What are my options? Ask for an explanation 3. Have the decision looked at again 4. Appeal against the decision. Appeal against the decision An appeal is a way of telling the benefit office that you think a decision is wrong.
How do I appeal? If you can't get hold of the official appeal form, make sure you include the following details in your letter: Your name and contact address Your National Insurance number A copy of the mandatory reconsideration notice Why you think the decision is wrong Your signature.
If you don't include all these details, your appeal form may have to be returned to you. Time limit You have one calendar month from the date on the mandatory reconsideration notice. Late appeal If you missed the deadline for reasons out of your control, such as illness or bereavement, you may be given more time to appeal. There is a section on the appeal form where you can give your reasons for it being late. If they decide that the original decision is wrong, they will change the decision and send you a new decision letter: If the new decision makes you better off your appeal will stop.
You can appeal this new decision if you think it is wrong If the new decision does not make you better off, your appeal will carry on but now it will be against the new decision. This explains: How they came to their decision What information they used What benefit law they based their decision on. The First Tier Tribunal 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.
The tribunal cannot: Change the law Deal with administrative complaints, such as delay or poor service see Complaints about your claim Consider changes of circumstances which have taken place since the decision was made. Benefits while appealing an ESA decision If you appeal against an Employment and Support Allowance ESA decision , you can ask to be paid ESA whilst you await the decision, unless you went on to Universal Credit while you were waiting for your mandatory reconsideration decision.
You must continue to provide medical certificates fit notes whilst you are getting ESA. Updated: September Previous Have the decision looked at again. What you were doing? What would you like to report? Security code. It is particularly helpful if your illness or disability isn't the same every day.
It also needs to reflect how you were affected at the time of the decision about your benefit, so is of most use if your health has not got worse since then. Keep a diary for a week or if you have a condition which fluctuates, a longer period will be helpful. It can be very brief.
For example - 'Monday — Very confused today. Marie needed to remind and prompt me to do simple everyday tasks, and not to get distracted. Include everything that is connected to the activities and descriptors that entitlement to these benefits are based on see How to write useful evidence for a Work Capability Assessment appeal for the list. If you get help from somebody and find this sort of thing hard, you could ask them to keep a diary of the help they have given you instead as an alternative to the letter - see above.
Be realistic about what you want to happen. If you have seen or spoken to an adviser - did they tell you what rate they thought you might be entitled to? Have you used our Work Capability Assessment Mandatory Reconsideration Tool to check what points you should get, by your own assessment? You should think about writing a statement for the tribunal, or getting a friend to help you. These can be very useful as they set out all your points, which means that you don't have to remember everything to say on the day.
They are also a useful way of telling the panel about mistakes and things left out of the assessment report. Stay away from accusing the assessor of lying as that is very difficult to prove. Instead give a flavour of the sort of things that are wrong and ask that the tribunal to listen to other evidence instead.
For more advice on how to write a statement and what to put in it, see How to write a statement for your appeal hearing. Read all the evidence through - does it reflect your difficulties accurately?
If it doesn't, you don't have to send it to the panel. If you don't think the evidence is useful it may be worth going back to the person who wrote it and discussing it with them. Looking again at our guidance on How to write useful evidence for a Work Capability Assessment appeal , is there anything they can add to make it more useful? If you've got useful evidence, photocopy it or take a picture of it on your phone in which all the text is clear , and send it into the HM Courts and Tribunal Service as soon as possible before your hearing.
Many tribunal centres now prefer email, but you MUST put the appeal number in the subject heading or it may not be read. Sending the evidence now is useful because it maximises the chance of the DWP changing the decision or a judge making the right preliminary decision. However, only accept a higher award without going to a hearing it if you think it is the right award.
On the day of your hearing, take your copies with you and ask the clerk or panel to confirm that they have received them. Some people find it helpful to work out how they will get to the hearing and even do a 'dry run', so that you know how to get there. The letter you receive about the hearing will usually give you details of public transport links and parking.
At most venues, you can book an accessible parking spot if you phone them in advance. If you are having a telephone or video hearing check that you know how to do that and have set up anything you need in advance. The guidance below assumes you are going to a face-to-face hearing. Most of the advice below will still apply. You can go alone or take a friend or family member with you for moral support.
If you are told that your hearing will be held over the phone or by video call, see our guidance in Court and tribunal hearings and Coronavirus which explains how things work and what you can do to help it go smoothly. If something goes wrong on the day or in the hearing, make you sure you tell them. If you are not sure that they can hear you, ask them if they can.
