How are fluctuating medical conditions handled under Personal Independence Payment (PIP)?

We know that many people have conditions or disabilities that may vary over time. They may have good and bad days, good and bad months, or good and bad times within a day. If you have a fluctuating condition, you will want to be sure that it will be fully considered during your consultation.

Health professionals are asked to establish how your condition affects you over a 12 month period. If your condition means you are unable to undertake a certain activity for the majority of days in the year, you will be considered unable to undertake the activity. Someone who is unable to perform an activity four days a week will be considered as effectively unable to complete the activity. Conversely if you are unable to perform an activity only two days a week you would be seen as able to perform the activity for the majority of days.

Where an activity cannot be performed for part of a day it is deemed that it cannot be done at all on that day.

In addition to the health professional establishing how your condition affects you over a period of time, they will also consider reliability – i.e. whether an activity can be completed safely, to an acceptable standard, repeatedly and in a reasonable time period.

If your condition varies, it’s a good idea to keep a diary to provide a picture of how your health condition impacts on your ability over time. In a diary over a typical period, you could note down that you need help doing certain activities; perhaps preparing meals may have been difficult for 5 days one week but OK on the other two days. This will help you answer any questions you might be asked about managing these activities. Longer-term diaries can be useful to record any difficulties lasting several days or weeks. The health professional will ask you specifically about variability of your conditions during your consultation, and will want to know if your ability in any of the PIP activities differs from time to time.