Hundreds of thousands owed up to £12,000 in PIP back payments after huge rule change

HUNDREDS of thousands of households could be owed up to £12,000 after a landmark ruling indicated that they were underpaid.

Some 326,000 PIP claimants could be due back pay and the DWP is urging those who’ve applied to check their entitlement.

It comes after a Supreme Court judgment in July 2019, following an Upper Tribunal decision, changed the way the DWP defines ‘social support’ in one of the assessed PIP categories.

Dubbed the “MM judgement”, the DWP realised that hundreds of thousands could now be due additional support.

It means that people may not have been given one of the two elements of PIP when they were actually entitled to it.

Others may have been awarded the standard rate but should have received the enhanced rate, which is a higher amount.

The Sun previously reported on one couple on PIP who had been left “shell-shocked” after learning that they were due £12,000 in back payments.

In response to the MM judgement, the DWP began an administrative exercise in 2021, looking at PIP claims since April 6, 2016 to check whether claimants may be eligible for more support.

In its latest update, the DWP says it identified around 326,000 cases to be reviewed.

Around 79,000 cases reflecting MM judgement have been reviewed so far and arrears totalling around £74 million have been paid out to 14,000 people.

The exact amount of backdated PIP payments you could be eligible for will depend on your own circumstances – but the average payout works out at around £5,285 per claim.

The DWP has recently prioritised terminally ill and recently deceased claimants to test processes and communications with claimants to ensure they are effective “before ramping up”.

A DWP spokesperson said: “We are monitoring the numbers of, and reasons for, revised awards closely and making regular quality checks to ensure our decision-making is accurate and fair.

“We are committed to making backdated payments to all claimants affected by this judgment as quickly as possible.

“So, as well as continuing to review claims affected by the definition of ‘social support’, we are also testing a more proportionate approach for claimants who might be affected by the timing element only.

“We will be inviting around 284,000 claimants in this group to contact the department if they think their claim is affected by this judgment and they were not previously identified as needing help to engage with other people face to face because any help they received was in advance.”

Who is affected?

There are two elements to PIP – a daily living part if you need help with everyday tasks and a mobility part if you need help with getting around.

Claimants eligible for each element are then awarded a standard or enhanced allowance.

When you apply for the benefit, you’ll receive points between zero and eight under 10 different ‘daily living activities’.

Those receiving the highest figure count are more likely to be awarded the enhanced payment – which is greater than the standard PIP entitlement.

The standard allowance for the daily living part of PIP is currently worth £68.10 a week and the enhanced rate is worth £101.75 a week.

One of the activities scored, otherwise known as activity nine, assesses a claimant’s ability to engage with other people face-to-face.

However, a Supreme Court judgment in July 2019, following an Upper Tribunal decision, changed the way the DWP defines ‘social support’ in activity number nine.

Dubbed the ‘MM’ judgement, the DWP realised that hundreds of thousands could now be due additional points for this activity in a move which could increase a claimant’s payments.

It means that people may have not been entitled to the daily living element of PIP when they were actually entitled to it.

Others may have been awarded the standard rate but should have actually received the enhanced rate.

However, the DWP is not reviewing claims if:

• The enhanced rate of the daily living part of PIP has been awarded continuously since April 6, 2016
• A Tribunal made a decision on a claim since April 6, 2016
• A decision not to award PIP was made before April 6, 2016

Halide Kalfaoglu, benefits expert at anti-poverty charity Turn2us, says: “This change to the PIP daily living component assessment rules has been in place since 2016. Since 2021, but the DWP has been reviewing PIP claims to see if any claimants are owed money. It’s an ongoing process and is expected to finish by 2026.

“A specific group of claimants are invited to contact the DWP if they think their claim is affected by this judgment.

“This includes those who currently score nine in their PIP assessment, where the prompting they receive should be considered as ‘social support’ and means scoring an extra two points.

“Those who score nine in their PIP assessment, who might benefit on just the timing part of the judgment (support in advance of the activity).”

If you’ve been contacted by the DWP or think you are affected by the MM judgement, you’ll need to appeal your PIP decision.

How do I appeal a PIP decision?

If you think a PIP decision was wrong, you can challenge it.

If you’ve been contacted by the DWP or think your PIP payments may be affected by the MM judgement, you should ask for a “mandatory reconsideration notice”.

This is where the DWP looks at your claim decision again.

If you are still unhappy with this outcome, you can then appeal to an independent tribunal.

You must send your appeal form within one month of the date shown on the mandatory reconsideration notice.

Be warned that it usually takes up to six months for an appeal to be heard by the tribunal.

Before it gets to the tribunal, the DWP can make a revision to the original claim.

If you’re unhappy with the decision you get from the tribunal, you may be able to get the decision cancelled – known as “set aside”. You’ll be told how to do this at the time.

You may also be able to appeal to the Upper Tribunal (Administrative Appeals Chamber) if you think the tribunal wasn’t able to give you proper reasons for its decision, or back up the decision with facts, or if it failed to apply the law properly.

Full details about challenging your PIP decisions can be found on Gov.UK.

You can get advice and support for appealing a decision for free from organisations like Citizens Advice.