Reconsiderations and Appeals
If you want to challenge any decision that has been made about your benefits, you have to first ask the Department of Work and Pensions to reconsider their decision before you start an appeal. It is best to do this in writing, so that you can prove that you have done this within the correct time period, and you have a record of what you say. You have a month from the date on your decision letter to do this, unless there are special circumstances that cause a delay, such as bereavement. You will not be given longer than a month if the reason for the delay is that you did not know or understand the law.
We have provided two sample letters of how to write a letter requesting a Mandatory Reconsideration, one for ESA and one for PIP. Please see the list on the right and click on the links. There is also a new online form you can use.
You need to say why you think the decision is wrong, and how you think you meet the criteria for a different award. It is extremely helpful if you can provide additional medical evidence at this stage. In our experience you are unlikely to get a decision changed just because you think it should be – the person who makes the decision (the ‘decision maker’) needs a reason to think the original decision was wrong.
You need to send your letter (or submit your form) including any supporting evidence to the benefits office that your decision letter was from. It gives them a chance to look at your file again, and they can change their decision at this time. When they have made a decision, they will send you what is called a Mandatory Reconsideration Notice – this is their final decision and you will need this if you want to go on to appeal.
If you are still unhappy with the decision made, you may want to complete an appeal form. However, you need to check that you have a right of appeal; some decisions have no right of appeal, but it should say so in the decision letter.
You can get an appeal form (called SSCS1) by asking the Department of Work and Pensions for a copy by phone or letter, or by downloading it here. There is a blank version as well as an example version in the list on the right, which you can use as a guide for how to fill the form in.
This form has to be sent directly to HM Courts & Tribunals Service – the address in Bradford is on the form. Keep a copy of everything you send, and obtain proof of posting which the Post Office will provide for free.
There is also a new way to submit an ESA or PIP appeal. You can do it online. Please be aware that we cannot help with completing the online form at the moment. They are testing this service in some areas, which includes Norfolk, but it might not apply if you live in a different area, or want to appeal a different benefit.
An appeal form does not give you very much space to explain why you want to appeal a decision, so you may want to attach additional sheets. If you do, please remember to put your name and National Insurance number on every page, and to sign it.
In order to make an appeal, it is not enough to just say that you think they have got the decision wrong. You will need to say why and explain exactly how you think you meet the legal rules for entitlement.
If you have been turned down for Employment and Support Allowance because you have failed the Work Capability Assessment, unfortunately it will not make any difference whether your GP thinks you are unfit for work.
For Employment and Support Allowance you will need to explain which points should have been awarded and why. If you think you should be in the support group, you will need to say exactly what grounds you have for thinking so.
This means you need to have a good understanding of the rules of entitlement. You may need some help to understand this.
The legal rules for entitlement for Employment and Support Allowance can be found online here. The points system is outlined on pages 17 to 27. You can also download the ESA points information if you look in the list on the right.
For Disability Living Allowance or Personal Independence Payment, you need to explain which component (mobility or care/daily living) you are appealing against. If you are happy with the decision that has been made about one component, please be very careful to explain that. You also need to suggest which rate you think should have been awarded and why. Again, this means you need to have a good understanding of the rules of entitlement, and you may need some help to understand this.
The legal rules for entitlement for Personal Independence Payment can be found online here. The points system is outlined on pages 83 to 116 (looking at the page numbers at the bottom of each page). You can also download the PIP points information if you look in the list on the right.
If you are currently receiving Jobseeker’s Allowance or Employment and Support Allowance (in the Work Related Activity Group), you may be asked to sign a document which lists all the things you agree to do in exchange for receiving your benefit. This is known as a Claimant Commitment. It can include the requirement to attend Work Focussed Interviews or do activities as part of the Work Programme. Please see our other Factsheets that give you more information – Employment and Support Allowance, and Employment and Support Allowance and the Work Related Activity Group.
Why you might have your benefits sanctioned
If you fail to complete any steps that are agreed as part of your Claimant Commitment, you run the risk of having your benefit reduced, or ‘sanctioned’.
It is the Department of Work and Pensions who make decisions about sanctions. You may have been referred to another company such as the Shaw Trust, who might help you with any work related activity tasks you have been asked to do. If you don’t complete those tasks, the company will report to the Department of Work and Pensions who will consider whether you should have your benefit sanctioned.
Someone from the Department of Work and Pensions called a ‘decision-maker’ may sanction your benefit (by 50% of your personal allowance for the first 4 weeks, and 100% after that).
