The relevant statutory provisions
The relevant statutory provisions
First, however, the relevant parts of the statutory scheme need to be set out. Part 4 of the Welfare Reform Act 2012 (“the WRA”) created the social security benefit PIP. By section 77(2) of the WRA a person can have an entitlement to the daily living component of PIP or the mobility component of PIP, or both.
Section 78 of the WRA deals with the daily living component of PIP and provides, insofar as is material, as follows:
“Daily living component
78:-(1) A person is entitled to the daily living component at the standard rate if—
(a) the person's ability to carry out daily living activities is limited by the person's physical or mental condition….
.
(2) A person is entitled to the daily living component at the enhanced rate if—
(a) the person's ability to carry out daily living activities is severely limited by the person's physical or mental condition….
(4) In this Part “daily living activities“ means such activities as may be prescribed for the purposes of this section.
See section…80…for provision about determining—
whether the requirements of subsection (1)(a) or (2)(a) above are met…”
Section 80 of the WRA has the heading “Ability to carry out daily living or mobility activities” and, again only insofar as is material, sets out:
“80:-(1) For the purposes of this Part, the following questions are to be determined in accordance with regulations—
(a) whether a person's ability to carry out daily living activities is limited by the person's physical or mental condition;
(b) whether a person's ability to carry out daily living activities is severely limited by the person's physical or mental condition…
(3) Regulations under this section—
(a) must provide for the questions mentioned in subsection… (1)… to be determined, except in prescribed circumstances, on the basis of an assessment (or repeated assessments) of the person;
(b) must provide for the way in which an assessment is to be carried out;
(c) may make provision about matters which are, or are not, to be taken into account in assessing a person.
(4) The regulations may, in particular, make provision—
(a) about the information or evidence required for the purpose of determining the questions mentioned in subsections (1) and (2);
(b) about the way in which that information or evidence is to be provided;
(c) requiring a person to participate in such a consultation, with a person approved by the Secretary of State, as may be determined under the regulations (and to attend for the consultation at a place, date and time determined under the regulations).”
The details of the entitlement rules for PIP are found in the PIP Regs.
Regulation 4 of the PIP Regs, as has been noted already, is concerned with the “Assessment of ability to carry out activities” and provides, relevantly, as follows (with ‘C’ meaning ‘the claimant’):
“4(1) For the purposes of section 77(2) and section 78 or 79, as the case may be, of the [WRA], whether C has limited or severely limited ability to carry out daily living or mobility activities, as a result of C's physical or mental condition, is to be determined on the basis of an assessment….
(2A) Where C’s ability to carry out an activity is assessed; C is to be assessed as satisfying a descriptor only if C can do so—
(a) safely;
(b) to an acceptable standard;
(c) repeatedly; and
(d) within a reasonable time period….
(4) In this regulation—
(a) “safely” means in a manner unlikely to cause harm to C or to another person, either during or after completion of the activity;
(b) “repeatedly” means as often as the activity being assessed is reasonably required to be completed; and
(c) “reasonable time period” means no more than twice as long as the maximum period that a person without a physical or mental condition which limits that person’s ability to carry out the activity in question would normally take to complete that activity.”
Regulation 5 of the PIP Regs provides for an assessment by reference to the daily living activities listed in Part 2 of Schedule 1 to the PIP Regs. Each applicable descriptor under each activity attracts specified points. A claimant will have limited or severely limited ability to carry out daily living activities where they score at least 8 or 12 points respectively.
The activity in Part 2 of Schedule 1 to the PIP Regs with which daily living activity 9 is concerned is “Engaging with other people face to face”, and the following point scoring descriptors apply under daily living activity 9.
9(a) Can engage with other people unaided. 0 points
9(b) Needs prompting to be able to engage with other
people. 2 points
9(c) Needs social support to be able to engage with other
people. 4 points
9(d). Cannot engage with other people due to such engagement causing either –
overwhelming psychological distress to the claimant; or
the claimant to exhibit behaviour which would result in a substantial risk of harm to the claimant or another person. 8 points
Part 1 of Schedule 1 to the PIP Regs provides a definition for what is meant by “engage socially”, even though that phrase does not appear in activity 9. It is accepted, however that the definition of “engage socially” is relevant when deciding whether someone can meet any of the descriptors under activity 9 (see further paragraph [9] of Hickey cited in paragraph 25 below). The phrase “engage socially” means:
“(a) interact with others in a contextually and socially appropriate manner;
(b) understand body language; and
(c) establish relationships.”
What is meant by “social support” is also defined in Part 1 of Schedule 1, but that is not an issue on this appeal.
- Heading
- The decision of the Upper Tribunal is to allow the appeal. The decision of the First-tier Tribunal made on 6 February 2023 under case number SC240/22/00718 was made in error of law. Under section 12(2
- Anonymity Order
- Introduction
- The FTT proceedings
- The extent of the Secretary of State’s support for the appeal
- Why this appeal is being allowed
- The relevant statutory provisions
- RC and Hickey
- Hickey
- Conclusions
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