If you think that a decision about your benefits is wrong, you have the right to challenge the decision by first asking for a 'mandatory reconsideration' and then appealing to an independent appeal tribunal.

One appeals system applies in England, Scotland and Wales, and a different system applies in Northern Ireland. In England, Scotland and Wales, the tribunals are administered by HM Courts and Tribunals Service. In Northern Ireland, the appeals are administered by The Appeals Service. In this web page, we have used the term 'tribunal' to refer to appeals under both systems.
 

How do I challenge a decision that has been made about my entitlement?

This can only be done by the benefit claimant; in the case of a young person under 16, this may be a parent/carer. An autistic adult may have an appointee. 

You must first ask for a 'mandatory reconsideration' of the decision, which is where the government department that issued the decision reviews it to see if they want to change it. 

Once they have carried out a reconsideration, they issue you a new decision, which you have the right to appeal against. 

The one exception to this is for Housing Benefit decisions for people living in England, Scotland and Wales. For these decisions, the 'mandatory reconsideration' stage is optional and you can choose to go direct to the appeal stage.

Some Employment and Support Allowance (ESA) decisions can go straight to tribunal following a change to the law in July 2020. If you are found to not have Limited Capability for Work following an assessment, you do not need to go through the mandatory reconsideration stage. You will get ESA paid at the assessment rate if you keep sending in a Fit note from your GP, until your appeal. The decision letter following your assessment will tell you if you can go straight to appeal.

How do I ask for a reconsideration?

You must either telephone or write to the office that issued you the decision. Your letter or telephone call must be received within one month of the date of the decision. 

It is better to ask for the appeal in writing if possible, but if you aren't able to write a letter, or don't have time for the letter to be received before the deadline, then contact them by phone. 

It is a good idea to ask for copies of any evidence that they used to make the decision to be posted to you. Keep a copy of your letter. If you request a full statement of the reasons why your benefit was not awarded, the one-month period can be extended by 14 days from the date it is provided to give you the chance to respond.

Personal Independence Payment (PIP) reconsiderations

The National Autistic Society regularly hears from people who have received a decision letter about their PIP claim and have phoned the PIP office to ask for a reconsideration. They are told by the PIP office that they cannot ask for a reconsideration yet, instead they must wait to receive a phone call from the PIP office to explain the decision. This is not correct.

If you disagree with the decision, you have the right to challenge it. Once you have received the decision letter, you have a legal right to request a reconsideration and there is no need to wait for any phone call.

If you ask for a PIP reconsideration, your case is passed to a different decision-maker who reviews the original PIP decision and can change the decision if they think it was wrong. They could stop, reduce, increase or reinstate the award. They will often ask you to provide more evidence and sometimes they give you a deadline for providing it, but it is not compulsory to provide more evidence for a reconsideration. 

There is no time limit for the department to complete a PIP reconsideration.

Read more about challenging a PIP decision and the reconsideration process. 

What will my benefit payment be while my reconsideration or appeal is pending?

Pending reconsideration or appeal, your benefit is usually paid at the rate awarded in the original decision. If your reconsideration or appeal is successful, a lump sum payment of arrears, totalling the difference between your entitlement and any other benefit payments you have received pending the outcome of the challenge, will be paid. The payment of Employment and Support Allowance (ESA) is an exception to this.  

What should I do after I have asked for a reconsideration?

It will strengthen your case if you can explain why the decision is wrong, and if you can send in more information or evidence to show why the decision is wrong. For example, if you have been refused Employment and Support Allowance based on a poor quality face-to-face assessment, you could write in explaining what was wrong with the assessment. 

If your child's disability living allowance award was reduced based on a report by a teacher who doesn't know your child very well, write in to explain that. Send in any supporting evidence that you have or can get and write in to explain why the decision is wrong. Then you have to wait for the reconsideration decision to be issued. You should be issued with two copies of this.

Reconsideration of ESA work capability assessment decision

If your ESA is refused because you are found to be capable of work, ESA will not be paid pending the outcome of the reconsideration. If the reconsideration is unsuccessful, you can then appeal. Once your appeal form is submitted, ESA can be reinstated (at the basic assessment rate) pending the outcome of the appeal (and backdated to cover the reconsideration period).

As noted above, there is no time limit for the department to complete their reconsideration. The Government has stated that they expect a ‘straightforward’” ESA reconsideration to take about 14 days. However, if you have more evidence you want to submit, they must give you at least one month to do this and if there is a lot of evidence to consider, it could reasonably take them longer to make a decision. This is important because you will have to decide whether you want to increase the chances of a successful reconsideration or whether you want a ‘quick’ decision based on existing evidence.

If you do not submit any more evidence, it is likely the reconsideration will be unsuccessful. However, you will then be able to submit an appeal and your ESA can be reinstated. The disadvantage of this approach is that the appeal process is very lengthy and it is therefore likely to be a long time before your full ESA entitlement is in payment.

If you do submit all your evidence, there is more chance that the decision will be changed at reconsideration and this will mean your full ESA entitlement will be in payment quicker. However, you will wait longer to get any ESA in payment and the reconsideration may still be unsuccessful.

If you don't live in a Universal Credit full service area, you can claim Jobseeker’s Allowance pending the outcome of the reconsideration and it will not affect the outcome. You will, however, need to comply with all the conditions attached to JSA. If your reconsideration is unsuccessful and you appeal, you should state when you appeal that you wish to go back on ESA, otherwise you will remain on JSA pending the appeal.

If you do live in a Universal Credit full service area, you could chose to claim Universal Credit pending the outcome of the reconsideration, but would then not be able to move back onto ESA regardless of the outcome of the appeal.

