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PIP claim - advisable or not?

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20 hours 53 minutes ago #309929 by tintack
PIP claim - advisable or not? was created by tintack
Hello,

I am currently on UC LCWRA but I do not get PIP. I am therefore seeking advice on whether it would be advisable or not to submit a PIP claim. I know the government plans to make receipt of PIP daily living the qualifying criterion for UC Health, but as far as I know they have not said if that change will affect existing claimants or will only apply to new claimants. The most recent article on the B & W news section I can find says the following:

"The work capability assessment (WCA) is the current test which gives access to the limited capability for work-related activity (LCWRA) element of universal credit.

The LCWRA element of UC will be replaced for new claimants from April 2026 by the UC health element.

Then, from 2028/29, the WCA will be axed and eligibility for the UC health element will depend upon being in receipt of the daily living component of PIP.

There is currently no certainty about whether current LCWRA claimants who do not receive PIP daily living will be affected by the change."

I have not submitted a PIP claim yet because I think it would be hard for me to qualify under the current criteria. However, I am due to go into hospital next week for major surgery and I obviously don't know what conditon I will be in after that. Maybe I will have a better chance of qualifying, I don't know. I am therefore wondering what I should do about PIP.

If the government applies the change in qualifying criteria to existing claimants, then as things stand I would lose LCWRA/UC Health because I don't get PIP daily living, which would be disastrous. On the other hand, if this change only applies to new claimants then I would be OK. If I applied for PIP and got daily living then I would still get UC Health; however, if I subsequently failed a PIP assessment, would I then lose UC Health as well? If so, and the qualifying criteria change for UC Health were only applied to new claimants, would it be better to stick with what I've got and not claim PIP? I'm really unsure what would be the best option. I have even wondered if it's worth risking triggering a WCA reassessment before the WCA is scrapped in the hope of being placed in the severe conditions group. The risk there is losing what I currently have, but if successful I should be left alone, and I do have written evidence from my consultant that my conditions are unlikely to ever improve.

Thanks for your help.

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17 hours 41 minutes ago #309934 by LL26
Replied by LL26 on topic PIP claim - advisable or not?
Hi tintack,
Unfortunately no one yet knows how the new proposal will work. Moreover, the previous reform proposals were not enacted so it is not a given that the new proposals will be put in place either. It is therefore impossible to advise on what will happen and any advantage of claiming PIP now.
My experience suggests that sometimes but not always, a failed PIP claim may lead to a WCA review.
Your post suggested that you were uncertain if you qualify for PIP. Obviously if you don't qualify then there is nothing to be done. I note that you are shortly due surgery. Without any details I am unable to advise whether or not surgery would enable you to claim. For all disabilities you would need to show that the relevant health condition has existed for at least 3 months prior to claim and the disability caused by it will be likely to last at least 9 months. This means if your surgery relates to a fairly new condition you may have to wait to claim.(Although you can put in an anticipatory claim now ready to be paid in 3 months time if you will have sufficient disability.
If you haven't done so, please read the Members guides. PIP like UC relies on descriptors, but whilst there is some crossover most of the descriptors are testing different things.
What I suggest you do is to open up the Members Guides and go through each descriptor.
For example Descriptor 1 is about preparing and cooking food. Make an analysis like this .
1. Can I prepare and or cook food for the majority of days?
2.If yes, can I do this 'reliably'
ie
safely,
within a reasonable time, ie no more than twice that if non disabled person,
Repeatedly
To acceptable standard

All 4 of the criteria must be fulfilled
Safely - this means is there a risk of substantial harm for you or another - in terms of cooking etc obviously risks could be cuts, scalding, kitchen accidents, maybe even falls- not just a one off - but risk of such accidents happening anytime you might do food. So think about poor grip and dropping things, there could be problems about not understanding knives are sharp or pans are hot, creating slip hazards, or poor balance creating a fall risk generally. Leaving the oven or hob could also create risk. I think also for food there is an argument about food hygiene - washing hands and surfaces before cooking, cooking meat properly etc, not cutting eg raw chicken then cutting vegetables to eat raw.
Things that are unsafe are often not comprising an acceptable standard - eg food safety - but also think about pain if you have significant levels of pain before or whilst doing a PIP descriptor activity then it will not be acceptable. Over or undercooking food is likeable to be unacceptable.Oversalting or sugaring etc could comprise unacceptable for food prep. The inability to read packets and understand cooking times may also be unacceptable.
The remaining criteria is repeatedly.
Some health problems wax and wane with some days worse than others.
Each PIP descriptor set requires the activities to be done across the whole day as many times as required.
Assuming a usual pattern of breakfast, lunch and supper this will require 3 times of food prep each day. However if you always tend to have 5 small meals per day, or need to eat regularly due to eg diabetes, then your personal repetition rate could be more.
For example, a person with incontinence may need to use the toilet more often that someone who doesn't have this problem.
Some activities such as communication might be required 24/7 ?
Thus if you can't manage to do all the daily repeats yourself then this might suggest you merit points within one of the descriptors in a set.
(The exception to this is when you fail to repeat for just a very short space of time.)
Repetition is often the key to gaining PIP points. It maybe that your limbs seize up and you physically can't manage one or more of the required number of repeats, it maybe that at times you aren't doing it acceptably it safely or indeed in a timely manners. If you don't meet all of the other 3 criteria you don't repeat!
(Reason for non repetition can be for different reasons.)
Even if you can manage the PIP activity for part of the time, you only need to show a problem for the majority of days, but bear in mind that any day where you can't 'repeat' as described above then that day will count towards the majority of days.

3. If you have decided that you can't meet all of the 4 criteria for the majority of days then think whether some form of help will allow you to perform the activity. Most of the descriptors look at whether you need an aid/appliance (some sort of helpful gadget, which can be improvised) , prompting, supervision and or physical help. Do going back to Descriptor 1 - would special grips help lift pans, if you can't stand for long maybe a perching stool? Maybe you need someone to help you read a recipe, and ensure you put correct quantities in? Alternatively someone to help you with chopping might be needed, or if you have epilepsy and could fit, having someone with you will help you remain safe and not falling or tipping hot food over you.
This will determine what help you need, and provided the help allows you to fulfil the 4 criteria then that will suggest the points level.
If no amount of help allows you to complete the activity and comply with the 4 criteria for the majority of days then you really can't do the activity.
Remember that whilst most of the activities are cumulative sometimes there are anomalies. Thus, for Descriptor 1 whereas most of the activity levels require difficulties with just one of preparing or cooking the final descriptor for cooking requires a disability that prevents both food prep and food cooking.
Use the same analysis to consider all descriptors. If your analysis suggests that you will easily get 8 points on daily living and or mobility then you may well succeed and could gain an award of PiP. It will then be up to you to consider whether to claim.
I hope this helps.
LL26

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