This is an HTML version of an attachment to the Freedom of Information request 'Official Policy Guidance to Decision Makers in relation to the application of sanctions to jobseeker claimants'.

Code of Appeals - Procedures Guide  
Introduction 
The Purpose and scope of this guide from and including 
28/10/2013. 
1.  This Code of Appeal Procedure (CAP) guide describes procedures for 
dealing with an appeal to a First-tier Tribunal (FtT). 
2.  It also provides: 
  procedures on related aspects, and  
  procedures for appeal to the Upper Tribunal (UT). 
3.  The Advice for Decision Making (ADM) and Decision Makers Guide (DMG) 
gives guidance on how to:  
  apply and interpret relevant decision making and appeals legislation, 
and 
  prepare and present appeals. 
4.  This guide contains details of the changes to the way we will deal with all 
appeals for any decisions made on or after 28 October 2013 under 
Appeals Reform changes.  
5.  Personal Independence Payment (PIP) and Universal Credit (UC) went 
live in April 2013 and are already operating the new Appeals process.  
6.  The main changes are: 
  Mandatory Reconsideration (MR) – the claimant cannot appeal against 
a decision until they have requested a Mandatory Reconsideration 
(MR) from the Department for Work and Pensions (DWP) and received 
a Mandatory Reconsideration Notice (MRN) 
  Direct Lodgement – the claimant can no longer appeal to DWP.  They 
must send their appeal request directly to Her Majesty’s Courts and 
Tribunals Service (HMCTS), enclosing a copy of their MRN 
  Time Limiting – HMCTS will request an appeal response from DWP, 
and DWP will have 28 calendar days from the date of receipt to 
prepare and submit their response to HMCTS. 
7.  If you have any queries on the content of the guidance please email the 
DWP Adviceline by completing their enquiry form. 
 
Background 
8.  A claimant cannot appeal against a decision notified on or after 28 October 
2013 unless they have first asked for an MR and received an MRN.  If an 
appeal is received before an MR has been conducted by the Decision 
Maker (DM) it will be treated as an application for an MR. 
9.  The conditions for claiming social security benefits are laid down by 
Parliament. In most cases claimants have the right of appeal to an FtT if 
they are dissatisfied with the outcome of their claim. For any decisions 
notified on or after 28 October 2013, the claimant must have had an MR of 
their decision before being able to appeal.  Decisions notified prior to 28 
October 2013 do not require an MR of the DM’s decision before the 
claimant can appeal.  

10. The conditions for amending existing decisions (revising), or replacing 
them from a later date (superseding), are also laid down by Parliament. 
11. People making an in time, or treated as in time application to have their 
benefit revised also have the right of appeal to an FtT if they are 
dissatisfied with the outcome of their application, but there are strict time 
limits.  However, the right of appeal is against the original decision, but in 
its revised form. 
12. Similarly, anyone making an application to have their award superseded 
also has the right of appeal to an FtT where they are dissatisfied with the 
outcome of their application.  However, unlike a “no revision/refusal to 
revise” decision, which has no right of appeal, a “no supersession” 
decision does have the right of appeal. 
13. There are exceptions to the rule outlined at 10/11 above where:  
  a decision refusing to revise is given – although this is a decision on an 
application, there is no right of appeal in these circumstances. The 
decision not to revise does not remove appeal rights against the 
original decision; the claimant has a further period of one month after 
the date on which notice that the decision would not be revised was 
sent to the appellant to provide a notice of appeal. Such a decision 
serves only to renew the appeal rights against the original decision, 
providing the application for revision is in time, or can be treated as in 
time 
  the Secretary of State (SofS) acts on his own initiative and makes a 
decision: 
 
to revise or 
 
to supersede or 
 
not to supersede 
14. Anyone affected by SofS decisions also has the right of appeal to an FtT if 
they are dissatisfied with the decision.  An MR must be requested and an 
appeal can be made to HMCTS upon receipt of an MRN. 
Important: In the case of a revision, the right of appeal lies against the 
decision in its revised form. 
Non appealable decisions 
15. There are some decisions that do not carry the right of appeal. These 
decisions include administrative matters, such as how benefit is paid and 
on what date it is to be paid on. There is also no right of appeal against a 
decision not to accept a late request for an MR. 
16. Non appealable decisions can be revised by the SofS at any time. 
17. Where these decisions are not revised, they can only be overturned by 
applying to the High Court for a judicial review of the decision in question.  
For further information see: 
  ADM  Annex E;  
  ADM Chapter 5, Paragraph A5900   
  Schedule 2 to the SS Act 1998;  
  Schedule 2 to the D&A Regs 1999. 
  DMG Chapter 6, Paragraph 6900 

Decision Makers/Decision Making 
18. Decisions on claims to benefit and changes to existing decisions such as 
revisions or supersessions, are made on behalf of the S of S by staff who 
are: 
  appropriately trained and skilled in decision making 
  know the difference between a claimant who wants to dispute a 
decision and someone who just needs a fuller oral explanation, or a 
written statement of reasons. 
19. All DWP staff should avoid the escalation of disputes and appeals by 
offering a full explanation or a written statement of reasons. 
20. Under the new appeals process it must be made clear to claimants 
wishing to dispute a decision that, following an MR, the appeal must be 
lodged directly with HMCTS and no longer with DWP.  All appeals made 
against decisions notified on or after 28th October 2013 must be lodged 
directly with HMCTS. 
21. Claims and changes to benefit are decided by: 
  establishing all the facts of the case 
  identifying the relevant Acts and Regulations 
  considering whether any case law applies such as SSC’s/UT decisions 
and decisions of Higher Courts, for example, Supreme Court,  Court of 
Session, Court of Appeal etc and 
  applying the law to the facts. 
22. Decision Makers must be able to explain the reasons for their decision to 
an FtT. 
23. Decision making is carried out at different levels.  These different levels 
have different responsibilities and include: 
 Decision Makers 
 First- tier Tribunals 
 Upper Tribunal 
  The Higher Courts, for example Court of Appeal, Court of Session, 
Supreme Court.                                                                                                                   
First-tier Tribunals 
24. FtTs give claimants the opportunity to put their case against a DM’s 
decision to an independent panel of people.  An FtT may consist of one, 
two or three members, at least one of whom must be an FtT Judge. When 
an FtT consists of only one member, that member must be an FtT Judge.  
25. The other members an an FtT must have relevant qualifications and 
experience depending on the issue(s) raised by the appeal, for example a:  
  medically qualified member or 
 financially qualified member or 
  member with experience of disability issues 
For further information on FtTs see: 
  ADM Chapter 5, paragraphs A5050 and A5060 and 
  DMG Chapter 6. 
26. Where there is more than one Judge on the FtT, the Chamber President 
will decide who will be the presiding member and will chair the FtT. When 
the FtT are reaching their decision after hearing all the evidence, if  the 

decision is equally divided the presiding member will have the final 
decision. 
27. In exactly the same way as the DM, when reaching a decision the FtT has 
to: 
  look at the circumstances of the case at the time the decision was 
made, and 
  establish the material facts and 
  correctly apply the relevant Acts, Regulations and case law. 
28. The FtT will consider: 
  issues in dispute 
  issues the Department and the claimant agree about, and 
  matters which are not relevant to the issues in dispute (that is, the FtT 
will look at the whole decision, not just the element in dispute). 
29. Legislation allows FtTs to consider other relevant aspects of the appeal if 
raised before or during the hearing. 
30. The FtT Judge deals with those issues that are not formally dealt with at 
an FtT hearing for example: 
  whether an appeal is duly made 
  whether an appeal can be admitted because it is late 
  postponing oral hearings 
  applications to correct FtT decisions 
  applications to set aside FtT decisions 
  order rehearings if there has been an error of law 
 jurisdiction 
  striking out appeals 
 reinstating appeals 
 whether disclosure of any documents is to be prohibited. 
Presenting Officers 
31. The role of the Presenting Officer (PO) is to: 
  present the SofS’s case and  
  support the tribunal to reach the correct decision on entitlement to 
benefit, based on the conditions set out in legislation.  
32. The PO must be confident that the decision is accurate and prepared to 
lapse appeals where this is not the case. They must highlight 
inconsistencies and take appropriate action when new evidence comes to 
light, including making a critical assessment of its validity.  
For further information on the PO role see  
Appendix 8   
ADM Chapter 5, paragraphs A5430, A5431  
DMG Chapter 6 
When should a Presenting Officer attend a hearing 
33. A PO should attend all FtTs when: 
  the facts and laws are considered to be complex, for example where 
complex legal arguments have been raised or where contentious case 
law has been referred to or 
  the decision involves an element of judgement or 

  the case involves new law which needs a ‘bedding in period’ (this 
period will be determined by the complexity of the legislation) or 
  directed to do so by a FtT judge 
  it is an FtT rehearing 
34. If  the  AT38 is noted that a PO will attend the hearing and attendance is not 
possible, HMCTS must be notified immediately.  The FtT will decide 
whether to proceed with the hearing. 
35. Where a hearing is arranged giving less than the usual notice (a short 
notice hearing) then: 
  if the AT38 has been noted that a PO will not be attending and 
  no notice has been issued directing a PO to attend 
HMCTS will not contact the office to ask whether a short notice hearing is 
acceptable. As long as the claimant and any other party are content they will 
simply list the hearing.  
Upper Tribunal Judges 
36. If the claimant or the SofS is dissatisfied with the FtT’s decision, they may 
(with permission) appeal on a point of law to the UT. 
37. In this instance permission can be given by the FtT or UT. On receiving 
the application for permission to appeal, the FtT must first consider 
whether to review their decision. 
38. If the FtT does not review or reviews but decides not to change the 
decision, it must still consider whether to give permission to appeal.  If the 
FtT refuses permission to appeal then it must notify reasons for the refusal 
and also set out the rights to then apply to the UT for permission to appeal. 
39. A claimant or the SofS can only appeal against a UT decision (with 
permission) on a point of law. These appeals are made to the Court of 
Appeal in England or Wales or the Court of Session in Scotland. In some 
circumstances, appeals (with permission) can also be made to the 
Supreme Court against a Court of Appeal or a Court of Session decision. 
40. In this instance permission can be given by the UT or by a judge of the 
Court of Appeal/Court of Session. On receiving the application for 
permission to appeal, the UT can review their own decision. 
Determinations 
41. Decisions are supported by separate findings of fact that have to be made 
before a decision can be made. These findings of fact are called 
determinations.   
42. Examples  of  determinations are findings of fact about: 
 capital 
 earnings 
 satisfaction of the contribution conditions 
  living together as husband and wife and living together as civil 
partners. 
43. One area of concern involves living together as husband and wife 
(LTAHAW) /living together as civil partners (LTACP) issues.  It is important 
to remember that a finding of fact on LTAHAW/LTACP is a determination 
and NOT a decision.  

44. If details of a LTAHAW/LTACP determination are sent to the claimant 
separately it is important that any reference to appeal rights is deleted 
from the communication before posting. However, the claimant should still 
be sent a full outcome decision containing reconsideration rights. 
45. Determinations do not have any legal “life” of their own outside the 
decisions in which they are embodied.  They cannot be: 
  revised or  
 superseded or 
 appealed 
by themselves – it is the decision in which they are embodied that is subject to 
revision and supersession and against which any appeal rights lie. 
46. Except for four instances, determinations made by a DM on one benefit 
are NOT binding on another DM when making a decision on the same or 
another benefit where such a determination applies.   
47. The four situations where determination is binding on another DM are: 
  a determination on incapacity for work 
  a determination on the date of onset of a prescribed disease 
  a determination that a claimant was not suffering from a prescribed 
disease and  
  a determination on limited capability for work. 
For further information on decisions and determinations see: 
 ADM Annex D 
  DMG Volume 1, Annex D, and  
  DMG Chapter 1. 
How the claimant appeals  
48. Where a DM makes a decision on a new claim, reconsideration or a 
change of circumstances (supersession), the claimant has the right to 
appeal that decision to an FtT.  
49. A claimant can only appeal after an MR of that decision has taken place 
and they have received two copies of an MRN. This applies whether the 
MR results in a revised decision or not. 
50. The claimant is told about their right of appeal in their MRN.  If the 
claimant continues to dispute the decision and wants to appeal, they must 
lodge the appeal directly with HMCTS and enclose a copy of their MRN. 
For further information on appeals see:  
  ADM Chapter A5 and  
  DMG Chapter 6 
51. The appeal has to be duly made and made within prescribed time limits in 
accordance with the Tribunal Procedure Rules. 
For further information on duly made and time limits see:  
  ADM Chapter A5 and  
  DMG Chapter 6 
Appeal sent to DWP in error 
52. If an appeal request is received by DWP in error, return the original appeal 
to claimant/representative along with any evidence they sent.  Issue a 
DL/CAP43 to the claimant containing instructions to send their appeal to 
HMCTS. 

53. If an MR has not been undertaken, treat the appeal request as a request 
for an MR and issue a DL/CAP42. 
54. If the claimant sends their appeal to DWP instead of HMCTS, consider the 
following action: 
  if the claimant has not had an MR on the decision they are appealing 
against, treat the appeal as a request for a MR and issue DL/CAP42 to 
claimant 
  if there is an MR already in progress, continue with the MR and return 
the appeal to the claimant along with the DL/CAP46. When the MR is 
completed, an MRN will be sent to the claimant which includes 
instructions on how to appeal. 
  if the claimant has included new information that affects the original 
decision: 
 
conduct a reconsideration 
 
record details on the benefit system/DMACR/ARTS/clerically 
 
issue a new decision notice and 2 MRNs,  which give directions 
about how to appeal. 
55. If the claimant has included new information that does not affect the 
original decision: 
  return the appeal 
  with the new information, and  
  a DL/CAP43 which contains instructions to send the appeal to HMCTS. 
Appeal sent or delivered to HMCTS 
56. Appeals must be made in accordance with the Tribunal Procedure Rules, 
which state that an appellant must start proceedings by sending a notice of 
appeal to the Tribunal. The appropriate address to send the notice of 
appeal will be shown on the MRN for the decision being appealed against. 
Appeals made on behalf of the claimant 
57. An appeal can be accepted if signed by a representative, provided it is 
accompanied by written notice from the claimant of the representative’s 
name and address.  If the representative is legally qualified then the above 
information is not required. 
HMCTS action on receipt of appeal  
58. The claimant must lodge their appeal directly with HMCTS. HMCTS will 
check if the appeal: 
  is in time, and 
  has been signed, and 
  includes a copy of the MRN, and 
  includes grounds for the appeal. 
59. HMCTS will send the appeal, with all relevant documentation to DWP and 
request a response. 
For further information on action on receipt of appeal see: 
ADM Chapter A5 and  
DMG Chapter 6. 
60. Where  the  appeal: 

  has not been signed, HMCTS will return the appeal to the claimant with 
an accompanying letter asking them to sign and return it. (Occasionally 
an unsigned appeal can be accepted, but if it is, it will always be 
accompanied by a waiver certificate when sent to DWP) 
  does not include a copy of the MRN, HMCTS send the appeal back to 
the claimant with a letter asking them to return the appeal with their 
MRN. If the claimant does not have an MRN, or they have lost it, they 
must contact DWP to: 
 
request a copy of their MRN, if one has previously been issued, or 
 
request an MR, if one has not previously been conducted, and wait 
for their MRN before returning their appeal to HMCTS. 
  does not include grounds for the appeal, HMCTS return the appeal with 
a letter asking them to state on what grounds they are appealing. 
61. Once the claimant complies with HMCTS and returns the appeal, HMCTS 
will send the appeal to DWP and request an appeal response. 
62. If the claimant does not comply, HMCTS will strike out the appeal and will 
not refer it to DWP. 
63. Provided reasons for a late appeal are supplied HMCTS will treat an 
appeal as made in time UNLESS the respondent objects.  When a late 
appeal is received DWP should consider the reasons given by the 
claimant and, if appropriate, raise objections on form AT39.  If DWP object 
to a late appeal the Tribunal Judge will decide if it can be accepted. 
For further information on strike out see: 
ADM Chapter A5 and  
DMG Chapter 6. 
Appeal response request received from HMCTS 
64. When HMCTS have completed their checks, they will attach: 
  form DL6/DL16 to the appeal request letter from the claimant, 
  the MRN, and 
  any other associated documents. 
65. These documents will be sent to DWP by post for an appeal response to 
be prepared. 
66. On receipt of the appeal response request from HMCTS: 
Step 
Action 

Immediately register the appeal response request on the benefits 
system/DMACR/ARTS/clerically. 

Record the date the appeal was received by DWP. 

Record the date on which the appeal was received by HMCTS, (or 
the date HMCTS has accepted the appeal was made on, if the 
appeal was not initially duly made). 

Include the HMCTS reference number which will be on the 
correspondence sent from HMCTS. 

Set a b/f for 21 calendar days. 

Obtain any case papers. 

Communication with Her Majesty’s Courts and Tribunals Service 
67. HMCTS use the NINO and their unique reference number to identify 
appeals. It is therefore important to quote the claimant’s NINO and 
HMCTS appeal reference number in any correspondence when known. 
The unique appeal reference number will appear on any correspondence 
received from HMCTS. 
68. If HMCTS receive any further documentation in connection with the 
appeal, they will forward it to DWP. 
Date of Appeal 
69. Treat the date of receipt as the date the appeal was made. This is the: 
  actual date of receipt in HMCTS if the appeal is duly made at the outset 
or 
  the date HMCTS has accepted the appeal was made on, if the appeal 
was not duly made initially  
Appeals not duly made 
70. Check whether appeal is duly made, including out of jurisdiction and no 
reasonable prospects of success. 
71. Send: 
 form AT39 and supporting documents to HMCTS, and  
  DL/CAP34 or DL/CAP31 to the claimant or their representative. 
72. When HMCTS receive the AT39 and refer it to the FtT to be heard: 
  the FtT will make a determination on the validity of the appeal 
  HMCTS will notify the FtT’s determination to 
 
DWP, and  
 
the claimant or their representative  
73. When DWP receives the FtT determination from HMCTS. 
  if the appeal is to proceed DWP will receive direction(s) from HCMTS. 
  if the appeal is not to proceed: 
 
update benefit system/DMACR/ARTS and clerical papers if 
appropriate 
 
clear the b/f. 
Appeal response request received from HMCTS – Out of 
Jurisdiction 
74. HMCTS has the authority to decide whether an appeal is within their 
jurisdiction. HMCTS will only send the appeal to DWP once they have 
accepted it.  
75. Out of Jurisdiction (OOJ) appeals will normally be identified from the MRN, 
however, HMCTS staff are not benefit trained, so in most cases OOJ 
appeals will be sent to DWP. 
76. This does not prevent the DM from referring a case back to HMCTS if the 
DM considers the matter outside the FtT’s jurisdiction because of 
information they hold that HMCTS may not be aware of.  
Decisions or determinations that are non-appealable are listed at: 
ADM Annex E1 
DMG Annex E 
For further information on response requests see: 

ADM Chapter A5  
ADM Annex E, and  
DMG Chapter 6. 
77. If DWP subsequently identify that an appeal is OOJ, the DM must request 
that HMCTS strike it out on these grounds. Do not prepare an appeal 
response, take action as follows: 
Step 
Action 

Access DMACR/’Hotdocs’, complete form AT39, attach supporting 
documents with reasons for objection, and send to HMCTS. 

In DMACR/Hotdocs’, complete form DL/CAP34, and send to the 
claimant to inform them that a request for strike-out has been 
made to HMCTS, on the grounds that their appeal is out of 
jurisdiction. 

Record the issue of these forms on the benefit system/DMACR/ 
ARTS/clerically, and set a b/f for 21 days from the issue date of the 
forms. 

