What is the PIP medical assessment?

We explain what the Personal Independence Payment (PIP) medical assessment is, and help you understand what to expect at your assessment.

Most people claiming Personal Independence Payment (PIP) will be asked to attend a PIP medical assessment with a healthcare professional.

Your medical assessment will be conducted by a private organisation - Atos or Capita – who have been contracted by the Department for Communities (DfC).

PIP medical assessment appointment letter

Once you have completed and sent your PIP form back to the DfC, you will receive a letter acknowledging they have got your claim.

Following this you will receive a PIP medical assessment appointment letter from Atos or Capita - usually within four weeks, however in specific areas there are delays, and it could take longer.

The appointment letter will invite you to a PIP medical assessment at one of their assessment centres. Your appointment should be a minimum of seven days away. Before attending, you should read our guide on how to prepare for your PIP medical assessment.

What to do if you can’t attend your PIP medical assessment

If you can’t attend your appointment, you must contact the private assessment provider who sent you the letter immediately – their contact number will be in your letter.

If you can’t attend an assessment centre because you are housebound as a result of a mental health condition, you can request a home PIP assessment.

You will need to contact the assessment provider and request a home assessment. You may be asked to provide medical evidence as to why you can’t attend the assessment centre.

What happens at a PIP assessment?

The PIP medical assessment is computer led and is an opportunity for you to explain how your condition affects you daily so the assessment provider can write an accurate report for the DfC. It is not a diagnosis of your condition or a medical examination.

The Health Professional will have reviewed your PIP form, along with any supporting evidence you provided before your assessment.

The PIP medical assessment consists of several parts and will last on average, 60 minutes:

1. Discussion and questions: The Health Professional will ask you questions about how your health affects your everyday life.
2. Physical and mental examination: If required, and with your consent, they will conduct a brief physical and mental function examination.
3. Report: Once your assessment has concluded, they will produce a report explaining which PIP descriptors apply to you and explain their reasoning.

Discussion and questions

In this part of the assessment, the health professional will ask you a series of questions about how your condition affects your everyday life. They will use drop-down lists, multiple choice answers and text boxes to record your information on a computer.

This part of the assessment is an opportunity for you to explain your needs face-to-face. It’s essential to be aware of the PIP descriptors as this is what they will base their decision on.

The assessor will have already read your PIP form and any supporting evidence you provided, so it’s vital that you update them if anything has changed since you submitted your form.

Physical and mental examination

The physical exam will only involve you performing simple movements, if relevant to your condition and within your capabilities. The mental function assessment will be specific to your situation.

You will be declared capable of doing something if you can do it:

• Safely: Can you do the activity without causing danger to yourself or someone else?
• Well enough: For example, you may be able to make a meal, but you will not be able to eat it if it is undercooked.
• More than once: Can you repeat the activity as many times as you need to?
• In a reasonable time: Does it take you a lot longer to do the activity than it would take most people?

PIP medical assessment report

The Health Professional will type their observations during the appointment, which you are entitled to view or have described to you.
At the end of your consultation, the Health Professional will complete an independent report and send it to the DfC.

What to do if you have missed a PIP medical assessment?

If you miss your assessment, the DfC will contact you asking you to explain why. The DfC will then decide if it’s a valid reason:

• Valid reason: they will rearrange your PIP medical assessment
• Non-valid reason: they will refuse your claim

If the DfC refuses your application, you can challenge their decision, start a new claim, or both.

What happens after your PIP medical assessment?

The DfC decision makers will now look at your PIP claim, and it’s supporting evidence which includes:

• Completed PIP form
• Supporting and further evidence
• Independent medical assessment report

The DfC will then send you a letter once they’ve made their decision, explaining why you will or won’t get PIP.