PIP claims are assessed by the DWP throughout the process, from the initial application and beyond. Where circumstantial changes such as improving health or hospital visits emerge, payments may be stopped but where claimants are unhappy with a decision from the Government, they can appeal it under “mandatory reconsideration”.
Mandatory reconsideration rules allow PIP and other benefit claimants to challenge the DWP on a decision that’s been made. Where these challenges arise, the Government is obligated to reconsider its decision.
People can challenge a DWP decision on PIP if the claimant does not get the benefit, got a lower rate than expected or thinks their award isn’t long enough. While most decisions can be reconsidered, some will not be and others will go straight through to an appeal process.
To request a mandatory reconsideration, claimants will need to contact the benefits office which gave the decision, which will typically be the DWP but can also include HMRC. These offices can be contacted by phone, letter or by filling in and returning a specific form.
According to Citizens Advice, however, there is a preferred option claimants should utilise. The charity explained: “The best way to apply for a reconsideration is to use the CRMR1 mandatory reconsideration request form on GOV.UK or write a letter to the DWP explaining why you disagree with the decision.
“You can call the DWP to ask for a reconsideration, but it’s better to have everything in writing. If you decide to call, make sure you follow up with a letter. The contact details will be on the decision letter from DWP.
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“Check the date on your decision letter. You need to ask for a mandatory reconsideration within one month of that date. If you use the form or send a letter, the DWP will need to receive it within one month.”
Citizens Advice went on to explain claimants will need to give specific reasons why they disagree with the decision. Their decision letter, statement of reasons and medical assessment report can help with this. Examples of what to include can be found on Citizens Advice’s website.
If a claimant is still not happy with the result of a mandatory reconsideration they may be able to appeal to the courts, and it is here where many claimants win their case.
In September, the Ministry of Justice released tribunal statistics for the period between April and June and compared the results to the same period in 2020. The First-tier Tribunal, also known as Social Security and Child Support (SSCS), saw the number of PIP and Universal Credit receipts fell.
However, James Taylor, an executive director of strategy at Scope, found that the data showed 70 percent of PIP tribunals were won (on behalf of the claimant). Additionally, 57 percent of ESA tribunals were won.
Mr Taylor said at the time: “These figures show the system is working against disabled people. Yet again, a high proportion of initial decisions are being overturned.
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“Alarmingly, these figures only tell half the story. 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.
“This is leaving many disabled people and their families at risk of getting trapped in poverty. 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.”
However, despite these commitments from the DWP, recent analysis from Scope showed 12,000 benefit claimants are winning appeals every month. The charity found between July 2019 and June 2021, there had been 12,579 successful appeals for PIP claims each month. This, it calculated, worked out as a mistaken benefit decision being made every minute of the working day.
Following this, Mr Taylor also said: “These wrong decisions throw a person’s life into turmoil. Having to fight for financial support puts a huge toll on disabled people’s mental and physical health and can plunge families into poverty.
“We’ve heard from huge numbers of disabled people who felt their assessors did not understand their condition or how it affects their life. The system is getting it wrong far too many times.”
The DWP once again addressed these issues in November and it assured the Government was focusing its efforts on the assessment process.
A DWP spokesperson told Express.co.uk: “For the majority of PIP claims, we get decisions right and all assessments are carried out by healthcare professionals trained to consider the impact of someone’s health condition or disability.
“But we are exploring what more we can do so the welfare system better meets the needs of disabled people through our Health and Disability Green Paper.”
Many PIP issues can be avoided by ensuring the Government is kept up to date with a claimant’s change in circumstance. A claimant may have to pay a penalty or even be taken to court if they fail to keep the DWP updated.
A change of circumstances can include personal changes such as moving home or going abroad.
To report these changes, a PIP enquiry line can be called on 0800 121 4433.
Claimants will also need to contact the DWP if they’ve been paid too much money as the cash may need to be returned ASAP.