If they cannot hear you either, they will realise that and usually end the call and call you back - so stay near your phone. If you are worrying about your hearing by phone or video, consider writing a statement and sending it to them in advance.
It will mean they already know all the important things you wanted to say on the day. When you arrive at the tribunal centre, you will have to go through security procedures. Expect to have to open your bag and be patted down with a metal detector. If you are at a Magistrates Court you will have to walk through a metal detector and have your belongings x-rayed.
If you have an ICD implantable cardioverter defibrillator then take the card with you to prevent you from having to walk through this. Arrive 10 minutes early to go through security. After security, you will usually be shown into a waiting room. You might have to wait here for a little while. While you are waiting, the clerk to the tribunal will call your name and come over to talk to you. This is your opportunity to check that the tribunal received the evidence and statement you have sent them, and to hand in any evidence or statement you have not already sent.
When the panel are ready for you, the clerk will call you into the room. The room the hearings are in are all slightly different. Often they look like a rather boring office and everybody is wearing normal clothes. When you go in there will be a big table in front of you. You and anyone who goes with you will sit at one side of the table and the panel sit on the other side.
There will be water and tissues on the table ready for you if you need it. The panel will usually be made up of two people. A judge and a doctor.
The doctor does not work for the government or the DWP. The panel should introduce themselves and explain what will happen. Remember the panel are completely separate from the DWP. They are here to see that you get the benefit if you can show you are entitled to it. Usually the members of the panel will be nice and easy to talk to, and will just want to get a full picture of your illness or disability and the help you need.
If this happens, try to keep calm. Don't take it personally. Stick to what you wanted to say, and answer their questions fully. It is ok to tell them that you feel they are going too fast, or making you anxious, or you feel you are not getting an opportunity to explain.
The DWP have a right to send somebody to your appeal to explain why they made their decision and they now do this more and more. Don't worry about this though. If they send someone, they are nice and non-confrontational. It will not be the person that made the original decision about your claim. Remember it is YOUR appeal. If you get upset, you can ask for a short break. If you are in discomfort from sitting in the chair after a while, you can simply get up and walk around the room a bit.
In the unlikely event that the panel are considering a reduction of your existing award for example because you appealed the decision not to put you in the support group, and the panel feel that you may not be entitled to any award at all , the judge will give you warning and ask if you want a few minutes to consider your options.
This is very rare. But if it does happen to you, ask for the hearing to be stopped and explain that you wish to withdraw the appeal. If you do this, the Tribunal is very unlikely to take away the benefit you get at the moment.
If you can't attend on the date they give you, contact the tribunal centre and ask for another date as soon as you can. Don't put it off or just do nothing about it - they are usually extremely helpful. You may have to explain why you can't go and you should have a very good reason, like a hospital appointment.
If they refuse to change the date, you should do everything you can to move your other appointment. In some areas, hearings are often postponed. Usually, if this has happened, you will get a phone call earlier in the day to warn you not to go. Hopefully this won't happen to you, but it is possible that you will arrive to find that you have had a wasted journey.
The panel will usually make the decision that day. You will be asked to go to the waiting room while the panel discuss your case. This usually takes between minutes. You will then be asked back into the room and told the decision. They will give you a written outline of their decision as well. Sometimes the panel will not be able to make a decision quickly.
If this happens, they will post it to you instead. It should arrive within a week. If they are not able to make a decision quickly, it does not mean that you have not been successful with your appeal. If you think it might help, ask a friend or family member to come with you for emotional support.
They might also be able to help by reminding you of things you have forgotten. If you do ask a friend, show them For friends or relatives. If your hearing is over the phone or by video, most of the advice below will still apply. Staying calm isn't easy, particularly in very stressful situations, like waiting for your appeal hearing. Having a friend or family member or support worker with you can help.
Many people find that the best way of reducing stress immediately is to concentrate on their breathing. Take several long, deep breaths. If you can, breathe in through your nose. Try to take the air into your stomach you should feel your stomach rising. And then slowly breathe out through your mouth. It might help to close your eyes and picture nothing, others like to imagine a scene they find calming. Some people prefer to keep their eyes open and to slowly read all the notices on the wall.
If you do this, try to concentrate on details. It doesn't matter what you look at or think about — what is helpful is slowing down your thoughts and your breathing. Some people also find it useful to clench and then relax their fists, arms, and jaw; and to frown and then relax, or raise their eyebrows and then relax them. If you are getting stressed because of the number of things you have to remember - write a list or get someone to write a list for you.
