demonstrating how your needs have changed since your last assessment. Be prepared to highlight how your condition impacts your daily living and mobility to meet the PIP criteria.
While challenging a decision, look into alternative benefit options and get guidance to ensure you understand your rights. With persistence and the right help, you have every chance of successfully claiming PIP.