If, on maturity of the b/f, there has been no reply from HMCTS, 
telephone the HMCTS processing team for an update. 

Set a further b/f for 28 calendar days or earlier, depending how 
long HMCTS consider it is likely to take to decide if strike out is 
appropriate and complete a TL1 to request an extension to the 
time limit. 

HMCTS will refer the appeal to the FtT to determine whether the 
appeal can be struck out or is to proceed. 

HMCTS will issue the FtT’s decision to the claimant and DWP. 

If HMCTS decide the appeal must proceed, prepare the appeal 
response in the normal way. A further extension to the time limit 
will be given, from the date of the FtTs decision, for DWP to 
prepare the response. Consider whether a request for an 
additional extension to the time limit will also be required. 

If HMCTS agree to strike out the appeal, update the benefits 
system/DMACR/ARTS/clerically, and clear the b/f set on receipt of 
the appeal. There is no need for DWP to contact the claimant as 
HMCTS will do this. 
Appeal response request received from HMCTS – No Reasonable 
Prospect of Success 
78. When an appeal response request is received from HMCTS, check 
whether it has ‘No Reasonable Prospect of Success’ (NRPS). If the appeal 
has NRPS, ask HMCTS to strike it out. An appeal response is not required 
at this stage. 
See examples of NRPS in: 
  ADM Chapter 5, paragraph A5233 
  DMG Chapter 6, Paragraph 06233 
79. To ask HMCTS to strike out the appeal: 
Step 
Action 

Access DMACR/ARTS, complete form AT39 and Appendix 15, 

and send them to HMCTS. (CAP Appendix 15 explains why the 
appeal has NRPS to support your request for strike out. Word 
carefully
, as it is also sent to the claimant). 

In DMACR/ARTS, complete form DL/CAP31, obtain a copy of the 
CAP Appendix 15 and send them to the claimant to inform them 
that a request for strike-out has been made to HMCTS. 

Record the issue of these forms on the benefit system/DMACR/ 
ARTS/clerically and set a b/f for 21 days from the issue date of 
the forms. 

If on maturity of the b/f, there has been no reply from HMCTS, 
telephone the relevant HMCTS processing team for an update. 

Set a further b/f for 28 calendar days or earlier, depending how 
long HMCTS consider it is likely to take to decide if strike out is 
appropriate. 

The FtT will give the claimant the opportunity of responding to 
the request for a strike out before they make their decision. 
HMCTS will then issue the FtT’s decision to the claimant and 
DWP. 

If HMCTS decide not to strike out, an appeal response must be 
prepared in the normal way. An extension to the time limit may 
need to be requested on form TL1 to prepare the response. 

If HMCTS agree to strike out the appeal, update the benefits 
system/DMACR/ARTS/clerically and clear the b/f that was set on 
receipt of the appeal. 
Striking out appeals 
80. HMCTS must strike out an appeal where:  
  the claimant has failed to comply with a direction which stated that 
failure to comply would result in the appeal being struck out or 
  the appeal is outside the FtT’s jurisdiction. 
81. HMCTS may also strike out an appeal where the: 
  claimant fails to comply with a direction and the direction stated that 
failure to comply may result in the appeal being struck out, or 
  claimant failed to cooperate with the FtT , or 
  FtT considers there is no reasonable prospect of the claimant being 
successful. 
82. If DWP fails to comply with the FtT’s direction then the effect of striking out 
will be to bar DWP from taking any further part in the appeal.  
For more information on striking out see: 
  ADM Chapter 5, paragraph A5230 – 38 and A5680-A5682 
  DMG Chapter 6, paragraph 06230. 
83. When HMCTS strikes out an appeal, they will notify the claimant and 
DWP. If DWP have requested strikeout due to OOJ or NRPS: 
  update the benefit system/DMACR/ARTS/clerical papers 
  take no further action on the appeal, but deal with any outstanding 
issues. 

Reinstating a struck out appeal 
84. If their appeal was struck out the claimant can apply in writing to the FtT 
for reinstatment.  
85. If DWP has been barred from taking further part in the proceedings they 
can apply to the FtT for the bar to be lifted.  
86. An application for reinstatement or lifting of the bar has to be made within 
one month of notification of a decision to ‘strike out’ or ‘bar’. In all other 
cases the claimant is asked for comments before strike out action is taken. 
87. If the FtT decides to reinstate the appeal, they will notify all Parties to the 
Proceedings (PTTP). 
88. When a reinstatement notification is received: 
  proceed with the case as for a normal appeal 
  re-enter the case on the benefit system, DMACR/ARTS/clerical papers, 
using the date HMCTS treat the appeal as having been made.  
Reconsideration of the decision after an appeal response has 
been requested by HMCTS 
89. When a request for an appeal response is received from HMCTS the DM 
must first consider whether the decision can be revised before processing 
the appeal.   
90. If the appeal cannot be treated as being made in time the DM should 
always look at whether the decision under appeal can be revised, or if not, 
superseded.   
91. In reconsidering a decision following receipt of an appeal response 
request there is no requirement for the DM to make a decision not to 
review if they cannot revise the original decision. 
92. The DM should consider supersession and, where appropriate, supersede 
the decision under appeal.  If the decision under appeal can be revised 
wholly in the claimant’s favour the appeal can lapse. However, an 
advantageous supersession cannot lapse an appeal. 
93. DM(s) must consider cases thoroughly, in particular ensuring that all 
existing and newly provided evidence and details from the MRN are 
considered carefully, where necessary obtaining further evidence. 
94. Where an appeal is underway and further evidence is received at any time 
before the Tribunal gives its decision, a further reconsideration of the 
decision under appeal must be carried out, for example following an 
adjournment.  
For further information on reconsideration of the outcome decision see: 
ADM Chapter 3, and  
DMG Chapter 6. 
95. Where, following receipt of an appeal response request, the DM does not 
revise the decision under appeal, before processing the appeal they must 
first make sure that it has been duly made. 
Further evidence received after appeal response issued to HMCTS 
96. If the claimant presents further evidence in support of their appeal after the 
response has been issued, but before the hearing, HMCTS will forward the 
further evidence to DWP for the DM to consider. 
97. DM(s)  must: 

  notify HMCTS on form AT39 if any decision under appeal is changed 
by revision or supersession and  
  ask HMCTS to tell the FtT what the effect of the revision or 
supersession will have on their jurisdiction. For example, appeal 
lapsed or jurisdiction limited to period/issues not covered by the 
supersession.  Supporting documents must be included if applicable. 
98. DM(s) must also notify HMCTS on form AT39 when the decision under 
appeal is reconsidered in light of the further evidence, but the decision 
cannot be revised. A further response and supporting documents must be 
attached. 
99. When a reconsideration leads to a changed decision which is not 
favourable to the claimant, the appeal response should not normally be 
sent to HMCTS until a month from when the revised decision is notified.  
100.  This is to allow time for the claimant to make representations to the 
Department on the revised decision and contact us further. However, if 
after a month the claimant does not respond, the response can be sent to 
HMCTS. 
101.  If further evidence is received: 
 check that: 
 
it is new evidence and not evidence already considered 
 
it relates to the time when the original decision was made 
 consider:  
 
if the evidence changes the decision under appeal 
 
if more evidence is needed 
 
when the evidence was supplied 
 
the weight to give to the evidence if more than a month has passed 
since the response was issued.  
102.  If further, new evidence is received, but it does not lead to a change to 
the decision: 
  tell the claimant that their further evidence has been received and 
considered, but does not affect the decision, so their appeal will 
continue and  
  complete AT39 and a supplementary response detailing the reasons 
why the evidence does not change the decision and drawing the 
attention to the tribunal to any particular issues, such as evidence 
being provided late.  Send it to HMCTS 
103.  If the further evidence leads to a revision of the appealed decision, the 
appeal will lapse if it is revised wholly in the claimant’s favour. 
104.  If the further evidence indicates a decision to revise partially in the 
claimant’s favour further action will be required. 
105.  Complete an AT39 to notify HMCTS that a partially advantageous 
decision has not been implemented, as the claimant either could not be 
contacted, or, requested for the appeal to continue. 
106.  If the decision can be revised but it leads to a decision that is less 
advantageous to the claimant, the appeal must continue. The appeal will 
be treated as though it is against the original decision as revised. 
107.  Record all details on the benefit system/DMACR/ARTS/clerical papers 
and action the revised decision. 

108.  If there is not time to consider the above actions because the appeal 
hearing is imminent, contact the PO urgently to request that the hearing is 
adjourned or contact HMCTS directly if the PO is unavailable. 
New evidence produced prior to the FtT hearing 
109.  If, following the reconsideration process, the decision under appeal is 
revised wholly in the claimant’s favour the appeal will lapse and HMCTS 
should be notified on form LT203C. Where the reconsideration does not 
result in a wholly favourable decision, a further response based on the 
additional fact(s) should be prepared on AT39. 
Appeal adjourned by HMCTS  
110.  In some circumstances, the FtT will adjourn a hearing. This may be 
because additional evidence or information or a further response from the 
DWP is needed, or the FtT identifies the need for a Party to the 
Proceedings (PTTP) to attend the hearing. 
111.  HMCTS will notify DWP with the reason why and whether or not a 
further response is required. 
112.  The decision under appeal should be reconsidered in the light of any 
new evidence or information obtained under these circumstances. If, 
following the reconsideration process, the decision under appeal is revised 
wholly in the claimant’s favour the appeal will lapse and HMCTS should be 
notified. 
113.  When following a reconsideration the decision under appeal cannot be 
revised wholly in the claimant’s favour, the FtT must be told what effect the 
new evidence or information has had on the decision under appeal and a 
further response prepared on AT39. 
For more information see:  
  ADM Chapter 5, Paragraph A5030 and 
  DMG Chapter 6. 
114.  In all cases, HMCTS will identify the first suitable hearing date and 
agree the new hearing date with the claimant, any representative and 
other PTTP. 
115.  Following an adjournment, if HMCTS have not previously requested a 
further response, but later decide they need one, they will inform DWP by 
post. HMCTS will include a date for completion of the further response. 
116.  It is the responsibility of DWP to call and notify any witnesses if the 
Tribunal has been adjourned using DL/CAP25. 
117.  Complete and send form AT39 to HMCTS. 
For more information on appeals adjourned see  
  ADM Chapter 5, paragraphs A5448 to A5451, and 
  DMG Chapter 6. 
Decision wholly in claimant’s favour 
118.  If, at any time during the appeal process, the DM decides the decision 
under appeal can be revised wholly in the claimant’s favour, update the 
benefit system/ DMACR/ARTS/clerical records. Tell HMCTS that the 
appeal has lapsed by completing LT203C. HMCTS will inform the claimant 
that their appeal has lapsed. 

Decision partially in claimant’s favour 
119.  If the revised decision would be to the claimant’s advantage but it 
would not give them all that they have asked for, contact the claimant by 
telephone (two attempts, three hours apart) to explain the decision or 
discuss any areas requiring clarification. This is to give them an 
opportunity to decide if they wish their appeal to continue. 
120.  If the claimant does not wish to proceed with their appeal, the decision 
can be revised and the appeal will lapse. The new decision can be 
implemented and any money owing paid immediately. 
121.  If the claimant does not agree with the new, partial decision, the appeal 
must continue and the revised decision cannot be implemented or paid. 
122.  The appeal must continue if the claimant cannot be contacted. 
123.  When writing the appeal response, notify HMCTS that a partially 
advantageous decision has not been implemented, as the claimant either 
could not be contacted, or was contacted and requested for the appeal to 
continue.  
Decision not changed 
124.  If further evidence is received prior to the appeal response being sent 
to HMCTS, but this does not change the decision, the appeal will continue. 
125.  Record why it does not affect the original decision on the benefit 
system/DMACR/ARTS/clerically. 
126.  When preparing the response for HMCTS record the evidence in the 
Schedule of Evidence at Section 2 of the response and update the benefit 
system/DMACR/ARTS/clerically with all actions taken. 
127.  Where the decision is not revised, but the DM considers it to be 
incorrect, the response to HMCTS must: 
  explain to the FtT why the decision has not been revised, and 
  ask that the correct decision is substituted for that of the DM.  
Time limits 
128.  The time limit for providing an appeal response is 28 calendar days 
from the date the appeal response request is received from HMCTS. 
129.  When an appeal response request is received from HMCTS a 21 day 
b/f must be set as a reminder, to ensure that the time limit date will be met. 
130.  However, to allow both DWP and HMCTS to address the existing head 
of work each has, it has been decided not to formally introduce the time 
limits until October 2014. 
131.  The time limits process is operational from 28 October 2013. However, 
if the appeal response cannot be provided to HMCTS within the time limit, 
until October 2014 a time limit extension request on form TL1 must be sent 
to the Appeals manager and not to HMCTS. 
132.  For further information refer to the Transitional Guidance for your 
benefit.  
133.  The following process will be fully operational from October 2014. You 
will be notified of the actual date nearer the time 

Completing TL1 to request an extension to the time limits 
134.  When an extension to the time limit for providing an appeal response is 
required, complete form TL1 as soon as this is identified and send it to 
HMCTS.    
135.  Dependant upon the individual circumstances of a case, when an 
appeal response request is received from HMCTS a request for an 
extension can be made at the outset if it is appropriate. 
136.  When completing form TL1 ensure that your reasons for the request 
are worded with care and discretion, HMCTS will send a copy of it to the 
claimant. 
137.  The claimant may challenge an extension to the time limit, for example 
on hardship grounds. 
138.  Ensure that HMCTS are given a clear, detailed explanation on the TL1 
of: 
  why the extension is needed, and  
  the date when the appeal response will be sent to them. For example, 
if the claimant states in the appeal request that they will send a 
consultant’s letter after an appointment: 
 
consider how long it might take to receive this evidence 
 
add on to this any assessment provider referral time, if appropriate, 
 
add on the appeal preparation time, including photocopying 
etcetera. 
  if an extension is requested to allow the claimant to provide additional 
evidence, the DM must always consider whether to request a direction 
from the Tribunal to provide the evidence. 
139.  Always continue preparing the response whilst awaiting the further 
evidence. 
140.  When HMCTS receive a request for an extension they will refer it to the 
FtT. 
141.  HMCTS will write to the claimant and DWP with the tribunal directions, 
either agreeing to or rejecting the request for a time extension. 
Extension request rejected 
142.  If the time limit extension request is rejected: 
  follow the tribunal direction(s) and,  
  using the information already held, write the appeal response and send 
it to HMCTS, the claimant and the PO, if there is one. 
143.  If the 21 day b/f matures and the deadline can be met immediately, 
send the appeal response to HMCTS, the claimant and the PO, if there is 
one. 
144.  If the 21 day b/f matures and the deadline cannot be met immediately, 
continue preparing the response and set a further b/f for the 28th day to 
remind the DM that the response must be sent on that day. This will give 
the DM another chance to apply to HMCTS for an extension if, on the 28th 
day it is apparent the deadline for completion of the response will not be 
met. 
145.  The time clock for DWP stops on the date the appeal response is sent 
to HMCTS. 

Preparing the appeal response 
146.  To prepare the appeal response  
Step 
Action 

Refer to the MRN, clerical case papers and any further 
information to complete the appeal response, setting out clearly 
the facts of the case, the claimant’s grounds for appeal, the law 
that applies and the reasons for the decision under appeal. 

If the claimant states in their appeal that there is further evidence 
which is not yet available, and the wait for this evidence will 
result in the appeal response taking longer than 28 days, apply 
for a time limit extension immediately and consider asking the 
Tribunal Judge for a Direction asking for the evidence to be 
provided and set an appropriate b/f. 

On maturity of the 21 day b/f, check that all the information has 
been received and the appeal response is on target to be 
completed within the 28 day time limit. 

If the appeal response is likely to be late, apply for a time limit 
extension using form TL1 as soon as this is identified, and email 
to HMCTS, marked ‘RESTRICTED’. Record the date and details 
of the extension request on the benefits 
system/DMACR/ARTS/clerically. 

Send a completed form AT38 with the appeal response to 
HMCTS, and the PO, if there is one. 
6 Access 
DMACR/ARTS to send a letter (DLCAP40) to the 
claimant with the appeal response, to let them know that the 
response has now been sent to HMCTS. 

The time limit clock stops once the appeal response has been 
sent. If this is within the 21 calendar days, clear the 21 day b/f set 
on receipt of the appeal. 

Record the date that the appeal response was sent to HMCTS, 
the claimant and the PO if there is one, on the benefits 
system/DMACR/ARTS/clerically. 
Sending the response 
HMCTS offices and email addresses 
147.  The HMCTS offices and email addresses for correspondence should 
be sent to the most geographically appropriate office, and will be one of 
the following: 
 
OFFICE  
 OFFICE CONTACT E.MAIL ADDRESS   
Sutton 
xxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
(London) 
Leeds 
xxxxxxxxxxx@xxxxx.xxx.xxx.xx 
Cardiff 
xxxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
 

ASC 
xxxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
Birmingham 
Liverpool 
xxxxxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
Newcastle 
xxxxxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
Glasgow 
xxxxxxxxxxxxx@xxxxx.xxx.xxx.xx 
Epsom 
xxxxxxxxxxx@xxxxx.xxx.xxx.xx 
HMCTS admits appeal 
148.  Where the FtT admits appeals that are late, not duly made or Out Of 
Jurisdiction (OOJ), they will send a letter to the Department asking for the 
appeal to be treated as valid and to produce an appeal response. This 
letter will include a unique reference number that HMCTS have allotted to 
the appeal. 
149.  When sending the response to HMCTS, include on the AT38 in the 
“Other Info” box the following information. “This appeal was submitted as 
[late/not duly made/OOJ] on date]. It was admitted on [date] and a 
response requested. The response is attached. The case is already 
registered at the Tribunals Service under [ref. no.].” 
Appeals against HM Revenue and Customs issues 
Issues raised in the appeal are only about HM Revenue and Custom 
Issues 

150.  If a request for an appeal response is received and the issues in the 
appeal are about HMRC: 
  send a copy of the appeal to HMRC for them to consider before the 
appeal can be processed 
  b/f the case for 3 months to allow for an HMRC response, and  
 complete form TL1 asking for an extension to the time limit for the 
completion of the appeal. 
Note
  appeals against NI contributions only affect those benefits which are 
contributory based 
  appeals against Employed Earners Employment only affect IIDB. 
151.  The appeal response request cannot be returned to HMCTS until 
HMRC have been given the opportunity to consider and respond to the 
issues under appeal. The DM must wait for HMRC’s decision, as the 
appeal response cannot be written without it. 
152.  If HMRC have: 
  resolved their issue, and  
  notified the DM of their decision 
  the DM must decide how to proceed with their response to the appeal 
in the light of that decision.  
Note: if the decision under appeal has been revised wholly to the claimant’s 
advantage, the appeal will lapse. 
153.  If the outcome decision has been reconsidered but has not been 
changed to the claimant’s advantage, the appeal will continue. The appeal 
response must be written:  
  focusing on the HMRC aspect and  

  including all relevant HMRC contacts, addresses and documentation in 
the “Schedule of Evidence”. 
Issues raised in the appeal are about HM Revenue and Customs 
issues and other DWP benefit related issues 
154.  If an appeal is received and at least one of the issues raised in the 
appeal is about NI contributions or Employed Earner's Categorization 
(EEC) and there are other benefit related issues, consider looking at the 
benefit issues. You may: 
  reconsider the outcome decision - if any new decision is revised wholly 
in the claimant’s favour, the appeal will lapse or  
  await the HMRC decision and reconsider the outcome decision using 
all the information available. If any new decision is more advantageous 
to the claimant, but is only partially in their favour further action will be 
required.  
155.  In either situation, if the appeal is to proceed an AT38 must be 
completed. The date of appeal will be the date the appeal was received in 
HMCTS. Annotate the ‘other information box’ on form AT38 that the 
appeal was first referred to HMRC. 
Limited Capability for Work appeals 
156.  A decision incorporating a No Limited Capability for Work (No LCW) 
appeal determination has the potential to affect other benefit decisions. 
157.  Where No LCW is an issue, a determination on that question made in 
connection with one benefit is binding on all other benefits claimed for the 
same period except 
  Statutory Sick Pay (SSP) and 
  Industrial Injuries Disablement Benefit (IIDB) 
Claimant appeals against more than one decision 
158.  If the claimant appeals against two (or more) decisions they may either: 
  include each of the appeals in a single notice of appeal, or  
  send a separate notice of appeal for each decision.  
159.  Where there has been more than one decision notified to the claimant, 
and they send in a single notice of appeal, possibly appealing against 
more than one decision, it must be assumed that the appeal is against 
both/all the decisions unless it is clear which of the decisions are being 
appealed. 
Appeal against decision given by the Compensation Recovery 
Unit 

District action on receipt of completed response 
160.  Any presentation to the FtT will be by a PO from the Compensation 
Recovery Unit . 
161.  If a CRU PO is required to attend the hearing, a copy of the response 
should be sent to them. 
162.  The CRU PO should preview the case before attending the FtT, 
contacting the CRU if necessary. 

