Mandatory reconsideration for PIP

A mandatory reconsideration is the first step of challenging a Personal Independence Payment (PIP) decision. It is asking the Department for Communities (DfC) to look at their decision again.

You can challenge the DfC’s decision on your PIP appeal by issuing a mandatory reconsideration if:

• You weren’t awarded PIP
• You were awarded a lower rate than you expected.

You will typically have to ask for a mandatory reconsideration within one month of your official PIP decision date (the date on your decision letter).

How to apply for a mandatory reconsideration for PIP

To ask for a mandatory reconsideration, you can either:

• Write a letter explaining why you disagree with the decision (The address will be on your PIP decision letter)
• Fill in a mandatory reconsideration form
• Call the DfC (contact details will be on your PIP decision letter).

We would advise that you either write to the DfC or fill in the form rather than ring or the following reasons:

• You can keep a copy of your letter or form
• It encourages you to send in further evidence if you have it available
• The mandatory reconsideration form is likely to be processed quicker than the letter.

However, if you are nearing the deadline, it may be better to call the DfC and then follow it up with a letter or form.

If you send in a letter, make sure you keep a copy and send it by recorded delivery - or get proof of postage – so you can prove you sent the letter, so they receive in the one-month time limit.

Asking the DfC for written reasons about their PIP decision

When you receive your PIP decision letter, you can ask the DfC for written reasons as to why they made their decision.

Asking for their reasons may help put forward your argument for a mandatory consideration as you could be able to challenge the reasoning. You should ask as soon as possible, as the process can take up to 14 days.

If you ask for reasons, you will have an extra 14 days to ask for a mandatory reconsideration, and additionally, if the DfC don’t send the written reasons within a month after their decision, you have 14 days from the date you receive them to ask for mandatory reconsideration.

What happens if I missed my PIP mandatory reconsideration deadline?

You are expected to have asked for a mandatory reconsideration within one month of the decision date (the date on the decision letter). However, you may be able to ask for a mandatory reconsideration after the month deadline if:

• You have requested a written statement of reasons
• You have a good reason for the delay
• You asked for a mandatory reconsideration as soon as possible, and the decision date was less than 13 months ago.

Examples of a good reason for being late:

• You received incorrect information about your appeal by an adviser
• Your partner or relative has been ill
• You have been mentally or physically unwell
• You have had problems receiving post at your address.

The DfC can still refuse your application if it’s late, but if you applied within 13 months of the date on your decision letter, you could appeal their decision at a tribunal.

What to write or say when asking for a PIP mandatory reconsideration

When you ask for a mandatory reconsideration - whether that’s by phone, form or letter – you need to tell the DfC:

• Your national insurance number
• The date of your decision letter
• Why you disagree with their decision
• If you are late, explain why.

Why you disagree with the DfC’s decision

When explaining why you disagree with their decision, you should use the PIP descriptors as a guide, so you understand where you think they have underscored you.

You will also need to give specific reasons. We advise that you look at the decision letter, the DfC’s statement of reasons and the independent medical assessment report and explain which statements you disagree with and why.

It will help if you have facts, examples and medical evidence which can support what you are saying.

Getting more evidence for a PIP mandatory reconsideration

You can ask for more evidence to support your PIP mandatory reconsideration. You should use our sample letter template when requesting medical evidence from a healthcare professional to help your mandatory reconsideration.

If you are going to seek new medical evidence, you should ring the DfC and ask them where to send it to and ask them not to make a new decision until they have received your evidence.

If the ‘decision-maker’ calls you, they may ask if you have any other medical evidence to support your claim. If you do have more evidence, the DfC will tell you where to send it, and they will give you one month to send them the evidence. They should agree not to make their decision until they have received the evidence.

If they don’t receive the evidence in one month, they will make their decision based on the information they have.

Getting your PIP mandatory reconsideration decision

A DfC ‘decision-maker’ - who has not seen your claim before – will investigate your case to see if the decision was correct.

There is no deadline to receiving your mandatory reconsideration decision – this is called a mandatory reconsideration notice - so can take several months.

The DfC will send you two copies of a mandatory reconsideration notice which explains what their decision is - you will need one copy if you want to appeal to a tribunal.

If the DfC change their decision in your favour, you will start receiving PIP payments immediately, and they will pay you the benefits you should have received from the date of your claim - this is called ‘backdating’.

If they don’t change their decision, you should continue with your appeal through a tribunal. A decision is more likely to be overturned at a tribunal than a mandatory reconsideration.