The PIP Scoring System
PIP Daily Living Component is assessed by scoring your ability to do ten activities:
- Making a simple cooked one-course meal from scratch – not just heating a ready-meal
- Eating – Cutting your food up, getting it to your mouth, chewing and swallowing. Whether your diet is a good, health one is irrelevant.
- Managing medication and home therapy
- Washing and bathing – looking separately at washing your upper body, lower body and hair.
- Managing toilet needs and incontinence – but not taking account of problems getting to the toilet.
- Dressing and undressing – looking separately at dressing your upper body and lower body
- Talking to people – being able to express yourself and to understand what other people say
- Reading things and understanding what you are reading
- Interacting with people face-to-face
- Managing money – dealing with simple purchases and checking your change; and dealing with more complex household budgeting
PIP Mobility Component is assessed by scoring your ability to:
- Plan and follow a journey; without getting lost or experiencing panic, anxiety or distress
- Move around; the two important tests relate to walking 20 metres or 50 metres
It does not matter whether you actually do the activities, or whether you actually have any help to do them.
The assessment is a hypothetical one, looking at what help you would need, to do the activity:
- Most days. Many people think PIP is about your worst days, but this is wrong. You must tell them about how your condition usually affects you.
- Whenever you need to do them – at all points in the day. So if you can do a task in the morning, but need help to do it in the evening, you count as needing help.
- In a reasonable time – no more than twice as long as the task would take without your illness or disability – counting any rest breaks that you need to take while you are doing the task
- Safely – without causing a risk to yourself, or to anyone else.
- Without too much pain, discomfort, dizzy–ness, vertigo, longer-term fatigue needing later periods of recovery.
You score points if you need:
- Aids – By aids, they mean things, that you would not need if you did not have your condition. For example, a stool in the kitchen counts as an aid for cooking, a rail by your toilet would count as an aid, a dosette box or blister pack would count as an aid for managing medication.
- Physical Help from another person. For example, you might need someone to move a heavy pan while cooking, you might need someone to help you with shoes and socks, you might need someone to wash your hair or help you in and out of a shower.
- Prompting, reminding, encouraging or explaining to do the PIP activities. For example, you might need someone to prompt you while cooking because of brain-fog. You might not be able to face getting dressed and need encouragement to do so.
- Someone with you all the time you are doing the activity to keep you safe – For example, you might need someone with you while cooking because of the dangers of dizzyness and heat-sensitivity. You might need someone with you in the shower, because of vertigo and dizzyness.
- Communication support or social support
If you have all this help, and you still can’t do an activity, safely, in a reasonable time, whenever you need to, without too much pain, fatigue, dizzyness and need for recovery, then you score maximum points for that activity.
Explaining Your Needs
You might need to explain the problems that your disability causes at several stages: on your form, during an assessment, when you’re writing a revision (mandatory reconsideration) request or when you are dealing with an appeal tribunal.
When you are doing this, it helps if you use words that exactly match what the soring system is trying to assess.
Before an assessment, or before an appeal hearing, it really helps if you practice using these words; explaining out loud, what you find difficult and what help you need.
Here are some examples of written explanations:
An Example – Preparing Food
Nowadays I never cook, it’s just too difficult, so my husband Lemmy does it all.
If I tried to cook a meal from scratch I would always need to use aids. For example: I would have to have a stool in the kitchen so that I could sit down; I would need lightweight pans, because the weakness in my wrists means that I can’t lift things; I would need lever taps, because I can’t grip the tap heads. Because of this problem with grip, I would need fat-handled utensils like peelers and knives.
If I tried to cook, my husband would usually have to prompt me and remind me as I was doing it. I get brain-fog, so I lose my way in complicated tasks like cooking.
Trying to do it just feels overwhelming, so I would not start unless he gave me a lot of encouragement.
If I tried to cook I would always need physical help with things like moving a full kettle, or holding things while I chop and peel them.
I am hypersensitive to heat, and I get vertigo where I feel dizzy and disoriented with no warning.
Both of these things mean that if I tried to cook Lemmy would always have to stay with me all the time I was doing it to keep me safe.
Although even if he was with me, it would not keep me safe. It would just mean that he was around to help out once I had already had an accident or injury.
Even if I had all of this help, making a meal from scratch would take me much longer than it used to.
I would need to take frequent rests so it might take a couple of hours to do what used to take me thirty minutes.
Another Example – Dressing and Undressing
Getting dressed is tiring and painful so I often stay in my pjs and dressing gown. I only get dressed if my wife encourages me to do so.
I need to have a chair to sit on while I am dressing. And I use two help-hand grippers grabber sticks.
I always get dressed on my own because I don’t want to feel dependent. However it now takes me half-an-hour to do what used to be a five minute task.
If I needed to dress in a more reasonable length of time I would need physical help.
Because I can’t bend easily without losing my balance, my wife Miriam would need to help me with getting my pants and trousers over my feet and with getting my shoes and socks on.
Because I can’t raise my hands above my head without getting dizzy and disoriented Miriam would have to help me with getting t-shirts, jumpers and sweatshirts over my head.
Because of my weak left side and poor shoulder mobility Miriam would have to help me get my arms into button-up-shirts and jackets
As I have said, in reality I manage these things by sitting in a chair and going very slowly.
Whether I do it myself, or whether Miriam helped me, getting dressed causes pain in my back, neck and shoulders.
Once I have got dressed, I need to spend half-an-hour resting to recover from the effort.
Another Example – Washing and Bathing
I always need aids to have a shower. I have grab rails and a shower stool in my walk-in cubicle.
Even with aids I always need physical help to have a shower. Because my balance is so erratic I need someone to keep me steady as I step over the rim of the shower tray. Because raising my arms above my head makes me dizzy I need someone to keep me steady as I was my hair, or to wash my hair for me.
I need someone with me all the time I am showering to keep me safe. I have fallen off the shower stool on a couple of occasions.
Even with all of this help it now takes me half an hour or more to have a shower, when it used to be a five-minute task.
Another Example of Washing and Bathiing
I always need prompting to wash and bathe.
Since I became ill I have lost all interested in life and everything seems pointless.
I can’t bring myself to manage even simple self-care tasks.
The only time I have a wash or shower is when my brother comes round and reminds and encourages me.
Managing Toilet Needs
I have rails in my toilet.
I use the toilet independently, but it takes me a long time.
I get such a high degree of fatigue that once I have done what I need to do, I have to sit and rest for five or ten minutes before I can stand up.
If I needed to use the toilet in a more reasonable time I would need physical help to get off it.
There is nobody to help me, and even if there was I would not want this help, so I struggle along independently
Unhelpful Words
Support. Help. Assistance – These don’t mean anything to a PIP decision maker