Appeals following Compensation Recovery Tribunals decision 
163.  If the decision under appeal was made following notification by the 
CRU of an FtT decision in a compensation recovery case and 
  the award of benefit is revised or superseded, and an overpayment 
decision made where appropriate and 
  the decision is appealed, 
to ensure that there is no breach of the rules of natural justice or of Article 6(1) 
of the European Convention on Human Rights (ECHR) it is important that NO 
members of the FtT hearing the benefit appeal were members of the FtT that 
heard the CR appeal. 
164.  A clear note about the CR appeal must be made in the “other 
information box” of form AT38.  
Advice and representation for claimants  
Interpreters 
165.  If a claimant needs an interpreter and has said so on the HMCTS pre-
hearing enquiry form, HMCTS will make the arrangements. However, if 
DWP records indicate that the claimant requires an interpreter this 
information must be also included on the AT38 / AT39. 
Local advice agencies 
166.  Offices must keep a printed list of local agencies which can advise 
claimants about their appeals and provide representatives at the FtT. 
Complaints 
167.  DWP has no responsibility for the standard of service offered by local 
advice agencies. If: 
  a complaint about one of the organisations is received, refer it without 
comment to the organisation concerned or 
  repeated complaints about a particular organisation are received, local 
DWP Managers may decide to contact the organisation about the 
problem to offer help and advice. 
Linked appeals 
168.  To ensure the minimum delay in processing a claimant's appeal(s), as 
well as to save administrative costs, it is important that linked appeals 
(where the outcome of one appeal is affected by, or depends on the 
outcome of the other appeal) are heard at the same time by the same FtT. 
169.  This may be difficult where the FtT composition is different for different 
benefits, for example IS and DLA. However, all that needs to happen is 
(taking linked IS and DLA appeals as an example) is for the medical 
member to retire from the FtT while an IS appeal is considered. 
170.  Linked appeals generally arise where qualifying benefits are involved. 
They may involve: 
  only one claimant, for example where entitlement to the Severe 
Disability Premium (SDP) on IS depends on the outcome of a related 
appeal about DLA, or  
  two different claimants, for example CA and DLA.  

171.  The onus is on the DM(s) to contact each other when they identify that 
they are dealing with linked appeals. 
172.  In many cases it will be clear from the appeal form or letter that there 
are linked appeals. However, problems may arise where: 
  there are linked appeals involving claimants with different surnames, 
for example partners, or  
  the claimant's SDP has been stopped because a non dependant's SDP 
has been lost (and so the non dependant is not treated as such).  
173.  Where it is known from local knowledge that such cases may arise, 
they should be linked as above for hearing. 
174.  Whenever linked appeals are identified, they should be noted on form 
AT38 in the linked appeal boxes. 
Appeal against NINO related conditions of entitlement 
175.  If an appeal is received which concerns a NINO related condition of 
entitlement, the DM must contact the relevant NINO Delivery contact 
centre and get: 
  a copy of the NINO application 
  any evidence submitted by the applicant 
  any evidence that was already available to the NINO officer and 
  a statement of reasons why the information and evidence was not 
considered persuasive. 
Completion and submission of appeal response to HMCTS 
Purpose of the Appeal response 
176.  The function of a response is to:  
  assist the FtT to reach the correct decision 
  explain to the claimant the reasons for the decision 
  allow the SofS to respond to the grounds of appeal. 
177.  The response must set out clearly: 
  what the case is about 
  the law that applies and  
  the reasons for the decision under appeal using information contained 
in the MRN. 
178.  The response must also: 
  respond to the claimant’s grounds of appeal  
  explain why any evidence has not been accepted 
  include all of the: 
 
relevant evidence, and  
  any procedural information which may affect the form of the FtT’s 
decision.  
179.  All appeal responses must be prepared as quickly as possible, in 
particular any appeals remitted to a new FtT by the Upper Tribunal (UT). 
Preparation of the appeal responses   
180.  Prepare all appeal responses using the response framework, including 
appeals against: 

  a Reduced Benefit Direction (RBD) 
  an IIDB decision (whether or not it centres on medical issues). 
181.  Sections 1, 4 and 5 of the framework should be used when drafting a 
response which is required for a FtT rehearing after the FtT’s original 
decision was set aside by a FtT or a UT. A further response may be 
required following: 
  a direction by a FtT 
  a direction in the UT’s decision 
  advice from DMA Leeds. 
182. A 
further 
response 
under cover of form AT39 may also be required 
when: 
  additional evidence is received after the response is sent to HMCTS, 
but  
  before the hearing a reconsideration is undertaken, but there is no 
change to the decision. 
The Appeal Response Framework  
183.  The appeal response framework at Appendix 7 contains: 
  examples appeals responses produced using the framework 
  specimen paragraphs for use in connection with habitual residence 
appeals/issues.    
184.  The framework follows the format:  
  Section 1: personal details 
  Section 2: Schedule of Evidence 
  Section 3: the decision 
  Section 4: the facts of the case 
  Section 5: the response. 
Section 1: Personal Details 
185.  This section provides the: 
  name and address of the claimant 
 NINO 
  benefit in payment 
  date of outcome decision 
  date the outcome decision was notified 
  date the MRN was issued to the claimant 
  date the appeal was received 
  DM(s) name and address 
  name and address of the DM(s) representative (if any) 
  address where documents for the DM may be sent or delivered 
  name(s) and address(es) of any respondent(s) and their 
representative(s) (if any). 
186.  The name and address of an appointee should be indicated clearly 
where appropriate. 

Section 2: Schedule of Evidence 
187.  This section lists evidence/relevant documents/MRN which have been 
used to make the outcome decision and to prepare the appeal response, 
using the form at Appendix 9. 
  space should be left for additions by HMCTS and the UT’s office as 
appropriate 
  all pages, including the response, should be numbered consecutively, 
and the date of receipt or preparation of documents indicated on the 
Schedule of Evidence.  
188. The 
MRN must be attached as part of the evidence. 
189.  If the claimant’s appeal is hand-written and the writing is difficult to 
read, a typed version of the grounds of appeal should be produced and 
listed in the Schedule of Evidence. 
190. If 

video recording has been used as evidence in the outcome 
decision and is used in the appeal response, it must be included in the 
“Schedule of Evidence”, including details about the length of the recording. 
Section 3: The decision 
191.  This section provides a record of the decision if it is available, or a form 
of words which accurately reflects the decision if it was computer 
generated. It must be clear about which decision is under appeal. This is 
particularly important where: 
  a series of decisions has been made 
  the decision under appeal is a decision to supersede (or not to 
supersede) an earlier decision 
  the decision under appeal is an original decision which has been 
revised. 
For further information on identifying the decision under appeal see:  
  ADM Chapter 05 and 
  DMG Chapter 3 
192.  If reconsideration of on appeal has resulted in a revised decision, 
which is unfavourable to the claimant, that should be explained here. 
193.  Care must be taken to ensure that the full decision is set out, and not 
simply the determination or reason for the decision. For example, where 
the DM has made a determination about LTAHAW/LTACP which resulted 
in supersession of an awarding decision, the supersession must be 
recorded as well as the LTAHAW/LTACP determination. 
For further information on recording decisions see:  
  ADM Chapter 01 and  
  DMG Chapter 3 
Section 4: The facts of the case 
194.  This section is used to present all the agreed facts relevant to the 
outcome decision clearly and in chronological order. It must include: 
  a brief description of the claimant’s background and their 
circumstances 
  a benefit/decision making history, so far as is appropriate, to show how 
the decision under appeal was made. For example, where the decision 
is a supersession, or a decision which has been revised: 

 
previous decisions for that claim/award, and their effect, should be 
recorded, and 
 
in renewal or repeat claims, previous claims/awards should be 
indicated briefly, especially where the claimant argues that there 
has been no change. 
195.  Where a late appeal has been accepted by HMCTS or DWP as being 
in time this should be referred to. 
196.  Any dispute about ‘facts’ must be explained in Section 5 of the appeal 
response. 
197.  If reconsideration has resulted in a decision which is not more 
advantageous to the claimant, the appeals officer must highlight the facts 
that gave rise to the new decision. 
198.  All references to evidence must be numbered. 
199.  Documents that have been lost or destroyed must be referred to, 
including information about the Department’s document/information 
retention policy where appropriate. 
Overpayments 
200.  If the appeal is against an OP decision, details of the amount and the 
reasons for the OP must be recorded. 
201.  An OP schedule must be prepared, included as evidence and listed in 
Section 2: Schedule of Evidence if it is not included as part of the decision 
in Section 3. 
202.  For overpayments of means-tested benefits, the response must include 
an example of the calculation of benefit before and after the change which 
caused the OP. 
203.  The whole of the claim form and any other relevant documents must be 
included to demonstrate a misrepresentation or failure to disclose. System 
prints must be included to show the issue of leaflet INF4: 
  prior to uprating 
  with new award decisions, or  
  with any supersession decision. 
204.  When the benefit decision has been made and the separate decision 
on the O/P is complete the response writer must demonstrate in this 
Section that the required revisions and/or supersessions have been 
carried out, in order to show that the provisions of section 71(5A) of the 
SSA Act 1992 have been complied with. 
Disclosure of information 
205.  If the claimant says that information has been disclosed but the SofS 
maintains that it has not, the appeal papers must include a certificate to 
show what searches and actions were undertaken to check the disclosure 
claim. 
Industrial Injuries Disablement Benefit (IIDB) 
206.  A schedule of previous assessment(s) for the same Prescribed 
Diseases PD(s) or accident(s) should be included in this section. 

Section 5: The response 
207.  This section draws the FtT’s attention to the issues to be decided. It 
contains the SofS’s reasons for the decision and reply to the grounds of 
appeal. Use the details on the MRN to aid in its completion.  
208.  The content of this part of the response will be determined by the 
complexity of the appeal. It must include: 
  what has and has not been accepted even if there is no dispute 
  what has been claimed by the claimant, and  
  the conclusion on each of these decisions. 
209.  It must be clear what facts have been accepted or disputed. Where 
evidence has not been accepted a reason must be given.  
210.  The response should include: 
  an explanation of the decision under appeal 
  an explanation, where required and appropriate, of the grounds for any 
revision or supersession. 
  a full response to all the points raised in the grounds of appeal 
  a recommendation for disposal of the appeal.  
211.  If the decision under appeal is based on a determination which does 
not deal with all relevant conditions of entitlement, the FtT should be 
invited 
  to consider the remaining conditions or 
  to adjourn for further information. 
212.  If the FtT should find for the claimant on the issue on the appeal, for 
example, where a DLA claim is disallowed because the claimant failed to 
attend a medical examination without good cause, they must be asked to 
also consider whether the claimant satisfies the conditions for an award of 
DLA if they find that there was good cause. 
213.  The response may also include: 
  a submission about whether it is appropriate for the case to be 
disposed of without a hearing 
  a recommendation that the FtT makes the same decision as the DM 
did, but if for different reasons.  
For example, if: 
  the DM says they have revised or superseded when in fact they have 
done the opposite, or  
  an OP is found to be recoverable due to misrepresentation, but the 
response writer considers failure to disclose was the cause of the OP 
the FtT may be invited to correct the decision accordingly. 
214.  If, exceptionally, the response writer asks the FtT to make a different 
decision, the reason for this and why the decision has not been revised 
should be clearly explained. An example of this could be: 
  when an appeal has been received against an OP decision, and 
  the DM could revise the OP decision to reduce the amount of the OP 
by a very small amount, but 
  it is clear from the claimant’s appeal that they are seeking to have the 
whole of the OP decision overturned. 
If the OP decision were to be revised favourably the appeal would lapse, and 
the claimant would then have to appeal the new OP decision again in order to 
fully resolve their issue. 

215.  The law used in making the decision is referred to here as far as it is 
relevant to the grounds of the appeal.  
216.  The relevant part of the law should be explained in plain English. The 
claimant should be informed at the end of the response that they may read 
the full text of the legislation by asking their representative, or via the 
Internet, or at a public library. 
217.  If it is necessary to quote a UT decision, the quotation must: 
  be relevant to the appeal, and 
  highlight the point the response writer is seeking to prove.  
If the UT decision is unreported, include copies in the papers sent to the 
claimant and HMCTS. 
Special circumstances – further action 
IIDB 
218.  Where appropriate for the purposes of possible aggregation a schedule 
of previous assessments for other prescribed diseases (PDs) or accidents 
should be provided in section 5. 
JSA 
219.  In JSA cases an appeal might be received following decisions: 
  to terminate the award on supersession, because the claimant failed to 
attend or provide a written declaration on the correct day and good 
cause has not been shown for that failure within 5 working days and 
  to refuse to backdate a late claim following that termination. 
220.  Where the appeal clearly covers issues in both decisions, the response 
should deal with: 
  the good cause issue on the termination decision, whether or not a 
determination on that issue was made and 
  the time for claiming issue on the late claim. 
Late appeals 
221.  In late appeal cases, the response should deal with any reason for 
lateness that might be at issue. 
222.  Where HMCTS has completed a waiver certificate and DWP has not 
objected to the lateness of the appeal, Complete form AT38 and annotate 
in the ‘Does the Appeals Officer have any further information to assist the 
tribunal?’ box that the appeal was late, but that a waiver certificate has 
been completed by HMCTS and lateness accepted by DWP. 
Computer extracts 
223.  An explanation of a computer extract that is sufficient to demonstrate 
the particular point for which the extract has been provided should be 
included. 
224.  There may be situations where it would be too difficult or complicated 
to provide a written explanation of a computer extract. If that is the case 
the DM should ensure that a PO attends the hearing to provide a verbal 
explanation. 

Viewing dialogues 
225.  When preparing a response, to view system information the following 
dialogues may be helpful: 
RP 
  RP001 to display basic personal details, certain forms issued, any BFs 
outstanding 
  RP002 to display benefit payments 
  RP003 to display other personal details 
  RP004 to display entitlement or claim position 
  RP005 to display NIRS entitlement details 
  RP006 to display all decisions. 
IB 
  RP001 to display basic personal details, certain forms issued, any BFs 
outstanding 
  RP002 to display benefit payments 
  RP003 to display other personal details 
  RP006 to display all decisions 
  RP008 to display entitlement or claim position, or referring claims to 
FtTs 
  RP010 to display information relating to the dispute process when the 
claimant is unhappy with a decision 
  RP011 to display details of incapacity and period of SSP 
  RP012 to display details of any permitted work. 
IS and SPC 
  IS500 to display details input on the claim 
  IS502 to display payment history 
  IS503 to display award details 
  IS510 to display notes held on the case 
  IS570 to display a record of letters/decisions issued. 
ESA/JSA 
  JA500 to display personal details 
  JA502 to display payment details 
  JA510 to display notes held on the case 
  JA513 to display details of suspensions, decisions and sanctions 
  JA523 to display award details. 
AA/DLA 
  DA/AA500 to display personal details 
  DA/AA500/501 to display claim details 
  DA/AA502 to display payment details 
  DA/AA570 to display notifications issued 
  DA/AA503 to display decision details. 

Preparing the response contents  
226.  When preparing to send an appeal response to all Parties to the 
Proceedings (PTTP) and to HMCTS, include all the relevant evidence 
available such as 
  the claim form or extracts where appropriate 
 MRN 
  Appeal form or letter 
 statements 
 letters 
  medical evidence including GP factual reports, Health Care 
Professional (HCP) reports, hospital records etc. 
  evidence from CRU Tribunals where appropriate 
  forms CP2(LT), AT38, A6 report or SofS certificate relevant to the 
decision under appeal. 
DLA 
227.  In DLA cases where there has been an award which has been 
superseded or revised, the evidence on which the original award was 
based must be included. 
228.  If entitlement was reduced or disallowed on renewal, the evidence on 
which the previous award was made should be included. The documents 
should be placed in chronological order with the earliest document first. 
229.  If there are any previous relevant FtT documents available include 
them in the response. 
Work Capability Assessment/Limited Capability for work 
230.  In second or subsequent Work Capability Assessment (WCA)/LCW 
cases where there has been an award and there has been no clear 
change or the claimant says that their condition has not changed or has 
worsened since that award, the earlier WCA/LCW papers should be 
included.  
231.  If they cannot be produced an explanation should be provided. Where 
storage contractors have destroyed earlier WCA/LCW papers (they are 
routinely destroyed after 15 months) include this information as part of the 
explanation. 
Fraud overpayment appeal cases 
232.  Where the appeal concerns an OP following a fraud investigation, all 
relevant documents held on the fraud file should be available to the FtT. 
233.  Where such evidence has been obtained as a result of a written 
allegation by a third party then it may be necessary to request that the FtT 
make an order prohibiting the disclosure of certain documents.  
Photocopying appeal responses 
234.  When an appeal response is prepared make sure that each page is 
clearly and boldly numbered in the top right hand corner so that when 
HMCTS prepare their papers for the FtT the numbers can clearly be 
reproduced. 

