APPLYING for benefits in the UK can be a tricky process with lots of hoops to jump through and confusing rules.
And even then, you can end up with a decision that you don’t agree with.
You can challenge a benefit decision if you don’t believe it’s right[/caption]
This could be because your claim is denied, you don’t get the level you expected, or you’re missing certain elements you think you qualify for.
Fortunately, the system allows you to challenge decisions that the Department for Work and Pensions (DWP) has made, and there’s evidence it’s well worth doing.
For instance, figures released by His Majesty’s Courts and Tribunals Service on 14 March show that 70% of all Personal Independence Payments appeals are won.
That means people are getting much-needed cash that they would have been denied if they hadn’t challenged the government’s decisions.
If you want to challenge a DWP decision, you usually need to apply for a mandatory reconsideration. But first, you need to understand why the benefits office made the decision it did, and gather evidence to show why they’ve got it wrong.
Getting an explanation
If your claim is denied or lower than expected, the first step should be to make sure you understand why. Sometimes, you’ll be sent the reasons in writing, for instance if you are rejected for a Personal Independence Payment claim.
If you haven’t been told why, you can ask the DWP to explain. Sometimes this can happen over the phone, or you can get a written statement of reasons. If you want the information in writing, you can request this and it must be provided.
Either way, you should move fast. There’s a time limit when it comes to asking for a mandatory reconciliation, so if you leave it too long, you might not be able to appeal.
To get the extra info, contact the DWP, HMRC or your local authority, depending on which benefit you’re trying to appeal. You should have the details on your decision letter.
It’s also worth speaking to them and explaining why you think the decision is wrong, sometimes it can be changed without launching a formal appeal.
For instance, if the decision was based on incorrect or missing information, the benefits office may be able to send you a new decision letter or it can explain what you can do next.
If your first language isn’t English, you can get an interpreter.
Turn2Us says that if you do telephone the benefit office, you should make a note of the time and date that you call, who you speak with and exactly what is said. This can be useful if you decide to formally challenge the decision.
If you’re still not happy with the outcome, the next step is usually to start the mandatory reconsideration process.
How long do I have to appeal the decision
Generally, you need to apply for a mandatory reconsideration within one month of your decision letter.
However, Turn2Us says that if you ask for written reasons within one month of the date on the decision letter, the time limit will be extended. The new limit will be:
- One month and 14 days from the decision date (if the written reasons are provided within one month of the decision date); otherwise
- 14 days from the date the written reasons are provided.
However, the charity cautions that this only applies if the reasons were not provided in the decision letter you received. It says: “If you are in any doubt, stick to the usual time limits.”
You can usually get an extension if you have a good reason, for instance, if you’re in hospital or if a member of your immediate family dies.
How to ask for a mandatory reconsideration
If you want a mandatory consideration, you should write to the DWP or other relevant department.
You need to ask for the decision to be reviewed, and include any evidence you have as to why it was wrong in the first place.
You should go into detail, and provide copies of supporting documents where possible, for instance medical reports, doctor’s records, and financial statements.
If you are challenging decisions to do with benefits such as PIP and ESA medical evidence can be extremely valuable, particularly if it contradicts your medical assessment report produced by DWP.
Send the letter by recorded delivery, so you know it arrives safely, and keep a record for yourself.
If you’re challenging a decision around Universal Credit, you can do so through your online journal.
A different person will look at the decision, and decide whether it should be overturned or changed.
Sometimes, the DWP will ask for more information or extra pieces of evidence. If this happens, you should send things through as quickly as possible.
If your mandatory reconsideration is successful, you’ll be sent a new decision letter. If the decision doesn’t change, you’ll also be told by post.
You can choose to appeal if you’re still not happy with the outcome you get.
How to take an appeal further
The next steps depend on which benefit you’re applying for. However, in almost all cases you need to act within a month.
We have explained what to do for each benefit below.
Budgeting loans
If you want to challenge a decision around a budgeting loan, you need to ask the Independent Case Examiner’s office to do a review. The ICE is an independent organisation that’s completely separate from the Department for Work and Pensions (DWP).
