Independent Assessment Services

3. Ms O complains IAS took too long to assess her for PIP. She says, despite applying for PIP in May 2018 and DWP sending the referral in June, it took IAS until October to assess her.

4. She says because of the delay she missed out on some of the PIP she would have otherwise received. This caused her hardship and she went into approximately £2,000 of debt as she needed to personally fund her living costs and the purchase of essential equipment to help meet her needs. This has also caused significant emotional distress, which still affects her.

5. Ms O would like to be paid the money she has lost due to the time taken to set up her PIP claim. She would also like money to cover the debt she entered and compensation to recognise the emotional impact on her.

6. Ms O was in receipt of Disability Living Allowance (DLA), which paid her £22.65 per week. DLA is a benefit paid by DWP to eligible claimants who have personal care and/or mobility needs due to a disability.

7. In February 2018 Ms O had a stroke. This meant her needs changed and she applied for PIP on 22 May 2018. PIP is a benefit also administered by DWP and replaces DLA. It is a payment designed to support people afford the extra cost of living due to their disability.

8. DWP had to understand Ms O’s disability needs so it could pay her the correct amount of PIP. It therefore referred her to IAS on 19 June. IAS is responsible for assessing people who apply for certain benefits like PIP and has a contract with DWP to perform these assessments. It produces a report that explains how the applicant's disability or health condition affects their daily life. Once IAS has provided the report, DWP can decide how much PIP the applicant is entitled to and start paying it.

9. On 22 June IAS decided Ms O’s health needs meant it needed to visit her at home to complete the assessment.

10. Ms O contacted IAS on 2 and 19 July, and on 6, 13 and 22 August to ask when her assessment was going to happen. The adviser explained IAS would contact her about the home consultation when an appointment was available. She called IAS again on 5 September and IAS told her it would be another few weeks before an appointment was available.

11. On 19 September IAS wrote to Ms O arranging to visit her at home on 10 October and carry out the necessary assessment. After IAS visited Ms O, it completed the report on the same day and sent it to DWP immediately. DWP considered this report and wrote to Ms O on 18 October. It explained she was eligible for the enhanced daily rate and mobility component of PIP. This resulted in an award of £85.60 and £59.75 per week respectively for each element.

12. The administration of PIP is complex. The Independent Case Examiner (ICE) independently investigates complaints about DWP when DWP cannot resolve them. ICE explains: ‘Existing DLA claimants who are reassessed for PIP continue to receive their award of DLA until a PIP decision is made. Once a PIP decision is made, DLA will continue to be paid for four weeks following the decision, and the effective date for PIP entitlement will apply after that four-week period.’

13. This meant Ms O’s entitlement to PIP started on 14 November. As it is paid in arrears, DWP paid £560.63 for the period 14 November to 10 December. It then continued to pay Ms O every four weeks.

14. On 29 October Ms O’s MP complained to IAS about how long Ms O had waited for an assessment. Her MP said the long delays in organising the PIP assessment were not Ms O’s fault. He said she should not be punished for these delays and was significantly worse off because of them. He asked IAS to pay Ms O the backdated benefit she had missed out on.

15. IAS responded on the same day and apologised for how long Ms O had to wait for an assessment. It explained there had been problems with the availability of assessors in Ms O’s area and referred her request for backdated benefits to DWP.

16. DWP’s customer relations team contacted Ms O’s MP by email. It explained PIP legislation prevented it from backdating the benefit and apologised for not being able to make the payment Ms O wanted.

17. Ms O’s MP complained to DWP again on 11 December. He reiterated no one was taking responsibility for the six-month wait Ms O experienced between applying for PIP and having it approved. He emphasised this wait was due to the delay in assessing Ms O’s needs and it was not her fault. DWP returned this complaint to IAS on 19 February 2019. It agreed to investigate and provide a written report to Ms O’s MP within 20 working days.

18. IAS apologised to Ms O’s MP on 20 March for its delay in providing a response, and instead sent its final report on 6 April. It explained staff sickness and resignations meant, in this instance, it could not meet its 40-day assessment target. IAS said, although it had moved staff from other areas, this did not avoid the problems entirely, and it could not prevent the problem Ms O experienced. IAS apologised for what happened but declined to pay Ms O any of the money she missed out on.

19. DWP and IAS dealt with the complaint in line with their own processes but their view stayed the same. They advised Ms O’s MP to send the complaint to ICE, which he did on 3 August. ICE published its report into what happened on 20 April 2021. It decided Ms O’s complaint was justified but took no further action as it accepted the explanations and apologies IAS gave.

22. Our ‘Principles of Good Administration’ say organisations should deal with people quickly, within reasonable timescales and within any published time limits. They should tell people if things take longer than stated or than can reasonably be expected to take.

23. Our ‘Principles of Good Administration’ also say organisations should provide effective services. They say where organisations are subject to published service standards they should plan and prioritise their resources to meet them.

