PIP overhaul could see DWP payments replaced with system from overseas

The DWP is planning a major rethink of its PIP disability benefit
The DWP is planning a major rethink of its PIP disability benefit -Credit:Getty Images

The Department for Work and Pensions (DWP) is planning a complete revamp of the Personal Independence Payment (PIP) system. The DWP is looking at alternatives that could see "stopping regular cash payments", which can reach up to £737 a month, and instead providing other forms of support for disabled people.

PIP is the main disability benefit for those of working age, although some people still receive its precursor, the Disability Living Allowance. Demand for the benefit is seeing 70,000 new applications each month.

This has led the DWP to voice concerns about the existing system's "sustainability". It is exploring "improved models of assessment, treatment and support."

In a Green Paper outlining potential changes, the DWP said it has considered PIP equivalents in other countries to find potential improvements to support people with with disabilities, BirminghamLive reports. The document said: "We want to consider whether supporting people through direct, regular cash payments is still the best approach, or whether other approaches would better target our resources, delivering the right support to the people who need it most. We want to know whether there are potentially groups of people who might need more than the current system provides, and what kinds of support they need."

It continued: "Different models are used in other countries. For instance, in New Zealand, people submit supporting medical evidence verifying their health condition and also provide estimates of their additional costs (e.g., £50 per month for physiotherapy), which are then approved for an ongoing award. In Denmark, awards for extra costs are determined on a case-by-case basis and issued by local government.

"In the United Kingdom, we have had a predominantly cash transfer system for extra costs since the introduction of Attendance Allowance and Mobility Allowance in the 1970s. Given there are other models of support used internationally, and the changes in disability benefit caseloads over time, we think it is right to ask about other models of support and the impact of these approaches, including stopping regular cash payments, if they were to be adopted here."

What are the PIP equivalents overseas and how do they work?


Payment: Five elements at different rates based on actual costs.

Assessment: Yes, usually in person.

The French system (Prestation de compensation du handicap or FR-PCH), offers financial assistance to cover additional costs associated with loss of independence due to disability. To qualify, individuals must show an absolute difficulty in performing one of five areas: mobility, personal conversation, communication, tasks and general requirements, and relationships with others, or a 'serious difficulty' (requiring assistance) in at least two of these activities.

While FR-PCH is not means-tested, it does consider income. It comprises five parts, each paid at varying rates: human aids, technical aids, housing adaptations, transport assistance, and animal help.

Applications for FR-PCH are made online and require a medical certificate less than a year old. Assessments are typically conducted in person by multi-disciplinary teams including professionals such as clinicians, social workers, and academics.

People are evaluated using a scoring guide for disability assessment and impairment. They are also required to submit a 'life plan', detailing their goals and what they wish to achieve but currently cannot due to their disability.

Following an evaluation, individuals are given a personalised compensation plan, devised by the professional panel, which outlines the duration of each component. Support can go beyond financial assessment and is largely influenced by the life plan. FR-PCH can be granted for life if a person's condition cannot improve, or for a maximum period of 10 years if this is not the case.


Payment: Monthly sum based on actual costs.

Assessment: Yes.

The DK-MTV (Merudgiftsydelse Til Voksne) is a monthly cash benefit distributed at a local level, designed to help people with the additional costs associated with disability. The aim of the benefit is to help individuals achieve a quality of life equal to others of the same age and circumstance.

There is a focus on providing people with the opportunity to decide how best to meet their needs. While the state has overall responsibility for the benefit, it is distributed by entities equivalent to local authorities.

DK-MTV is intended to cover necessary additional costs, with no maximum award. Costs must reach a minimum threshold for eligibility. A full list of costs is not provided, but may include medicine, commuting to work, leisure activities and disability-oriented courses.

The process of benefit localisation means that assessment procedures can vary slightly, but generally, individuals submit a written application and are assigned a social worker who helps identify their needs. The award is determined on an individual basis by the social worker, who also decides what evidence is required.

This could include notes from a GP, or meetings with the individual and healthcare professionals. In cases where the need is evident, such as for amputees, the assessment can be conducted solely by the social worker without the need for additional evidence.


Payment: Monthly amount with six rates based on actual costs.

Assessment: Yes, on paper.