Contact the ICE office in writing asking it to look at the decision again. You need to include your:
- Name
- Contact details
- National insurance number
- Details of the benefits you applied for
- The date of the decision
- Information about why you disagree with the decision and evidence to back this up.
The ICE will decide whether the decision should be changed.
Employment and Support Allowance
If you’re making an appeal regarding ESA, you might want to skip the mandatory reconsideration process.
Turn2Us says this applies if you already getting the payment, you’re appealing a decision that says you are fit for work, and the decision is not based on you having failed to return your ESA50 questionnaire or attend an assessment.
It must also be either:
- The first time you have been found fit for work at an assessment, or
- You have been found fit for work at a previous assessment but since then had an assessment where you were found to have limited capacity for work.
The reason for going straight to appeal is that you can keep getting your benefits during the appeal, but you can’t when going through a mandatory reconsideration process.
If you’ve been through the mandatory reconsideration and aren’t happy with the outcome, you can still choose to appeal either online or by post.
You can appeal a decision online through GOV.UK, if you are in England, Scotland or Wales or through The Appeals Service, if you are in Northern Ireland.
You can also write to HM Courts and Tribunals Service at the following addresses:
- England and Wales: HMCTS SSCS Appeals Centre, PO Box 12626, Harlow, CM20 9QF
- Scotland: HMCTS SSCS Appeals Centre, PO Box 13150, Harlow, CM20 9TT .
- Northern Ireland: The Appeals Service, PO Box 2202, Belfast, BT1 9YJ.
The First Tier Tribunal will decide if you are entitled to a benefit and can change a decision. However, it’s worth knowing that its decision could leave you worse off so it is often best to seek advice first.
Universal Credit
If you believe the DWP has calculated your Universal Credit using the wrong income, you need to raise a Real Time Earnings (RTI) dispute. You can do this by leaving a note in your journal.
If your claim has been closed and you want to make a challenge, you should call the DWP helpline 0800 328 5644. You can also use the Challenge a decision made by the Department for Work and Pensions form.
Further appeals follow the same process as for an Employment and Support Allowance claim.
Personal Independence Payment
If you’ve tried a mandatory reconsideration for your PIP claim and you still aren’t happy, the next step is to go to a tribunal. You normally need to do this within a month.
In England, Wales and Scotland, use the SSCS1 appeal form or the online form on the Gov.uk website. In Northern Ireland, use the NOA1(SS) appeal form.
You need to explain which decision you’re challenging, what you think the outcome should have been, and why you disagree with the DWP’s decision.
PIP is awarded based on points, so you need to include information about how many points you think you should have been scored for each activity and medical evidence where possible to back up your claims.
Turn2Us says you can also apply for judicial review if the way a decision was made was wrong or very unfair.
Council tax support
If you’re challenging a decision on council tax support you need to send a letter or email to your local authority instead of DWP. You should include your council tax reference number, why you think the decision is wrong and any documents that back up your argument.
The next step is to make an appeal. This could focus on whether you are entitled to a reduction in your council tax, or how much you have been awarded under the local Council Tax Support scheme.
You can get a copy of the appeal form or complete it online from:
Child benefit
If you’re challenging a child benefit decision, you need to speak to HMRC not DWP, but the mandatory reconsideration process is the same.
If you’re still not happy with decision, you might be able to go to tribunal, although not all decisions can be appealed.
For instance, you cannot appeal against a decision about who gets child benefit if you and the other parent could not agree and had equal priority.
If you are appealing, you need to write directly to the Tribunal Service.
In England, Wales and Scotland, you use the appeal form SCS5 on the Gov.UK website. There are also SSCS5 guidance notes to help you fill the form. You need to include the mandatory reconsideration notice that you received from HMRC.
In Northern Ireland, y use appeal form NOA1 (HMRC)
Housing Benefit
Like with council tax challenges, appeals around housing benefit need to go through your local authority first, not DWP. However, the mandatory reconsideration process is the same.
If you then go on to appeal the decision, it will be looked at by an independent tribunal, which is separate from your local authority or the Housing Executive. You can appeal without having to ask for a reconsideration first.
The First Tier Tribunal will decide if you are legally entitled to a benefit and can change a decision if they think it is wrong.
