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How to Appeal a PIP Decision for Disabled Adults in England and Wales
Written by
Georgina, Founder of Purpl
Published on
January 27, 2025
Personal Independence Payment (PIP) is a government benefit designed to help people with disabilities or long-term health conditions manage the extra costs associated with their conditions. If you are looking for information about PIP or how to apply, then head to our Purpl Guide to PIP here.
However, not everyone who applies for PIP receives the decision they were hoping for. If you believe your PIP decision was incorrect, you have the right to appeal. Our Purpl Guide provides an in-depth guide to the PIP appeal process to help if you need to appeal your PIP decision.
This guide is for England and Wales only
Appeal a Benefits Decision in Northern Ireland
Appeal an Adult Disability Payment Decision in Scotland
In this Article
- Understanding PIP and Why Appeals are Necessary
- Understand Your PIP Decision Letter
- Challenging a PIP Decision with a Mandatory Reconsideration
- How to Request a Mandatory Reconsideration
- What Happens After You Request a Mandatory Reconsideration
- How to Appeal a Mandatory Reconsideration Decision for PIP
- How to Prepare for a Tribunal Hearing
- What Happens at a Tribunal Hearing
- Tips for a Successful PIP Appeal
- Common Mistakes to Avoid When Appealing a PIP Decision
- Statistics on PIP Appeal Outcomes
- Frequently Asked Questions
- Appeal a Benefits Decision in Northern Ireland
- Appeal an ADP Decision in Scotland
- Conclusions
- About the Author
Understanding PIP and Why Appeals are Necessary
PIP is divided into two components: the daily living component and the mobility component. Each component has two rates: standard and enhanced. The amount you receive depends on the extent to which your condition affects your ability to carry out daily tasks or get around.
When you apply for PIP, your eligibility is assessed by a healthcare professional, and the Department for Work and Pensions (DWP) makes the final decision based on their report. Unfortunately, many people feel that their decision doesn’t accurately reflect their needs. Statistics show that a significant number of PIP decisions are overturned at appeal stages, suggesting that the initial process may not always be thorough or accurate.
If your PIP claim was rejected, don’t worry, it doesn’t mean you won’t be able to get the decision overturned, just follow our guide below.
Understand Your PIP Decision Letter
Before you challenge your PIP decision make sure you understand your decision letter. Take the time to read it thoroughly. The letter will:
- Explain how the DWP reached its decision
- Include a breakdown of the points you were awarded for each activity
Compare this information to the descriptors and points system used by the DWP for PIP assessments. Identify areas where you believe the decision was incorrect.
Challenging a PIP Decision with a Mandatory Reconsideration
If you disagree with the decision made about your PIP claim then you need to request a Mandatory Reconsideration.
You can only ask for a Mandatory Reconsideration for PIP based on the following:
- you didn’t receive it
- you got a lower rate than you expected
- you believe that your award isn’t long enough
If you decide to challenge the amount or length of your award, the DWP might look at your whole PIP claim again. This could mean that they decide you shouldn’t get PIP at all. We recommend talking to someone to get advice first, if you are worried this could happen to you. Citizens Advice can help if you require.
If your condition has got worse since your initial claim then you may need to follow a different procedure so we would advise contacting the Citizens Advice to get guidance.
Act Quickly: You have one month from the date on your decision letter to request a Mandatory Reconsideration. If you miss this deadline, you may still request one, but you’ll need to provide a valid reason for the delay.
We will guide you through the process below for England, Scotland, Wales and Northern Ireland
You must act quickly if you disagree, you only have one month from the date on your decision letter to request a Mandatory Reconsideration.
Georgina’s Disability Money Saving Tip
How to Request a Mandatory Reconsideration
Remember, you have one month from the date on your decision letter to request a Mandatory Reconsideration. If you miss this deadline, you may still request one, but you’ll need to provide a valid reason for the delay.
You will need to contact the DWP to let them know that you wish to have a mandatory reconsideration.
You will need to download the CRMR1 Mandatory Reconsideration Request form from the government website
Complete the form and post it back as it can’t be submitted online
If you are unable to complete or download the form you can send a letter directly to the DWP explaining why you disagree with the decision.
When writing your letter make sure to include:
- Your National Insurance number
- A detailed explanation of why you disagree with the decision.
- Any additional evidence that supports your case (e.g., medical reports, care plans, or letters from healthcare professionals).
You can also 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.
What Happens After You Request a Mandatory Reconsideration
The DWP will review your mandatory reconsideration and look at any additional information you have provided. They will then send you a new decision letter, known as a “Mandatory Reconsideration Notice.” This will state whether the decision has been changed or remains the same.
If the DWP changed their decision, you will start getting your PIP benefit payment straight away.
If the decision was about a new claim, the DWP will backdate your PIP benefit payments to the date you made the initial claim.
If the decision was about an ongoing claim, the DWP will backdate your PIP benefit payments to the date it was stopped or reduced.
If you are still not happy with the decision you can appeal to an independent tribunal. The tribunal will be impartial and will review your case thoroughly.
How to Appeal a Mandatory Reconsideration Decision for PIP
If you’re unhappy with the outcome of the Mandatory Reconsideration, you can appeal to an independent tribunal. The tribunal is impartial and will review your case thoroughly.
To be eligible for appeal you will need:
- your ‘Mandatory Reconsideration Notice’ letter that you received from the DWP – if you’ve lost it, ask them for a new one
- send your appeal form in within one month of the date shown on the mandatory reconsideration notice
To submit your appeal within 1 month from the date on your Mandatory Reconsideration Notice, you can do this in two ways:
Complete the online appeal form via the government website
Or download the SSCS1 form to print out and complete, you will then need to post this to the HM Courts & Tribunals Service address listed on the form.
You will need to
- provide a copy of your Mandatory Reconsideration Notice letter
- explain why you disagree with the decision
- provide any evidence you have not already submitted
- if you missed the deadline, you must include a detailed explanation for the delay.
Once your appeal has been received, you’ll receive an acknowledgment from the tribunal service.
I recommend you send any documents by recorded delivery so you have proof of postage. This could be vital evidence if the Tribunal Service says your form didn’t turn up or was late.
Georgina’ Disability Money Saving Tips
The Tribunals Service will check your form and ask the DWP for their response within another 28 days.
You will then receive:
- a copy of the DWP’s response
- information about what happens next
- details of when and where the hearing will be (if you’ve asked for a face to face hearing, rather than a paper one)
How to Prepare for a Tribunal Hearing
The tribunal will consider all the evidence you’ve submitted, as well as any additional evidence provided by the DWP.
You can choose to have your appeal decided:
- On Paper: this means the tribunal will review the documents and evidence without a hearing.
- At a Hearing: this is a face-to-face meeting where you can present your case directly. It may be online or physically in person.
Attending a hearing often increases your chances of success. If you choose to attend, here’s how to prepare:
- Gather Additional Evidence: Provide any new medical reports, witness statements, or supporting letters from healthcare professionals that strengthen your case.
- Familiarise Yourself with the Process: Understand the points system and descriptors used in PIP assessments. Be ready to explain how your condition affects you in line with these criteria.
- Seek Representation or Support: You can bring a friend, family member, or representative (e.g., a welfare rights adviser) to the hearing. Organisations such as Citizens Advice can offer free support.
- Request Adjustments: If you need any adjustments due to your condition (e.g., a wheelchair-accessible venue), inform the tribunal service in advance.
If you need to contact the HM Courts and Tribunal Service please call 0300 123 1142, Monday to Friday, 8.30am to 5pm or email [email protected]
What Happens at a Tribunal Hearing
If you’ve opted for a face-to-face hearing, it will be held at your local tribunal venue. A typical panel includes:
- A judge (to oversee proceedings)
- A doctor (to provide medical insight)
- A disability expert (to understand how your condition impacts you)
The tribunal will ask questions about your condition and its effects on your daily life. Answer honestly and provide as much detail as possible. The panel may ask follow-up questions to clarify your situation.
The tribunal’s decision may be given:
- On the Day: In some cases, you’ll be told the outcome at the end of the hearing
- In Writing: The tribunal will send a detailed decision letter explaining the outcome
If your appeal is successful, the DWP will adjust your PIP payments accordingly. If your appeal is unsuccessful, you may consider seeking further advice to explore other options, such as a judicial review.
Tips for a Successful PIP Appeal
- Be Honest and Specific: Clearly explain how your condition impacts your ability to perform specific activities.
- Focus on Key Points: Use the descriptors and points system as a guide to frame your arguments.
- Provide Strong Evidence: Include recent, detailed evidence from healthcare professionals.
- Stay Organised: Keep copies of all correspondence and evidence.
- Seek Professional Advice: Charities such as Scope, Citizens Advice, and Disability Rights UK can provide guidance and representation.
Common Mistakes to Avoid When Appealing a PIP Decision
- Missing Deadlines: Ensure you adhere to all deadlines for requesting a Mandatory Reconsideration and submitting an appeal.
- Submitting Insufficient Evidence: Always provide detailed and relevant evidence to support your claim.
- Failing to Prepare for the Hearing: Familiarise yourself with the tribunal process and anticipate questions.
- Ignoring Free Support Services: Take advantage of resources and advice from welfare rights organisations.