As soon as it is down on paper, you don't have to remember it. You can take a friend or relative to the appeal with you. If you have asked somebody to come with you to give you support, show them the information in the next section. It explains what they can do to help. If you were successful, the DWP will work out how much they owe you.
You will start receiving the new amount every month, and a sum covering any amount they owe you while you waited for the appeal. You will usually receive your money in about 4 - 6 weeks. If you weren't successful, you will be sent a leaflet to explain your options. Sometimes you might be able to appeal to the Upper Tribunal. This is like a higher court.
However, this can only be done if the panel did something wrong with the law. It is very complicated, and very few people can do this without an experienced adviser. You cannot appeal to the Upper Tribunal without the Statement of Reasons. See How to find an adviser. The DWP also has the right to appeal to the Upper Tribunal if they think the tribunal panel did something wrong. This rarely happens. If it does happen, they will write and tell you. Adviser This is a benefit expert who can give you advice about your claim.
They may also be able to help you prepare for the hearing or even represent you. Appeal This means a panel of two experts who do not work for the DWP will look at your claim and see if the right decision was made. If they think the wrong decision was made, they will change it.
Carer This is a person who helps you often, like every day or every week. It might be somebody you pay, or might be your partner, a family member, or a friend or neighbour. Clerk to the Tribunal This is the person who organises the hearing and deals with the paperwork and admin. They also run Jobcentres and the office which arranges the face to face assessments. Descriptors These are the descriptions of very specific difficulties on which entitlement to ESA or Universal Credit on the basis of limited capability for work is based.
Each descriptor that applies to you gives you points. If you receive 15 or more points, you are entitled to ESA. First-tier Tribunal This is another name for the panel of experts who hear appeals. Hearing This is when your appeal is looked at by the Tribunal. We strongly advise you to go to a hearing in person. You have a much better chance of success if you do.
Limited capability for work LCW This is the group that you are put in if you claim Universal Credit and the DWP accept that your condition limits your ability to work now, but that you will be able to return to some form of work in the future and they want you to do some things to prepare for this. It is the equivalent of the work-related activity group in ESA.
Limited capability for work element Universal Credit is a new benefit being brought in to replace 6 income-based benefits — one of which is income-based Employment Support Allowance.
Under universal credit everyone has to sign to accept a work commitment, if you can't work at the moment but it is thought that in time or with additional support you may be able to in the future then you will be place in this group.
Most people must ask for a mandatory reconsideration before you can appeal a decision. Both the claimant and the DWP will be asked if they accept the preliminary view.
Representative This is an expert in benefits who might help you prepare for the hearing, gather evidence for the appeal, write to the tribunal and may be able to will come with you to help you put your case. SSCS1 This is the form you use to ask for an appeal. You can also do it online. See How to ask for an appeal for advice on how to fill it in. Submit your appeal This is a new system that allows you to lodge your appeal online.
Supersession This means having your claim looked at again because your illness or disability has worsened since the date of the decision.
It is the ESA equivalent of limited capability for work and work-related activity in Universal Credit. If you are entitled to contribution-based or New Style ESA because you have paid enough NI contributions you can also receive it as long as you meet the requirements for the benefit, rather than a year.
If you submitted your appeal online you may have already signed up to it. If not, see What to prepare before the hearing for details of how you sign up. Tribunal Judge This is the legally qualified member of the panel who will make a decision on your case. He or she will usually welcome you to the hearing. If the members of the panel do not agree what should happen on your case, the Judge gets the deciding vote. Upper Tribunal This is like a higher court.
If you weren't successful in your appeal, you might be able to appeal to the Upper Tribunal, but you can only do this if the panel made a mistake with the law. Work Capability Assessment This is the process by which the DWP assess whether you have limited capability to work or limited capability for work-related activity, and are therefore entitled to Employment Support Allowance or the limited capability for work element of Universal Credit.
It consists of a form and a face-to-face or telephone assessment. Work-related activity group This is the group that you are put in if you claim ESA and the DWP accept that your condition limits your ability to work now, but that there are things you can do to improve this. It is the equivalent of the limited capability for work group in Universal Credit.
Work-related activity These are activities that the DWP believe will help you prepare for a job in the future. If you are in either the limited capability for work LCW group on Universal Credit or the Work-related activity group on ESA you need to do the work-related activity you have agreed with the DWP to continue receiving the benefit. Work-related activity may include meeting with your job coach at the Jobcentre, going to occasional training courses, or joining a support group.
