A woman who says she cannot eat or drink, speak, wash or dress herself, and can walk only a few steps with help, was awarded zero points in her PIP assessment.
Rachael Field, 56, from Rhondda Cynon Taf, has had cancer of the tongue four times in six years. She has been given around three years or less to live. Her tongue and voice box have been removed, her windpipe reconstructed using tissue from her chest, and she receives nutrition through a feeding tube.
Her case, reported by BBC News Wales, raises a painful question: how can an assessment record no qualifying difficulties when someone describes needs this extensive?
Rachael’s claim is still in progress. Her family say they appealed several months ago and are waiting for an outcome. The DWP says it has been unable to complete the claim because it needs further evidence, and that it has tried to contact Rachael to resolve the situation. The family say they are in discussion with the department.
That distinction matters. This is not a concluded appeal. But the account shows why a decision awarding zero points should be examined carefully, not treated as a final judgement on someone’s life or needs.
The images in this article are illustrative and do not depict Rachael or her family.
A life-changing condition and a stressful wait
Rachael says she needs help to wash, dress and use the bathroom. She can manage only a few steps with assistance. She told the BBC: “I cannot eat or drink, everything has to go through my feeding tube.”
After being diagnosed with cancer six years ago, she had to stop working in a factory. Her daughter, Kyra Hawkins-Field, 20, launched a fundraiser to help her mother enjoy the time she has left and avoid worrying about money.
Kyra criticised an assessment process she felt relied too heavily on a checklist and did not reflect her mother’s real-life difficulties. “They’ve basically turned around and said, ‘we think you’re fine’,” she said.
Rachael has praised the medical treatment she received, describing it as “outstanding”. Her concern is with the system used to assess PIP. Her message was direct: “People need the help while they are alive.”
What does a zero-points decision mean?
Personal Independence Payment (PIP) is assessed across daily living and mobility activities. In each activity, the decision-maker considers whether a specific description of difficulty, known as a descriptor, applies, and awards points accordingly.
A zero-points decision means the decision-maker has recorded no qualifying descriptor across the activities assessed. It does not mean a person has no diagnosis, no symptoms or no support needs. It means the decision did not recognise those needs in a way that met the relevant PIP criteria.
So how can a person with serious needs end up with zero?
An assessment depends on information being gathered, understood and matched to the right criteria. Difficulties can be missed if answers do not explain what happens in practice, if important evidence is missing, or if an assessment report does not capture the person’s circumstances accurately. Delays or rescheduling can add further strain.
These are possibilities to check, not conclusions about Rachael’s case. The DWP says it needs further evidence to complete her claim; her family say the assessment process was repeatedly rescheduled. Her appeal remains ongoing.
None of these circumstances, by themselves, mean that a claimant is lying or “fine”. They may mean the written account and decision have not shown the full reality.
What PIP eligibility is based on
PIP is not awarded simply because someone has a particular diagnosis. It is based on how a long-term health condition or disability affects their ability to manage specified daily living and mobility activities.
In general, PIP may be available to people aged 16 up to State Pension age who meet the residence and other eligibility conditions. It is not means-tested: income and savings do not decide entitlement, and being in work does not automatically rule someone out. The rules also consider how long a person has experienced difficulties and how long they are expected to continue.
The assessment looks at these activities:
Daily living
- Preparing food
- Eating and drinking
- Managing treatment or monitoring a health condition
- Washing and bathing
- Using the toilet and managing incontinence
- Dressing and undressing
- Communicating verbally
- Reading and understanding written information
- Mixing with other people
- Making decisions about money
Mobility
- Planning and following journeys
- Moving around
For each activity, the question is not simply whether someone can do it once, on a good day, or with considerable effort. The assessment considers whether they can do it safely, to an acceptable standard, repeatedly and within a reasonable time.
For example, a person may be physically able to take a few steps, but need another person’s help to do so safely. Someone may manage a task once but be unable to repeat it when needed. Those details can matter.
Explain what happens, not only what the condition is
A diagnosis and medical records can provide important context. But they may not explain how a condition affects everyday tasks. The most useful account connects the health problem to the activity and describes the support required.
Where it is relevant, explain:
- What you can and cannot do on an ordinary day
- How often the difficulty happens, including better and worse days
- What help, prompting, supervision or equipment you need
- What happens if you try without that support
- Whether you can repeat the activity and how long it takes
- Any risks, pain, exhaustion or distress involved
A short answer such as “I can wash” may leave out that you need help getting in or out of the bath, washing parts of your body, or staying safe. “I can walk” may not explain that you manage only a few steps with support, or what happens afterwards.
Where the person claiming cannot easily explain their needs themselves, information from a family member, carer or medical professional may help give a fuller picture. It should describe what they have observed and the assistance actually provided.
People who are seriously ill, exhausted or relying on someone else to help with paperwork can find it particularly hard to describe their needs in the detail a form requires. That is not a personal failing. It is one reason decisions should be checked against the person’s real circumstances.
Zero points is a decision, not a verdict
If a PIP decision does not reflect your needs, it can be challenged. In most cases, the first step is to ask for a mandatory reconsideration. This is usually requested within one month of the decision; check the decision letter and get advice promptly if the deadline is close or has passed.
If you disagree with the outcome of the mandatory reconsideration, you can appeal to an independent tribunal. A tribunal can consider the evidence and hear directly from the claimant. It is a separate process, and the initial decision is not the last word.
Tribunal decisions do sometimes change the outcome of a claim. That is why it is important to explain the difficulties clearly and provide relevant supporting evidence. A decision that appears to have treated a complex life as a checklist should be examined against the actual rules and the person’s day-to-day experience.
The PIP rules also contain a separate route for people who are terminally ill; understanding which route applies can be crucial.
We are here to help you make sense of the decision
At Benefit Answers, we are independent of the DWP. We help people understand benefit decisions, set out how health conditions affect daily living and mobility, and prepare reconsiderations and appeals. We aim to present your case in the best light, in plain English and without adding to the stress.
Our overall service-wide success rate is 86%. This is not a prediction or guarantee for any individual claim.
Our initial advice is always free. If you then ask us to provide direct assistance with a claim, reconsideration or appeal, we work on a success fee basis. We are not part of the DWP and receive no government funding.
If you have received zero points and the decision does not match your daily reality, you do not have to work through it alone. We are here to help.
Contact Benefit Answers at info@benefitanswers.co.uk or call 0333 121 2128.