Central Government

PIP and the value of further evidence

Our investigation found that the Department for Communities and Capita failed to properly obtain and use all relevant medical information to help them assess claims for the Personal Independence Payment (PIP) benefit.

Report Summary

The report recommended significant changes in how further evidence is used in assessing and awarding entitlement to PIP.  The investigation found that repeated opportunities were missed to make the right payment as early as possible in the process. 

It found that a failure by both the Department for Communities and Capita to seek and use further evidence, including that from medical professionals, meant claimants had to continually challenge the decision, often all the way to Appeal, before the correct decision was made. The repeated nature of the failures led the Ombudsman to conclude that it constituted ‘systemic maladministration’.

 Ombudsman Ms Kelly said: “Too many people have had their claims for PIP unfairly rejected, and then found themselves having to challenge that decision, often ‘in the dark’, and on multiple occasions, while not knowing what evidence has been requested and relied upon to assess their entitlement."

Supporting publications

Central Government
Department for Communities
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