If you think your ESA decision is wrong - mandatory reconsideration

If you think a decision about your Employment Support Allowance (ESA) is wrong, there are things you can do to try and change it.

You can ask the Department for Work and Pensions (DWP) to look at their decision again. This is called a ‘mandatory reconsideration’.

If you’ve already had a mandatory reconsideration and the DWP didn’t change their mind, you can appeal to an independent tribunal.

You can appeal without a mandatory reconsideration if:

• it's the first time the DWP has decided you don't have 'limited capability for work'

• you didn't score enough points on your Work Capability Assessment

If you're not sure if you need to ask for a mandatory reconsideration, check your decision letter.

If it’s the first time the DWP decided you don’t have limited capability for work - you might be entitled to get ESA while you’re waiting for a decision on your appeal. You can find out how to appeal to an independent tribunal. 

Asking for a mandatory reconsideration

You can ask for a mandatory reconsideration if you think the wrong decision was made about:

• having your ESA refused

• being put in the work related activity group instead of the support group

• having your payments stopped or reduced

• being refused a hardship payment

If your mandatory reconsideration is about being placed in the work related activity group

The DWP might look at your entire ESA claim again, not just which group you’re in. This could mean they decide you shouldn’t get ESA at all. Contact your nearest Citizens Advice if you think this could happen to you.

Fill in a form or send a letter

It’s best to ask for a mandatory reconsideration in writing. You can either:

• print and send a CRMR1 mandatory reconsideration request form on GOV.UK

• write your own letter

Send your form or letter to the address on your decision letter. If you don’t have your decision letter, contact the office where you applied for ESA.

Ask the Post Office for free proof of postage - you might need to show when you sent your form or letter.

Send your request within 1 month

Make sure you ask for a mandatory reconsideration within 1 month of the decision date on your letter, unless there’s a good reason. For example, you were in hospital, coping with a bereavement or had an emergency at home.

If you’re close to the 1 month deadline, you can make a request over the phone instead of sending it in writing. Call the number at the top of your decision letter.

If you miss the 1 month deadline

If you’re sending the request late, it must be within 13 months of the decision date on your letter. You’ll need to explain why it’s late when you request the mandatory reconsideration. You don’t need to have proof of why the request is late, but if you do you should send it with the form. For example, hospital appointment letters or a discharge notice.

If the DWP won’t accept your request, you can appeal to a tribunal.

Proving why the decision is wrong

Your decision letter from the DWP should include a full ‘statement of reasons’ explaining their decision.

Go through the statement of reasons and try to give more information about the specific points you disagree with.

Example

Your decision letter might say you scored no points for difficulty with mobilising and give a reason why. For example, it could say they accept you can’t walk more than 200 metres, but they don’t accept you can’t walk more than 50 metres. You should get more medical evidence on this point to show you can't walk more than 50 metres.

If you’re not sure how to fill in the form, read the guide How to disagree with a decision made by the Department for Work and Pensions on GOV.UK. 

If you didn't get a statement of reasons

If you think your decision letter doesn’t include a statement of reasons, or your letter says you need to ask for it separately, you should do this as soon as possible. The quickest way is to phone the number on the decision letter. You can also write a letter - use the address on your decision letter if you do.

You'll have 1 month to make this request but you should do it as soon as possible.

If you ask the DWP for a written statement of reasons, you should get some extra time to ask for a mandatory reconsideration. Your letter with the statement of reasons should tell you your new deadline.

Gathering evidence

Make sure the evidence covers each point you disagree with on the statement of reasons.

Provide new evidence you haven’t already sent, for example:

• results of a medical completed by your GP or specialist

• a report or letter from a medical professional

• a diary showing how your condition affects your life each day - this can be really useful if your condition varies from day to day

Your GP or another healthcare professional might have already written a letter about you or given you a fit note, but this might not have been enough information about your condition. You can ask them to send more evidence about you now, including detailed information about how your condition affects your ability to work.

Your doctor might charge you to provide extra evidence. You should contact your GP surgery to find out if you’ll be charged and how much.

You should submit your request for a mandatory reconsideration as soon as you’ve filled in the form. Don’t worry if you don’t have evidence yet - you can send it afterwards.

Send your request to the address on your original decision letter. Write your full name, date of birth and National Insurance number on each sheet of paper you include. Find out where to get your National Insurance number on GOV.UK.

If you’re not sure what evidence you need or you’re having trouble getting it, talk to an adviser.

If you need money while waiting for a decision

While the mandatory reconsideration is taking place you won’t get any ESA unless the mandatory reconsideration is because you think you’re in the wrong group. You should think about what money you’ll need to live on in the meantime. 

Making a new ESA claim instead

If you’re waiting for a mandatory reconsideration because your ESA was stopped, you can make a new claim for ESA if:

• your condition has got worse

• you develop a new condition

This could mean that you’ll start getting ESA sooner. If the mandatory reconsideration is successful then you’ll get a backdated payment to the date your ESA was stopped or reduced.

There might be other circumstances when you can make a new claim. Find out what to do if your ESA is stopped or reduced.

Claiming Universal Credit

If you claim Universal Credit while you're waiting for a decision about your ESA, you won't be able to go back onto income-related ESA - even if your mandatory reconsideration or appeal is successful.

It might be better to wait to find out if your mandatory reconsideration is successful and you’re getting ESA, instead of claiming Universal Credit.

If you claim Universal Credit while you’re waiting for a decision about your new-style ESA, you’ll be able to get both if your mandatory reconsideration or appeal is successful.

Although you won’t normally get ESA during a mandatory reconsideration, you might start to get ESA if you appeal at a tribunal.

An adviser can calculate which benefit would leave you better off - contact your nearest Citizens Advice for help.

Getting a decision

The DWP will look at the original decision and decide if it was correct. If it’s a simple case it could take as little as 14 days, but it could be much longer.

Someone from the DWP might call you to ask for more information or evidence. If they do ask for more evidence, send it within 1 month of them contacting you. If you don't, the DWP will decide without it.

Once a decision has been made you’ll receive a letter with the outcome.

If the DWP change their decision, you’ll get the money you're owed backdated.

If the decision was about a new claim, they’ll backdate your ESA to the date you made the claim.

If the decision was about an ongoing claim, they’ll backdate your ESA to the date it was stopped or reduced.

If the DWP doesn’t change their decision

If you still don’t agree with the decision after the mandatory reconsideration, you can appeal to a tribunal.