TO YOUR BENEFIT
How to challenge a benefit decision as 100,000 have had rulings on PIP overturned – leaving them £9,000 better off
Plus, we've explained who's eligible for PIP
OVER 100,000 households have had their PIP decision overturned after being originally rejected from claiming the benefit.
New figures published by the Department for Work and Pensions (DWP) suggest that thousands more could have their PIP rejections overturned.
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Individuals suffering from a long-term illness, disability or mental health condition can get extra help through personal independence payments (PIP).
The maximum you can receive from the Government benefit is £172.75 a week - and it's well worth applying if you have a long-term illness or mental health condition.
Latest PIP statistics show that as of January 2024 there were 3.3million claimants entitled to PIP in England and Wales
Over half of those who attend a PIP assessment, or 56%, have been awarded the benefit, according to the latest DWP statistics.
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But between October 2018 and January 2024, 670,000 of those whose claims were approved or halted at these assessments challenged this decision by asking for a "mandatory reconsideration".
You can challenge a PIP rejection or your claim if you don't feel as though you've been awarded enough.
All 140,000 of those whose mandatory reconsideration was left unchanged appealed this decision at a tribunal.
In the end, 70% or 100,000 had their decision overturned at the tribunal - meaning the original decision was revised in favour of the PIP claimant.
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This precedence means that most of those who apply for PIP and get rejected can often get this original rejection overturned by challenging the decision and appealing it at a tribunal hearing.
We've explained how you can challenge your PIP rejection in detail below to ensure that you don't lose out.
What is PIP?
HOUSEHOLDS suffering from a long-term illness, disability or mental health condition can get extra help through personal independence payments (PIP).
The maximum you can receive from the Government benefit is £172.75 a week.
PIP is for those over 16 and under the state pension age, currently 66.
Crucially, you must also have a health condition or disability where you either have had difficulties with daily living or getting around - or both- for three months, and you expect these difficulties to continue for at least nine months (unless you're terminally ill with less than 12 months to live).
You can also claim PIP if you're in or out of work and if you're already getting limited capability for work and work-related activity (LCWRA) payments if you claim Universal Credit.
PIP is made up of two parts and whether you get one or both of these depends on how severely your condition affects you.
You may get the mobility part of PIP if you need help going out or moving around. The weekly rate for this is either £26.90 or £71.
While on the daily living part of PIP, the weekly rate is either £68.10 or £101.75 - and you could get both elements, so up to £172.75 in total.
You can claim PIP at the same time as other benefits, except the armed forces independence payment.
Make a claim by calling the Department for Work and Pensions (DWP) on 0800 917 2222.
How do I ask for a mandatory reconsideration?
If you disagree with a decision about PIP you can ask for the decision to be looked at again - this is called "mandatory reconsideration";.
It's free to ask for mandatory reconsideration.
You can ask for mandatory reconsideration if any of the following apply:
- You think the office dealing with your claim has made an error or missed important evidence
- You disagree with the reasons for the decision
- You want to have the decision looked at again
Some decisions cannot be reconsidered. Others can go straight to an appeal.
Your original decision letter will say if this applies to you.
You usually need to ask for mandatory reconsideration within one month of the date of the decision.
You can ask for it after one month if you have a good reason, for example, if you’ve been in hospital or had a bereavement.
Make sure you understand the reason for the decision you received before you ask for mandatory reconsideration.
This will help you explain why you disagree.
To ask for a mandatory reconsideration you'll need to contact the benefits office that gave you the decision.
You can contact them:
- By phone
- By letter
- By filling in and returning a form for asking for mandatory reconsideration
The contact details are always provided on your decision letter.
But if you do not have your decision letter, contact the office where you applied for the benefit.
When you ask for mandatory reconsideration, you need to give:
- The date of the original benefit decision
- Your name and address
- Your date of birth
- Your National Insurance number
Explain what part of the decision is wrong and why - you can send evidence to support your reasons.
Any evidence you send needs to support your reasons for why the decision was wrong. It could, for example, be:
- New medical evidence
- Reports or care plans from specialists, therapists or nurses
- Bank statements or payslips
Once you've sent your evidence, the benefits office that gave you the original benefit decision will reconsider it.
When they've reconsidered it, you’ll get a letter called a "mandatory reconsideration notice" telling you whether they’ve changed the decision.
The mandatory reconsideration notice will explain the reasons for that decision and the evidence it was based on.
If you disagree with the outcome, you can appeal to the Social Security and Child Support Tribunal if you think the decision in the mandatory reconsideration notice is wrong.
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How do I appeal a benefit decision?
It’s free to appeal a benefit decision.
Appeal to the tribunal within one month of getting your mandatory reconsideration decision.
If you start your appeal after a month, you'll have to explain why you did not do it earlier. Your appeal might not be accepted.
After you submit your appeal, you can manage your appeal online and provide evidence to the tribunal.
Your appeal will be decided at a tribunal hearing.
To submit your appeal you'll need:
- Your National Insurance number
- The details of the representative helping with your appeal (if you're using one)
- Your mandatory reconsideration notice
If you do not need a mandatory reconsideration your decision letter will say why. Include this explanation when you submit your appeal.
You’ll need to choose whether you want to go to the tribunal hearing to explain your appeal in person.
You can submit your appeal by visiting www.gov.uk/appeal-benefit-decision/submit-appeal.
You can appoint someone as a ‘representative’ to help you with your appeal. A representative can:
- Help you submit your appeal or prepare your evidence
- Act on your behalf
- Give you advice
Anyone can be a representative, including friends and family.
Your appeal will be sent to the department that made the decision about your entitlement to benefits.
They'll respond to your appeal explaining why they made the decision.
You'll get a copy of the response.
Your appeal is decided at a tribunal hearing. The tribunal will tell you the time and location of the hearing.
You’ll get the decision by post after the hearing. You may get a decision on the day if you go to the hearing.
It usually takes up to 6 months for an appeal to be heard by the tribunal.
If you're unhappy with the tribunal's decision you may be able to:
- Get a decision cancelled ("set aside")
- Appeal to the Upper Tribunal (Administrative Appeals Chamber)
You'll be told how to get a decision set aside (cancelled) if you think there’s been a mistake in the process.
You can then start the appeal process again so a new decision can be made.
You can only appeal to the Upper Tribunal (Administrative Appeals Chamber) if you think the decision was wrong for a legal reason, for example, if the tribunal did not:
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- Give proper reasons for its decision, or back up the decision with facts
- Apply the law properly
Find out more by visiting www.gov.uk/appeal-benefit-decision/unhappy-tribunals-decision.
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