In Norway, disability support is provided through the Basic Benefit (NO-BB). This is a monthly cash payment at one of six set rates designed to cover, fully or partially, extra expenses incurred due to illness, injury or congenital defects and disabilities.

Assessments are carried out on paper without a face-to-face evaluation. Individuals must provide a letter from their own GP detailing the nature of their condition and the associated extra costs, and receipts may also be required.

IAdditional expenses related to a medical condition such as a permanent injury, illness or functional impairment must be sustained for 2-3 years. Individuals can receive financial aid for various needs including the use of assistive technology (like electricity required for charging a wheelchair), transport costs, special diet foods, clothing, bedding, and shoes. A doctor contracted to the Norwegian equivalent of DWP reviews the evidence and makes the final decision on entitlement.


Payment: Monthly amount with three rates based on actual costs.

Assessment: Yes, on paper.

In Sweden, a monthly cash payment is provided at one of three set rates for individuals who have a disability or illness and consequently require assistance or have extra expenses. To qualify, the disability should be expected to last for at least a year.

Additional costs are those that arise due to the disability and exceed what is anticipated for people of the same age. These costs cover a broad range divided into seven categories: health, medicines and foods; wear and tear and cleaning; travel costs; assistive devices; assistance in daily life; housing; or other purposes (additional costs which do not meet the above criteria).

To apply, individuals complete an online form and calculate their extra costs, before submitting a medical statement describing their disability. Costs can be estimated online using data provided by the Social Security Insurance Agency.

Individuals have the option to verbally detail their costs instead of submitting them with their application. The form is then evaluated to ensure that the costs stated are due to a disability, exceed what is expected in non-disabled individuals of the same age (using information from agencies such as the Swedish consumer agency), and that the cost is reasonable or fair.


Payment: Monthly sum which is means-tested.

Assessment: Yes, may include medical examination.

There are two federal disability benefits in the USA. Supplemental Security Income (SSI) is the one most similar to PIP.

This is a monthly payment given to adults who have a disability or blindness and have little or no income and resources. It takes into account the individual's ability to work and their earnings. It can be paid to people who are working, but their income is considered.

Disability is assessed based on:

  1. The individual's current work activity (if any). A person must demonstrate they are unable to engage in substantial gainful activity, measured as a varying amount of monthly income based on impairment type;

  2. The severity of their impairment(s);

  3. A determination of whether their impairment(s) meets or medically equals an entry on the list (see below);

  4. The individual's ability to perform their past relevant work;

  5. Their ability to do other work based on age, education, and work experience.

There is a list of eligible conditions split into 14 categories. If a person's condition is on the list, that is usually enough to establish that a person who is not working is disabled. If a person's condition is not on the list, the assessor moves on to the next step and applies other rules in order to resolve the issue of disability.

People apply through an online form, telephone or at a social security office, and are asked to provide their medical history, contact details for medical professionals and give permission to access medical records. They are also asked to provide their work history for the past two years and evidence of any other financial resources.

If the medical evidence is unavailable or insufficient to determine eligibility for SSI, they may be asked to attend a consultative examination. SSI is paid by the federal government. Many states pay a supplemental benefit to people in addition to the federal payments.

Other states manage their own programs and make their payments separately. More information can be found on SSI at the US Social Security website here.

New Zealand

Payment: Weekly or fortnightly amount which is means-tested and based on actual costs.

Assessment: No.

The New Zealand Disability Allowance (NZ-DA) is designed to assist individuals with the ongoing, additional costs associated with having a disability expected to last at least six months. Applications can be made online or via a paper form and, unlike PIP, applicants are not assessed but are categorised based on their health-related needs.

The amount of Disability Allowance paid is calculated based on actual extra costs. These costs must be confirmed by the individual's health practitioner as being a result of the person's disability, ongoing, and necessary and therapeutically beneficial for the individual.

Costs that can be covered include clothing, counselling, medical alarms, gym/swimming pool fees, power (gas and heating), special foods and prescriptions. All costs must be supported by relevant evidence in the form of receipts, tickets and bills.

This is a means-tested benefit with limits based on age, childcare needs and whether the person is part of a couple. The disability allowance is directly deposited into the individual's bank account weekly or fortnightly, based on the extra costs submitted.