Personal Independence Payment | Addictions UK

Personal Independence Payment

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Your contact details

First Name
Last Name
Date of Birth
House Number or Name
Street
Town, City etc.
Country
Postcode, Zip, etc.
Telephone
Fax
Mobile
Email
Reference
Confirmation Code
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Please select one answer to each question. Remember your answers are not an assessment of your physical capability – you should answer whether you can be motivated to complete the task on a bad day i.e. Will you do it NOT Can you do it ….?

1. Preparing food

Can prepare and cook a simple meal unaided.
Needs to use an aid or appliance to be able to either prepare or cook a simple meal.
Cannot cook a simple meal using a conventional cooker but is able to do so using a microwave.
Needs prompting to be able to either prepare or cook a simple meal.
Needs supervision or assistance to either prepare or cook a simple meal.
Cannot prepare and cook food.

2.Taking nutrition.

Can take nutrition unaided.
Needs either - (i) to use an aid or appliance to take nutrition; or (ii) supervision to be able to take nutrition; or (iii) assistance to be able to cut up food.
Needs a therapeutic source to take nutrition.
Needs prompting to be able to take nutrition.
Needs assistance to be able to manage a therapeutic source to take nutrition.
Cannot convey food and drink to their mouth and needs another person to do so.

3.Managing therapy or monitoring a health condition.

Either - (i) does not receive medication or therapy or need to monitor a health condition; or (ii) can manage medication or therapy or monitor a health condition unaided.
(i) to use an aid or appliance to be able to manage medication; or (ii) supervision, prompting or assistance to be able to manage medication or monitor a health condition.
Needs supervision, prompting or assistance to be able to manage therapy that takes no more than 3.5 hours a week.
Needs supervision, prompting or assistance to be able to manage therapy that takes more than 3.5 but no more than 7 hours a week.
Needs supervision, prompting or assistance to be able to manage therapy that takes more than 7 but no more than 14 hours a week.
Needs supervision, prompting or assistance to be able to manage therapy that takes more than 14 hours a week.

4.Washing and bathing

Can wash and bathe unaided.
Needs to use an aid or appliance to be able to wash or bathe.
Needs supervision or prompting to be able to wash or bathe.
Needs assistance to be able to wash either their hair or body below the waist.
Needs assistance to be able to get in or out of a bath or shower.
Needs assistance to be able to wash their body between the shoulders and waist.

5.Managing toilet needs or incontinence.

Can manage toilet needs or incontinence unaided.
Needs to use an aid or appliance to be able to manage toilet needs or incontinence.
Needs supervision or prompting to be able to manage toilet needs.
Needs assistance to be able to manage toilet needs.
Needs assistance to be able to manage incontinence of either bladder or bowel.
Needs assistance to be able to manage incontinence of both bladder and bowel.

6.Dressing and undressing.

Can dress and undress unaided.
Needs to use an aid or appliance to be able to dress or undress.
Needs either - (i) prompting to be able to dress, undress or determine appropriate circumstances for remaining clothed; or (ii) prompting or assistance to be able to select appropriate clothing. 2 points
Needs assistance to be able to dress or undress their lower body.
Needs assistance to be able to dress or undress their upper body.
Cannot dress or undress at all.

7.Communicating.

Can express and understand verbal information unaided.
Needs to use an aid or appliance to be able to speak or hear.
Needs communication support to be able to express or understand complex verbal information.
Needs communication support to be able to express or understand basic verbal information.
Cannot express or understand verbal information at all even with communication support.

8.Reading and understanding signs, symbols and words

Can read and understand basic and complex written information either unaided or using spectacles or contact lenses
Needs to use an aid or appliance, other than spectacles or contact lenses, to be able to read or understand either basic or complex written information.
Needs prompting to be able to read or understand complex written information.
Needs prompting to be able to read or understand basic written information.
Cannot read or understand signs, symbols or words at all.

9.Engaging with other people face to face.

Engaging with other people face to face.
Needs prompting to be able to engage with other people.
Needs social support to be able to engage with other people.
Cannot engage with other people due to such engagement causing either - (i) overwhelming psychological distress to the claimant; or (ii) the claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person.

10.Making budgeting decisions.

Can manage complex budgeting decisions unaided.
Needs prompting or assistance to be able to make complex budgeting decisions.
Needs prompting or assistance to be able to make simple budgeting decisions.
Cannot make any budgeting decisions at all.

11.Planning and following journeys.

Can plan and follow the route of a journey unaided.
Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimant.
Cannot plan the route of a journey.
Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid.
Cannot undertake any journey because it would cause overwhelming psychological distress to the claimant.
Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid.

12.Moving around

Can stand and then move more than 200 metres, either aided or unaided.
Can stand and then move more than 50 metres but no more than 200 metres, either aided or unaided.
Can stand and then move unaided more than 20 metres but no more than 50 metres.
Can stand and then move using an aid or appliance more than 20 metres but no more than 50 metres.
Can stand and then move more than 1 metre but no more than 20 metres, either aided or unaided.
Cannot, either aided or unaided, (i) stand; or (ii) move more than 1 metre.