24. IAS says it aims to assess applicants within 40 working days. This means it should have visited Ms O by 14 August. Instead, it took 81 working days to complete the assessment. This fell far short of the published timescale.

25. We asked IAS to explain what caused the delay, as we understand sometimes circumstances mean things go wrong completely unavoidably. We also asked it what action it took at the time to try and avoid or lessen the delay (including explaining the reasons to Ms O), and what action it had taken since to prevent the same problem happening again.

26. IAS tells us the reasons for the delay were outside its control and it did act to reduce the wait. We have considered these reasons before deciding if the delay amounted to a failing or not.

27. IAS explained that, when Ms O needed her assessment, it had difficulty with its staffing levels. This was due to a high rate of staff sickness and resignations. We completely accept staffing can be a challenge to any organisation. What is important in this instance is what was done to try and correct the problem.

28. When IAS explained this to Ms O’s MP in the complaint process, it said, ‘We do whatever we can to limit such impacts - for example, by moving staff from other areas, but it is not always possible to mitigate them entirely. It was such a staffing challenge that resulted in the delay in this instance.’ It said the delay was not due to maladministration (fault), but unavoidable events beyond its control.

29. IAS tells us that, at the time, it offered overtime to existing staff. It did not tell us what the uptake was for that offer or how it had any bearing on its provision of home assessments. It also tells us it is constantly recruiting assessment staff to fill vacancies as they come up. It also says training staff takes time, which means recruitment does not immediately fix delays. We recognise this, and accept there can be a lag between a staffing shortage happening and being corrected and thought carefully about this issue before reaching our final decision.

30. ICE investigated what happened and agreed the delay happened due to events beyond IAS’s control. It said the delay was unfortunate but not excessive and was not caused by maladministration. It concluded Ms O’s complaint was ‘justified’ but made no recommendations to put things right.

31. We recognise IAS took steps to reduce the delay by moving staff, offering them overtime and recruiting more people. However, these actions did not go far enough to prevent the significant delay Ms O experienced. We have seen no evidence of what it actually did, how it planned for the staffing shortage or the impact its actions had at the time. Despite the steps it says it took, the service IAS provided was not effective.

32. For these reasons we have taken a different view to ICE and decided the additional 41 working days Ms O had to wait were excessive. The failure to assess Ms O in a timely manner fell far short of providing an effective service and amounts to a failing.

33. Further, we cannot ignore how important this assessment was for Ms O. She was not simply waiting for a complaint response or reply to a letter. Instead, Ms O needed the appointment to prove her eligibility for money that would help her manage a sudden and profound disability. The matter was of potentially life-changing importance to her.

34. We also cannot ignore what IAS said to us during our investigation of this complaint. It told us, ‘Indeed, Ms O could have requested a face-to-face assessment at a consultation centre rather than waiting for a home visit, which would have reduced her waiting time, potentially within the 40 working day period, thereby removing the circumstances that resulted in the complaint.’

35. We strongly disagree and had serious concerns about this comment. The point of the home assessment is that some people, such as Ms O, simply cannot attend an assessment centre. Those comments caused us concern as they imply IAS is not taking the need for home assessments as seriously as it should.

36. Having seen evidence of a failing, we looked at the impacts Ms O has associated with IAS’s actions. She says, because of what happened, she: • waited longer than she should have done to start receiving her PIP payments • borrowed money to pay for treatment and adapt her home, which meant she went into debt and • experienced a lot of stress.

37. We have considered these impacts in turn.

38. DWP needed the IAS assessment before it could confirm Ms O’s eligibility for PIP and start paying it. As DWP did not have the necessary information it significantly delayed paying PIP to Ms O. This meant Ms O was receiving the lower DLA amount when her health meant she was eligible for the higher rate of PIP and associated mobility element.

39. If IAS had kept to its agreed timescale, it would have visited Ms O on 14 August at the latest. There is no sign Ms O’s condition changed during this time, which means we are confident she would have been eligible for PIP had it done so. However, the time it took IAS to visit her resulted in an eight-week delay to DWP approving her PIP.

40. Ms O received £122.70 more per week on PIP than when she was on DLA. Due to the additional eight weeks she had to wait, she is £981.60 worse off.

41. We have also spoken to Mr Y about the debt Ms O entered to better understand how this came about.

42. He explained Ms O relied on loans from family and friends to purchase a powered wheelchair that allowed her to continue being mobile. She also needed private physiotherapy sessions to help manage the symptoms of her stroke.

43. He says that, if she was in receipt of PIP sooner, she could have applied to the Motability Scheme to cover the cost of her wheelchair. The Motability Scheme is a programme endorsed by DWP that allows people in receipt of PIP or DLA to exchange their mobility element for leasing certain means of transport, including things like a powered wheelchair.

44. Ms O took receipt of a powered wheelchair on 7 June 2018. This cost £890. She bought it using loans from family and friends as she could not afford to buy it herself. We know how important this powered wheelchair is for Ms O’s quality of life and understand how quickly she needed it.

