DWP refusal to resume PIP payments following discharge from hospital or psychiatric unit

Use this template if all the following apply

• your client was in receipt of PIP
• your client went into hospital for more than 28 days and PIP was suspended
• your client has been discharged from hospital into accommodation that the DWP are treating as if it is a hospital or similar, when it is not
• your client does not receive medical care or treatment in their accommodation, but may receive personal care or attention
• PIP payments have not been resumed
• your client has made several attempts to resolve the issue and has provided evidence of the type of accommodation they are in showing no treatment is provided there

This letter assumes that (so can be changed)

• your client's current accommodation is funded by the NHS

When not to use

Do not use this letter if:

• your client has already submitted an appeal

See instead CPAG’s resources on expediting appeals - Request for an appeal to be dealt with urgently (FTT116)

The main legal arguments in this template are:

1. Under the Social Security (Personal Independence Payment) Regulations 2013 (PIP Regs) (made under the Welfare Reform Act 2012 (WRA)) PIP is not be paid to a claimant while they reside in specific types of accommodation. In particular, a claimant will not receive PIP after they have resided in hospital as a patient for over 28 days, in accordance with s.86 WRA and regs 29 and 30 PIP Regs. A person is defined as “a patient” where they are receiving medical treatment as an in-patient in a hospital or similar institution and the costs of the treatment are paid ‘out of public funds.’
2. DWP guidance ‘Advice for Decision Making’ chapter P3 ‘Hospitals, Similar Institutions and Care Homes’, paragraphs P3002-3012 explains that to be treated as an in-patient in a hospital or similar institution, a person must be receiving medical treatment or support appropriate to their needs and that this does not include ‘straightforward personal care and attention by medically unqualified staff.’
3. Despite being funded by the NHS, the accommodation the claimant is in should not therefore be considered a hospital or similar institution as no medical care or treatment is provided and payments of PIP should resume.
4. Further, DWP’s power to suspend payment of PIP is provided by reg 44 or reg 45(6) Universal Credit, Personal Independence Payment, Jobseeker's Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations 2013 (D&A Regs).
5. The suspension of the claimant’s payments is to allow DWP to decide whether a decision on the award of benefit should be revised under s.9 of the Social Security Act 1998 or superseded under s.10 of that Act.
6. If the claimant’s award is neither revised nor superseded following the suspension under reg 44 or reg 45, under reg 46 D&A Regs SSWP must resume payments.

Information about your client

• name
• address
• national insurance number (NINO)
• date of birth

Background facts

Such as:

• your client's medical conditions / disability
• the date your client went into hospital and reason for admittance and stay
• the date PIP payments stopped
• the date your client was discharged from hospital, how and when they notified the DWP
• your client's current address, details of landlord, and how funded
• details of any support provided by the accommodation provider or otherwise and how funded
• details of how DWP have responded
• details of efforts made to get PIP restarted including dates, what has been said, and what evidence has been provided
• details of the impact of non payment of PIP on your client

Information relating to the decision

• the date of the supersession request (ie, to restart PIP), evidence provided, and how the request was made
• how the DWP responded, including date and quotes from DWP correspondence

We've created this guide to help you successfully use our judicial review pre-action letter templates: Guide to using CPAG's judicial review pre-action letter templates

Once you've finished your letter, please email it to us at: [email protected] before you send it to the lawyers acting for DWP/HMRC/your local authority. We'll try to reply as quickly as possible and will do so within 7 days.