You may have applied for disability benefit for yourself or your child and were not successful. If you are unhappy with the decision and believe the claimant does meet the criteria, you can challenge the decision.
Here, Sue, one our fantastic volunteers, details her experience of appealing a DLA and PIP claim.
What experience do you have dealing with a DLA/PIP appeal?
My son has a very rare autoimmune blood disorder and ASD. I have gone through the appeal process three times but won each time at tribunal. The first time appealing I had the help of Citizens Advice; the second time I was helped by a local welfare rights charity; and the last appeal I did on my own.
What is the process of appealing a decision?
When you receive your decision letter and you disagree with the decision made by the Department for Work and Pensions (DWP), contact them straight away, to tell them that you do not agree with the decision and ask for a Mandatory Reconsideration. You must do this within one month of the date on the decision letter, but this can be done by phone or post. You can ask them to explain the decision over the phone and request a copy of the assessment report. The telephone number and address will be on the decision letter. You should give reasons why you think the decision is wrong and lodge further information or evidence at this stage. Your case will be passed to another decision maker to look at your claim again. When the DWP has looked at it again, they will issue two copies of the Mandatory Reconsideration notice, with details of the outcome. One copy of the notice is required to appeal.
If you still disagree with the outcome, you can now appeal to the Social Security and Child Support Tribunal using form SSCS1 with a copy of the notice, or you can appeal online. You must do this within one month of the date on the Mandatory Reconsideration notice and you may complete it yourself or have a representative do it for you. If you think you will miss the date, you must give a reason on the form why it is late. You must state the grounds for the appeal and further evidence can be sent later to the tribunal office or even taken on the day of the hearing. You may choose to attend the hearing or have the panel decide from the papers alone. However, it may be a better option to attend the tribunal, rather than having the decision made from the papers alone, as panel members will ask questions to gather further evidence.
What is the tribunal hearing like?
Make sure you arrive early; you will have to go through a security check and then wait until the previous hearing has finished. The clerk will explain the process and you may pass them any further evidence you want the panel to consider.
The panel usually consists of a judge, a disability representative and a doctor. You may take a family member or friend to support you, and your representative, if you have one. The DWP may send a representative but rarely do. They may ask questions but these are not involved in the decision process. Each member of the panel will ask questions in turn, about how your condition affects your mobility or daily living. Your representative or family member will be asked if they want to add anything. At the end of the hearing, you will be asked to wait outside while the panel makes its decision. When you are called back in, the decision will be typed up and left for you on the desk. If they have awarded 8-11 points, you will be given the standard rate. If you are awarded 12 points, you will get the enhanced rate.
Is it worth appealing a decision?
According to Government statistics, 73% of PIP appeals and 66% of DLA appeals were overturned with the decision revised in favour of the claimant. Any money owed to the claimant should be paid within 4 weeks of the tribunal date and backdated to either the date the benefit was stopped or the date the application was made.
What further advice would you give?
Get as much new evidence as possible; we paid for a doctor’s letter each time. This attracts a fee, but it was worth it. Other evidence could include a diary or a letter of support from another family member.
Get help and advice from Citizens Advice, a welfare rights service or a charity.
The Benefits and Work website states that, “the law says that you only count as being able to do something if you can do it safely; to an acceptable standard; repeatedly and in a reasonable time period. Pain, fatigue, breathlessness, nausea and motivation should all be taken into account.”
Inform tax credits or universal credit of any successful award for a child, as you may be able to get an additional payment called the ‘disabled child element’, depending on the rate awarded.
Useful Websites for making a DLA/PIP Appeal:
https://www.benefitsandwork.co.uk/ (Membership for £19.95 gives full access)
https://www.nidirect.gov.uk/articles/personal-independence-payment-pip (Northern Ireland)
For further support or advice with appealing or claiming a benefit, please contact our Core Services team on email@example.com or 0845 241 2173.