Statistics on PIP Appeal Outcomes
You may feel that if you have not received the outcome you wish for that it is the end of the road for you and PIP, many people worry about the stress and anxiety around going through an appeal process. But the statistics are on your side, and may be a surprise for many.
The success rate for Personal Independence Payment (PIP) mandatory reconsiderations has varied over time. As of June 2023, approximately 27% of mandatory reconsiderations resulted in a higher award for the claimant. This indicates that just over a quarter of those who challenged their initial PIP decision through a mandatory reconsideration saw a positive change in their award.
It’s important to note that if the mandatory reconsideration does not lead to a favorable outcome, claimants have the option to appeal to an independent tribunal.
The success rate for tribunal appeals in the three months leading up to July 2023 was 68% meaning that almost three quarters of people who go to tribunal will get a positive change in their award.
Though it may cause stress and worry and take time, it is worth appealing the PIP decision if you feel it is not correct for your situation.
Frequently Asked Questions
Is it worth challenging PIP?
Absolutely! If you believe your award is incorrect then it is worth appealing your PIP decision. Almost three quarters of people who appeal their decision will get a positive change to their award.
What are PIP assessors looking for?
PIP) assessors look at how a person’s health condition or disability affects their ability to carry out daily activities. They consider the impact on a person’s mobility and how much help they need with these activities. The following activities are assessed, Preparing food, Eating and drinking, Managing treatments, Washing and bathing, Using the toilet, Dressing and undressing, Communicating, Reading, Managing money, Planning and following a journey.
They consider whether you can use an aid or appliance to help them complete activities, the impact of the condition on a person’s ability to carry out activities and how much help a person needs with activities.
Has anyone won a PIP Mandatory reconsideration?
Most definitely, over a quarter of people who apply for a Mandatory Reconsideration for PIP will have a positive change to their award. And three quarters of those who go through to Tribunal will have a positive change.
What happens if I miss the one month deadline?
You can still ask for a mandatory reconsideration, as long as it’s within 13 months of the decision but you will need a valid explanation for why you missed the deadline, e.g. you were ill or dealing with difficult personal circumstances which meant you couldn’t apply in time.
Use your form or letter to explain why your application is late, as well as why you disagree with their decision. The DWP can refuse your application if it’s late, but as long as you applied within 13 months of the date on your decision letter you can still appeal their decision at a tribunal.
What not to say to a PIP assessor?
When speaking to a PIP assessor, never lie and avoid saying things that exaggerate your condition, claim you can do absolutely nothing, focus solely on your “worst day,” or make unrealistic statements about your abilities, as this can undermine your credibility and damage your claim; always be honest and explain how your condition impacts your daily activities realistically, focusing on the majority of the time rather than just your worst moments.
What if I can’t attend the date for the Tribunal Service?
If you can’t attend your scheduled PIP Tribunal hearing date, you should contact the tribunal office immediately to explain why you can’t attend and request a new date; if you have a valid reason, they will likely reschedule your hearing for another time.
Reach out as soon as possible to let them know you can’t make the scheduled date. Explain why you are unable to attend, such as a medical appointment, unexpected travel issues, or a serious personal situation. Depending on the reason, you might need to provide supporting documentation like a doctor’s note.
If you don’t contact them and miss the hearing without a valid explanation, your appeal might be decided based on the existing evidence without your presence, which could negatively impact your case
Will they backdate my payments if successful?
Yes, if you win your PIP appeal at a tribunal, your payments will usually be backdated to the date your claim was initially made or the date your previous PIP entitlement stopped or was reduced, depending on the circumstances of your case.
Appeal a Benefits Decision in Northern Ireland
We are in the process of producing a guide for the appealing a benefits decision in Northern Ireland, until then, please refer to the Northern Ireland government website here.
Appeal an ADP Decision in Scotland
We are in the process of producing a guide to appealing a benefits decision in Scotland, until then, please refer to the Scottish Citizens Advise website advice here.
Conclusion
The PIP appeal process can be daunting, but understanding the steps and preparing thoroughly can significantly improve your chances of success. Remember, you have the right to challenge a decision if you feel it’s unfair or inaccurate. By following this guide, seeking support, and presenting a strong case, you can navigate the appeal process with confidence.
If you’re currently facing a PIP appeal, don’t hesitate to reach out to local support services or charities for guidance. With the right preparation and persistence, you can achieve the outcome you deserve.
About the Author
Georgina is the founder of Purpl Disabled Discounts, she understands the financial challenges that come with living with a disability as she has MS and ADHD. She is on a mission to help the disabled community save money through discounts on everyday products and services, as well as creating a place to support every individual living with a disability in the UK. You can read her story about why she launched Purpl and her ultimate goal of launching a foundation to give grants to disabled people in the UK.
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