235.  Where the response includes a bulky claim form, to ease photocopying 
it is acceptable to guillotine the spines and remove them. Where 
photocopying is carried out by contractors such as where there are more 
than 25 copies, this should be part of the request. 
Non disclosure of evidence 
236.  The FtT must have everything before it that the DM had. If there is 
evidence that either the FtT or any PTTP thinks is not appropriate for 
disclosure to certain parties there is provision for such evidence not to be 
included.  
For more information on non disclosure see: 
ADM Chapter 05, and  
DMG Chapter 6. 
Arrangement of documents 
237.  The documents to be sent to HMCTS should be arranged as follows 
  all sections of the response, including the Schedule of Evidence, 
should be placed at the beginning and the pages must be numbered 
sequentially (1,2,3 etc). 
Note: suffixes (for example 1A – 1Z) may be used for the response where 
they are unavoidable, for example because of software constraints or 
operational difficulties. 
  the appeal form or letter should come next, numbered sequentially 
following on the numbering of the response. Where suffixes are used 
for numbering the response the appeal form or letter will be numbered 
‘2’ (or 2, 3, 4, etc depending on how many pages the appeal form or 
letter contains) 
  all other documents should follow the response and appeal form, and 
should be arranged in the order in which they were received or 
produced and numbered sequentially, including copies of any 
decisions relevant to the decision under appeal, with the earliest 
document at the top 
  where a complete page of the evidence is left out of the unedited set of 
documents, it should not be numbered sequentially for the purposes of 
that set of documents. For example, if a report has 8 pages, the 7th of 
which is not to be disclosed, that page should be numbered 6A, and 
the 8th page numbered 7. This avoids the need to renumber 
documents if that page is included in the bundle issued to the claimant. 
  where any page contains only some information not to be disclosed it 
should be numbered as normal with the harmful information blanked 
out in the edited response that eventually goes to the claimant 
 if a video recording has been used as evidence, the copy of the video 
evidence should be put at the bottom of the documents. 
Assembling the response for despatch 
238.  Subject to non disclosure of evidence, send copies of the response and 
all the documents to: 
 HMCTS 

  the claimant (both members of  a couple in joint claim couple appeals) 
or representative if there is one and 
  the PO, if there is to be one. (For PIP, the PO is responsible for 
obtaining a copy of the relevant documents). 
Note: Where the claimant has a representative then all papers must be sent 
to them and, although the rules indicate that none need be sent to the 
claimant, it is good practice for the claimant to be sent a set of papers too. 
The DM can assume that the representative remains authorised until the 
claimant notifies otherwise. 
239. An 
AT38 should be attached at the top of the documents sent to 
HMCTS.  
Appeals involving documents not to be disclosed 
240.  The appeals officer should prepare two sets of documents including the 
response, when: 
  certain evidence used to make a decision is not to be disclosed and 
  an appeal is made against the decision. 
241.  The first set should have all the evidence included along with the form 
at Appendix 12. This form is to be used to: 
  explain what evidence is not to be disclosed, and  
  why it is not to be disclosed, and 
  ask HMCTS to refer to the FtT for a ruling on disclosure. 
242.  The other set should exclude the information not to be disclosed. Both 
sets of the response must be sent to HMCTS.  
243.  On no account must the response be sent to the claimant, the 
claimant’s representative or the PO.  
244.  Set a case control for two weeks for receipt of the FtT’s ruling on 
disclosure. 
245.  The non disclosure box (currently still labelled as the Potentially 
Harmful Medical Evidence (PHME) box) of the AT38 should be ticked 
“yes” and the field below annotated “I request a direction from the FtT 
Judge re non disclosure. See non disclosure form”. 
246.  The covering letter at Appendix 12 must be included with the 
documents sent to HMCTS in the normal way. 
247.  On receipt of the FtT’s ruling, HMCTS will 
  send the appropriate response as directed to the claimant and any 
representative and 
  send a copy of the ruling to the appropriate DWP office. 
248. Where 
the 
claimant 
has a representative and the FtT has decided that 
some information should not be disclosed to the claimant, the FtT can 
direct that the representative can see it. 
For more information on non disclosure see: 
ADM Chapter 05, and  
DMG Chapter 6. 
249.  The DWP file should be noted to ensure that the ruling is followed in 
any contact with the claimant or representative. The appropriate response 
should be issued to the PO if there is to be one. (For PIP, the PO is 
responsible for obtaining a copy of the response). 

250.  DL/CAP 38 should be included with the bundle of documents sent to 
the claimant and, where appropriate, to the claimant’s representative. 
Preparation of AT38 
251.  A completed form AT38 must be sent with every response sent to 
HMCTS. The AT38 gives HMCTS as much information as possible about 
the appeal and enables HMCTS to determine 
  the likely length of the appeal hearing and 
  whether a specialist panel member is needed etc 
Completion of AT38 – late appeals 
252.  When a late appeal response request is received from HMCTS, the DM 
should decide whether to object to the late appeal being accepted. 
253.  Where the late appeal has been accepted by DWP, the AT38 should 
be completed as for a duly made appeal. Section 4 of the response should 
include a statement that the appeal has been accepted. 
254.  Where an appeal has not been accepted, complete an AT39 to 
HMCTS for the FtT to make a determination. 
255.  If there is a discrepancy between the date of the decision on the AT38 
and that given by the claimant in their letter of appeal, include an 
explanation of the discrepancy in the other information box on the AT38 
and the appeal response. 
Completion of AT38 – late appeals on advance decisions 
256.  When a late appeal response request against an outcome decision that 
applies from a future date is received, the time to appeal starts from the 
original decision date notified to the claimant on the MRN. 
257.  Record details of the date from which the decision under appeal took 
effect in the “Any other information” box on the AT38. 
Preparation of AT39 
258. A 
completed 
AT39 must be sent if there is a request for Tribunal 
direction or if there is a requirement for additional information for the 
Tribunal. It is needed in the following circumstances: 
  a decision has been made on an intervening new claim 
  the decision under appeal has been superseded 
  information received raises new issues which have not been addressed 
before 
  contentious case law or legal arguments are given 
  a further response has been requested by the FtT following an 
adjournment. 
Note: This list is not exhaustive. Any supporting documents must be sent with 
the AT39. 
Suspected Appeal Campaign 
259.  If it is known or suspected that a case is part of an appeal campaign 
the appeal response should be prepared and submitted to HMCTS in the 
normal way. The AT38 should be noted with any information or suspicions 
concerning any appeal campaign. 

Complex issues 
260.  Whether or not a case is classified as complex is determined by the 
length of time the hearing is likely to take. A case is determined to be 
complex if it is likely to take longer than the usual time slot HMCTS allow 
for each particular benefit.  
261.  If, for example, you are dealing with an appeal on a criminally 
investigated fraud case, you need to consider: 
  how long it will take to watch any video evidence at the hearing, and 
  whether the case involves entitlement and overpayment issues. 
262.  If the case is likely to take longer than one slot, the AT38 should be 
marked as ‘complex’. Record the reasons why it has been marked 
‘complex’ on the second page of the AT38. The reasons need to be 
specific and clear to enable HMCTS to determine the length of time to 
allocate for the hearing.  
263.  If a PO is required to attend a complex appeal hearing, complete the 
oral hearing box on the front page on the AT38. This will ensure a PO is 
called to attend. 
264.  Request an oral hearing on complex appeal cases even if the claimant 
has opted for a paper hearing and ensure that a PO is available to attend.  
265.  If you do not ask for an oral hearing the Tribunal has the option to 
decide the case on the papers alone, despite the fact you have indicated 
the case is complex. 
Annotating the AT39 
Court proceedings pending 
266.  Where court proceedings have been instigated following a fraud 
investigation, the “any other information” box of the AT39 should be 
completed.  A note should be included as part of the response giving 
details. If the appeal is still outstanding when the court proceedings are 
over HMCTS must be informed and told what the outcome is.   
Compensation recovery cases 
267. Where 
the 
decision 
under appeal was made following notification by 
the CRU of a FtT decision in a compensation recovery case the “any other 
information” box of the AT39 should be annotated to ensure that no 
members of the FtT who heard the compensation recovery appeal will be 
a member of the FtT who hears the benefit appeal. 
Claimant has a potentially violent marking 
268.  Where a claimant is classified as PV and their appeal is to be referred 
to HMCTS, the relevant boxes on the AT39 should be completed and the 
appropriate proforma (see pages 6 & 7 of form IF2) should be included in 
any papers sent to them. If the PV marking has not been disclosed to the 
claimant, this fact and the reasoning behind it should be highlighted in the 
“Any other information” box on the AT39. 
Further medical evidence 
269.  Where an appeal involves disability or medical issues, the claimant or 
representative may indicate in the letter of appeal or other document such 
as the claim form that a GP, consultant or other person may be contacted 

by the decision making authorities for further information in support of their 
appeal. 
270.  If there is no evidence from this named contact in the documents used 
to make the decision under appeal, for example because the DM 
considered that there was sufficient evidence from other sources to decide 
the claim or application, the FtT may wish to consider whether 
  to obtain evidence from those identified by the claimant or 
representative or 
  to give directions to the claimant about obtaining evidence or attending 
a hearing. 
271.  This is best done as part of the pre-hearing process, in order to avoid 
unnecessary hearings. 
272. Where: 
  the claimant or representative states that a GP, consultant or other 
person may be contacted for information about their medical or 
disabling condition and 
  no evidence has been obtained from the named source 
the "other information" box on the AT39 should be noted.  
Claimant living outside Great Britain 
273.  If you know that the claimant is living outside GB, tell HMCTS on the 
AT38. 
274.  If the claimant is being represented and the representative is to attend 
the hearing, the claimant is asked to tell HMCTS if the representative has 
a preferred hearing location. 
275.  The appeal will be heard at the venue either specified by the claimant 
or preferred by the representative, unless all PTTP have agreed to no 
hearing, in which case the appeal will be heard at Newcastle upon Tyne. 
HMCTS will notify all PTTP, and any representatives of the time, date and 
venue for the hearing. 
Suspected fraud 
Appeal withdrawn 
276.  If an appeal is withdrawn on a suspected fraud case, notify FIS 
immediately 
Information not yet laid 
277.  If an appeal is made in a suspected fraud case on which a case is to 
be referred for prosecution where the appeal response request is received 
notify FIS. 
278.  If information has not yet been laid (in Scotland read ‘laying 
information’ as ‘reporting a case to the Procurator Fiscal’) take normal 
appeal action. When the response is sent to HMCTS inform them that the 
case is being considered for prosecution, and ask HMCTS to ensure that 
the appeal is heard as quickly as possible. Notify FIS about the result as 
soon as it is known. 
279.  Where an appeal is connected to matters that may result in criminal 
proceedings against the claimant, no mention of this should be made in 

the written or oral response. However, it must be brought to the attention 
of HMCTS. 
Information laid 
280.  If information has been laid (or is about to be laid urgently) prepare the 
response in the usual way. Tell HMCTS that criminal proceedings are 
pending. 
281.  The response should not be delayed where the Department is bringing 
criminal proceedings against the claimant. The response should be sent to 
HMCTS as normal and the matter of the criminal proceedings should be 
brought to the attention of HMCTS with details of how far those 
proceedings have progressed. The FtT decides whether the hearing 
should be put on hold. 
282.  HMCTS will send out a copy of the FtT’s ruling as soon as possible. If 
the FtT’s ruling is: 
  to proceed with the hearing, liaise closely with FIS to make sure the 
appropriate papers and documents are available for both the appeal 
hearing and the court proceedings. Notify FIS as soon as the appeal is 
completed or 
  to delay or postpone the hearing, notify FIS immediately, and tell 
HMCTS when the court proceedings are over and what the outcome is. 
Claimant represented 
283.  If you know that the claimant has given written authority for someone to 
act on their behalf, you must make any enquiries concerning the appeal 
through them. 
Representative identified when the response is prepared 
284.  When an appeal response request is received from HMCTS and it is 
clear that the claimant has a representative, and the response is 
assembled and ready for despatch. 
Step 
Action 

Photocopy the appeal response and relevant documents for 
HMCTS, the claimant, their representative if the claimant has 
one.  
Note: where non disclosure of certain evidence is involved this 
guidance should not be followed. 

Send a photocopy of the response and relevant documents and 
a copy of the video recording (if one has been used as evidence) 
with a completed AT38 to HMCTS and note the date of despatch 
on the appropriate method of recording appeals. 

Send photocopies of the appeal response and relevant 
documents and a copy of the video recording (if one has been 
used as evidence) to the claimant. 
Note: see note to step 1 above where non disclosure is involved. 

Send photocopies of the appeal response and relevant 
documents and a copy of the video recording (if one has been 
used as evidence) to the claimant’s representative with DL/CAP 

37. 
Note: see note to step 1 above where non disclosure is involved. 

Keep the original response and relevant documents and a copy 
of the video recording (if one has been used as evidence) in the 
file. Annotate the file that a copy of the appeal response has 
been sent to the claimant’s representative where appropriate. 
 
No representative identified when the response is prepared 
285.  Where a representative is not identified by the time the response is 
sent to HMCTS, annotate the other information box of the AT39. Note: 
This annotation must be clear and in capital letters. 
Representative identified to HMCTS after DWP has issued the 
response 
286.  After DWP has returned the response, it may become apparent to 
HMCTS that the claimant has a representative. HMCTS will inform DWP of 
the representative’s details. 
Step 
Action 

Send a photocopy of the response and relevant documents and 
a copy of the video recording (if one has been used as evidence) 
to the representative with DL/CAP 36. 

Annotate the file that a copy of the response has been sent to the 
representative. 
Note: HMCTS will only be able to identify where the appeal 
papers have not been issued to the representative by referring to 
the AT38. 
Representative identified to DWP after the response has been 
issued 
287.  If, after the appeal response has been sent to HMCTS the claimant 
informs DWP that they have a representative. 
Step 
Action 

Send a photocopy of the response and relevant documents and 
a copy of the video recording (if one has been used as evidence) 
to the representative with DL/CAP 37. 

Annotate the file that a copy of the response has been sent to the 
representative. 

Copy the letter from the claimant informing DWP that they have a 
representative and send it to HMCTS with an AT39. 
Duplicate appeal papers requested 
288.  When a request for duplicate papers is made, a copy should be issued 
if the request is reasonable, for example, where the papers did not arrive 
in the post or have been lost. If the request is made to HMCTS, they will 
notify DWP if a copy should be issued. 

Video/taped evidence 
289.  If a video recording or taped interview has been used as evidence in 
making the decision that is under appeal, copies of the complete video or 
tape, not just relevant extracts, must be made for HMCTS, the claimant, 
their representative and the PO (if there is to be one). 
290.  Where a video/tape recording is used as evidence, the person who 
took the video/tape may have to be asked to attend the FtT hearing to 
answer any questions arising from that video/tape. 
291.  If the identity of the person who took the video is not known to the 
claimant, a written statement should accompany the video recording 
testifying to its authenticity. 
292.  If the person who took the video would be at serious harm if their 
identity was revealed then there is provision for that person’s identity not to 
be disclosed.  
For more information see: 
ADM Chapter 1, and  
DMG Chapter 6. 
Witnesses 
293.  DWP is responsible for calling its witnesses to the hearing. Send 
DL/CAP 25 to the witness at the same time as the documents are sent to 
the FtT.  
294.  When the date of hearing is known, the PO sends the witness DL/CAP 
26 with a pre-paid envelope. 
Asking for cases to be deferred 
295.  HMCTS may defer a decision on an appeal if it involves the same point 
of law that is being challenged before the UT, or in the Courts, in another 
case. The case before the UT or the Court is known as the lead case. The 
case being considered is known as the “lookalike” case. 
For further information on cases to be deferred see: 
ADM Chapter 5, and  
DMG Chapter 6. 
Look-alike appeals 
296.  Where it has been established that an appeal is pending following the 
decision on another case, DMA Leeds will: 
  identify the lead case 
  issue notifications detailing the point of law in dispute and the benefits 
which are affected by the decision. 
Withdrawing an appeal 
297.  Appellants should contact HMCTS to withdraw an appeal, by telephone 
or in writing. 
298.  HMCTS will decide if the request to withdraw can be accepted. 

Claimant’s withdrawal request sent to DWP 
299.  If the claimant sends their withdrawal request to DWP in error, contact 
the claimant to tell them that they must contact HMCTS who will deal with 
their request. 
300.  If the appeal response request has not yet been sent through to DWP, 
once the claimant has been told to contact HMCTS, there will be no further 
action for DWP to take. This is because there will be no appeal record at 
this stage. HMCTS will decide if the appeal can be withdrawn and notify 
the claimant. 
301.  If HMCTS have already sent the appeal response request to DWP, tell 
the claimant to contact HMCTS to withdraw it but continue to action the 
appeal in case: 
  HMCTS do not accept the withdrawal request 
  the claimant decides not to withdraw 
  the claimant does not contact HMCTS to withdraw. 
302.  Where HMCTS tell us they have accepted the request to withdraw, 
update the benefit system/DMACR/ARTS/clerically to close the appeal 
record. 
For more information on requests to withdraw see: 
ADM Chapter 5, Paragraph A5194, and  
DMG Chapter 6. 
Request for reinstatement of withdrawn appeal 
303.  Any party who has withdrawn their appeal may apply to the FtT for it to 
be reinstated. The request must be made in writing and be received by 
HMCTS within one month after: 
  the date the FtT received the request to withdraw the appeal, or 
  the date of the hearing at which the appeal was withdrawn orally. 
304.  If the appeal is withdrawn before it has been passed to DWP for a 
response, and HMCTS agree to reinstate, they will recommence their 
action before requesting the appeal response from DWP. Once passed to 
DWP it will treated as a new appeal but, retain the original date of appeal. 
305.  If the appeal is withdrawn after it has been passed to DWP for a 
response, that is: 
  before the response has been prepared, or 
  after the response has been prepared but before it is sent to HMCTS, 
or 
  after it has been sent to HMCTS and withdrawal is accepted at an oral 
hearing 
and HMCTS accept the reinstatement, they will advise DWP that they have 
reinstated the appeal and request a response. 
306.  DWP will have 28 calendar days from the date the reinstatement was 
received in DWP, to prepare the response. 
For more information see: 
ADM Chapter 5, Paragraph A5220, and  
DMG Chapter 6. 

Appeal response request received - further evidence required 
307.  DWP may receive a request for an appeal response from HMCTS 
where it is identified, by a DM, that further evidence is required before the 
response can be written. 
308.  The claimant is given one month to provide information following our 
request. At this stage, set a 14 day b/f to await the return of the evidence. 
If the b/f matures and the evidence has not been received, it is unlikely 
that the response will be prepared in time to meet the 28 day deadline. In 
these cases consider asking HMCTS for a time limit extension using form 
TL1, and consider asking the Tribunal for a Direction requiring the 
evidence to be provided. 
309.  If the further evidence is not received within one month, continue with 
the appeal response ensuring that details for contact etc are included in 
the appeal response and send to HMCTS. 
310. Record 
all 
action 
and details on the benefit 
system/DMACR/ARTS/clerical papers. 
New claim received – appeal outstanding against earlier 
decision 
311.  If a new claim is received and there is an outstanding appeal against 
an earlier decision, this claim will be decided and recorded in the usual 
way. When preparing the appeal response, explain to the Tribunal that a 
decision has been made on a new claim and state the outcome of that 
decision. 
312.  If the appeal response has already been sent to HMCTS, complete 
form AT39 advising them of the new claim decision. Advise HMCTS to 
restrict their appeal decision to the day before the effective date of the new 
claim. 
For more information see: 
ADM Chapter 5, Paragraphs A5010 –A5014, and  
DMG Chapter 6. 
Extra information to be provided by the Department 
313.  If the FtT directs the Department to provide further information, check 
carefully to see what details are needed and obtain the information within 
the timescales set out in the FtT’s direction notice. If difficulty is 
experienced in obtaining the additional information/evidence within the 
timescales directed, the DM should apply to the FtT for an extension of the 
time limit. 
314.  When the additional information/evidence is available, the decision 
under appeal should first of all be reconsidered in the light of the new 
information/evidence. If the decision under appeal can be revised wholly in 
the claimant’s favour, go to section ‘Decision wholly in claimant’s favour’. 
The appeal will lapse. 
315.  If the decision under appeal cannot be revised wholly in the claimant’s 
favour go to section ‘Decision partially in claimant’s favour’. The 
supplementary response should also be sent to the PO if required. 

Claimant changes address 
316.  If the claimant notifies a change of address after the response is sent 
to HMCTS, telephone:  
 HMCTS and 
 if appropriate, International Pensions Centre (IPC) and 
  any other DM involved in the appeal. 
317.  Tell them the new address and the date of change, and if necessary 
confirm the telephone call in writing. 
New address outside Tribunal’s area 
318.  If the claimant moves to a different area and their case is transferred to 
another DWP office, check whether the appeal needs to be transferred to 
a different FtT. 
319.  If the response has already been sent to HMCTS, they will notify the 
claimant if the case has to be processed at a different location. 
320.  If the claimant notifies that they have changed their address before the 
response is sent to HMCTS 
Step 
Action 
1 Note 
the 
AT38 that the address has changed and also identify to 
HMCTS which DWP office will now be dealing with the appeal. 

