PIP stands for Personal Independence Payment and is a welfare benefit in the UK that helps people with disabilities or long-term health conditions cover the extra costs they face due to their conditions. There are two rates of PIP – standard and enhanced. The enhanced rate provides a higher level of financial support. This article will examine who is eligible for the enhanced or ‘high’ rate of PIP.
PIP Assessment Criteria
To receive PIP, a person must undergo an assessment to determine how their condition affects their daily living and mobility needs. The assessment considers 12 activities – 10 daily living activities and 2 mobility activities. Each activity is scored based on the level of need, with points awarded for needing:
- No help with the activity
- Help sometimes or supervision
- Help most of the time
- Help all of the time
The total points awarded determines whether a person qualifies for PIP and at what rate. To get the enhanced rate for the daily living component a person needs to score at least 8 points. For the enhanced mobility rate they need to score at least 12 points.
Daily Living Activities
The 10 daily living activities considered in the PIP assessment are:
- Preparing food
- Taking nutrition
- Managing therapy or monitoring a health condition
- Washing and bathing
- Managing toilet needs or incontinence
- Dressing and undressing
- Communicating verbally
- Reading and understanding signs, symbols and words
- Engaging with other people face-to-face
- Making budgeting decisions
Let’s look at each activity more closely and the types of difficulties that would score high points:
Preparing food
A person who needs prompting or reminding to cook, difficulty preparing food and drink safely, or help cutting up food or hold utensils or cups may score some points. Needing someone else to prepare all meals would score full points.
Taking nutrition
Difficulty eating or drinking due to illness may score some points. If someone needs to be fed entirely by another person or fed through a tube they would score full points.
Managing therapy or health condition
Needing help managing medication, therapy or a health condition scores points. If someone else must do it all, the maximum points are awarded.
Washing and bathing
Being unable to wash or bathe independently scores points, with full help needed scoring maximum points.
Managing toilet needs
Incontinence or needing help accessing the toilet and cleaning oneself scores points, with being fully dependent scoring full points.
Dressing and undressing
Needing prompting or help with dressing and undressing due to illness or disability scores points. Being unable to dress at all scores maximum points.
Communicating verbally
Having difficulty speaking or being understood could score some points. Being unable to communicate at all verbally scores full points.
Reading and understanding
Difficulty reading or understanding due to sensory or cognitive impairment scores points, with being unable to read at all scoring maximum points.
Engaging with others
Difficulty interacting with others due to mental or physical health problems scores points. Being unable to engage with people at all scores full points.
Budgeting decisions
Difficulty managing money or making financial decisions due to illness or disability scores points. Being unable to budget at all scores maximum points.
Mobility Activities
The two mobility activities assessed are:
- Planning and following a journey
- Moving around
Again, scoring depends on the level of need. Some examples of limitations that score high points:
Planning and following a journey
Being unable to plan or follow a route due to sensory or cognitive disability. Getting lost or confused easily. Needing another person to help navigate.
Moving around
Being unable to stand or move without significant pain or exhaustion. Needing a wheelchair or other aid. Being unable to weight bear or transfer independently.
Health Conditions That May Score High Points
Here are some examples of health conditions that typically result in high rates of PIP:
Sensory disabilities
- Severe vision impairment
- Profound hearing impairments
Limits the ability to safely prepare food, dress, move around, communicate and engage in other assessed activities without help.
Mental health conditions
- Schizophrenia
- Severe depression
- Bipolar disorder
- Dementia
Can significantly impact daily functioning, ability to communicate, engage in self-care, make decisions, plan journeys, manage therapies.
Learning disabilities
- Down’s syndrome
- Autism spectrum disorders
May limit ability to communicate, understand, self-care, plan journeys, manage finances depending on severity.
Progressive illnesses
- Parkinson’s disease
- Multiple sclerosis
- Motor neuron disease
Symptoms such as tremors, weakness, spasms, balance issues progressively reduce mobility and ability to self-care.
Injuries or conditions affecting mobility
- Amputations
- Spinal cord injuries
- Cerebral palsy
Restricts ability to stand, transfer, balance and move around without assistance. Difficulty dressing and self-caring also often results.
Conditions causing severe pain, fatigue or breathlessness
- Chronic obstructive pulmonary disease (COPD)
- Chronic fatigue syndrome (CFS)
- Fibromyalgia
- Complex regional pain syndrome (CRPS)
Severe, constant pain and exhaustion means needing help with most daily activities like preparing food, dressing, washing, mobilizing.
Conditions requiring frequent medical intervention
- Kidney dialysis
- Cancer treatment
- Colostomy bag care
- Catheterization
- Tracheostomy care
Help is required to manage therapies, medication administration, monitor health. Some therapies also physically restrict ability to perform daily living activities.
Case Studies
Here are two examples of individuals with conditions that make them eligible for the enhanced rate of both the daily living and mobility components of PIP:
Jane – Cerebral palsy
Jane has severe cerebral palsy affecting all four limbs. She uses a motorized wheelchair but cannot self-propel a manual chair. She can feed herself with modified cutlery but cannot prepare food or drink safely alone. She needs assistance bathing, dressing and using the toilet. Jane also requires help taking medications on time. Her condition means she would score the maximum points for all daily living activities. For mobility, Jane cannot stand or move unaided and needs help navigating journeys. Her high care needs would qualify her for the enhanced rates of both daily living and mobility PIP.
Frank – Emphysema and chronic back pain
Frank has severe emphysema causing extreme breathlessness, as well as chronic back pain from spinal arthritis. He becomes exhausted just getting dressed and struggles washing himself. He relies on his wife to help him in and out of the bath and to prepare all his meals. Frank has difficulty rising from chairs without assistance and can only mobilize short distances, needing a wheelchair for longer journeys. The impact of the emphysema and back pain mean Frank would score maximum points for most daily living and mobility activities, qualifying him for enhanced rates of both components.
Conclusion
In summary, to qualify for the enhanced rate of daily living PIP, a person generally needs to score at least 8 points in the 10 daily activity categories. To qualify for the enhanced mobility rate, they need to score 12 points across the two mobility activities.
The most common conditions leading to high scores are severe sensory and cognitive disabilities, degenerative neurological conditions, severe mental illness, learning disabilities, injuries/conditions severely limiting mobility, and illnesses causing severe fatigue and pain. All of these typically result in needing full-time care and assistance with most daily activities and mobilizing.
Ultimately the PIP assessment aims to evaluate how a person’s health condition or disability impacts their everyday life. Those whose conditions lead to extreme limitation of independent functioning are the most likely to be awarded the enhanced rate for both components of PIP.
| Condition | Impact on Daily Living | Impact on Mobility |
|---|---|---|
| Cerebral palsy | Unable to self-care, dress, prepare food. Needs help taking medication. | Unable to stand or mobilize without wheelchair, needs assistance navigating. |
| Severe arthritis | Needs help dressing, washing, preparing meals due to pain. | Extreme pain limits ability to stand and walk unaided. |
| Blindness | Unable to safely prepare food or bathe alone. Needs guiding. | Unable to plan or follow routes unaided. |
| Autism spectrum disorder | Needs prompting with self-care. Unable to manage finances. | Gets confused and disoriented when traveling alone. |
| Chronic fatigue syndrome | Too exhausted to wash, dress or make food without help. | Mobility severely limited. Needs wheelchair. |
| Kidney dialysis | Much time occupied by treatment. Often too unwell to self-care. | Low energy restricts mobility between treatments. |