Qualifying Period for a PIP Award
In decision CPIP/2504/2016, the Upper Tribunal looked at the period over which you have to satisfy the PIP descriptors in order to qualify for an award.
The UT began by confirming that there are two periods that need to be looked at:
1. The three months before the date the claim was made, known as the retrospective period 2.
2. The nine months after the date of claim, known as the prospective period The UT then decided that the 50% rule applies to each of these periods separately, not as one period of a year.
That means that a person has:
Firstly, to be have been sufficiently affected by their condition to score enough points for an award on 50% of the three month period before they claimed AND Secondly, to be have been likely to have been sufficiently affected by their condition to score enough points for an award on 50% of the nine month period after they claimed. Importantly, the Upper Tribunal then decided that if a person can’t prove they were entitled to an award in the retrospective period (the three months before they claimed), then the DWP and Tribunals needn’t even consider whether they were entitled in the prospective period (after they claimed).
The DWP and a Tribunal can just refuse the claim/appeal straightaway because the person failed in the retrospective period. What this means for you is that you need to make sure in your claim that you look at the retrospective period and prospective period separately and make sure you provide evidence for meeting the descriptors in both those periods. This is particularly important if your condition has changed or got worse or if you are making a new claim.
Finally, the Upper Tribunal also looked at ‘advance’ claims, where a person claims before a condition actually makes them sufficiently disabled to meet the descriptors. Such claims can be accepted under PIP Regulation 33 where the person is likely to be entitled to a claim within 3 months of making the claim. In such cases, the three month retrospective period will end not on the date of claim, but the date on which the person had qualified for PIP for at least 3 months.
The UT noted that the 50% rule will apply to these sorts of claim during the retrospective period just as it does for ordinary claims. You can read the full judgement here: