PIP Mandatory Reconsideration (A comprehensive guide)

In this brief guide, we will look at the process of PIP mandatory reconsideration, as well as other things you may need to know about the process of claiming PIP.

PIP Mandatory Reconsideration

PIP mandatory reconsideration is the part of the process of claiming PIP where you can challenge the decision that has been made about your PIP by asking the DWP to consider your case again and revisit the evidence again.

PIP mandatory reconsideration serves as sort of prerequisite before a tribunal hearing, because if one does not get their benefits changed after this step, they are free to go to the tribunal to get their case heard at the court and have a third party make the necessary judgment.

Here are the instances in which one may file for a mandatory reconsideration with the  Department for Work and Pensions (DWP):

  • You didn’t get the PIP
  • You received a lower rate than you expected
  • You think your award isn’t long enough

Additionally, if you are not able to make up your mind about applying for a mandatory reconsideration, you should also know that recent government statistics show that more than half of PIP decisions are changed after mandatory reconsideration or an appeal to a tribunal, and this proves that if you think that you haven’t received the award you need to function well, you can challenge the decision and it is also recommended because it won’t cost you anything to appeal.

Apart from PIP mandatory reconsideration, you can also use this process for other benefits including:

  • Employment and Support Allowance (ESA)
  • Carer’s Credit
  • Child maintenance (sometimes known as ‘child support’)
  • Compensation Recovery Scheme (including NHS recovery claims)
  • Diffuse Mesothelioma Payment Scheme
  • Disability Living Allowance
  • Attendance Allowance
  • Bereavement Allowance
  • Carer’s Allowance
  • Industrial Injuries Disablement Benefit
  • Jobseeker’s Allowance (JSA)
  • Sure Start Maternity Grant
  • Universal Credit (including advance payments)
  • Winter Fuel Payment
  • Funeral Expenses Payment
  • Income Support
  • Maternity Allowance
  • Pension Credit

You can ask for a PIP mandatory reconsideration in the following ways:

  • by phone
  • by letter
  • by filling in and returning a form

The contact details that you need to file the mandatory reconsideration are on your decision letter, so that should not be a problem.

How to apply for a PIP mandatory reconsideration?

To apply for a PIP mandatory reconsideration you need to either call them, send them a letter, or fill out and return a form (CRMR1 form), and make sure you do this within one month of the decision.

If you are filing for the mandatory reconsideration beyond the one month from the date of the original decision for some reason, you can still do it within 13 months of the decision, but you will likely have to provide evidence or explain why you couldn’t do it in the stipulated time.

The necessary mandatory reconsideration forms can be downloaded at this link, and the Gov.UK website also gives other information about Mandatory reconsideration.

What to say in the PIP Mandatory Reconsideration Process?

When asking for a mandatory reconsideration you can choose to write a letter, in which case you will also need to give specific reasons about why you disagree with the decision and what aspect of it you want changed through the mandatory reconsideration process.

To describe what your issue with the decision is, you need to use the decision letter, statement of reasons and medical assessment report to make a note of each of the statements you disagree with and why. 

You need to include all the facts, give examples and medical evidence, if available, to support what you’re saying.

Examples of what one might say for their mandatory reconsideration include:

“I don’t think you have adequately assessed the extent of my mobility problems. You say I can walk 50 meters unaided. In reality, doing this causes me significant pain and would mean I can’t walk for the rest of the day. I have enclosed a letter from my physiotherapist which explains this in more detail.”

“The report from my medical assessment states I don’t need any aids or help to prepare my meals. This is untrue. I can’t cook any food from scratch – I can only heat up food in a microwave and I need to use a stool in my kitchen.”

When you are requesting a PIP mandatory reconsideration, you also need to ensure that you have necessary medical evidence to back up your claim that you were not assessed properly or that you truly have the problems that require a better benefit that was given to you.

In this case, you may need to reach out to a healthcare worker and get them to provide you with the necessary evidence, and if you have never applied for something like that, here is a sample letter you can use:

“To: (add name of professional) 

Address: (add address of professional) 

Date: (add date)   

Dear Sir/Madam 

Request for medical evidence

Name: (add your name)

Address: (add your address)

D.o.B: (add your date of birth)

I am challenging a decision about my entitlement to Personal Independence Payment and I am writing to ask if you would offer some evidence that may help my case. Evidence from medical professionals can be extremely useful in helping decision makers at the Department for Work and Pensions (DWP) make correct decisions.

I would be very grateful if you could answer the questions that you think are relevant to my condition from the list below (and return them to me in the envelope provided. Please be aware that I am not in a position to pay for any report or information) (Insert or delete as applicable). 

The challenge is about a decision made in (add date mm/yy) so I would be grateful if you could provide information based on how my condition affected me at that time. 

The questions focus on my mental health rather than my physical health. But if you have information regarding my physical health, please include this at the end of the form.  Thank you very much, in advance for any help you can provide towards my claim.

Yours faithfully,

(Add your name).”

PIP Mandatory Reconsideration Success

PIP mandatory reconsideration success is touted as quite high in some places, whereas it is notoriously low in other cases as well, and there have recently been reports that compared to the ESA mandatory reconsideration, PIP mandatory reconsideration success rate stands at a meager 54%, which is quite low.