Send the appeal response to the appropriate HMCTS office. 

Transfer the appeal file to the new DWP office. 

Update the benefit system/DMACRS/ARTS and clerical papers. 
Adjourned appeals 
321. Where 
the 
claimant: 
  changes their address and 
  moves to an area covered by a different DWP office and 
  the appeal is adjourned 
the original office must send all the relevant documentation to the new DWP 
office.  
322.  The new DWP office must take any/all further necessary action. 
323.  In most cases, when an appeal is adjourned HMCTS will arrange a 
new hearing date immediately.  
Appeal response request received against DM’s decision at a 
previous office 
324.  If an appeal response request is received against an outcome decision 
made at the previous office location and responsibility for the case has 
been transferred to a new office, the new office must process the appeal.  
325.  Contact the previous office by telephone or minute if any further 
information is needed. If necessary, return the case to the previous office 
for further investigation. 
Claimant dies after appeal lodged 
326.  If the claimant dies after they have lodged an appeal with HMCTS, 
consider nominating an appointee so that the appeal can proceed. 

327.  Notify HMCTS of the new details. The appeal will continue. 
328.  If the claimant had an appointee before their death, the authority for the 
appointee ceases when the claimant dies. 
329.  Another appointee will need to be nominated but this can be the same 
person as before, if no other suitable person is identified. 
330.  HMCTS will allow DWP six months to nominate an appointee. If no 
appointee is nominated within this time, the appeal will be brought to an 
end. This process is referred to as abatement. 
331.  If an appointee is nominated, DWP will be responsible for issuing a 
copy of the appeal response to the appointee. 
For further information on claimant dies after appeal lodged see: 
ADM Chapter 5, Paragraphs A5470 and A5670 , and  
DMG Chapter 6. 
332.  If the notification of death is received by HMCTS, they will notify DWP. 
For example, a family member might send a letter with a copy of the death 
certificate and the name of someone who wishes to act as an appointee. 
333.  HMCTS will contact DWP and halt the processing of the appeal. If 
DWP have details of a different person who is appointed to continue the 
appeal on behalf of the claimant, for example, an executor or solicitor, this 
takes precedence. 
Claimant living outside Great Britain – Attendance at hearing 
Representative nominated 
334.  If the claimant is living outside GB, the case will proceed as normal if 
the claimant nominates a representative to take their place at the hearing. 
335.  The representative may not live in the area covered by the Tribunals 
Service office that the appeal papers are initially sent to. In this case 
HMCTS will transfer the papers to the appropriate Tribunals centre and 
notify DWP. Send any further details about the appeal to the new 
Tribunals centre location. 
Appeal held over 
336.  If the claimant wants the appeal held over until their return to GB, 
HMCTS will notify all parties that there is a delay in the appeal hearing. 
Appeals staff must note on benefit system, DMACR/ARTS and clerical 
papers. 
337.  When the claimant returns to GB, HMCTS will notify all parties and the 
hearing will proceed as normal. 
Hearing and post-hearing procedures 
338. For: 
 
  general information on FtT hearings and 
  guidance for POs when presenting appeals 
See: 
ADM Chapter 5, Paragraphs A5270 - A5273, and  
DMG Chapter 6. 

Production of documents at hearings 
339.  The claimant is entitled to see any document used by the DM in 
making the decision which is the subject of the appeal (provided that the 
evidence is relating to the disputed facts). All such documents must be 
sent to the claimant under cover of the Schedule of Evidence.  
340.  Further questions may arise at the hearing which would require 
reference to the appropriate papers. The FtT will decide what evidence to 
disclose. 
Sensitive documents 
341.  Fraud Investigators (FIs) will not send sensitive material to DM(s) that 
they do not want disclosing to claimants. For example they will not send a 
document which may reveal the identity of a person who made a fraud 
allegation.  
342.  This is because the claimant only has the right to see the evidence 
that the DM used to reach a decision. 
343.  However, evidence from the fraud file which was originally before the 
DM may be missing from the papers. In this case the DM should ask the FI 
to supply copies of it. 
344.  The FtT will need to see all of the evidence that the DM used as a 
basis for the decision. As documents may be required for prosecution 
purposes the DM/appeals officer may have to ask the FI to provide copies 
of documents that were used to make the decision that may still be in the 
fraud file. Provided copies of original documents are legible FtT’s do not 
need the originals. Copies of all the evidence used by the DM should be 
included in the appeal papers. 
345.  In exceptional circumstances the FtT can insist on seeing original 
documents. If this occurs and the prosecution is still proceeding, 
arrangements should be made for the FI to attend the FtT hearing with the 
original documents. 
346.  If it is not possible to provide original documents for the FtT because, 
for example, the court hearing is on the same day as the FtT hearing, a 
postponement (or an adjournment if the FtT hearing has started) should be 
requested until such time as the original documents can be supplied. 
Appeal against an overpayment decision, including where a 
Civil Penalty has been imposed. 
347.  When HMCTS request an appeal response against a recoverable 
overpayment decision, recovery action must be suspended by Debt 
Management. This includes the recovery of any associated Civil Penalty 
(CPen), against which there is also a right of appeal. 
348.  Recovery action will have been reinstated following the MR.  You must 
email Debt Management immediately, to suspend further recovery action 
pending the appeal outcome. 
Medical evidence  
349.  HMCTS will make the necessary arrangements if the Tribunal: 
  needs additional medical evidence or 
  wants the claimant to be examined or 

  requires a report given by another practitioner, for example the 
claimant’s own doctor or a consultant or 
  requires a factual report based on hospital case notes. 
Extra witnesses to be produced for DWP 
350.  If the FtT has adjourned a case so that extra witnesses can attend, it is 
the responsibility of the DWP to provide these witnesses and contact them 
as quickly as possible. Send the names and appropriate addresses of the 
witnesses to HMCTS so that a further hearing date can be arranged. 
First-tier Tribunal’s decisions 
351.  All decisions made by FtTs are given in summary form on a HMCTS 
Decision Notice (DN). The FtT may also decide to give a decision orally at 
the hearing however this does not remove the requirement for the FtT to 
provide the written DN as well. 
352.  The FtT does have powers under the rules to make consent orders 
disposing of proceedings. However under no circumstances should the PO 
agree to any suggestion of a consent order. 
353.  In appeals involving the WCA/LCW LCWRA, if the outcome decision is 
not upheld the FtT should always: 
  issue a revised score and 
  either attach the revised score to DN, or note the revised score on the 
DN.  
Note: DMs will have facility in Decision Maker Appeals Case Recorder 
(DMACR) to select "reason for Tribunal outcome" from dropdown box. 
Record of Proceedings 
354.  The presiding member of the FtT is required to make a record of 
Proceedings (ROP) at the hearing that is sufficient to indicate: 
  the evidence taken 
  submissions made, and  
  any procedural applications.  
355.  The ROP can be in whatever form the presiding member may direct, 
for example recorded:  
 clerically  
  electronically or  
  on audio tape. 
356.  The FtT must keep a copy of the RoP for a period of six months from 
the date on which HMCTS issue: 
  the FtT decision 
  any written reasons for the FtT’s decision 
  any correction of the decision notice 
  a refusal to set aside the decision of the procedural reasons 
  a determination of an application for permission to appeal against the 
decision or 
  until the date on which those documents are sent to the UT in 
connection with an appeal, or an application for permission to appeal, if 
that is within the six months quoted above. 

357.  Any PTTP may apply in writing to HMCTS for a copy of the RoP within 
the time limit above and HMCTS must send a copy to that party. However, 
HMCTS will send the RoP with all written statement of reasons and 
adjournment notices. 
Written statement of reasons 
358.  A written statement of reasons (WSoR) for the FtT’s decision and its 
findings on questions of fact can be requested from HMCTS. However, 
this should only be done where the DM is considering an appeal to the UT. 
The request must be made in writing. 
359.  If the PO makes a verbal request at the Hearing, this must be followed 
up in writing. 
360.  Any requests for a WSoR must be made within one calendar month of 
the Decision Notice (DN) being given or sent out. The request should be 
made on the form attached at Appendix 10. 
Implementation of First-tier Tribunals decision 
361.  When the FtT’s decision has been received, it must be date stamped. 
The decision should then be put into effect as soon as possible. This must 
include notifying the Local Authority where appropriate 
Note: Where the appeal Tribunal has: 
  allowed the appeal and 
  decided the claimant can get benefit but, 
  not quantified the amount of extra benefit payable 
 
calculate the arrears due 
 
make a payment to the claimant, and  
 
issue DL/CAP11. 
Liberty to apply 
362.  Where the FtT allows the appeal, but remits calculation to the DM, any 
dispute about further calculation by the DM should be referred back to the 
same FtT. This is known as "liberty to apply".  
363.  In such cases the claimant has no right to appeal against the 
calculation, but disagreements can be referred back to the FtT. 
364.  The process of referring disagreements about calculations back to the 
Tribunals is usually applied in overpayment cases, where the FtT decides 
that an overpayment is recoverable but calculation of the amount is 
referred to the DM. However, it can also be considered in other benefit 
cases. 
365.  “Liberty to apply” is only appropriate where the decision notice clearly 
states that it is available. The FtT will usually set a time limit for making an 
application. Appeals officers should note that this process is not an 
alternative to making an appeal. It is available because the claimant has 
no right of appeal against the DM’s determination in cases where 
calculation is referred to the DM. 
366.  If the claimant contacts DWP and disagrees with the DM’s calculation, 
the DM or appeals officer should refer the matter to the FtT for 
consideration, with an explanation of the calculation. Alternatively the 

claimant may apply directly to the FtT. The FtT will inform DWP that an 
application has been received. 
367. Where 
the 
application 
is admitted by the FtT, the appeal will be listed 
before the same FtT for hearing. The sole issue before the FtT is the 
calculation by the DM. The FtT may direct that a further response is 
produced before the hearing to explain the calculation. 
368. Where 
the 
application 
is not admitted, the FtT may treat it as a request 
for: 
  a written statement of reasons 
  an application for set aside or 
  an application for permission to appeal. 
First-tier Tribunals decisions which cannot be implemented 
369.  There may be some FtT decisions which cannot be implemented, not 
because of accidental error but because they are unclear in the context of 
the case. In any such case clarification should be sought from HMCTS. 
370.  Generally there will be no queries on an FtT decision. However, there 
may be case when it appears that the FtT has made an accidental error or 
the DM considers that an appeal to the UT might be appropriate. 
Enquiries /complaints from claimants 
371.  If a claimant does not understand the FtT’s decision, give them an 
explanation of how the decision was reached. 
372.  If there are insufficient details to answer the enquiry, advise the 
claimant to contact HMCTS. Consider writing on the claimant’s behalf if 
they have difficulty in writing themselves. 
Suspected fraud cases 
373.  When the appeal hearing is completed notify FIS immediately, and 
send all the papers, including the FtT’s DN and WSoR (if requested), to 
them without delay. 
Note: Consider whether any successful appeal should be appealed to the UT. 
If it is to be appealed liaise closely with FIS, as any ongoing prosecution could 
be adversely affected. If any successful appeal is not to be appealed 
to the UT make sure that any payment awarded by the Tribunal is issued 
before the papers are passed to FIS. 
Accidental error 
374.  If the Tribunal’s decision appears to contain an accidental error, any 
party to the proceedings can apply to HMCTS to have the error corrected 
at any time. 
375.  To have an accidental error corrected: 
  circle in pencil the part of the decision notice which contains the 
accidental error,  
  complete form AT39 explaining why the decision contains an 
accidental error and send to HMCTS. 
376.  The status of the appeal will remain open. 
For further information See: 
ADM Chapter 3, Paragraphs A3041-3045, and  

DMG Chapter 6. 
377.  If the Tribunal refuses to correct the decision, and the error affects the 
amount of benefit payable, consider whether the case is suitable for an 
appeal to the UT. If benefit is not affected the decision should be 
implemented as it stands. 
378.  If the Tribunal correct their decision by amending the original decision 
notice, the time limit for an application for permission to appeal to a UT 
remains unchanged. The time limit starts from the date of issue of the 
decision notice prior to any correction. If however, a new decision notice is 
issued, the time limit starts from the date of issue of the new decision 
notice. 
For further information on decision wrong in law see: 
ADM Chapter 5, and  
DMG Chapter 6. 
Tribunal gives partial decision  
379.  If the Tribunal has given a partial decision and has referred the case to 
the DM for the final outcome decision, follow the Tribunal’s direction 
unless you consider the Tribunal has erred in law. The Tribunal will advise 
the claimant of their partial decision and that the final outcome decision will 
be issued in due course. 
380.  If there is insufficient evidence to make an outcome decision, obtain 
the further evidence required. 
381.  Where there is sufficient evidence to make an outcome decision, do 
this without delay and incorporate the Tribunal’s decision. As the Tribunal 
has already notified the claimant of the action that will be taken, it will be 
sufficient to notify the claimant of the final outcome decision only. 
382.  The DM decision will have a right of revision. The claimant cannot use 
this revision to reopen the issue decided by the Tribunal unless there are 
new grounds to do so. 
Incomplete decisions 
383.  A decision is incomplete if the Tribunal has failed to address all the 
relevant issues raised by the appeal. If this occurs request a re-hearing, 
stating that all matters raised by the appeal have not been decided 
explaining which issue(s) has not been addressed. 
For further information on incomplete decisions see: 
ADM Chapter 5, Paragraphs A5515, and  
DMG Chapter 6. 
The Tribunal refuses to re-list appeal 
384.  If the Tribunal refuses to re-list the appeal, where they have failed to 
take account of something which occurred after the effective date of the 
claim, supersede the Tribunal decision. 
For further information re-listing appeals see: 
ADM Chapter A4, and  
DMG Chapter 4. 
385.  If a Tribunal refuse to re-list the appeal where they have failed to take 
account of something that was an issue at the date of claim, the DM 
cannot normally supersede the Tribunal decision on this ground. 

386.  In these cases consider whether the case is suitable for appealing to 
the UT. 
For further information on UT see: 
ADM Chapter 5, and  
DMG Chapter 6. 
Decision wrong in law 
387.  A Tribunal decision can be challenged on the basis that it contains an 
error in law. Applications for permission to appeal to the UT are made by 
DMA Leeds. Before a case is referred to DMA Leeds to consider a request 
for an application for leave to appeal to the UT, a WSoR and RoP must be 
obtained from the FtT" 
For further information on decision wrong in law see: 
ADM Chapter 5, and  
DMG Chapter 6. 
Setting aside First-tier Tribunal decisions on certain grounds 
388.  Under rule 37 of the FtT’s Rules, any PTTP can apply to have all or 
part of the FtT’s decision set aside if: 
  a document relating to the proceedings was not sent to, or received by, 
a PTTP, or their representative, or was not sent to the FtT at an 
appropriate time or 
  a PTTP, or their representative, was not present at the hearing or 
  there has been some other procedural irregularity in the proceedings. 
389.  An application under this rule cannot be used where the issue under 
consideration is about errors of fact or errors of law. The application for set 
aside must be made in writing to the FtT and be received no later than one 
month after the date on which the FtT sent the DN to the PTTP. 
Further evidence comes to light after the First-tier Tribunal 
decision – grounds for supersession 
390.  Consider supersession if: 
  the FtT was ignorant of a material fact, for example evidence was held 
by DWP  but had not been disclosed to the FtT or 
  further evidence is disclosed after the FtT has given a decision and that 
evidence may affect the decision or 
  the DM is required to supersede a FtT or an UT’s decision made under 
the stayed appeals procedures or 
  a relevant change occurred which the FtT were unable to take into 
account. 
For further information and guidance on superseding the FtT’s or UT’s 
decision and fixing the appropriate effective date see: 
ADM Chapter A4, and  
DMG Chapter 6. 
Judicial review 
391.  The guidance about continuing an appeal does not apply where the 
claimant challenges a decision outside the SS appeal system. This is most 
likely to happen when: 

  a claimant’s appeal to the FtT is dismissed and 
  an application for permission to appeal is refused by the District Judge 
and the UT, and 
  the claimant applies for judicial review of the UT’s refusal to grant 
permission. 
392. Where 
the 
claimant 
was entitled to reduced rate IS because an appeal 
against the decision about the WCA was ongoing, that entitlement ends 
when the UT gives a ruling refusing the application for permission.  
393.  The claimant’s entitlement to IS can only continue if they satisfy 
another condition of entitlement. Alternatively, they could claim JSA. 
Appeals performance indicator 
394.  Appeals clearance performance is measured by AACT. Different 
business units have their own AACT. 
395.  Count the calendar days and include the day the appeal response 
request is received from HMCTS and the day the appeal response is 
returned to HMCTS. Note: Calendar days mean weekend days, public 
holidays, bank holidays and privilege days. 
Range of benefits to be covered 
396.  When the question of jurisdiction is in doubt, appeals sections may 
consider it good practice to keep a copy of letters sent to the FtT and list 
the cases on form A98, dummy form LT245 or other appropriate method of 
recording appeals. This ensures that effective follow up action can be 
implemented when necessary. 
Recording appeals 
Completion of form LT245 guide or other appropriate method of 
recording appeals 

397.  Recording the appeals will be captured within DMACR/ARTS.   
Appendices 
Appendix 1 - Forms 
The primary forms referred to in this code are: 
Form 
Description 
AT38 
Notification of response (to HMCTS). 
AT39 
Request for tribunal’s direction or additional information for the 
Tribunal  
AT60 
Request to HMCTS to strike-out an appeal on the grounds of ‘no 
reasonable prospect of success’ 
AT61 
Non-disclosure of evidence 
AT62 
Request for first-tier Tribunal documents 
AT63 
Schedule of evidence 
AT64 
Request for consideration of an appeal to the Upper Tribunal DMA 
MRN Mandatory 
Reconsideration 
Notice 
TL1 
Request for an extension to a time limit 

 
Appendix 2 - Draft letters 
 
Appendix 2 contains: 
  a list of DLCAP letters  
  instructions on how to use the draft letters.  
List of DLCAP letters 
Draft letter  Description 
DLCAP1 
Covering letter to the LA when we are sending them a copy of 
an appeal  
DLCAP8 
Letter to appellant in Housing Benefit appeal cases  
DLCAP11 
Letter to tell appellant about the DM’s quantification of a First-
tier Tribunal’s decision  
DLCAP25 
Letter to a person whom the Department will require as a 
witness at the First-tier Tribunal  
DLCAP26 
Letter notifying witness of hearing  
DLCAP31 
Letter notifying appellant of the Departments application to have 
the appeal struck out by the First-tier Tribunal due to ‘no 
reasonable prospect of success’ 
DLCAP34 
Letter to tell appellant their appeal is considered to be OOJ 
DLCAP36 
Letter to appellant’s representative when sending a copy of the 
response to them following confirmation from HMCTS 
DLCAP37 
Letter to appellant’s representative when sending a copy of the 
response to them when the appellant has informed the Agency 
that he has a representative. 
DLCAP38 
Covering letter to accompany an appeal response bundle sent 
to the appellant or the appellant’s appointee 
DLCAP40 
Letter to tell appellant that we have sent the appeal response to 
HMCTS 
DLCAP41 
Letter to tell appellant that we have received their request for a 
Mandatory Reconsideration 
DLCAP42 
Letter to tell appellant that as they have not requested a 
mandatory reconsideration their appeal request letter received 
in the department will be treated as a request for a mandatory 
reconsideration 
DLCAP43 
Letter to tell appellant that their appeal letter is being returned 
to them as they have sent it to the department in error 
DLCAP44 
Letter to tell appellant that the department have objections to 
their late appeal 
DLCAP45 
Letter to tell the appellant their late request for a mandatory 
reconsideration is refused 
DLCAP46 
Letter to tell the appellant that a mandatory reconsideration is in 
process and therefore their appeal letter has been returned to 
them 
 