Find the appeal form or ask for an appeal online. You can find details about how to claim expenses, appeal venues and how to get to them, as well as other information about the appeal process.
Remember our guidance about whether to appeal, how to appeal, and how to put your case well will be more helpful than theirs as we are independent. See How to find an adviser for help to find an adviser or representative. Citizens Advice have some helpful information about ESA, how claims are assessed, and how to appeal. This site is really helpful if you are trying to find out a bit more about what a particular descriptor or regulation means.
Youre able is an online community of and for disabled people with some really useful and supportive forums. Run by the Disabled Living Foundation. You can write a short complaint letter detailing the errors in your assessment and any other problems to the Health Assessment Advisory Service. Up-to-date details of postal and email address for complaints can be found on their contact us page.
You may also like to send a copy to your MP — it may help them to understand the scale of the problems faced by disabled people accessing benefits. Print out and show this page to the people you are asking to write evidence for you. Remember to mark the descriptors you meet below. Remember that you can only score points for one descriptor either a, b, c or d in each of the activities so choose the descriptor that you meet that gives you the most points.
We have written this page for medical staff, social workers, support workers, and other professionals who might be able to tell the tribunal what they need to know. It explains how to write helpful evidence for this kind of benefit appeal. Evidence from doctors and other professionals helps the tribunal to come to the right decision more than anything else.
Your evidence doesn't need to be long or typed. This appeal is about a decision that was made on …………………………. Your evidence needs to be about how their condition affected them at that time. For example, if they sometimes have seizures, violent outbursts, frequent falls, suicidal thoughts, delusions, or need supervision to stay safe, it would arguably be dangerous for them to be forced to travel and work without supervision.
Or if they would be unable to look for jobs, and go to meetings and training on time and without fail perhaps because of depression or confusion there is a substantial risk that their benefit payments would stop and they would be unable to feed or care for themselves. If the stress of looking for a job or going to work might make them relapse, that can be counted too. Please confirm all those that you can in your evidence. For example, if they cannot walk into your consulting room without discomfort, or if they are slow and it takes them twice as long as somebody else, please say that.
If you cannot confirm the descriptor your patient has marked but can confirm another in that activity, please include that. If you cannot confirm any from that activity, please just leave it out as your patient may have evidence from someone else who knows more about their problems with this.
Activity 1: Moving around without the help of another person — including using a walking stick, manual wheelchair or other aid you could use. Descriptors: a Cannot move between one seated position and another seated position located next to one another without receiving physical help from another person - 15 Points b Cannot, for the majority of the time, remain at a work station, either: i standing without help from another person even if free to move around ; or ii sitting even in an adjustable chair for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion - 9 Points c Cannot, for the majority of the time, remain at a work station, either: i standing unassisted by another person even if free to move around ; or ii sitting even in an adjustable chair for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion - 6 points.
Descriptors: a Cannot raise either arm as if to put something in the top pocket of a coat or jacket - 15 Points b Cannot raise either arm to top of head as if to put on a hat - 9 Points c Cannot raise either arm above head height as if to reach for something - 6 Points. Descriptors: a Cannot pick up and move a 0.
Activity 6: Making yourself understood through speaking, writing, typing, or other means, without help from someone else. Descriptors: a Cannot convey a simple message, such as the presence of a hazard - 15 Points b Has significant difficulty conveying a simple message to strangers - 15 Points c Has some difficulty conveying a simple message to strangers - 6 Points. Activity 7: Understanding communication by either verbal means such as hearing or lip reading and non-verbal means such as reading large print , using anything to help that you could use glasses, hearing aid etc , without help from someone else.
For the descriptors below, you only have to show that you have difficulty or are unable to understand a spoken or written message, and not both.
Descriptors: a Cannot understand a simple message due to sensory impairment, such as the location of a fire escape - 15 Points b Has significant difficulty understanding a simple message from a stranger due to sensory impairment - 15 Points c Has some difficulty understanding a simple message from a stranger due to sensory impairment - 6 Points.
Activity 8: Finding your way and being safe, using a guide dog or other aid if normally used. Descriptors: a Unable to find your way around familiar places, without the help of another person, due to sensory impairment - 15 Points b Cannot safely cross the road or complete another potentially dangerous task , without the help of another person, due to sensory impairment - 15 Points c Unable to find your way around unfamiliar places, without the help of another person, due to sensory impairment - 9 points.
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