The Department for Work and Pensions (DWP) has shared new steps being implemented to improve deciding what Personal Independence Payments (PIP) claims are successful. Following the annual benefits uprating, PIP is now worth between £26.90 and £101.75 each week to successful claimants.
Jonathan Ashworth, Labour’s Shadow Work and Pensions Secretary, asked DWP bosses recently what steps were being taken to “reduce the incidence of individuals being refused a PIP award at initial claim and Mandatory Reconsideration before receiving an award due to lapsed appeal”. It comes as recent figures show more than 5,000 claimants successfully challenged the DWP over its decision not to award them PIP.
During the 2022/23 financial year, around 5,300 people appealed their initial denied PIP application and won. Of that total, some 1,500 claimants have also been awarded at least one enhanced payment rate of either the daily living or mobility component of the disability benefit through the Mandatory Reconsideration process, reports the Daily Record.
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These figures include Mandatory Reconsideration decisions up to December 30 last year, which means the number of successful appeals could increase as more data is collected. During the 2021/22 financial year, 24,100 PIP claimants had an award decision given through Mandatory Reconsideration with 7,600 receiving at least one enhanced component payment rate.
In a written response last month, Minister for Disabled People Tom Pursglove said the DWP’s aim is to “make the right decision as early as possible in the process”. He explained: “We have made improvements to the decision-making process at both the first decision and the Mandatory Reconsideration stage, giving decision makers additional time to proactively contact claimants if they think additional evidence may support the claim.”
He added: “We are continuing to learn from decisions overturned at appeal. For example, we gather insight from Presenting Officers who regularly provide feedback from hearings they attend, with a view to learning from overturned decisions.”
There are some steps you can take if you think you have incorrectly denied PIP:
Check the PIP decision
If you do not understand the decision on your letter, you can ask the DWP to explain it by contacting them using the details on the top right of the decision letter. If you don’t know if the decision is right, you can check whether you qualify by doing the PIP self test on the Benefits and Work website here.
This mock test has all the questions plus the points awarded for each answer and will help you understand:
Whether you would score enough points to receive PIP for each component (daily living and mobility).
Whether you would qualify for the standard or enhanced rate of each component.
Ask for Mandatory Reconsideration
A Mandatory Reconsideration is when the DWP looks at their decision again and decides whether to change it. The best way to ask for a Mandatory Reconsideration is to write to the DWP at the address on your decision letter. You normally have one month from the date you got your decision letter to ask for Mandatory Reconsideration.
Get a Mandatory Reconsideration Notice
Once the DWP has looked again at the decision, they will send you a Mandatory Reconsideration Notice. The Mandatory Reconsideration Notice will tell you if the decision has been changed or it stays the same.
Appeal to a Tribunal
If the DWP does not change their decision when you asked them to look at it again, you can appeal to an independent panel, called a tribunal. The tribunal looks at the evidence from both sides, then makes a final decision. It is part of the court system - it is not part of the DWP.
When you can appeal to a tribunal
You can appeal any decision made about your PIP claim. Some of the most common reasons are:
You did not get PIP.
You got a lower level of PIP than you expected.
You think your PIP award should last for longer.
The appeal will look at whether the decision was right at the time it was made - they will not consider whether your condition has got worse since then. Get advice from your local Citizens Advice, welfare support team at your local council or online at Benefits and Work.
To be allowed to appeal to a tribunal, you will need:
Your letter from the DWP with the words ‘Mandatory Reconsideration Notice’ at the top - if you have 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.
Citizens Advice warns that the tribunal process can take a long time. A statement on their website reads: “The process can be draining but it’s worth remembering that more than half of people who appeal their PIP decision win at a tribunal. If you feel the decision is wrong, don’t be put off appealing.”
Complete the appeal form
There are two ways to appeal. You can either:
Fill in an appeal form, called the SSCS1 - get a copy of the SSCS1 and check the guidance notes for the SSCS1 on Gov.uk.
Appeal against the decision online on Gov.uk.
Make sure you complete the whole appeal form otherwise your appeal could be rejected.
Explain why you are appealing
The most important part of the application is ‘grounds for appeal’- if you’re filling in form SSCS1, this is Section 5. In this box you need to give the specific reasons why you disagree with the decision.
Use your decision letter, statement of reasons and medical assessment report to note each of the statements you disagree with and why. Give facts, examples and medical evidence (if you have any) to support what you’re saying.
You might have done this already for your Mandatory Reconsideration Letter - if so, you can use the same examples and pieces of evidence again. You can include all this information on a separate sheet if you’d prefer - just write ‘See enclosed information’ in the box and attach any papers securely to the form.
Tribunals can look at your whole award again. So you should consider whether you risk losing your current award - for example, if you've got evidence to support a daily living component but might lose your mobility award because you can now move better. If you're not sure, you should get advice from your nearest Citizens Advice or support team at your local council.
Getting help with your appeal
You can get help with your appeal from your local Citizens Advice, or a local disability support agency or group. You might be able to get someone like an adviser or a solicitor to act as your representative during the appeal, but they are not always available.
A representative can help you with the paperwork and might speak on your behalf. Do not worry if you don’t have a representative - the tribunal board is most interested in hearing how your condition affects you and in your own words. Support from a friend or family member can really help, and you can do it without a professional.
Tribunal dates availability - ask for what you need
You can add the dates you are not available and information about anything you need at the hearing - if you are filling in form SSCS1, this is Section 7. Think about anything that might stop you being able to go to the hearing and to write it down. For example:
You can only attend a hearing during school hours because of childcare responsibilities.
Holidays you have booked.
Any dates you’ve got important medical appointments.
If you do not mention these and the hearing is booked for a date you’re not available, you might not be able to change it.
Sending the form
If you fill out the online form, it is sent when you have completed it. If you have filled out the paper form, send your documents to HM Courts and Tribunals Service, not to the DWP. The address is on the form. You should include the following:
The completed SSCS1 form.
A copy of your Mandatory Reconsideration Notice.
Any further evidence you have - you can also send this later.
Citizens Advice guidance states to post your appeal documents by recorded delivery if you can. Otherwise go to your local Post Office to post them and ask for proof of postage. This can help you later if the tribunal service says you did not meet the deadline or if the letter gets lost in the post.
HM Courts and Tribunals Service will check the form and then ask the DWP for their response within another 28 days. For more advice about challenging a PIP decision and understanding the tribunal process, Citizens Advice have detailed information plus examples of statements showing what to write when making an appeal.
You can find all this information here.
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