Welsh Language 
398.  Any draft letters sent to customers in Wales need to be available in 
Welsh if that is their preference. If a claimant has chosen to undertake 
their business with us in Welsh, complete the draft letter and send it to: 
xxxx.xxxxxxx@xxxxxxxxxxxxx.xxx.xxx.xx for translation. 
Appendix 3 - Benefit Assessment type codes and issue codes 
Benefit assessment type codes 
New Code  Benefit 
002 
Personal Independent Payment (PiP) – New Claim 
003 
Personal Independent Payment – Reassessment Case 
13 Attendance 
Allowance 
13El Attendance 
Allowance 
(Exportability Issue) 
37 
Disability Living Allowance 
37EI 
Disability Living Allowance (Exportability Issue) 
45 
State Pension Credit 
51 
Employment and Support allowance (ESA) and ESA(EU) 
52 Incapacity 
Benefit 
56 Carer’s 
Credit 
61 Income 
Support 
64 
Industrial Death Benefit 
67 
Industrial Injuries Disablement Benefit 
67 
Reduced Earnings Allowance 
67 Retirement 
Allowance 
70 Carers 
Allowance 
70EI 
Carers Allowance (Exportability Issue) 
73 Jobseekers 
Allowance 
76 Lookalikes 
79 Maternity 
Benefit/Allowance 
82 Retirement 
Pension 
85 
Severe Disablement Benefit/Allowance 
88 
Social Fund Maternity 
89 
Social Fund Funeral 
91 VDP 
94 
Bereavement Benefit/Widows Benefit 
99 Others 
DN:     UC codes will be included when notified   
Issue Codes 
New Code  Benefit 
AA Invalid 
AP 
Assessed Income Periods 
AR 
Alternative Dispute Resolution 
AS Asylum 
BW 
Back to Work Bonus 

CB Contribution 
Record 
CC Conditions 
of 
entitlement – complex 
CD Care 
(DLA) 
CE Conditions 
of 
entitlement 
CF 
Care Mobility (DLA) 
CL Capital 
 
CM 
Child Maintenance Bonus/Premium 
CO Community 
Order 
CP Civil 
Penalty 
CR Credits 
CS 
Chest – pneumo’, asbestos etc 
DA 
Disability and Carers 
DE 
Date of entitlement 
DD 
Appeal Directly Lodged 
DP Disability 
Premium/Severe Disability Premium 
DQ Disablement 
Question 
EC 
European Court of Human Rights (ECHR) 
EI Exportability 
EX EC 
Legislation 
GC Good 
Cause 
HC Housing 
Costs 
HT 
Habitual Residence Test 
IA Industrial 
Accident 
ID Industrial 
Disease 
IQ Income 
Query 
LC 
Daily Living Component 
LE 
Late (extending back) 
LM 
Labour Market Issues continued 
LT 
Living Together as Husband and Wife/Civil Partners 
(LTAHAW/CP) 
MD Mobility 
(DLA) 
MO Mobility 
Component 
ML Daily 
Living/Mobility 
NC Non-Compliance/Sanction 
OC 
Overpayment – capital 
OK 
PD A14 – Osteoarthritis of the knee 
ON One 
Project 
OS 
Overpayment – straightforward 
OX 
Overpayment – complex 
PC Property/Capital 
Settlement 
PF 
Pensions from Abroad 
PR Premiums 
RA 
Rate of Assessment/Assessment/Payability Issues 
RB 
Reduced Benefit Decision 
RC 
Rate of Assessment/Assessment/Payability Issues – complex 
RG Reciprocal 
Agreement 
SF Funeral 
 
SG 
Support Group Placement 

SM Maternity 
SS 
Self Employed – straightforward 
SX 
Self Employed – complex 
TB 
Termination of benefit – failure to provide further information 
TT Term 
Time 
VW Verbal 
Withdrawal 
WC 
Work Capability Assessment 
WF 
Winter Fuel Payments 
Appendix 4 - Benefit specific and issue code permutations 
1.  All 53 issue codes are acceptable. However, depending upon 
benefit/assessment-type composition may be subject to alteration. 
Attendance Allowance (13) 
AT38 code  Issue 
13AA 
Invalid 
13AR 
Alternative Dispute Resolution 
13CC 
Conditions of entitlement - complex 
13CD 
Care (DLA/AA) 
13CE 
Conditions of entitlement 
13CF 
Care/Mobility (DLA/AA) 
13DQ 
Disablement Question 
13EC 
European Court of Human Rights 
13EX 
EC legislation 
13GC 
Good cause 
13LE 
Late (extending back) 
13MD 
Motability (DLA/AA) 
13OC 
Overpayment - capital 
13OS 
Overpayment - straightforward 
13OX 
Overpayment - complex 
13RA 
Rate of assessment/payability 
13RC 
Rate of assessment/payability - complex 
Disability Living Allowance (37) 
AT38 code  Issue 
37AA 
Invalid 
37AR 
Alternative Dispute Resolution 
37CC  
Conditions of entitlement - complex 
37CD  
Care (DLA/AA) 
37CE  
Conditions of entitlement 
37CF  
Care/Mobility (DLA/AA) 

37CP 
Civil Penalty 
37EC  
European Court of Human Rights 
37EX  
EC legislation 
37GC  
Good cause 
37LE  
Late (extending back) 
37MD  
Mobility (DLA/AA) 
37OC  
Overpayment - capital 
37OS  
Overpayment - straightforward 
37OX  
Overpayment - complex 
37RA  
Rate of assessment/payability 
37RC  
Rate of assessment/payability - complex 
Personal Independence Payment - New Claim Appeals (02) 
AT38 code  Issue 
002GC 
Good Cause 
002LE 
Late (extending back) 
002MD 
Mobility (DLA) 
002OC 
Overpayment - capital 
002OS 
Overpayment - Straightforward 
002OX 
Overpayment -Complex 
002RA 
Rate of assessment/payability issues 
002RC 
Rate of Assessment/Payability Issues - Complex 
002ON 
ONE Project 
002CC 
Conditions of Entitlement - Complex 
002CD 
Care (DLA) 
002CE 
Conditions of Entitlement 
002CF 
Care/Mobility (DLA) 
002EC 
ECHR 
002EX 
EX Legislation 
002AR 
Alternative Dispute Resolution 
002EI 
Exprtability Issues 
002VW 
Verbally Withdrawn 
002CP 
Civil Penalties 
002LC 
Daily Living Component 
002MO 
Mobility Component 
002ML 
Daily Living/Mobility Component 

Personal Independence Payment - Reassessments (03) 
AT38 code  Issue 
003GC 
Good Cause 
003LE 
Late (extending back) 
003MD 
Mobility (DLA) 
003OC 
Overpayment - capital 
003OS 
Overpayment - Straightforward 
003OX 
Overpayment -Complex 
003RA 
Rate of assessment/payability issues 
003RC 
Rate of Assessment/Payability Issues - Complex 
003ON 
ONE Project 
003CC 
Conditions of Entitlement - Complex 
003CD 
Care (DLA) 
003CE 
Conditions of Entitlement 
003CF 
Care/Mobility (DLA) 
003EC 
ECHR 
003EX 
EX Legislation 
003AR 
Alternative Dispute Resolution 
003EI 
Exprtability Issues 
003VW 
Verbally Withdrawn 
003CP 
Civil Penalties 
003LC 
Daily Living Component 
003MO 
Mobility Component 
003ML 
Daily Living/Mobility Component 
State Pension Credit (45) 
AT38 code  Issue 
45AA 
Invalid 
45AP  
Assessed Income Periods 
45AS  
Asylum 
45CC  
Conditions of entitlement - complex 
45CE  
Conditions of entitlement 
45CL  
Capital 
45DA  
Disability and Carers 
45DP 
Disability Premium/Severe Disability Premium 
45EC  
European Court of Human Rights (ECHR) 
45EX  
EC legislation 
45HC  
Housing Costs 
45HT  
Habitual Residence Test 

45IQ  
Income Query 
45LE 
Late (Extending Back) 
45LT  
Living Together 
45OC  
Overpayment - Capital 
45OS  
Overpayment - Straightforward 
45OX  
Overpayment - Complex 
45PF  
Persons from Abroad 
45PR 
Premiums 
45RA  
Rate of Assessment/Payability Issues 
45RB 
Reduced Benefit Decision 
45RC  
Rate of Assessment/Payability Issues - Complex 
45SF 
Funeral 
45SS  
Self Employed - Straightforward 
45SX  
Self Employed - Complex 
Employment Support Allowance (51) 
AT38 code  Issue 
51AA 
Invalid 
51CB 
Contribution records 
51CE  
Conditions of entitlement 
51EC  
European Court of Human Rights 
51GC 
Good Cause 
51HT  
Habitual Residence Test 
51LE 
Late Extending back 
51LT 
Living together 
51NC 
Non-compliance/Sanction 
51OS  
Overpayment 
51PC  
Property/Capital Settlement  
51RA 
Rate of assessment 
51SG  
Support Group Placement 
51WC 
Work Capability Assessment 
Incapacity Benefit (52) 
AT38 code  Issue 
52AA 
Invalid 
52AT  
Personal Capability Assessment (All Work Test) 
52CB 
Contribution records 
52CC  
Conditions of entitlement - complex 
52CE  
Conditions of entitlement 

52CR  
Credits 
52EC  
European Court of Human Rights 
52EX  
EC legislation 
52GC  
Good cause 
52LE  
Late (extending back) 
52NC 
Non-compliance 
52OS  
Overpayments - straightforward 
52OX  
Overpayment - complex 
52RA  
Rate of assessment/payability 
52RC  
Rate of assessment/payability - complex 
52RG 
Reciprocal agreement 
Income Support (61) 
AT38 code  Issue 
61AA 
Invalid 
61AS  
Asylum 
61CC  
Conditions of entitlement - complex 
61CE  
Conditions of entitlement 
61CL  
Capital 
61CO  
Appeal against a decision to penalise a claimant in breach of a 
Community Sentence order 
61CR  
Credits 
61DP  
Severe Disability Premium 
61DQ  
Disablement Question 
61EC  
European Court of Human Rights 
61EX  
EC legislation 
61GC  
Good cause 
61HC  
Housing Costs 
61HT  
Habitual Residence Test 
61IA  
Industrial Accident 
61ID  
Industrial Disease 
61IQ  
Income Query 
61LE  
Late (extending back) 
61LM  
Labour Market Issues 
61LT  
Living Together as Husband and Wife (LTAHAW)/Civil Partners 
(LTACP)  
61OS  
Overpayment - straightforward 
61OX  
Overpayment - complex  
61PC  
Property capital settlement 
61PF 
Persons from abroad 
61PR 
Premiums 

61RA 
Rate of assessment/payability 
61RB  
Reduced Benefit Direction 
61RC  
Rate of assessment/payability - complex 
61RG  
Reciprocal agreement 
61SF  
Funeral 
61SM  
Maternity 
61SS  
Self employed - straightforward 
61SU  
Suspensions 
61SX  
Self employed - complex 
61TT 
Term time 
61WF  
Winter fuel payments 
continued 
Employment and Support Allowance Conversion (62) 
AT38 code  Issue 
062AA 
Invalid 
062CB 
Contribution Records 
062CE 
Conditions of Entitlement 
062EC 
European Court of Human Rights 
062GC 
Good Cause 
062HT 
Residency Issues  
062LE 
Late Extending Back (Backdating) 
062LT 
Living Together 
062NC 
Non Compliance/Sanction 
062OS 
Overpayment 
062PC 
Property/Capital  
062RA 
Rate of Assessment 
062SG 
Support Group Placement 
062WC 
Work Capability Assessment 
Industrial Death Benefit (64) 
AT38 code  Issue 
64AA 
Invalid 
64CC  
Conditions of entitlement - complex 
64CE  
Conditions of entitlement 
64CS  
Chest - pneumoconiosis, asbestosis etc 
64DQ  
Disablement Question 
64EC  
European Court of Human Rights 
64EX  
EC legislation 
64GC 
Good cause 

64IA  
Industrial Accident 
64ID  
Industrial Disease 
64LE  
Late (extending back) 
64OS  
Overpayment - straightforward 
64OX  
Overpayment - complex 
64RA 
Rate of assessment/payability 
64RC 
Rate of assessment/payability - complex 
Industrial Injuries Disablement Benefit/Reduced Earnings 
Allowance/Retirement Allowance (67) 

AT38 code  Issue 
67AA 
Invalid 
67CB 
Contribution Records 
67CC  
Conditions of entitlement - complex 
67CE  
Conditions of entitlement 
67CS  
Chest - pneumoconiosis, asbestosis etc 
67DQ  
Disablement Question 
67EC  
European Court of Human Rights 
67EX  
EC legislation 
67FW 
Forestry worker 
67GC  
Good cause 
67IA  
Industrial Accident 
67ID  
Industrial Disease 
67LE  
Late (extending back) 
67OK 
PD A14 - Osteoarthritis of the knee 
67OS  
Overpayment - straightforward 
67OX  
Overpayments - complex 
67RA  
Rate of assessment/payability 
67RC  
Rate of assessment/payability - complex 
Carers Allowance (70) 
AT38 code  Issue 
70AA 
Invalid 
70CC  
Conditions of entitlement - complex 
70CE  
Conditions of entitlement 
70EC  
European Court of Human Rights 
70EX  
EC legislation 
70GC  
Good cause 
70LE  
Late (extending back) 

70OS  
Overpayment - straightforward 
70OX  
Overpayment - complex 
70RA  
Rate of assessment/payability 
70RC  
Rate of assessment/payability - complex 
Jobseeker’s Allowance (73) 
AT38 code  Issue 
73AA 
Invalid 
73AS  
Asylum 
73CB 
Contribution records 
73CC  
Conditions of entitlement - complex 
73CE  
Conditions of entitlement 
73CL  
Capital 
73CO  
Appeal against a decision to penalise a claimant in 
breach of a Community Sentence order 
73CR  
Credits 
73EC  
European Court of Human Rights 
73EX  
EC legislation 
73GC  
Good Cause 
73HC  
Housing Costs 
73HT  
Habitual Residence Test 
73IQ  
Income Query 
73LE  
Late (extending back) 
73LM  
Labour Market Issue continued 
73LT 
Living Together as Husband and Wife (LTAHAW)/Living 
together asCivil Partners (LTACP) 
73OC  
Overpayment capital 
73ON 
One Project 
73OS  
Overpayment - straightforward 
73OX  
Overpayment - complex 
73PF  
Persons from abroad 
73RA  
Rate of assessment/payability issues 
73RB  
Reduced Benefit Decision 
73RC  
Rate of assessment/payability - complex 
73RG  
Reciprocal Agreement 
73SM 
Maternity 
73SS  
Self Employed - straightforward 
73SU  
Suspensions 
73SX  
Self Employed - complex 
Look-alikes (76)  
AT38 code  Issue 
76AA 
Invalid 
76AS  
Asylum 
76CC  
Conditions of entitlement - complex 

76CD  
Care (DLA) 
76CE  
Conditions of entitlement 
76CF  
Care/Mobility 
76CL  
Capital (DLA) 
76CR  
Credits 
76CS  
Chest - pneumoconiosis, asbestosis, etc 
76DP  
Severe Disability Premiums 
76DQ  
Disablement Question 
76EC  
European Court of Human Rights 
76EX  
EC legislation 
76GC  
Good Cause 
76HC  
Housing Costs 
76HT 
Habitual Residence Test 
76IA  
Industrial Accident 
76ID  
Industrial Disease 
76IQ  
Income Query 
76LE  
Late (extending back) 
76LM  
Labour Market Issue 
76LT  
Living Together as Husband and Wife (LTAHAW)/Living 
Together As Civil Partners (LTACP) 
76MD  
Mobility (DLA) 
76OC  
Overpayment capital 
76OS  
Overpayment - straightforward 
76OX  
Overpayment - complex 
76PC  
Property Capital Settlement 
76PF 
Persons from Abroad 
76PR  
Premiums 
76RA  
Rate of assessment/payability issues 
76RB  
Reduced Benefit Decision 
76RC  
Rate of assessment/payability - complex 
76RG  
Reciprocal Agreement 
76SF  
Funeral 
76SM  
Maternity 
76SS  
Self Employed - straightforward 
76SU  
Suspensions 
76SX  
Self Employed - complex 
Maternity Benefit/Allowance (79) 
AT38 code  Issue 
79AA 
Invalid 
79CC 
Conditions of entitlement - complex 
79CE  
Conditions of entitlement 
79EC  
European Court Human Rights 
79EX  
EC legislation 
79GC  
Good cause 
79LE  
Late (extending back) 

79LT  
Living together as Husband and Wife (LTAHAW)/Living 
Together as Civil Partners (LTACP) 
79OS  
Overpayment - straightforward 
79OX  
Overpayment - complex 
79RA  
Rate of assessment/payability 
79RC 
Rate of assessment/payability - complex 
Retirement Pension (82) 
AT38 code  Issue 
82AA 
Invalid 
82CB 
Contribution records 
82CC  
Conditions of entitlement - complex 
82CE  
Conditions of entitlement 
82EC 
European Court of Human Rights 
82EX  
EC Legislation 
82GC  
Good Cause 
82LE  
Late (extending back) 
82LT 
Living Together as Husband and Wife (LTAHAW) 
82OS  
Overpayment - straightforward 
82OX  
Overpayment - complex 
82RA  
Rate of assessment/payability issues 
82RC  
Rate of assessment/payability - complex 
Severe Disablement Benefit/Allowance (85) 
AT38 code  Issue 
85AA 
Invalid 
85CC  
Conditions of entitlement - complex 
85CE 
Conditions of entitlement 
85DQ  
Disablement Question 
85EC  
European Court of Human Rights 
85EX  
EC legislation 
85GC  
Good Cause 
85LE  
Late (extending back) 
85OC  
Overpayment capital 
85OS  
Overpayment - straightforward 
85OX  
Overpayment - complex 
85RA  
Rate of assessment/payability issues 
85RC  
Rate of assessment/payability - complex 

Social Fund Maternity (88) 
AT38 code  Issue 
88AA 
Invalid 
88CC  
Conditions of entitlement - complex 
88CE 
Conditions of entitlement 
88EC  
European Court of Human Rights 
88EX  
EC legislation 
88GC  
Good Cause 
88LE 
Late (extending back) 
88OC  
Overpayment capital 
88OS  
Overpayment - straightforward 
88OX  
Overpayment - complex 
88PF  
Persons from Abroad 
88RA  
Rate of assessment/payability issues 
88RC  
Rate of assessment/payability - complex 
88SF 
Funeral 
88SM  
Maternity 
Social Fund Funeral (89) 
AT38 code  Issue 
89AA 
Invalid 
89CC  
Conditions of entitlement - complex 
89CE  
Conditions of entitlement 
89EC  
European Court of Human Rights 
89EX  
EC legislation 
89GC  
Good Cause 
89LE  
Late (extending back) 
89OC  
Overpayment - capital 
89OS  
Overpayment - straightforward 
89OX  
Overpayment - complex 
89PF  
Persons from Abroad 
89RA  
Rate of assessment/payability issues 
89RC  
Rate of assessment/payability - complex 
89SF 
Funeral 
89SM 
Maternity 

Widows Benefit/Bereavement Benefit (94) 
AT38 code  Issue 
94AA 
Invalid 
94CB 
Contribution records 
94CC  
Conditions of entitlement - complex 
94CE 
Conditions of entitlement 
94EC  
European Court of Human Rights 
94EX  
EC legislation 
94GC  
Good Cause 
94LE  
Late (extending back) 
94LT 
Living Together as Husband and Wife (LTAHAW)/Living 
Together as Civil Partners (LTACP) 
94OC  
Overpayment capital 
94OS  
Overpayment - straightforward 
94OX  
Overpayment - complex 
94RA  
Rate of assessment/payability issues 
94RC  
Rate of assessment/payability - complex 
Appendix 5 - Checking the appeal response 
Introduction 
1.  DWP may consider it advisable to check a selection of appeal responses 
prior to forwarding them to HMCTS. Special attention should be paid to 
ensuring that the response does not support an incorrect decision and that the 
appeals officer has fully and effectively presented the facts in a focused 
manner. 
2.  DWP will be best placed to assess who is the most suitable officer to 
undertake these vetting duties. Experience and competence will be the most 
important qualities when choosing this post. 
3.  The following checklist will: 
  assist the officer vetting the appeals responses, and 
  be useful to the officers writing the appeal responses to ensure that all 
relevant sections are correctly completed prior to vetting. 
4.  If any of the questions are answered ‘no’ arrange for: 
  amendment of the response, or 
  further enquiries, or 
  revision of the decision under appeal. 
5.  Officers taking up vetting duties for the first time should familiarise 
themselves with the guidance contained in the Advice for Decision Makers 
(ADM) for all PIP and UC appeals, and appeals against decisions made on or 
after 28th October 2013. 
6.  Continue using the Decision Maker’s Guide (DMG) for appeals against 
decisions made before 28th October 2013.  
7.  If an electronic template is used, ensure that it reflects current guidance, 
that all the legislation quoted is relevant and that the template up to date. 

