Question to the Department for Work and Pensions:

To ask the Secretary of State for Work and Pensions, how fluctuating symptoms are taken into account within Personal Independence Payment assessments.

Personal Independence Payment (PIP) assessments focus on the functional impact of a claimant’s health condition, rather than diagnosis or treatment alone. At assessment, Health Professionals (HPs) gather information on any past, current and ongoing medical treatment related to conditions that impact function, including medication, therapy, monitoring, side effects and effectiveness. Where necessary to properly inform their advice, HPs should and routinely do seek additional evidence from treating health professionals or other appropriate sources.

Medical treatment is covered throughout training and guidance, and HPs routinely consider the effects of ongoing medical treatment on functional ability when advising on appropriate descriptors. This includes both positive effects, where treatment enables activities to be completed more reliably, and negative effects, such as side effects or symptom fluctuation. These factors are particularly important when applying the reliability criteria, including whether an activity can be carried out safely, to an acceptable standard, repeatedly, and within a reasonable time. The impact of treatment is also assessed directly within activity 3, which relates to managing therapy or monitoring a health condition.

Where symptoms fluctuate, including because of treatment variability, HPs assess functional impact over a 12-month period to reflect good and bad days and determine how descriptors apply on the majority of days. HPs also consider what medical treatment is being undertaken when advising on a recommended review date, aligning this with the point at which an individual’s functional needs could reasonably be expected to change, for example following recovery or changes to treatment. Claimants are also expected to notify the Department directly of any changes in their condition or circumstances, so that their award can be reviewed where appropriate.