Many people are put off applying for PIP because they have heard that it is very difficult to get an award for their particular condition. Yet Benefits and Work research shows that in some cases pessimism about the outcome is not supported by the statistics.
Last month we published an article entitled Revealed - the hardest and easiest conditions to claim PIP for which looked at some of the conditions with the highest and lowest percentage success rate for PIP claims. We compared these to the overall average for successful PIP claims, which is 52%.
We asked readers to tell us which conditions they thought were particularly hard to claim for.
One condition that came up repeatedly was fibromyalgia.
Lorraine told us:
“Fibromyalgia is a hard one to claim for as it is quite a complex condition with no definitive diagnosis. If you dare to say you have good days, you are doomed to failure.”
Whilst we agree that saying you have ‘good’ rather than ‘better’ days is unlikely to help your claim, the reality is that the success rate for PIP claims for fibromyalgia is 62.7%, considerably above the average.
Similarly, ZuluAssegai believed that ME/CFS was one of the harder conditions to claim for:
“The condition ME/CFS is very hard to get DLA/PIP for as it is a disabling, fluctuating condition and it is a hidden disability. It doesn't fit the tick box format.”
Yet the success rate for chronic fatigue syndrome is 54.8%, slightly above average.
Osteoporosis was another condition a number of readers mentioned, with Anne telling us “It doesn’t even seem to be recognized.”
In fact, 67.6% of claims where the primary condition is osteoporosis get an award, again considerably above the average.
Autism is a condition that some people felt would not be easy to get PIP for. But the award rate is actually very much higher than average, at 72.3%.
Yet for Asperger’s syndrome the award rate is just below the average, at 51.1%, even though,
as Porridge explained:
“ . . any of us with Asperger Syndrome will already be aware our lives are very tough, especially if you are quite far along the spectrum, and it is a fact that we are just as autistic as anyone else with autism and we are also likely to have other problems like dyslexia, dyspraxia, severe anxiety and other significant difficulties.”
Other conditions also present a mixed picture. As kysgillett explained:
“Epilepsy is invisible (most of the time) and fluctuating (all of the time). It is also a complex condition with many different types of seizures. It is very difficult for someone who may be unconscious to explain how being unconscious affects them. It is difficult to get any award without having to go to a tribunal.”
Our statistics don’t tell us how many people had to go to a tribunal before getting their award, but our reader’s opinion that it’s a complex situation with many different types of seizure was borne out by the statistics.
Generalised seizures (with status epilepticus in last 12 months) attracted a higher than average award rate at 58.7%.
But partial seizures (with status epilepticus in last 12 months) was below average with 47.6%.
However, there were four other classifications of seizures, with some getting awards above and some below the average:
- Partial seizures (without status epilepticus in last 12 months) 40.2%
- Generalised seizures (without status epilepticus in last 12 months) 50.1%
- Seizures – unclassified 54.1%
- Non epileptic Attack disorder (pseudoseizures) 59.2%
Diabetes is another condition where award rates vary depending on the type of diabetes, although all of the awards are below average.
Reader CP explained that:
“It's generally accepted by parents of children with Type 1 diabetes that, whilst their children will be entitled to DLA at at least middle rate, the chances of them getting PIP when due to transfer is virtually zero. Apparently, all the ways in which diabetes affects their lives magically disappear in their 16th birthday! It would be interesting to see what percentage of T1 diabetics do qualify.”
Whilst the award rate for type 1 diabetes is not zero, it is still very low indeed:
- Diabetes mellitus Type 1 (insulin dependent) 28.2%
- Diabetes mellitus (category unknown) 45.6%
- Diabetes insipidus 45.7%
- Diabetes mellitus Type 2 (non insulin dependent) 45.8%
Kim warned that you:
“Cannot claim pip for Crohn’s disease!! They totally disregard this disabling condition.”
Again, this isn’t quite the case, but it definitely is far below the average with a 30.7% success rate.
Nika1000 suggested endometriosis as a hard condition to claim for, in spite of the fact that it is:
“A life limiting disease. Truly heartbreaking to see my daughter rolling on the floor with pain with frequent flare ups and totally depleted of energy and fatigued the rest of the time, not able to study or work.”
And indeed, the award rate for this condition is very poor at 34.5%.
But whilst there is no question that some conditions are very much harder to claim for than others, it’s definitely worth considering making a claim even if yours is one of the least successful health issues.
The likelihood is that you will have a better than one in four chance of getting an award and, for most conditions, it is likely to be better than a 50/50 chance.
And some of the conditions which it is assumed are the hardest of all, such as ME/CFS and fibromyalgia, actually have an above average success rate.
Members can download the full list of conditions and percentage success rates in a pdf file entitled ‘Success rates for PIP claims by condition’ from the ‘Claims’ section of the PIP guides page.