What this means is that the results of the mandatory reconsideration turned out in the claimant’s favour only about 54% of the time, which is just barely above half, and that may not be a reassuring figure at all, but at the time time there have also been reports that the DWP is also spending more and more money towards mandatory reconsiderations and tribunals.

For instance, Ken Butler, DR UK’s Welfare Rights and Policy Adviser, said:

“A decade of austerity driven welfare reform has led to the obscene situation where the DWP is seemingly spending more money defending wrongful disability benefit claim decisions than it is on disabled people’s benefits.

Both ESA and PIP assessments have been strongly criticised by disabled people ever since their introduction – often on the grounds that the health care professionals used no nothing about their disability and that their resulting reports are also inaccurate.

Recent DWP figures show that the success rate for PIP mandatory reconsiderations is 57% and for ESA mandatory reconsiderations more than 80%.

While its welcome that mandatory reconsideration decision making is at last improving, it highlights that the root of the problem remains the poor assessment examinations and reports of the private sector health care providers.

Yet in July, Atos, Capita, and Maximus PIP and WCA assessment contracts were actually increased by up to two years.

Medical assessments for benefits need to be removed from private contractors as soon as possible and brought in house.

But more fundamentally, we need widespread reform of the benefits system so that it is no longer based on conditionality and sanctions but on dignity, inclusion and the social model of disability and that ensures a quality of life that is more than the bare minimum.”

This statement says what so many others all around the internet forums say too, that the private contractors that work with the DWP to help with the PIP process, especially the assessment part, are responsible for a lot of the problems that happen, which lead to mandatory reconsiderations and tribunals, which obviously ends up hitting the government in terms of their expenditure.

Conclusion

In this brief guide, we looked at the process of PIP mandatory reconsideration, as well as other things you may need to know about the process of claiming PIP.

Mandatory reconsideration is extremely important to the process of claiming PIP because it provides claimants with some power to question the decisions of the DWP if they feel that they have somehow been misrepresented or if they have not been given fair treatment.

With all the criticism that the PIP assessment process often receives, the process of PIP mandatory reconsideration is a welcome relief in the face of possible problems with the assessors and so on.

If you have any more questions or comments about PIP mandatory reconsideration, please feel free to reach out to us at any time.

Frequently Asked Questions (FAQs): PIP Mandatory Reconsideration

How long does a mandatory reconsideration take for PIP?

There is no rule about how long it takes for a mandatory reconsideration for PIP, as the DWP does not have a deadline for doing the Mandatory Reconsideration. 

In some cases the mandatory reconsiderations take 2 weeks, whereas in some cases it can take several months. 

In case you have not received your Mandatory Reconsideration Notice, for a while, you can call the DWP after 2 weeks to check they have logged your Mandatory Reconsideration or what the status of your request is.

How successful are mandatory reconsiderations for PIP?

Mandatory reconsiderations for PIP are not as successful as the ones for the ESA, or the Employment and Support Allowance, and according to some statistics, “The DWP often counters that while 70% of PIP appeals are successful only 9% of PIP decisions to date have been appealed. Again, this DWP research shows that 51% of PIP mandatory reconsideration requests are made as PIP assessments were felt to be unfair and due to a lack of regard to evidence submitted.”

Is Pip backdated after mandatory reconsideration?

Yes, your PIP may be backdated after mandatory reconsideration, and usually this backdating of the PIP is to the date of the original decision.

There are strict time limits to asking for a mandatory reconsideration, that is, you need to ask within 1 month of the date on your decision letter, and if the DWp does change their decision, your PIP will be backdated to the date of the original decision that prompted the mandatory reconsideration.

What happens after a mandatory reconsideration?

After a mandatory reconsideration, two things can happen, either the DWP will change their original decision as a result of a revision to the result and your benefits might be increased, or they may not rule in your favor and your benefits might get reduced, in which case you can appeal to the tribunal and get your benefits rechecked by a third party that has nothing to do with the DWP.

Citations

https://www.disabilityrightsuk.org/news/2020/september/dwp-spent-£120-million-pounds-defending-challenges-esa-and-pip-decisions-just#:~:text=Recent%20DWP%20figures%20show%20that,mandatory%20reconsiderations%20more%20than%2080%25.

https://www.mentalhealthandmoneyadvice.org/en/welfare-benefits/pip-mental-health-guide/challenging-a-pip-decision/mandatory-reconsideration-for-pip/

https://www.gov.uk/mandatory-reconsideration

https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/appeals/mandatory-reconsideration/

https://www.mentalhealthandmoneyadvice.org/en/welfare-benefits/how-do-i-ask-for-a-mandatory-reconsideration/sample-letters/

Divya is currently a Clinical Psychology Trainee in a Master of Philosophy program and holds a Master’s in clinical psychology. She has a special interest in Personality studies and disorders, having researched the subject before, and Neuropsychology; with an additional interest being Mood disorders. She likes to write about Psychiatric issues, having worked in multiple specialty setups during her time as a clinical psychology student, and in her free time she likes to cook and read.