You can challenge an ESA decision if you disagree with it. The DWP will write to you confirming any decision they have made about your ESA claim. This is called a decision letter.
The DWP decision letter should include:
If you disagree with the DWP’s decision, you can ask them to look at their decision again. This is called mandatory reconsideration.
You must contact the benefits office that gave you the decision. Their address and telephone contact details will be on the decision letter they sent you.
You can ask for mandatory reconsideration by:
When you contact the benefits office, you should:
You should request mandatory reconsideration within 1 month of the decision date (this will be 1 month from the date near the top of your decision letter).
You can still ask for a mandatory reconsideration up to 13 months of the original ESA decision, but you must explain why your request is late. The DWP will expect you to have a good reason. Reasons can include:
Aurelia experiences severe depressive episodes with psychotic symptoms. She often sees things that aren’t there and sometimes feels things that aren’t real. She receives treatment through her local GP and IAPT services. Aurelia’s mental health condition makes it difficult for her to work and she is eligible for new style ESA. Aurelia applies for new style ESA and is placed on the assessment rate whilst she waits for her work assessment.
Following her Capability for Work assessment, Aurelia receives an ESA decision letter from her local benefits office. The letter has rejected her ESA claim. The letter states that the DWP believe Aurelia did not score enough points on her Capability of Work questionnaire and is able to work without ESA.
Aurelia is very distressed and seeks help from a welfare benefits adviser. The adviser looks at Aurelia’s case and the reasons the DWP have sent back. The adviser discovers that the DWP have not considered Aurelia’s severe depressive episodes. The DWP have not looked at the medical reports and fit notes provided by Aurelia’s GP as evidence of her limited capability to work.
The welfare benefits adviser helps Aurelia fill in the Mandatory Reconsideration request form online. The adviser reminds Aurelia to attach all the medical evidence that the DWP did not consider to the form.
Aurelia submits the mandatory reconsideration form two weeks after she receives her decision letter. She includes all the medical evidence the DWP did not consider.
A month later, the DWP write back to Aurelia confirming they are changing their decision and backdating her ESA payments to the date of the original decision.
You can only appeal an ESA decision if:
If you have applied for mandatory reconsideration and the DWP have not responded, you may be able to go straight to the appeal stage. If this happens, you should seek advice from a welfare benefits adviser before lodging an appeal.
You only have 1 month from the date of your mandatory reconsideration decision letter to appeal.
To appeal your ESA decision, you will need:
Once you have this information, you can begin the appeal process by completing the Benefit appeal form (SSCS1). You can complete the form online before downloading it and printing it off. You can also print off a blank form and complete it by hand.
The form has 8 sections. This can feel overwhelming, so be sure to take your time and read each section carefully. You can ask the person you want to represent you (eg. family member, carer, social worker, welfare benefits adviser) to help you complete the form.
Once you have completed the form and attached any new evidence to support your appeal, you should send your form to the address detailed in ‘Section 9: Sign and post’.
Her Majesty’s Courts & Tribunals Service (HMCTS) will send a copy of your appeal to the benefits office that rejected your ESA mandatory reconsideration. The benefits office will then respond to HMCTS with their reasons. HMCTS should send you:
Your hearing might not occur for up to 6 months after you have submitted your appeal. If you are concerned about losing money during this time, you should seek advice from a welfare benefits adviser. You might be able to claim other benefits whilst you wait.
The hearing will have one or two experts on ESA and a judge. They do not work for the government and operate independently as part of the legal system. They will not know you and the judge will base their decision purely on evidence they receive from you and the DWP.
You can attend the hearing alone, but if you are worried about your mental health, you can have someone go with you. This can be a social worker, friend, relative, carer, welfare benefits adviser or support worker. You can ask for support when you fill out the appeals form.
If you choose to attend the hearing you will be offered a choice on how you prefer to attend. You can attend:
If your mental health condition means you cannot attend the hearing, you can authorise someone to attend on your behalf. This is called ‘Authority to Act’ and you can select this option when you fill out the appeal form. Your representative can be a social worker, welfare benefits adviser, carer, mental health support worker, family member or a close friend.
The tribunal will usually give you their decision on the same day. If you are not there, the decision will be posted to you.
If your appeal is unsuccessful, you might be able to send an appeal to the upper tribunal of HMCTS. Details on how to do this will be sent along with your appeal decision letter. You should try to seek advice from a welfare benefits adviser.