Decision details 
8.  When checking the decision details, consider the following: 
  Is the appeal against a DM’s decision? 
  Has the decision under appeal been fully reconsidered? 
  Have all the facts and details contained in the Mandatory 
Reconsideration Notice (MRN) been considered and included? 
  Is the DM’s decision correct? 
  Is the date the DM’s decision was issued correct? 
  Are all the decisions appealed against included? 
Appellant’s letter of appeal 
9.  Consider the following: 
  Is the claimant’s Notice of Appeal (NOA) or appeal letter included in the 
list of documentary evidence? 
  If the NOA/appeal letter is illegible, has a typed version of the grounds 
of the appeal been provided, and listed in Section 2 of the appeal 
response? 
Summary of facts 
10. Ensure the MRN has been used and all of the following have been 
covered: 
  Are all the facts required by the regulation(s) under which the decision 
was made included? 
  Does the summary include all the relevant facts put forward by the 
claimant either before, during or after the appeal? 
  Has documentary evidence been included to establish each fact? 
  Does the summary include all other relevant facts outlined in 
investigating the claim, or held in the file (whether they support the 
decision or not)? 
  Can the tribunal reach a full decision on the facts presented? 
Provisions of the Acts and Regulations: 
11.  It is important that the correct legislation is used and quoted: 
  Are all the relevant provisions of the Acts and Regulations shown 
which the DM needed to consider to reach their decision? 
  Is the reference to the legislation used correct? 
  Is the correct year of the legislation shown? 
Relevant decisions of the Social Security Commissioners/Upper 
Tribunal 
12. Consider the following: 
  Are all the relevant sections of the reported decisions of the SSC/UT 
shown, including any reported since response(s) issued? 
  If the customer has quoted an unreported decision in their NOA/Appeal 
letter, has a copy been obtained and included in the papers? 
DM’s appeal response 
13. Check the appeal response: 

  Are the provisions of the Acts and Regulations which the DM 
considered, explained or, if complex, quoted in full? 
  Are the provisions listed, as per para 11 above, are the same as, and 
exactly match, those used in the DM response? 
  Does the response explain how the Acts and Regulations have been 
applied to the facts? 
  If the DM has followed a SSC decision, does the response state what 
the SSC decided? 
  Are the arguments clear and logical? 
  Are there any secondary questions? 
  Is there a focused introduction and conclusion to which the evidence 
and argument point? 
  Is there a recommendation to the FtT? 
Form AT2A 
14. If Form AT2A is appropriate: 
  Have any relevant AT2A forms been completed? 
  Is/are the assessment(s) correct? 
  Is/are the appropriate week(s)/period(s) of assessment shown? 
Documentation 
15. Check the documentation: 
  Have all the documents been included and numbered properly? 
  Are all the numbered documents noted in sequence at section 2 of the 
response? 
  Has any potentially harmful information, that must not be disclosed to 
the claimant, been considered and flagged? 
16. To capture and record MI please refer to: MISP Portal - Management 
Information System Programme. 
Appendix 6 - abbreviations 

 
AA Attendance 
Allowance 
AACT 
Average Actual Clearance Times 
ADM 
Advice for Decision Making 
ARTS Appeals 
Reconsideration Tracking System 
 
 

 
b/f brought 
forward 
 
 

 
CA Carers 
Allowance 
CAU 
Carers Allowance Unit 
CAP 
Code of Appeal Procedure 
CB Contributory 
Benefit 
CPen Civil 
Penalty 
CS Act 1991    Child Support Act 1991 
CR Compensation 
Recovery 

CRU 
Compensation Recovery Unit 
CS Child 
Support 
CTB 
Council Tax Benefit 
 
 

 
D&A Regs 
Social Security and Child Support (Decisions and Appeals) 
Regulations 1999 
DBC 
Disability Benefit Centre 
Dis Ben 
Disablement Benefit 
DLA 
Disability Living Allowance 
DM Decision 
Maker 
DMA 
Decision Making and Appeals 
DMA (Leeds) 
Decision Making and Appeals (Leeds) 
DMACR 
Decision Making and Appeals Case Recorder 
DMG 
Decision Makers’ Guide 
DN Decision 
Notice 
DO District 
Office 
DP Disability 
Premium 
DRAMA 
Data Base for Recording and Monitoring Appeals 
DWP 
Department for Work and Pensions 
 
 

 
ECHR European 
Convention 
for 
the 
Protection of Human Rights and 
Fundamental Freedoms 
 
EEC Employed 
Earner’s 
Categorization 
EMP 
Examining Medical Practitioner 
ECJ 
European Court of Justice 
 
 

 
FI / FIs 
Fraud Investigator(s) 
FIS 
Fraud Investigation Service 
FtT First-tier 
Tribunal 
 
 

 
GB Great 
Britain 
GP General 
Practitioner 
 
 

 
HB Housing 
Benefit 
HMRC 
Her Majesty’s Revenue and Customs 
HMCTS 
Her Majesty’s Courts and Tribunals Service 
HCP Healthcare 
Professional 
 
 

 
IB Incapacity 
Benefit 
IfW 
Incapacity for Work 
IIDB 
Industrial Injuries Disablement Benefit 

IPC International 
Pension 
Centre 
IS Income 
Support 
 
 

 
JSA Jobseeker’s 
Allowance 
 
 

 
LA Local 
Authority 
LCW 
Limited Capability for Work 
LCWRA 
Limited Capability for Work Related Activity 
LM Labour 
Market 
LTACP 
Living Together as Civil Partners 
LTAHAW 
Living Together as Husband and Wife 
 
 

 
MR Mandatory 
Reconsideration 
MRN Mandatory 
Reconsideration 
Notice 
 
 

 
NI National 
Insurance 
NINO 
National Insurance Number 
NIRS 
National Insurance Recording System 
NOA 
Notice of Appeal 
NPC 
National Pension Centre 
NRPS 
No Reasonable Prospect of Success 
 
 

 
OOJ 
Outside of Tribunal’s Jurisdiction 
OOT 
Own Occupation Test 
OP or O/P 
Overpayment 
 
 

 
PCA 
Personal Capability Assessment 
PD Prescribed 
Diseases 
PDCS 
Personal Data Computer System 
PHME 
Potentially Harmful Medical Evidence 
PIP 
Personal Independent Payment 
PO Presenting 
Officer 
PSCS Pension 
Strategy Computer System 
PTTP 
Party (Parties) to the Proceedings 
PV Potentially 
Violent 
PVP 
Potentially Violent Person 
 
 

 
RBD 
Reduced Benefit Direction 
RO Reviewing 
Officer 
RP Retirement 
Pension 
RoP 
Record of Proceedings 

 
 

 
SofS 
Secretary of State 
SDM 
Sector Decision Maker 
SDP 
Severe Disability Premium 
SPC 
State Pension Credit 
SS Social 
Security 
SS Act 1998 
Social Security Act 1998 
SS Act 1992 
Social Security Administration Act 1992 
SSC 
Social Security Commissioner 
SSP 
Statutory Sick Pay 
 
 

 
UC Universal 
Credit 
UT Upper 
Tribunal 
 
 

 
WCA 
Work Capability Assessment 
WSoR Written 
Statement of Reasons 
Appendix 7 - Example Appeal Responses 
Contents 
Example 1 
State Pension Credit – Amount of income taken into account 
when SPC awarded 
Example 2 
State Pension Credit  - Refusal to specify AIP 
Example 3 
Income Support – date of claim/evidence requirements 
Example 4 
Jobseeker’s Allowance – Claimant entitled to a reduced rate of 
JSA (IB) because of earnings 
Example 5 
Jobseeker’s Allowance – Claimant does not  meet the 
prescribed conditions for a backdated payment 
Example 6 PIP 
Disallowance 
on Disability – Daily Living component 
Example 7 
Jobseeker’s Allowance (Income Based) – Supersession 
because earnings in excess and recoverable overpayment 
Example 8 
Employment and Support Allowance - Claimant’s income 
exceeds the applicable amount   
Example 9 
Universal Credit – New Partner 
Example 10  Disablement benefit Appeal – Disallowance of IIDB because an 
earlier assessment of disablement has not been increased 
Example 11  Disability Living Allowance – disallowance of renewal claim 
Example 12  Attendance Allowance – Disallowance of claim 
Example 13  Carer’s Allowance – Supersession of Award   
Example 14  Employment and Support Allowance – Claimant fails Work 
Capability Assessment 
Example 15  PIP Mobility Award – Disallowance of Daily Living Component 
Example 16  PIP – Residence and Presence: Not habitually resident in 
Great Britain 
Example 17  Universal Credit – Limited Capability for Work 

Example 18  Universal Credit - Sanction imposed due to not attending an 
arranged job interview 
Example 1 - State Pension Credit - amount of income taken into 
account when SPC awarded 

Section 1: 
Personal Details 
 
Mr Terence Stone 
1 Quarry Avenue 
Leeds 
National Insurance Number: 
ZZ000001A 
Benefit: 
State pension credit 
Date of outcome decision:   
19 November ----- 
Date decision notified: 
20 November ---- 
Date of mandatory reconsideration: 
30 November ---- 
Date of appeal: 
4 December------ 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s representative (if any): 
 
Address where documents for the 
 
decision maker may be sent or delivered:
Names and addresses of any other 
 
respondents and their representatives (if 
any) 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and Supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Extract from PC1 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of Mandatory 
reconsideration 
Pages (-) 
(--/--/--) 
(--/--/--) Form 
AT2A 
Pages (-) 
(--/--/--) 
(--/--/--) 
Mandatory reconsideration decision 
/ LT54 
Section 3: The decision under appeal 
 
Mr Stone is entitled to a reduced rate State Pension Credit of £73.70 a week 
from 11 November. 
 
Section 4: The facts of the case 
Mr Stone is a single man aged 63, born on 11 November ----. He   claimed 
pension credit on 11 November ----. 
 

On 11 November ---- he was also in receipt of Employment and  
Support 
Allowance (Contributory Based). His entitlement was £71.70  per week. He 
had no other income. 
 
A decision was made on 20 November ---- awarding Mr Stone  
pension 
credit of £73.70 per week from 11 November ----. 
 
The pension credit standard minimum guarantee for a single 
person is £145.40 per week. Mr Stone is not entitled to any prescribed 
additional amounts so his appropriate minimum guarantee is £145.40.  
 
ESA is taken into account in calculating a person’s PC entitlement. 
Accordingly, the £71.70 ESA entitlement was deducted from the £145.40 
leaving a guarantee credit amount of £73.70 per week. Mr Stone was notified 
that he was entitled to pension credit of £73.70 per week on 20 November 
 
On 25 November Mr Stone applied for a mandatory reconsideration.  His 
ground was that he thought he would be entitled to £145.40 SPC in addition to 
his ESA. The decision maker explained the basis for the calculation. Mr Stone 
did not accept it. 
 
On 27 November the decision maker refused the application – see pages 
……. 
On 30 November ---- Mr Stone appealed. His grounds was as above. 
 
Section 5: The decision maker’s response 
The decision maker opposes the appellant’s case. 
It would be appropriate for the case to be disposed of without a hearing.  
 
 
The point of contention in this appeal is whether ESA should be taken into 
account as an income in calculating Pension Credit. 
 
Section 15 (1) (e ) The State Pension Credit Act 2002 
Regulation 15 (1) The State Pension Credit Regulations 2002 
 
Although it was explained to Mr Stone that the law is clear that it is  such an 
income (see Annex), he has not accepted this fact.  
 
I request that the appeal is dismissed. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
 

Example 2 -State Pension Credit – Refusal to specify an AIP 
Section 1: 
Personal Details 
Mrs Joan Wilkinson 
12 Bank Place 
Birmingham 
B16 8NU 
National Insurance Number: 
ZZ123456A 
 
Benefit: 
State pension credit 
Date of outcome decision: 
16 February ---- 
Date decision notified: 
 
16 February ---- 
Date of mandatory reconsideration: 
23 February ---- 
Date of appeal: 
28 February ---- 
Decision maker’s name and address: 
 
 
Name and address of the decision 
 
maker’s representative (if any): 
Address where documents for the 
 
decision maker may be sent or delivered:
 
Names and addresses of any other 
 
respondents and their representatives (if 
any): 
Section 2:  Schedule of evidence  
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Extract from PC1 
 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration 
Pages (-) 
(--/--/--) 
(--/--/--) 
Mandatory reconsideration decision 
/ LT54 
Section 3: The decision under appeal 
 
The Wilkinsons are entitled to Pension Credit but not with an Assessed 
Income Period.  
 
Section 4: The facts of the case 
Mrs Wilkinson is aged 65 – she was born on 12 May ----. She made  
an 
application for pension credit from 6 February ----.  Her husband,   Mr 
Wilkinson, is 58 years old, and they applied as a pensioner   couple. 
 
A decision was made on 16 February ---- awarding Mr and Mrs  
Wilkinson 

state pension credit of £xx.xx from 6 February ----. A   decision was also 
made that they do not qualify for a five year  
assessed income period 
because Mr Wilkinson is aged under 60. 
 
On 18 February Mrs Wilkinson made an application for mandatory 
reconsideration. Her reason for disputing the decisions was that her twin 
sister, who is in similar circumstances and whose husband is 68 years old, 
has been given a five year assessed income period. Mrs Wilkinson thinks that 
she should qualify for a five year assessed income period, which would mean 
that she would not have to provide information about her retirement provision 
on a regular basis. 
 
Mrs Wilkinson received an explanation from the Pension Service – see para 2 
above - but was still not satisfied. On 20 February the DM refused the 
application – see pages 
 
On 23 February ---- Mrs Wilkinson appealed. 
 
Section 5:  The decision maker’s response 
The decision maker opposes the appellant’s case. 
It would be appropriate for the case to be disposed of without a hearing.   
 
The only issue in this appeal is whether the Secretary of State should 
 
have set an AIP of five years. 
 
Mrs Wilkinson contends that as her circumstances mirror that of her twin 
sister then she should also have an AIP of five years. This is simply not 
correct. Her twin sister’s husband is 68 and Mr Wilkinson was 58 when the 
claim was made. Where one of a PC couple is below 60, the Secretary of 
State cannot set an AIP.  
Section 6 (1) and (2) (b) The State Pension Credit Act 2002 Regulation 10 (1) 
(a) The State Pension Credit Regulations 2002 
 
This was explained to Mrs Wilkinson but she did not accept it as legally 
correct.  
 
I request that the tribunal dismiss the appeal.  
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 

Example 3 - Income Support – date of claim/evidence requirement 
Section 1: 
Personal Details 
 
Ms Joan Smith 
1 Quarry View 
Leeds 
LS12 5YZ 
National Insurance Number: 
ZZ000002C 
Benefit: Income 
Support 
Date of outcome decision:   
16 May ---- 
Date decision notified: 
16 May ---- 
Date of mandatory reconsideration: 
20 May ---- 
Date of appeal: 
22 May ---- 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s representative (if any): 
 
Address where documents for the 
 
decision maker may be sent or delivered:
Names and addresses of any other 
 
respondents and their representatives (if 
any) 
Section 2:  Schedule of evidence  
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Extract from form A1 
Pages (-) 
(--/--/--) 
(--/--/--) A164 
reply 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
Decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Copy of form sent to claimant 
requesting further evidence of 
Capital 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration / LT54 
Section 3: The decision under appeal 
 
Ms Joan Smith is not entitled to income support from 6 April ----to 19 May ---- 
 
Section 4: The facts of the case 
Ms Joan Smith is a 22 year old single parent with 1 dependant child. She 
claimed income support on 25 April ---- having contacted the Social Security 
Office on 6 April ----. She had finished work at "Steelite" on 5 April ----. As 
required by the evidence requirements provisions she was required to supply 
her most recent bank books to allow the verification of any capital she 
declared when claiming. She did not do so. 

 
Ms Smith was sent an A164 form on 28 April ---- informing her that her bank 
books were required. This form stated that if the documents requested were 
not received by 6 May ---- she would only be paid from the date they were 
received. 
 
On 10 May ---- a reply to the A164 was received along with Ms Smith's bank 
books. The decision maker decided that the claim had not been properly 
completed until that date. As this was more than 1 month fter the information 
was requested, the date of claim became the 10 May. 
 
On x date Mrs Smith applied for a mandatory reconsideration. She said that 
the letter she had received from the department gave the date for providing 
the information as 10 May and that she had met that date. The decision 
maker asked her to provide a copy of the letter she had received. She said 
she no longer had it. He checked the benefit system and this showed a return 
date of 6 May – the screen print is at page….Accordingly the application was 
refused.  
 
Mrs Smith appealed on x date. 
 
Section 5:  The decision maker’s response 
The decision maker opposes the appellant’s case. 
It would be appropriate for the case to be disposed of without a hearing. 
 
The key issue in this appeal is the date by which Mrs Smith had to provide 
information to the Secretary of State about her capital. This was an evidence 
requirement in connection with her claim for Income Support. 
Regulations 4(1A) and 6(1A) of the Social Security (Claims and Payments) 
Regulations. 
 
The Secretary of State sent form A164 to Mrs Smith on 28 April and asked 
her to provide her bank books by 6 May. Mrs Smith provided them on 10 May.  
Accordingly she had failed to satisfy evidence requirements in relation to her 
claim and the date of claim became the date that they were received by the 
Secretary of State, namely, 10 May. The Secretary of State had no reason to 
extend the time for replying. 
 
In her application for mandatory reconsideration Mrs Smith said that the date 
she had been told to return the books was 10 May. However, she could not 
provide any evidence which contradicted the Secretary of State’s contention 
that it was the 6 May. The screen print provided clearly indicates this date. 
 
The Secretary of State does not accept that there could have somehow been 
a discrepancy between the dates. If Mrs Smith could have provided the 
written evidence then, of course, the date of claim would have been the 
original date.   
 
I request that the tribunal dismiss the appeal.  