45. When considering if IAS’s actions meant Ms O entered debt, we can see she bought the wheelchair two weeks after making her PIP application. Even if IAS had met its published timescales, she would not have been receiving PIP at this time. In fact, DWP had not sent the referral to IAS by that point.

46. Further, there was the possibility Ms O could have rented a wheelchair until her PIP was awarded. She could have then applied to the Motability Scheme, which might have covered the cost her the chair. We recognise Ms O had to borrow money in this instance. However, this happened regardless of the delay at IAS, so we cannot say the delay resulted in Ms O taking on this part of the debt.

47. Ms O also attended three private physiotherapy sessions between 24 August and 18 October 2018. These appointments cost £70 each. Mr Y explained the appointments helped to manage the symptoms of Ms O’s stroke. But, had she had the PIP, she could have paid the £210 out of that. As we have recommended DWP pay her the PIP she missed out on, this money will settle the cost of the private physiotherapy.

48. Additionally, Ms O borrowed the money from family and friends. This means there was no cost for borrowing the money like there would be for spending on a credit card. As such, we cannot see any extra financial impact here. If this money has not been paid back, it can presumably be done so from the recommended payments discussed below.

49. Mr Y also says Ms O found it difficult and distressing to borrow money. We do not doubt this, and we agree the long wait Ms O experienced was very worrying for her. It must have been incredibly upsetting to have to borrow money through no fault of her own. We agree this has understandably been a source of frustration and upset for Ms O while she attempted to put right what happened.

50. We have looked at what IAS and DWP have done to put right the financial loss and emotional impact that resulted from what happened.

51. IAS’s complaint responses to Ms O sincerely apologise for the impact she has experienced due to the delays. However, it has declined to pay compensation to Ms O as it says it followed the relevant processes in trying to arrange a visit to her. It explained it could not reimburse her missed benefits and told her to speak to DWP to try and recover the money. When she did so, DWP told her she had missed out on payments ‘as a result of maladministration by the Assessment Provider’. It therefore chose not to pay her any additional money.

52. Ms O remains underpaid because DWP would have paid her additional PIP if the appointment had happened when it was supposed to. The apology from IAS does not go far enough to put right her individual experience, and the impacts she has experienced are unresolved.

1. The Parliamentary and Health Service Ombudsman has found Independent Assessment Services (IAS) did not assess Ms O in line with its service standards, and this amounted to a failing. This meant Ms O received her Personal Independence Payment (PIP) entitlement later than she should have done, which had a financial and emotional impact. We have therefore upheld this complaint.

2. As Ms O missed out on £981.60 of PIP while waiting for her assessment, we have asked the Department for Work and Pensions (DWP) to make an equal compensatory payment. This payment will put Ms O back in the position she would have been in had her assessment happened on time. We have also asked it to pay her £250 in line with our severity of injustice scale (a scale we use to judge how unfairly someone has been treated to make sure our recommendations are consistent and transparent). This payment is to put right the understandable upset and worry Ms O has experienced.

53. Our ‘Principles of Remedy’ state public organisations should put things right and, if possible, return the person affected to the position they would have been in if the poor service had not happened. If that is not possible, they should compensate them appropriately. Our ‘Principles of Remedy’ also say organisations should recognise their mistake when things have gone wrong and put things right.

54. Having seen the service improvements IAS has put in place we are satisfied it has improved this enough to assess potential claimants effectively. Indeed, IAS has explained the average wait for an assessment currently meets the targets set by DWP, which is reassuring to learn. However, the improvements alone do not put right the individual impact Ms O suffered.

55. DWP told Ms O her PIP cannot be backdated due to legislation. This does not, however, prevent it from paying compensation equivalent to the net amount of benefits she has missed out on.

56. In order to return Ms O to the position she would have been in DWP should compensate her for the difference between DLA and PIP. This means it should pay £981.60 to put right the financial impact to Ms O’s benefits due to the delay she experienced.

57. Any debt Ms O entered was due to not having the increased benefit payments. By reimbursing this difference, we consider it also covers the debt and the cost of the private physiotherapy she paid for when she should have been receiving PIP.

58. However, that recommendation is for financial loss only. We consider Ms O suffered a non-financial loss in terms of the distress she experienced. To decide on a level of financial compensation, we review similar cases where the person has experienced similar issues, along with our severity of injustice scale. Our scale helps us to decide how much financial compensation is fair for non-financial losses, for example, when distress has been experienced. Ms O’s experience falls within level 2. This is described as ‘when what has gone wrong has had a relatively low impact on the person affected. This will often result in a degree of distress, inconvenience or minor pain.’

59. Based on our scale, DWP should also pay Ms O £250. This is to materially recognise the emotional distress she has experienced from missing out on the benefits she was entitled to. It would also recognise the distress she experienced from borrowing money.

60. DWP should make these payments within two weeks from the date of this final report. We hope this brings this unfortunate matter to an acceptable conclusion for Ms O and assures her that her upsetting experience has been appropriately recognised.