When you apply for any sort of benefit, occasionally the decision doesn't go the way you expect. In the case of a Personal Independence Payment (PIP), roughly seven in ten people are rejected, according to disability equality charity Scope.
It also takes quite a long time to actually get the money after applying - it can often take around four months from starting the application with the Department for Work and Pensions (DWP). Any problems with the application then extend that time even further.
Once the process is complete, any number of issues could arise, including getting a lower rate than expected, an award for not long enough, or even being rejected entirely. So how do you appeal a PIP decision?
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The appeals process is also very lengthy, but Citizens Advice says that it is worth doing. The first stage of appealing is asking the DWP for 'Mandatory Reconsideration' - whereby the decision is reviewed by the agency. If that doesn't work, you can take it to a tribunal.
There is plenty of help and support available to you if you do wish to appeal a DWP decision, including Citizens Advice, a solicitor if you so choose, as well as friends and family. So if you think you need to appeal, here is how to do it.
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Am I eligible for PIP?
In order to be eligible for a Personal Independence Payment (PIP), you must be aged between 16 and your state pension age. According to Citizens Advice, you must also:
- find it hard to do everyday tasks or get around because of a physical or mental condition - you can make a claim whether you get help from another person or not
- have found these things hard for 3 months and expect it to continue for another 9 months
- usually be living in England, Scotland or Wales when you apply
- have lived in England, Scotland or Wales for at least 2 years - unless you're a refugee or an immediate family member of a refugee
There are exceptions to the rules if you’re terminally ill or in the armed forces.
You get assessed not on the condition you have or the medication you take, but on the level of help you need and how your condition affects you. You will be assessed on the level of assistance you need with certain activities, such as making food, washing and bathing, taking treatments, communicating with others, reading and understanding written information, and more. For the full eligibility list, click here.
How to appeal a PIP decision
The first stage of appealing a PIP decision is challenging the DWP directly. You can ask for 'mandatory reconsideration' within one month of being told the outcome of your benefit claim, but if you miss that deadline, Citizens Advice says that it is still worth asking within 13 months, but you will need to explain why you were late.
The best way to apply is to use the CRMR1 mandatory reconsideration request form on the government website, or you can write a letter to the DWP explaining why you disagree. You will need to give specific reasons why you disagree, giving facts and medical evidence to support what you are saying.
Citizens Advice gives this example based on preparing food: "The report from my medical assessment states I don’t need any aids or help to prepare my meals. This is untrue. I can’t cook any food from scratch - I can only heat up food in a microwave and I need to use a stool in my kitchen."
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Do bear in mind that this would be a reconsideration of your whole award, therefore you should think about whether you risk losing an element of what you are already receiving if certain aspects of your condition have improved.
If you do not get a higher award after 'mandatory reconsideration', you can choose to appeal to a tribunal. The tribunal is part of the court system, not DWP, and it looks at evidence from both sides before making a decision.
You must file the appeal within one month of the date on your 'mandatory reconsideration notice', and the ensuing tribunal will only look at whether the correct decision was made at the time - it will not consider any changes to your condition.
To be allowed to raise an appeal to a tribunal, you will need the following:
- your letter from the DWP with the words ‘Mandatory Reconsideration Notice’ at the top - if you’ve lost it, ask them for a new one
- to send your appeal form in within one month of the date shown on the mandatory reconsideration notice
To start the appeal, you can either complete the online form on the government website or you can fill in form SSCS1, print it, and post it to HMCTS. You will need your contact details, National Insurance Number, and 'mandatory reconsideration' notice.
You must explain why you are appealing the decision, and Citizens Advice provides the following example of challenging a mobility decision: "I don’t think you’ve properly understood my mobility problems. You say I can walk 50 metres unaided. In reality, trying to do this causes me significant pain and means I can’t walk at all for the rest of the day. I have enclosed a report from my occupational therapist which explains this in more detail."
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Due to Covid, it is possible that a tribunal judge will assess your case without an in-person hearing, although you can request one if you do not agree with the provisional decision. Citizens Advice says: "Having an oral hearing gives you more opportunities to put your case forward and a better chance of winning."
Appealing PIP decisions can take a matter of months overall, so it is worth thinking carefully before proceeding, but if you do not think that your award is fair, it is certainly something you should consider. Help is available through Citizens Advice, and friends and family can offer support throughout the process.
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For the latest news from the DWP, click here.
