Who to appeal to?
The Department of Work and Pensions (DWP) for benefits such as:
- Income Support
- Jobseeker’s Allowance
- Employment and Support Allowance
- Attendance Allowance
- Disability Living Allowance
- Personal Independence Payments
- Universal Credit.
HM Revenue and Customs for benefits such as:
- Tax credits
- Child benefit.
Your local authority for benefits such as:
- Housing Benefit
- Council Tax Support.
How to appeal
To challenge a local authority decision, you must contact your local council and follow its appeals process. If you are still not happy with the outcome, you can register a complaint with the council and ask a legal ombudsman to look into the matter.
The DWP administers most disability benefits. To appeal a disability benefit, you must start by asking them for a review of the decision. This is known as a mandatory reconsideration.
You must ask the DWP to reconsider the decision before you can make an appeal.
You can ask for a reconsideration in writing, in person, or by phone. You are usually allowed to submit the request from the day after the date of the decision letter up until one month after this date.
If a statement of reasons for the decision is not provided, you can ask for this. You are allowed a minimum of 14 extra days to ask for a reconsideration after the issuing of a statement of reasons.
In special circumstances where it is not possible to seek a reconsideration within one month, the decision maker may allow an extension of 12 months.
The decision maker will contact you if they need any additional evidence after you have requested a reconsideration. If you have further written evidence that may help your case, the decision maker may postpone the reconsideration for one month to allow time to receive these extra documents.
There is no time limit within which the DWP must carry out a mandatory reconsideration.
Note: It is important to bear in mind that a reconsideration will mean that the decision could be changed to increase or decrease the level of benefit that has been awarded in the original decision.
If you are unhappy with the outcome of the reconsideration, you have the right to appeal.
You should appeal to HM Courts and Tribunals Service within one calendar month of the new decision. You can appeal a DWP decision by letter or by filling out the form available on the government website.
To learn more about how to ask for mandatory reconsiderations or appeal a decision on a benefit that the DWP administers, please see the latest government guidance.
When gathering evidence:
- It is useful to have as many supporting letters from people who are familiar with your needs. It is important not just to show evidence of your condition, but how it affects you on a day-to-day basis.
- Always focus on your worst days. The decision makers will need to know the full extent of your needs so they can award you the correct level of support.
- You can gather evidence from health professionals, such as:
- your GP
- occupational therapist
- neuromuscular care advisor
- organisations that are familiar with your condition
Challenging needs assessments and NHS decisions
You can request a revision of the decision or submit a complaint if you have had an assessment for a care package and:
- are not happy with the way the assessment was carried out
- disagree with the care plan that has been drawn up.
To do this, contact your local authority and follow their procedure.
Always remember to:
- State that you are submitting a complaint and why/whether you would like a review
- Be as specific as possible about dates, times and names
- Submit supporting evidence if you can or if this will help your case
- Keep a copy of all documents you submit.
If you are not happy with the response to your complaint/request for the decision to be reviewed, you can take the complaint to the ombudsman.
If you need more support with your health needs, you may be eligible for continuing healthcare. You can submit an appeal:
- If you are not happy about the way in which this assessment is carried out
- If you feel the NHS is wrong to decide that you do not qualify for continuing healthcare.
To appeal a continuing healthcare decision, you can ask your local Clinical Commissioning Group (CCG) for a reconsideration within 6 months of the decision. Before you do, remember to ask for:
- The full report of the assessment
- The criteria that you must meet to qualify for continuing healthcare.
Again, you have the final option of bringing your complaint to the Parliamentary and Health Service Ombudsman.
You could also write to your local MP or take your story to your local press.