What you can do about this
You can challenge these decisions. Guidance for decision-makers suggests they should look at whether any reasonable person would act in the way that you have. You need to ask the Department of Work and Pensions to reconsider their decision, and provide them with your good reason (or ‘good cause’) within 5 working days. If they won’t change their mind and have given you a final Mandatory Reconsideration Notice, you can appeal. Please see our other Factsheet on Reconsiderations and Appeals.
You can ask them to reconsider their decision by telephone, but it is important to make a note of who you speak to, as well as date and time. Ask for a transcript (a written note of your conversation). If you would find it difficult to deal with them over the telephone, ask them to reconsider by letter and ask them to reply in writing.
If your reason is health-related, you would need to provide medical evidence. If you say that you have not received notification of an appointment, you would need to show that there was a problem with your postal delivery or some other good reason for this, as it is assumed that post that has been sent has definitely been delivered.
These are examples of what might be accepted as good cause:
- Unforeseen circumstances such as an important appointment that could not be rearranged, or a funeral of a relative, or difficulties with caring responsibilities
- Misunderstandings due to language, literacy or learning difficulties
Going to Work Focused Interviews
You will be excused from attending Work Focussed Interviews if you have a child under 1. People who have other caring responsibilities may also be excused and asked to attend at a later date. The Interview can take place at your home if travelling elsewhere would cause serious inconvenience or endanger your health.
If attending an Interview seems impossible for you at the present time due to health or other problems, you need to have a discussion with the Jobcentre to see if they will delay or defer it. They can delay this requirement, but not for more than 90 days.
If you are on Jobseeker’s Allowance they will focus on what steps you should be taking to find work now. The Department of Work and Pensions has said that looking for work should be a full-time job. If you are on Employment and Support Allowance, they will consider what help you might need to eventually get back to work; this can include offering some types of therapy, short training courses, or looking at self-employment possibilities.
You may need to tell them about your qualifications, your work history, your child-caring responsibilities, and be willing to talk about what work you hope to do in the future. They need to know about any paid or unpaid work that you are already doing.
Employment and Support Allowance
If you are on Employment and Support Allowance (in the Work Related Activity Group) you will not be expected to complete any Work Related Activity if you have child-caring responsibilities for a child under 5 or caring responsibilities, but you will be expected to attend an Interview.
The requirement to do any Work-Related Activity must be reasonable, taking into account your circumstances. If you take part in this, you cannot be asked to apply for any jobs or do any work, or undergo any medical treatment. If you have child-caring responsibilities for a child under 13, you cannot be asked to do any Work-Related Activity outside of normal school hours.
You should never be asked to do anything that would be detrimental to your physical or mental health. Everything should be tailored to you as an individual. If you think you are being asked to do something that is too hard, even if you agreed to it in the first place, you can always ask the Department of Work and Pensions to reconsider it, but you have no right to appeal their decision once they have done this.
You can expect that they will listen to your opinions about how your physical or mental condition will affect your ability to obtain work or attend interviews or training, and that they will provide the reasonable support you need.
Make sure you carry on signing on or sending in your medical certificates.
ESA RECONSIDERATIONS AND APPEALS- UNIVERSAL CREDIT UPDATE
Please note that If you are an existing ESA Claimant who has had their benefit stopped due to a re-assessment, the DWP may inform you that you will need to make a Universal Credit (UC) claim. However, if you do this, and then win your ESA Appeal, the ESA Decision will only apply up to the date of your new UC claim and you will lose your ESA Premiums, and possibly any additional financial components due to being in the Work Related Activity Group that you would continue to be entitled to as a continuing ESA Claimant.
Provided that you do not make claim for UC, once your ESA Appeal has been lodged with the Tribunal Services you will be entitled to the ESA Appeal rate, which is equivalent to the basic Job Seeker’s Allowance (JSA) rate. You will therefore need to consider as to whether you are able to financially manage without the ESA Appeal rate for the Mandatory Reconsideration period between the date of your new ESA decision, and the date you lodge your appeal, normally a period of 2 months. Bear in mind you are likely to need to wait at least for about 5-6 weeks before your claim for UC is processed.
If you are able to manage without this income during this period and win your ESA Appeal you will remain entitled to your additional ESA benefits that you would otherwise lose as a new Universal Credit claimant.
You need to request an application form from the Jobcentre. Not everyone will be eligible, even if benefits have been sanctioned. These are paid where someone can show they are vulnerable because they have no other resources to fall back on, and it would cause detriment to their family or cause health problems. The Jobcentre may also refer you to your local Foodbank. If in doubt about your eligibility, ask for one at the Jobcentre – the worst that can happen is they will tell you that you’re not eligible, and you can challenge that decision.
Impact of sanctions on other benefits
If you are also getting Housing Benefit or a Council Tax reduction, you need to inform the local authority as soon as possible, and make sure they know what your current income is.
Please refer to this guide for more information.