A mandatory reconsideration is not an appeal, and the order matters

People who disagree with a PIP decision often say they want to appeal. In the benefits system that word has a narrow meaning, and reaching for it first is one of the more common ways to lose time. There are two distinct stages, in a fixed order, and each produces a document the next one needs.

Stage one is a mandatory reconsideration, and it is internal

A mandatory reconsideration is a request that DWP look at its own decision again. It is handled inside the department, by a decision maker who was not involved in the original decision. Nothing about it is independent, and that is the point: it exists to catch decisions that can be put right without a tribunal.

The request can usually be made by phone or in writing. A written request has the practical advantage of creating a record of exactly what was disputed and on which grounds.

Stage two is an appeal, and it is not DWP's to decide

An appeal goes to the First-tier Tribunal, which is part of HM Courts and Tribunals Service and independent of DWP. The panel for a PIP appeal normally includes a judge alongside members with medical and disability expertise. They look at the evidence afresh and reach their own decision on the points and the rates.

To start an appeal, the tribunal needs the document produced at the end of stage one — the mandatory reconsideration notice. Without it, there is nothing to appeal against, which is the mechanical reason the order cannot be reversed.

The deadlines, and the one that is easy to miss

Because the clock starts on the letter's date rather than its arrival, a letter opened a week late has already consumed a quarter of the window. Where more time is needed to gather evidence, it is better to make the request inside the deadline and send further evidence afterwards than to miss the deadline while assembling a complete case.

Ask for the reasons before arguing with them

A PIP decision letter sets out the points awarded under each activity. What it does not always set out in full is the reasoning — which descriptor was chosen for each activity and why the evidence was read that way. A written statement of reasons can be requested, and it is usually the most useful document in the whole process, because it shows precisely where the decision and the claimant's account diverge.

Comparing that statement against the published descriptors tends to produce a much sharper reconsideration request than a general statement of disagreement. The useful form of words is activity by activity: this descriptor was applied, this one should have been, and here is the evidence for it.

What actually changes a decision

Reconsiderations and appeals turn on the same thing the original decision turned on: whether the evidence supports a particular descriptor under a particular activity. The framework is described in the points decide a PIP award, not the diagnosis.

Evidence that tends to carry weight speaks to the activities rather than to the condition in general terms — how a task is attempted, what goes wrong, how long it takes, what help is needed, how often that is true. The four qualifiers matter here too: whether the task can be done safely, to an acceptable standard, repeatedly, and in a reasonable time. A letter confirming a diagnosis, on its own, rarely moves a descriptor.

A worked sequence

Suppose a decision letter dated 3 March awards four points for daily living and none for mobility, and the claimant believes the washing and bathing and dressing descriptors were read too favourably.

• Early March. Request the written statement of reasons, and request the mandatory reconsideration within the one-month window rather than waiting for the statement to arrive.
• Mid March. With the statement in hand, set out the disputed activities one by one, naming the descriptor that should apply and the evidence for it.
• Later. Send any further evidence as it becomes available — a district nurse's note on what help is given, an occupational therapy report, a two-week diary showing how often the difficulty occurs.
• On the notice. If the reconsideration does not change the decision, the mandatory reconsideration notice is the document that opens the appeal, and a fresh one-month limit starts from its date.

Choosing a hearing rather than a paper decision

An appellant can ask for the tribunal to decide on the papers or to hold a hearing they can attend. Ministry of Justice tribunal statistics have consistently shown that a substantial proportion of PIP appeals determined at a hearing result in the original decision being revised, and attending allows the panel to ask about the activities directly rather than inferring from the file. Travel expenses can usually be claimed, and representation by an adviser, a relative or a friend is permitted.

In Scotland the names and the route differ

New disability claims in Scotland go through Adult Disability Payment rather than PIP. The equivalent first stage there is called a redetermination by Social Security Scotland, with its own time limit, and an appeal goes to the First-tier Tribunal for Scotland. Scotland also provides short-term assistance in defined circumstances where an existing award is being challenged. We cover the differences in Scotland replaced PIP, and the replacement keeps its own rules.

Where to get help with it

Free, independent advice on both stages is available from Citizens Advice and from local welfare rights or advice services, including help with wording a request and representation at a hearing. There is no need to pay for access to the rules themselves: the criteria, the forms and the time limits are all published.

The practical summary is short. Reconsideration first, inside a month of the letter's date. Ask for the reasons. Argue activity by activity. Keep the notice when it comes, because the appeal runs from it.