Personal Independence Payment (PIP) appeals

Tips suggested by members of our online community about PIP appeals

Even if you’ve had your Personal Independence Payment PIP claim rejected or reduced, you may still be able to get the benefits you believe that you are eligible for. In fact, as of the final quarter of 2016, more than 60% of PIP appeals were successful.

Knowing and understanding the appeals process will give you a greater chance of being successful in your appeal. So to help you, we’ve compiled some tips from members of Scope’s online community who have already been through the process.

Mandatory reconsiderations

If you disagree with your Personal Independence Payment (PIP) decision, the first step to take is to apply for a mandatory reconsideration (MR), challenging the Department of Work and Pensions (DWP) to change their decision. Watch our video about mandatory consideration.

Make sure that you apply for your MR within one month

Your application for reconsideration needs to reach the DWP no more than a month after the date of the original decision. This date will be printed on your decision letter, and it is important to note that this is the date that matters, not the date that you received it. You can also call the DWP to request reconsideration, but Citizens Advice recommend sending a letter so that you have everything in writing. You should send your request to the address on the decision letter.

Only in special circumstances, which made it impossible for you to challenge within one month, will exceptions be made to this rule. In these cases, reconsiderations will be accepted for up to 12 months from the original deadline.

Keep calm and state your reasons clearly

One community member stresses the importance of remaining calm and logical when applying for a MR: “I went through each point that the DWP made. Those that I agreed with, I said so. I didn’t rant and rave, didn’t call anyone a liar… I just pointed out to them where I thought they were wrong with their decision, and how my mobility affected me. I was successful.”

Another member echoes this sentiment: “Do not do anything while you are angry. It will cloud your mind and make you write weak arguments… list clearly and concisely all the errors in their ‘interpretation’ of the last assessment.”

Keep records

Throughout the appeals process, it’s important to keep track of who said what, and some community members suggest keeping copies of all incoming and outgoing correspondence, and recording phone calls via a phone app, such as Automatic Call Recorder.

Request evidence

In order to make a case for why your claim should be considered, you may need to better understand what evidence led to the decision being taken. Disability Rights UK recommend that you:
  • “Request a mandatory reconsideration of the decision. State your grounds simply at this stage, such as, ‘I believe that you have underestimated the degree of my disability and consequently underestimated the extent of my mobility problems and/or the difficulties I have in carrying out daily living activities’
  •  Ask them to send you copies of all the evidence that was used in making the decision; and
  •  Ask them not to take any further action until you have had the chance of responding to that evidence.
When you do receive the evidence, you should have a better idea of why the decision was made. This will help you frame your argument and build up evidence to support your case.”

State your case

The key point of a mandatory consideration is for you to convince the decision makers that the initial assessment and evidence differs from your actual abilities and needs. On building a case for your reconsideration, Disability Rights UK say that you should compare the evidence you have received with what you said on your claim:

“For example, you may have written on the form that you could not get on and off the toilet without support, but the healthcare professional noted in their report that they thought you could manage by yourself. Now try to get medical evidence showing that what you said on the form was correct – eg a letter from your doctor or consultant confirming the difficulties and risks you have getting on and off the toilet unassisted.”

Your request for reconsideration must highlight these differences between your daily reality and what the assessor has said, and to stand the best chance of being successful you need to support each point with evidence as far as is possible.

Don’t panic

Once you’ve sent off your mandatory reconsideration request, you may have to wait a little while as the DWP does not operate to set deadlines on these. Many community members receive a decision within two months or so, but if you are concerned you can ring the DWP to check that your MR request has been logged.
Even if you are not successful, as many are not at this stage, you can still appeal to a tribunal. For this you will need to send a copy of you’re mandatory reconsideration notice you receive, so make sure you keep hold of this.

Appealing to a tribunal

Appealing to a tribunal is the next step to take if you are unsuccessful in your request for mandatory reconsideration and you are still unhappy with the result.

Appeal promptly

When you receive your mandatory reconsideration decision letter, you have up to one month from the date on the letter to appeal, so you must make sure your appeal is sent and received within this timeframe. The appeal will be handled at a tribunal by an independent panel that will look at the evidence from both sides – yours and the DWP’s.

To find out more about how to appeal, download the HM Courts and Tribunals Service's digital leaflet. The form you need to send off is the SSCS1 (Notice of appeal) against a decision of the department for Work and Pensions)’,which you should print out, fill in and then send to the appeals centre. Ensure that you fill out every section to avoid the appeal being rejected, and remember that you must include a copy of your mandatory reconsideration notice. The address to send it to can be found at the bottom of the form.

Get help and advice

Though the appeals process may be daunting, there are lots of organisations that can help you along the way. The benefits advisors in Scope’s online community can offer advice and answers to any questions you may have, and your local branch of Citizens Advice will be able to offer you face-to-face support.

Don’t try to fit everything into the ‘grounds for appeal’ box

If you feel that you need to provide more information than the box on the form will allow, continue on a separate additional page to be included with the form, typed if possible.

Focus on the evidence

Your appeal should outline the specific reasons you have for disagreeing with your PIP decision, and draw on any evidence you have (such as your decision letter and any medical evidence you may have). You may also want to re-examine the PIP descriptors that are used when determining points, and reference these where applicable. One community member provides these very useful tips for filling out the form:
  • List your arguments of how the DWP’s points differ from your actual situation.
  • List any statements the DWP made that can be disproved.
  • List any mismatch between what you sent them in the PIP application and what they claim.
  • List any flaws in their position compared to their own rules.

Attend the hearing if you’re able

Attending a hearing gives you more of a chance to get your side of the argument across, so if you wish to do so make sure you enter a tick in the appropriate box. If and when a hearing is decided upon, you will be given at least 14 days’ notice.

Take evidence to the hearing

Bring along all relevant documents that you have, including medical evidence and anything related to your original claim or appeal. It’s also a good idea to take notes of what you want to say that you can refer to in order to get your point across.

Don’t worry about the tribunal

Your tribunal hearing won’t take place in a courtroom filled with lawyers and the like – it will be an informal meeting between you, a judge and up two other independent members of the tribunal board. Disability Rights UK says of the hearing: 

“The Judge will normally introduce the tribunal and explain its role. They usually go on to ask you questions about the issues related to your appeal… they will often ask you to describe what you do on an average day… once the tribunal is satisfied that everyone has had the chance to put their case, they will ask you to leave the room while they make their decision.”

Though it’s understandable that you may feel nervous or anxious prior to the hearing, it’s important to realise that no one there is trying to trip you up or catch you out. The aim of the hearing is to ascertain how your condition affects you, and to make a judgement based on this.Disabled woman in a powered wheelchair

Be your normal self

Don’t put on a ‘brave front’ or try to look extra smart, just be yourself. The panel is trying to make a judgment based on how you are on a normal day, so make sure this is what you show to them.

Getting your decision

In normal circumstances you will receive the tribunal’s decision on the day. If successful, the decision will be passed on to the DWP, who will then put your new benefits level into effect. 

If you are not successful in your appeal, you can request a ‘statement of reasons', which will explain how the decision is made. If after reading this you believe that a legal mistake has been made, you may be able to appeal again to an upper tribunal.

Get more advice and share your experiences

If you’d like more advice on your appeal and your specific situation, you can speak to our community benefits advisors online. You can also talk to members of Scope’s online community who may have already been through the appeals process, in our PIP/DLA discussion group. If you’d like to talk to someone on the phone about your appeal, call Scope’s free helpline on 0808 800 3333 (Monday to Friday 9am to 5pm).
Looking for advice, support and friendship from people in a similar situation to you? Join our online community today.