DLA to PIP transfers, good reason and negative determinations

Once a claimant who gets disability living allowance (DLA) makes a claim[i] for personal independence payment (PIP), their DLA continues until a decision is made about entitlement to PIP. However, if the claimant fails to attend an assessment or return the PIP2 without ‘good reason’ a ‘negative determination’ is made and the PIP claim is refused. [ii] In these circumstances the DLA award also stops.

A claimant can request a mandatory reconsideration of the PIP decision and then appeal, and argue that they had a good reason for the failure[iii]. Claimants in this position may also want to make a new PIP claim in case their challenge is unsuccessful.

If a claimant is successful in showing that they had good reason, the PIP application will then go on to be assessed in the usual way[iv]. Caselaw[v] has established that after a negative determination has been overturned, the DLA award should also go back into payment until a PIP entitlement decision is made. Late last year the DWP issued updated guidance[vi] on this issue, so claimants in this situation should now see their DLA reinstated.

Previously the DWP did not reinstate DLA in these circumstances. It is now reviewing[vii] all negative determination decisions since 23 November 2017 (the date of the judgement), and should reinstate DLA where claimants have since been found to have a good reason. This is in addition to the reviews that the DWP are already undertaking in Mobility 1 and the definition of ‘safely’[viii].

The claimant in this case was transferred from DLA to PIP as part of the migration of working age claimants, but the ruling equally applies to children who are transferred to PIP at the age of 16.

 


[i] This will usually be when they are invited to claim PIP as part of the transfer of working age claimants to PIP  or when a child turns 16.

[ii] Regs 8(3) and 9(2) SS(PIP) Regs

[iii] See CPAG Welfare Benefits and Tax Credits Handbook chapters 56 and 57

[iv] See CPAG’s Factsheet - Personal independence payment

[v] OM v Secretary of State for Work and Pensions (PIP): [2017] UKUT 458 (AAC)

[vi] ADM Memo ADM 24-18

[vii] http://data.parliament.uk/DepositedPapers/Files/DEP2018-1299/Frequently_Asked_Questions-__December_2018.pdf

[viii] See WRB Issue 266 “PIP guidance round-up