If you think that a decision about your benefits is wrong you have the right to appeal to the First Tier Tribunal (Social Security and Child Support). Your case will be heard by an independent tribunal. One set of rules applies in England, Scotland and Wales, and a different set of rules applies in Northern Ireland.


Challenging a decision in England, Scotland or Wales 

How do I challenge a decision that has been made about my entitlement?
You must first ask for a 'reconsideration' of the decision. A reconsideration is where the government department which issued the decision reviews their decision to see if they want to change it. Once they have carried out a reconsideration they then issue you with a new decision. You then have the right to appeal against that second decision. You must send your appeal request directly to the Courts and Tribunals Service.

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. We recommend that you telephone and write a letter to confirm that you wish to have a reconsideration to make sure that your request is received. 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.

 

 

Personal Independence Payment (PIP) reconsiderations

The NAS welfare rights service regularly hear 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. 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.

What happens after I have asked for a reconsideration?
Your case is passed to a different decision-maker who reviews the original 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 DWP to complete their reconsideration.

Benefit payment pending the outcome of reconsiderations or appeals
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. There is one notable exception to this: the payment of ESA following a work capability assessment decision. See below for more details. 

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. Or if your child's DLA 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 the reconsideration decision.

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 DWP 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, the DWP 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.

You can claim Job Seekers 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.  

How do I ask for an appeal?
You can 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 SSCS1 appeal form.

When you request the appeal you must:

  • enclose with your appeal letter or form a copy of the reconsideration decision letter that you have received
  • include your name, address and national insurance number
  • explain why you disagree with the decision
  • state whether you want to attend the appeal hearing (we recommend that you do attend).

If you live in England or Wales your appeal request must be sent to:

HMCTS SSCS Appeals Centre
PO Box 1203
Bradford BD1 9WP

If you live in Scotland your appeal request must be sent to:

HMCTS SSCS Appeals Centre
PO Box 27080
Glasgow G2 9HQ

 

 

Challenging a decision in Northern Ireland

In Northern Ireland the Government intends to change the appeal process, but the required changes to the law have not yet been passed by the Assembly. It is unclear at the time of writing (March 2015) if the changes will happen. The old rules still apply which means that you have the right to go direct to the appeal stage. You can ask for a reconsideration, but it is optional.

How do I challenge a decision that has been made about my benefit entitlement?
If you disagree with a decision you can ask for a reconsideration or you can go straight to an appeal of that decision. If you opt to have a reconsideration first, a different decision-maker looks at the case. You can provide additional information and they may choose to change the decision. If after the reconsideration you still disagree with the decision, you can then ask for an appeal.

Should I go direct to the appeal stage, or should I choose to have a reconsideration first?
If you are appealing a decision to stop your Employment and Support Allowance (ESA) because you were found fit for work then you should go direct to the appeal stage and not have an optional reconsideration. This is because once you have asked for an appeal your ESA can be paid at a basic rate whilst you are waiting for the appeal to be heard, whereas if you ask for a reconsideration no ESA is paid. If you are appealing a different type of decision you need to weigh up the pros and cons of each approach. To take the quickest, most direct approach you should go direct to the appeal stage. If you are not sure whether you want to take your dispute as far as the appeal stage, you might opt for a reconsideration first. When you ask for an appeal the Social Security Agency will review the decision first before passing it on to the Appeals Service, and they can change the decision at this point if they realise it was wrong. 

Is there a time limit for requesting an appeal?
There are strict time limits for appealing. Your appeal must reach the relevant office within one month of the date that the decision was sent to you. It is possible to make a late application for an appeal, but you have to have special reasons. In these circumstances it is best to get advice.

How do I ask for an appeal?
You must request the appeal in writing. You can write a letter but it is easier to use the official GL24 appeal form which you can get by ringing the office that sent you the decision. Your appeal request should be sent to the Social Security Agency office that issued the decision.

 

 

General information about appealing

The rest of this information is relevant for all of the UK. 

Who should request the reconsideration or appeal?
It is the claimant who must request the reconsideration or 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 adult then the appointee must ask for the appeal.

Should I challenge the decision?
Whenever you ask for a reconsideration or an appeal the decision-maker or tribunal could reduce, increase, stop or reinstate the benefit. Before choosing to ask for a reconsideration or appeal you need to understand the potential risk that you are taking and compare this to the potential for you 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 that you believe you are entitled to then you do need to be cautious because you could end up worse off.
 
How long might my appeal take to be heard?
There can be long delays in reconsideration and appeal decisions. You are likely to have to wait a couple of months for an appeal hearing and 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 decision that they think is correct. It is best to get advice so you can make an informed decision 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. You will have the opportunity to explain your case to the tribunal. If you choose not to attend the hearing you should make sure that you put everything that you want to say in writing and send this to the tribunal in advance.

I claim benefits on behalf of a child under 16, or am the appointee for an adult. Do they need to come to the hearing?
Only the claimant or appointee has to attend the hearing, so a child or an adult who has an appointee does not need to attend. You can choose to take the child or adult who you claim benefits for if you think that would help the tribunal to understand your case.

What if I can't attend the hearing?
If you cannot 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 is 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.

Travel and other expenses
You can claim for reasonable expenses. 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 DWP presenting 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 whilst 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.

The tribunal 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 in 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.


For advice and information about benefits or to request a telephone appointment, please contact our Welfare Rights Service by emailing welfare.rights@nas.org.uk or advice40plus@nas.org.uk (for people aged over 40 with ASD, their families or carers) or by completing our contact form.


Quick link to this page: www.autism.org.uk/benefitappeals