PIP and Fluctuating Conditions: The 50% Rule

Regulation 7 of the PIP Regulations 2013 says that where a description of a difficulty (a “descriptor”) is met on more than 50% of the days in the period being looked at, that descriptor applies. A day “counts” if it is likely that, had you been assessed on that day, you would have met the descriptor. So you are not asked to prove what happened on one particular date, you are asked what is likely to be true across your days.

The “more than 50% of days” test is not measured over a single week. Under regulation 12, PIP uses the required period condition, which looks across roughly a year:

• ✓The 3 months before the date your claim is assessed (the past, 'qualifying' part), and
• ✓The 9 months after it (the future, 'prospective' part)

Added together that is about 12 months. The question is therefore: across that year, are you likely to have this difficulty on more than half your days? That is why a fair, typical picture of your year matters far more than how you happen to feel on the day of the assessment.

Conditions do not just switch between “fine” and “can't do it”. Regulation 7 deals with the in-between:

• ✓If two or more descriptors in the same activity are each met on over 50% of days, you get the one that scores the most points
• ✓If no single descriptor reaches 50% on its own, but two or more (that score points) together apply on over 50% of days, you get the descriptor that applies on the most days
• ✓If they apply on an equal number of days, you get the higher-scoring one

In practice this means a claim where, say, you need help preparing food on some days and supervision on others should still score, as long as a points-scoring difficulty applies on more than half your days overall. Spell out the mix; do not let it be rounded down to your best version.

The DWP cannot count your bad days if you do not describe them. For every activity that varies:

• ✓Say how many days a week (or month) the difficulty applies, for example 'on 4 or 5 days out of 7 I cannot...'
• ✓Describe a typical bad day and what you cannot do reliably on it
• ✓Explain the after-effects, if doing something on a good day leaves you unable the next day, that next day is a bad day too
• ✓Keep a short diary noting the date, what you couldn't do, and how long the episode lasted

A common trap is the assessor noting how you present on the day. If you happen to attend on a better day, or you push through because it is important, that single snapshot is not supposed to decide your claim, the 50% rule looks at your year, not one appointment. If a report scored you on a single good day and ignored your typical pattern, that is a ground of challenge.

See our guides on challenging a PIP assessment report and the PIP appeal process. The 50% rule applies in the same way to Adult Disability Payment in Scotland and to PIP in Northern Ireland.