Advice: Can I appeal SSA's decision to refuse me Employment and Support Allowance?

Q: I have been turned down for Employment and Support Allowance (ESA) following a medical; can I appeal the decision?

A: There are two steps to challenging a decision.

If your benefit decision was made on or after May 23, 2016 you must ask the Social Security Agency to look at the decision again. This is called ‘mandatory reconsideration’.

If you still disagree after the mandatory reconsideration, you can appeal to an independent tribunal. You can’t appeal to a tribunal until you have the result of a mandatory reconsideration in writing.

If your benefit decision was made before May 23, 2016 you can ask for it to be reconsidered or you can appeal it directly.

• How to ask for mandatory reconsideration

There isn’t a mandatory reconsideration form - you can just call or write a letter, using the contact details on your decision letter, to ask for the decision to be reconsidered.

The deadline to ask for a mandatory reconsideration is one month from the date on the decision letter.

It’s important to get medical evidence to support your case. This will help the decision maker understand more about how your condition affects you.

Your GP or a consultant may have already written a simple letter about you, but this might not have been enough information about your condition. You can ask them to send more detailed evidence about you now, including information on how your condition affects your ability to work. However your doctor might charge you to provide extra evidence.

You won’t get any ESA payments while you’re asking for a mandatory reconsideration if:

• you’ve been told you won’t get ESA at all because you’re not eligible (eg you scored 0 points at your medical)

• you didn’t go to your medical, or you didn’t return the ESA50 form

For advice about help you may be able to receive while you are going through a mandatory reconsideration contact your local Citizens Advice.

• Getting the result of your reconsideration

The SSA will write to you and tell you the outcome of the mandatory reconsideration.

If they’ve changed the original decision, you’ll get a backdated payment of ESA, going back to the date of the original decision.

If you’re still not happy with their decision, you can appeal to an independent tribunal. In some cases you can receive payment of ESA while appealing the decision.

• Get free, confidential and independent advice from your nearest Citizens Advice – go to www.citizensadvice.org.uk/nireland or call at: Citizens Advice Newtownabbey, Dunanney Centre, Rathmullan Drive, Rathcoole, Newtownabbey, BT37 9DQ. Telephone advice is available 9am – 4pm each day on 028 9085 2271 (Lunch 1pm - 1:30pm). Email advice is available at [email protected]