Appealing a welfare benefits decision
The effects of brain injury can sometimes lead to brain injury survivors or their carers applying for welfare benefits. Unfortunately, brain injury may not be recognised or understood by benefits decision makers, and you may therefore feel that an unfair decision has been made on your eligibility.
If you disagree with a decision made about your benefits application, there are a number of steps you can take to challenge this. To start with, you should contact the Department for Work and Pensions (DWP) for an explanation of their decision. You can choose to have this provided in writing or over the phone. To do this, contact the benefit office using the contact details on your decision letter. Remember that there are strict limits for requesting an explanation. Details of this will be included in your decision letter.
If you are not satisfied with the explanation provided by DWP, you can apply for a mandatory reconsideration - this is another consideration of your application by the DWP.
In most cases, you will need to follow these steps before you appeal. However, in some cases you can go straight to appealing. Your decision letter will tell you whether or not you can go straight to appealing.
To start the process of appealing, you need to complete a form called the SSC1. This is available from your local Jobcentre or the UK government website. You can also write to HM Courts and Tribunal Service.
Tips for appealing
Some further points to consider when appealing:
- Keep dated copies of any application forms or decision letters relevant to your claim, as this can be useful evidence.
- Medical evidence can be very useful at any stage of your application or appeal. This can be in the form of medical reports or letters from your GP.
- Be aware of any time limits within which you need to appeal. Make a note of important dates on a calendar and set alarms. If you miss the deadline because of the effects of your brain injury or because you are waiting for letters or reports to arrive, you may still be able to appeal but will need to explain why you missed the deadline.
- If you are appealing to receive a higher rate of benefit, consider seeking specialist advice before making an appeal. This is because, although the appeal may be successful, it may also lead to a reconsideration of your entitlement and leave you with less than before the appeal.
- If you are waiting for a reconsideration for an ESA decision, you will not continue being paid while waiting for a mandatory reconsideration, so you should consider going straight to appeal. If you stop receiving ESA while waiting, you can apply for Universal Credit instead but you will not be able to return to ESA.
- If you need help with your appeal, you can contact the benefit appeals helpline.
After submitting your appeal
After submitting your appeal, you will get a letter by post with details of a tribunal hearing. The hearing is where your appeal will be discussed and decided by a judge and experts. They will be independent of DWP.
Remember, there is no need to be nervous about the hearing. It is an opportunity for you to present your case and inform decision makers about the impact of your brain injury.
You may receive your decision straight after the hearing, although in most cases this will take a number of weeks and arrive as a letter through the post.
If your appeal is successful, you will start to receive your new payments and any backdated payments owed to you by the DWP.
If you lose your appeal, you can only challenge this if you have a legal basis, not just because you disagree with the tribunal’s decision. To challenge the decision at this stage, you will need to appeal to the Upper Tribunal Administrative Chamber. It is advisable to contact Citizens Advice or a welfare benefits advisor at this stage for guidance on next steps.
For more detailed guidance and advice, see the factsheet Appealing a welfare benefits decision (PDF).