If your ESA is refused because you are found to be capable of work, you can now take your claim straight to appeal and you do not have to go through the mandatory reconsideration stage. You should be paid at the basic assessment rate pending appeal.

The benefits appeal process

You can usually only ask for an appeal once you have had a reconsideration and have been issued with a new decision. You must request the appeal in writing. You can write a letter but you must include certain information so it is easier to use the official form.

In England, Scotland and Wales, use the SSCS1 Appeal Form. 

For Northern Ireland, use the NOA1 Appeal Form. 

Who should request the appeal?

This is the person who the decision letter was addressed to. If you claimed for a child under 16, then you are the claimant and can make the request. If you are the appointee for an autistic adult, then you can make the appeal on their behalf. 

Should the decision be challenged?

When you ask for a reconsideration or an appeal, the decision-maker or tribunal could reduce, increase, stop or reinstate the benefit. Before asking for a reconsideration or appeal you need to understand the potential risk that you are taking and compare this to how likely you are to succeed in getting the decision changed. If the benefit has been stopped or refused altogether, then you have nothing to lose, but if you have been awarded the benefit at a lower rate than you believe you are entitled to, then you could end up worse off. 

How long might my appeal take to be heard?

There can be delays in reconsideration and appeal decisions. You are likely to have to wait at least a couple of months for an appeal hearing, some people have waited a lot longer. If the tribunal decide to award or increase your benefit entitlement, the money will be backdated.

Can my benefit go down as well as up?

Yes. The decision-maker and the tribunal will look at the case afresh and can replace the decision with a new one. It is best to get advice so you can make an informed choice about the risk to your existing entitlement.

Should I attend the hearing?

It is better to attend the hearing. You will have a greater chance of success as you will have the opportunity to explain your case. If you choose not to attend, you should make sure that you put everything that you want to say in writing and send this to the tribunal in advance.

A parent/carer of a child under 16 or an appointee of an autistic adult can choose whether or not the person they are claiming on behalf of attends the hearing. You may find it useful for them to be there if you think it would help the tribunal to understand your case. 

The tribunal can insist that the child or adult in question attends the hearing if that is the only way they think a fair decision can be made. 

What if I can't attend the hearing?

If you can't attend the hearing and you want it postponed, you must apply in writing to the clerk to the tribunal saying why you want a postponement. It is always best to ring before your hearing takes place to check if a postponement has been agreed. If you do not attend and you have not obtained a postponement, the tribunal is likely to hear the case without you.

Who can I take with me to the hearing?

It's important to distinguish between a representative and other people who may come with you to the appeal hearing. A representative is an adviser who is experienced in representing at tribunals and who knows about social security law. Organisations such as local advice centres, law centres and local authority welfare rights services may provide this service and will not charge you for it.

A representative will explain the law to you, help you to collect evidence and may represent you at the hearing. You do not have to have a representative; the hearing is set up to be accessible to a person without a representative. But you do have a better chance of success if you have representation. 

You can also take a friend, family member or professional to the appeal hearing. They can support you and help you to explain your case. They will not know about the law, but can help you because they will know about your situation.

Claims for reasonable expenses may be paid. Contact the tribunal service before the hearing to agree what they will refund. If they agree that you cannot use public transport, they will pay for taxi fares. Keep any receipts or tickets.  

Who will be at the hearing?

There is always a judge who is legally qualified, and up to two other members who are a doctor and a person who has experience of disability. Disability Living Allowance and Personal Independence Payment appeals are heard by all three, Employment and Support Allowance appeals by a judge and a doctor. 

Occasionally, the Department for Work and Pensions (or Social Security Agency in Northern Ireland) will send a presenting officer. It is their job to attend the hearing, they will not be the person who made the decision that you are appealing against.

What will happen at the hearing?

Tribunals tend to be held in a large office room. There is normally a big table in the middle, you and anyone you bring with you sit on one side, and the tribunal members sit on the other side of the table. If the Department for Work and Pensions Officer is present, they will sit on the same side of table as you, facing the tribunal panel. The clerk often has another desk in the room and might come in and out of the room while the appeal is being heard.

The tribunal should consider all the facts, evidence and law relevant to your case. They will ask you questions to help them to understand the situation and make a decision. They can usually only consider whether a decision was correct at the time it was made.

Remember that before the tribunal members meet you, all they know about the case is what is in the appeal papers. Think about what you want to say to them to explain what the real situation is. To help you to remember, you could make a list of points that you want to make, or things that you want to explain in the hearing.

The tribunal members are genuinely independent and had nothing to do with the original decision. Although you may be angry and upset about the decision, try not to direct it at the tribunal members.

Do not take lots of extra evidence to the hearing; send this to the Tribunal Service in advance. If you arrive with lots of extra paperwork, the tribunal are likely to postpone the hearing because they will not have time to read all the new evidence.

When will I get a decision?

Usually you are told of the decision at the hearing and you are given a decision notice confirming it. If the tribunal are not able to give you a decision on the day, the notice should be sent to you later by the clerk.

What if I am unhappy with the tribunal's decision?

If you are not happy with the tribunal's decision, you have the right to ask for a statement of reasons for the decision. You must ask for this in writing within one month of the initial decision notice and it should be provided within one month. You can then ask for the decision to be set aside or you can seek leave to appeal to the Upper Tribunal. You have one month from the date you receive the full decision to do this. Challenging a tribunal's decision is complex and it is best to get advice.

Useful resources

• How to win a PIP appeal - Advicenow (England and Wales)
• How to win a DLA appeal - Advicenow (England and Wales)
• England, Scotland and Wales appeals information - Citizens Advice 
• Northern Ireland appeals information - Citizens Advice
• Appeals and mandatory reconsiderations - Disability Rights UK