PIP UK: Appeal rules explained – what to expect and how to prepare for a tribunal hearing

Justin Tomlinson gets questioned on PIP assessments

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PIP and other benefit claimants can challenge decisions made by the DWP under mandatory reconsideration rules and beyond this, cases can be taken to a tribunal. This can be a daunting process but Citizens Advice issued clear guidance on what should be expected.

Preparing for the hearing

Citizens Advice explained prior to the hearing, claimants should:

  • Phone straight away if you want to change the date – it should be for a good reason (eg a hospital appointment)
  • Read through all the information the tribunal service sends you so you know what to expect
  • Send any new evidence to the tribunal – try not to turn up with lots of new evidence on the day
  • Arrange for a family member or friend to go with you for moral support, if you feel it would help
  • Check the venue has everything you need, eg if you asked for a sign language interpreter, check they will be there
  • Check what expenses you can claim and how to claim them – the tribunal service will give you this information

Before heading to the hearing, claimants will need to gather certain items to help with their case. This can include appeal papers sent to the claimant, any new evidence, and notes covering what the claimant wants to say.

What to expect at the hearing

The tribunal, according to Citizens Advice, is informal in nature and the hearing panel will be composed of a legally qualified judge and up to two other independent people, including a doctor.

During the hearing, claimants can expect the following:

  • The judge will introduce the tribunal and explain what it’s for – they might call you “the appellant” and the DWP “the respondent”
  • They’ll ask you questions about your reasons for appealing, and get you to describe things like what you do on an average day
  • If someone from the DWP is there, the judge will also ask them questions
  • If someone goes with you, they might be asked if they want to say anything
  • Once everyone has had a chance to speak, you will be asked if there’s anything more you’d like to say – so if there’s anything you want to add or clarify, you can
  • You’ll be asked to leave the room while a decision is made
  • You’ll be called back into the room and told the decision, although occasionally you may have to wait three to five days to get a decision letter in the post

Claimants will be asked about how their condition affects them so they can “make the right decision.” They’ll need to correct anything which isn’t correct and ensure their details are completely understood by the panel.

If claimants win their appeal, they’ll get an official notice in the post within a couple of weeks and they’ll receive their updated payments within four weeks. The DWP will also need to pay the claimant all the money they should have been receiving from the date of their initial claim, but these back payments can take up to six weeks to arrive.

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Appeal success rates

Where applicable, it may be worth taking cases to the tribunal as the chances of success are relatively high. In September the Ministry of Justice released tribunal statistics for the latest quarter (April to June) and compared the results to the same period in the previous year.

For the First-tier Tribunal, also known as Social Security and Child Support (SSCS), the number of PIP and Universal Credit receipts fell.

However, James Taylor, an executive director of strategy at Scope, analysed the data and found 70 percent of PIP tribunals were won (on behalf of the claimant). Additionally, 57 percent of ESA tribunals were won.

Mr Taylor warned these figures showed disabled benefit claimants are being failed by the system.

“These figures show the system is working against disabled people. Yet again, a high proportion of initial decisions are being overturned.

“Alarmingly, these figures only tell half the story. As disabled people migrate to Universal Credit, far fewer are applying for ESA. But data about Universal Credit appeal success rates for disabled people is not publicly available, making it impossible to hold the Government to account.

“Disabled people should get the right benefits the first time around. Instead, they are being systematically failed by the assessment process. Far too many people have to endure a long and stressful fight to get the right support.”

In recent months, the Government has prioritized benefit reform, especially for those with disabilities or long term ill-health issues. The DWP has assured it will overhaul the assessment process for PIP and other benefits in a green paper in which claimants are encouraged to help shape the entire system.

However, Mr Taylor argued more needs to be done: “Despite attempts at reform there are 1.8 million more disabled people and their families living in poverty than 15 years ago.

“The Government must use the green paper to fix these issues so disabled people get the right benefits first time around.”

In response, a DWP spokesperson said: “We are committed to ensuring that disabled people get the full support they are entitled to.

“Appeals make up a small proportion of PIP and ESA claims and decisions are made using all the information that’s available to us at the time, including from a person’s GP or medical specialist. If someone disagrees with that decision, then they have the right to ask for a review.”

How to appeal a decision

Before appeals are launched, claimants will usually need to ask for a decision to be reviewed under mandatory reconsideration rules. If a claimant is still now happy following a mandatory reconsideration decision, they’ll be able to appeal to the First-tier Tribunal within one month.

Appeals can be launched from the Government’s website and claimants will need to have certain information at the ready to do so. This includes their National Insurance number and mandatory reconsideration notice.

Claimants can appoint someone as a “representative” to help them with their appeal. This representative can help prepare evidence, act on the claimant’s behalf and give advice.

Anyone can be a representative, including friends and family.

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