 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 4 - Jobseeker’s Allowance – Claimant entitled to a 
reduced rate of JSA(IB) because of her earnings 

Section 1: 
Personal Details 
 
Mrs Jenny Thompson 
18 London Place 
Basingstoke 
RG74 99YZ 
National Insurance Number: 
ZZ000009C 
Benefit: 
Income based jobseeker’s 
allowance 
Date of outcome decision:   
27 May ---- 
Date decision notified: 
27 May ---- 
Date of mandatory reconsideration: 
20 June ---- 
Date of appeal: 
25 June ----  
 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s representative (if any): 
 
Address where documents for the 
 
decision maker may be sent or delivered:
Names and addresses of any other 
 
respondents and their representatives (if 
any) 
Section 2:  Schedule of evidence  
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Extract from form A1 
Pages (-) 
(--/--/--) 
(--/--/--) 
A15C – request for details of part 
time work 
Pages (-) 
(--/--/--) 
(--/--/--) 
Letter of confirmation of closure of 
previous claim and notification of 
rate of entitlement for period 
16/05/05 to 21/05/05 
Pages (-) 
(--/--/--) 
(--/--/--) 
Copy of  pay advice for payment 

received on 27/05/05 
 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Letter from customer disputing 
decision. Requested 
reconsideration 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration / LT54 
Pages (-) 
(--/--/--) 
(--/--/--) 
Letter of notification of closure of 
claim from 28/05.  Also confirming 
bank account details used and rate 
of entitlement for period ending 
27/05/05 
Pages ( 
(--/--/--) 
(--/--/--) 
Letter from customer requesting an 
explanation of letter issued on 
30/06/05 
Pages ( 
(--/--/--) 
(--/--/--) 
Letter of notification of taxable 
benefit awarded to Jenny 
Thompson for period from 16/05/05 
to 27/05/05 and copy of P45 
Pages ( 
(--/--/--) 
(--/--/--) 
Letter from customer requesting 
explanation of taxable benefit letter 
Pages ( 
(--/--/--) 
(--/--/--) 
Letter of explanation in response to 
requests from Jenny Thompson for 
explanation of letters issued by 
Jobcentre Plus on 30/06/05 & 
01/07/05 
Pages ( 
(--/--/--) 
(--/--/--) 
Jenny Thompson’s supporting 
evidence  - chronology of events 
Pages ( 
(--/--/--) 
(--/--/--) 
Jenny Thompson’s supporting 
evidence – Co-operative Bank bank 
statements 
Pages ( 
(--/--/--) 
(--/--/--) 
Jenny Thompson’s supporting 
evidence – letters from Basingstoke 
Council Housing Benefits 
department 
Pages ( 
(--/--/--) 
(--/--/--) 
Jenny Thompson’s supporting 
evidence – pay slips for periods 
06/05/05 to 24/06/05 
Pages ( 
(--/--/--) 
(--/--/--) 
Computer record – income support 
payment for period ended 13/04/05 
Pages ( 
(--/--/--) 
(--/--/--) 
Computer record – linked benefit 
details showing first effective day 
(FED) of linked period 
Pages ( 
(--/--/--) 
(--/--/--) 
Computer record JSA payment 
history 
Pages ( 
(--/--/--) 
(--/--/--) 
Computer record – JSA enquiry 
letters issued 
Pages ( 
(--/--/--) 
(--/--/--) 
Computer record – notes relating to 

the case 
Pages ( 
(--/--/--) 
(--/--/--) 
MF40 – memo recording small 
overpayment (official error) 
Section 3:  The decision under appeal 
 
Jenny Thompson is entitled to income based jobseeker's allowance totalling 
£80.35 for the period from 16/05/---- to 27/05/----. 
I respectfully request that the following decision be substituted for the original 
decision: 
Jenny Thompson is entitled to income-based jobseeker's allowance totalling 
£63.92 for the period from 16/05/---- to 27/05/----. This is because she has 
declared earnings that must be taken into account when calculating her 
entitlement. 
 
Section 4:  Facts of the case 
On 16/05/---- Jenny Thompson contacted the local Jobcentre Plus outlet in 
order to claim both contributions-based and income-based jobseeker's 
allowance. She completed the rapid reclaim form JSA4 (RR) as required 
because she had previously claimed the same benefit from 14/04/---- until 
24/04/----. That earlier award had ended because Mrs Thompson had failed to 
sign on her next due fortnightly interview date (12/05/----). Before that earlier 
claim Mrs Thompson had claimed incapacity benefit and income support from 
06/03/1999 to 13/04/----. 
 
Jenny Thompson stated in the claim form JSA 4(RR), completed and 
submitted by her on 24/05/----, that she was currently undertaking part time 
employment with XYZ Catering as a catering assistant, working on average 1 
day a week (Page(s) [-]). 
 
It was determined that the tax years ending 5th April ---- and 5th April ---- 
should be used in assessing entitlement to contribution-based jobseeker's 
allowance. This was based on the details of her previous claims as linking 
rules apply. (Page(s) [-]. 
 
On 27/05/---- the decision maker established that Jenny Thompson did not 
satisfy the contribution conditions based on the tax years ending 5th April ---- 
and 5th April ---- and as a result she was not entitled to contribution-based 
jobseeker's allowance from 16/05/----. However, as Mrs Thompson had stated 
in her claim form that she also wished to claim income-based jobseeker's 
allowance, the decision maker further determined that she would be entitled to 
benefit at the full standard entitlement rate of £55.65 for each week in which 
a) she did not work, b) she was available for work, and c) for which she 
attended the local Jobcentre Plus office at fortnightly intervals to provide 
evidence that she was still actively seeking work. 
 
On 27/05/---- Jenny Thompson attended her local office as requested and 
informed the local office that she had worked for less than 16 hours in the 
period ending 20/05/---- and that she had received £21.00 She further 
declared that in the period ending 27/05/---- that she had worked for less than 

16 hours and had earned £26.00 
 
Jenny Thompson’s entitlement was then calculated as follows: weekly rate of 
entitlement was determined based upon the declaration that she had received 
£21.00 earnings per week 
i) 
Week ending 20/05/---- Personal Allowance £40.20 Mrs Thompson 
claimed for 5 days in that benefit week (16/05/---- to 20/05/----) thus 5/7 of 
£40.20 = £28.72 due 
ii)  
Week ending 27/05/---- Personal Allowance £56.20 Less: income from 
earnings: £16.00 (1st £5.00 of earnings is disregarded for benefit calculation 
purposes) Total: £40.20 
 
On 27/05/---- a benefit cheque for the sum of £68.92 (28.72 + £40.20) was 
issued to Jenny Thompson 
 
On 31/05/---- Jenny Thompson prepared a letter, that she states she posted 
to the local office on 01/06/----, to dispute the decision that her weekly 
entitlement was to be paid at the weekly rate of £40.20. She asked for an 
explanation of this decision. (Page(s) [-]. 
 
Coincidentally, on the same day, 31/05/----, the decision maker revised the 
benefit decision and determined that the correct benefit rate for w/e 20/05/-- -- 
was £56.20, not £40.20 as previously calculated, and that 5/7 of £56.20 = 
£40.15. As £28.72 of this sum had already been paid to Jenny Thompson for 
that week (as shown above), the decision maker determined that she was 
owed a further £11.43 and this was paid to her on 31/05/---- by bank credit 
transfer. (Page(s)[-] 
 
(Note. This payment did not take into account any income from earning for 
that period). 
 
On 06/06/---- Jenny Thompson reported non-receipt of the £11.43 payment.  
She noted that the payment notification issued to her, indicated that the 
payment had been sent to an incorrect bank account, Mrs Thompson offered 
her correct bank account details again in this letter and asked that a 
replacement payment was issued to her. She also informed the local office 
that she had not worked since 19/05/----, as she had declared when she 
attended the local office on 27/05/----, and she enclosed the payslip she had 
received later on in the day (27/05/----) for that work. She also again queried 
the rate of entitlement that had been notified to her in letters sent by the 
Department to Mrs Thompson on 31/05/1111. (Page(s) [-]. 
 
It is noted that the claim records show that the bank account details were 
corrected and that a replacement for the £11.43 payment was sent to Jenny 
Thompson on 30/06/1111. (Page(s) [-]. 
 
As a result of receiving the wage slip and Jenny Thompson's query 
concerning the rate of entitlement, the benefit decision was looked at again on 
17/06/---- and was changed, but not favourably. Jenny Thompson had 
provided payslips with her letter that showed that her entitlement for the 

period from 16/05/---- to 27/05/---- should have been calculated as follows: 
Week ending 20/05/---- Personal Allowance £56.20 Less: Income from 
earnings: £16.00 (1st £5.00 of earnings is disregarded for benefit calculation 
purposes) Total: £40.20 
 
Mrs Thompson claimed for 5 days in that benefit week (16/05/---- to 20/05/----) 
thus: 5/7 of £40.20 = £28.72 due. 
iv) Week ending 27/05/---- Personal Allowance £56.20 Less: Income from 
earnings: £21.00 (1st £5.00 of earnings is disregarded for benefit calculation 
purposes) Total due to Mrs Thompson £35.20. 
Total due for period 16/05/---- to 27/05/---- is £28.72 + 35.20 = £63.92. In 
consequence, an overpayment of jobseeker's allowance totalling £5.00 was 
identified but as this had been caused by an official error, Mrs Thompson was 
not required to repay the overpaid amount. (Page(s) [-]. 
 
On 22/06/---- Jenny Thompson appealed against this decision. She gave her 
reasons for appealing as " Please look at all your paperwork sent to me from 
the beginning of April ----... Income of £21 earned in one week only, cannot 
pay my rent of £78.01 plus council tax... The Government states that for 
income-based jobseeker's allowance that rent will be paid. Therefore why is 
mine not? Plus my Jobseeker's is £56.20 not £40. So why have you said I'm 
entitled to a lower rate of Jobseeker's Allowance”. 
 
On 30/06/----, the local office sent a letter to Jenny Thompson to inform her 
that her jobseeker's allowance award had come to an end after 27/05/---- 
because she had not attended to sign her declaration after 27/5/----. 
(Page(s)[-]. 
 
On 26/07/---- the decision maker sent a letter to explain how the income tax 
years are used to establish entitlement to the contributions based element of 
Jenny Thompson’s claims (she had subsequently claimed benefit again from 
21/07/----) and also to give an explanation as to how payment of Mrs 
Thompson’s income based benefit for May ---- had been calculated. This 
letter had been sent in response to two further requests for explanation from 
Mrs Thompson, both of these having been received in the local office on 
19/07/---- (Page(s) [-]. 
 
On 09/08/---- Jenny Thompson sent in a further letter concerning her appeal 
providing details of her income and of her bank statements from April ---- to 
support her appeal. (Page(s) [-]. 
 
Section 5:  The decision maker’s response 
The decision maker opposes the appellant’s case.  
It would be appropriate for the case to be disposed of without a hearing. 
I request the tribunal dismiss the appeal and uphold the decision that Jenny 
Thompson is entitled to income-based jobseeker's allowance totalling £63.92 
for the period from 16/05/---- to 27/05/----. This is because she has declared 
earnings that must be taken into account when calculating her entitlement. 
The law used in making this decision  

 
Applicable amount 
A person is entitled to income-based jobseeker's allowance if he has no 
income or his income does not exceed the applicable amount. Section 3(1)(a) 
of the Jobseeker's Act 1995 - Jenny Thompson is a single person aged not 
less than 25. In the case of an income-based jobseeker's allowance the 
applicable amount shall 
  If a claimant has no income, the applicable amount; 
  if a claimant has an income, the amount by which the applicable amount 
exceeds his income. 
 
Therefore for any week in which Mrs Thompson does not work she is entitled 
to a personal allowance of £56.20 a week. Section 4(3) of the Jobseeker's Act 
1995; Regulation 83 of, and paragraph 1(1)(e) of Schedule 1 to, the 
Jobseeker's Allowance Regulations 1996. 
 
Income 
Earnings derived from employment shall be taken into account from the first 
day of the benefit week in which they are paid, or the first succeeding benefit 
week in which it is practicable to take them into account, over a period equal 
to the length of the period for which they are due to be paid. Where a payment 
is treated as paid before the first benefit week and a part is to be taken into 
account for some days only in that week ("the relevant days"), the amount to 
be taken into account for the relevant days shall be calculated by multiplying 
the weekly amount of the benefit by the number of relevant days and dividing 
the product by seven. It is the net earnings after tax, which is taken into 
account. The weekly disregard for a single person is £5.00. 
Regulations 94, 96, 97 (1)(a) &(4)(b), 98 & 99 and Schedule 6 of the 
Jobseeker's Allowance Regulations 1996 
 
In accordance with the above regulations, net weekly earnings of £21.00 were 
paid to Jenny Thompson on 20/05/----. A £5.00 disregard has been applied. 
Therefore the income to be taken into account from 16/05/---- to 20/05/---- is 
£21.00. 
 
I therefore submit that Jenny Thompson is entitled to income-based 
jobseeker's allowance at the weekly rate of £40.20 (£56.20 - £16.00) from 
14/05/---- to 20/05/----. As Mrs Thompson claimed from 16/05/---- and the first 
period claimed for was for 5 days (16/05/---- to 20/05/----) 5/7ths of £40.20 is 
due, resulting in an entitlement of £28.70 for that period. 
 
I further submit that Jenny Thompson is entitled to income-based obseeker's 
allowance at the weekly rate of £35.20 from 21/05/---- to 27/05/----. The total 
amount to which Mrs Thompson is entitled for the period 16/05/---- to 27/05/---
- is £28.70 + £35.20 = £63.92. 
 
Other Matters 
It is noted that the actual amount paid to Jenny Thompson for the period 
16/05/---- to 27/05/---- was £85.35 (£68.92 issued on 27/05/---- + £11.43 
issued on 30/06/----). Because the overpayment was made as a result of 

official error, and because the overpayment is £16.43, within de minimus 
limits, it has been accepted by the decision maker that Mrs Thompson is not 
required to repay that sum 
In her appeal Jenny Thompson also states that she wishes her claim to be 
revised from April ----. When Mrs Thompson made her claim, she asked for 
her claim to be backdated for the period from 25/04/---- to 15/05/----. That 
request was refused by a decision maker on 27/05/----, and is the subject of a 
separate appeal to be submitted to the Tribunal. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 5 - Jobseekers Allowance – Claimant does not meet the 
prescribed conditions for a backdated payment 

Section 1: 
 Personal Details 
 
Mrs June Delamere  
1 Quarry Drive 
Birmingham 
B16 8NSS 
National Insurance Number: 
ZZ000003D 
Benefit: 
State pension credit 
Date of outcome decision:   
9 June ---- 
Date decision notified: 
9 June ---- 
Date of mandatory reconsideration: 
20 June ---- 
Date of appeal: 
7 July ---- 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s representative (if any): 
 
Address where documents for the 
 
decision maker may be sent or delivered:
Names and addresses of any other 
 
respondents and their representatives (if 
any) 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Form JSA5 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
Decision 

Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration / LT54 
 
Pages (-) 
(--/--/--) 
(--/--/--) 
Notice of redundancy 
Section 3: The decision under appeal 
 
Mrs June Delamere is not entitled to jobseeker’s allowance from 18 April. 
 
Section 4:  The facts of the case 
Mrs Delamere claimed jobseekers allowance on 22 May ----. 
She claimed because her employment with M G Rover Group had ended on 
17 April ----. 
 
Mrs Delamere also completed form JSA5 requesting that her claim be 
backdated to 18 April. She explained that she had not claimed 
earlier as Price Waterhouse Administrators informed her that during her 8 
week statutory notice period that any jobseeker’s allowance that she claimed 
would be deducted from her notice pay. She also stated 
that she was actively seeking work during this period and that she did not 
realise that delaying the claim would impact upon her national insurance 
situation. She gave details of the efforts she had made to find employment 
during the period in question. 
 
The decision maker decided that Mrs Delamere’s claim should not be 
backdated.  
 
On x date Mrs Delamere applied for a mandatory reconsideration.  She said 
that she had not claimed earlier as she was not aware of the implications in 
delaying her claim. As she did not provide any new evidence for the delay the 
application was refused. 
 
Mrs Delamere appealed on x date 
 
Section 5:  The decision maker’s response  
The decision maker opposes the appellant’s case. 
It would be appropriate for the case to be disposed of without a hearing. 
 
A claim for Jobseekers Allowance will only be backdated if the claimant can 
satisfy one or more of the conditions of regulation 19(5) or (7) of the Claims 
and Payments Regulations – please see the Annex. 
 
Mrs Delamere did not claim as soon as she lost her job because her 
employer, Price Waterhouse Administrators, informed her that during her 8 
week statutory notice period that any jobseeker’s allowance that she claimed 
would be deducted from her notice pay. Further that she did not understand 
the implications of a delay in claiming. 
 
Neither ground satisfies any of the conditions of regulation 19. Regulation 

19(5)(f) does not apply because she was not told by her employer that her 
claim would not succeed only that if successful it would affect her notice pay. 
 
In her application for mandatory reconsideration she did not provide any new 
evidence.  
 
I request that the tribunal dismiss the appeal. 
 
The law used in making this decision 
Claims and Payments Regulations, regulation 19  
As far as it is relevant, it says: 
 
  …in the case of…jobseeker's allowance ... the prescribed time for 
claiming the benefit shall be extended, subject to a maximum 
extension of three months, to the date on which the claim is made, 
where: 
  Any of the circumstances specified in paragraph (5) applies or has 
applied to the claimant; and 
  As a result of that circumstance or those circumstances the claimant 
could not reasonably have been expected to make the claim earlier. 
  The circumstances…are – 
   The claimant has difficulty communicating because:- 
  he has learning, language, or literacy difficulties; or 
  he is deaf or blind  
and it was not reasonably practicable for the claimant to obtain assistance 
from another person to make his claim: 
  Except in the case for jobseeker's allowance, the claimant was ill or 
disabled, and it was not reasonably practicable for him to obtain 
assistance from another person to make his claim; 
  The claimant was caring for a person who is ill or disabled and it was 
not reasonably practicable for him to obtain assistance from another 
person to make his claim; 
  The claimant was given information by an officer of the Department 
of Social Security or of the Department for Education and 
employment which led the claimant to believe that a claim for benefit 
would not succeed; 
  The claimant was given written advice by a solicitor or other 
professional adviser, a medical practitioner, a local authority, or a 
person working in a Citizens Advice Bureau or a similar advice 
agency, which led the claimant to believe that a claim for benefit 
would not succeed; 
  The claimant or his partner was given written information about his 
income or capital by his employer or former employer, or by a bank 
or building society, which led the claimant to believe that a claim for 
benefit would not succeed; 
  The claimant was required to deal with a domestic emergency 
affecting him and it was not reasonably practicable for him to obtain 
assistance from another person to make his claim; or  
  The claimant was prevented by adverse weather conditions from 

attending the appropriate office. 
Alternatively  
…the prescribed time for claiming the benefit shall be extended, subject to a 
maximum of one month, to the date on which the claim is made, where… 
   The appropriate office where the claimant would be expected to 
make a claim was closed and alternative arrangements were not 
available; 
  The claimant was unable to attend the appropriate office due to 
difficulties with his normal mode of transport and there was no 
reasonable alternative available; 
  There were adverse postal conditions; 
  The claimant was previously in receipt of another benefit, and 
notification of expiry of entitlement to that benefit was not sent to the 
claimant before the date that his entitlement expired; 
  the case of a claim for family credit ….; 
  the claimant had ceased to be a member of a married or unmarried 
couple within the period of one month before the claim was made; 
or 
  during the period of one month before the claim was made a close 
relative of the claimant had died …….. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 6 - Personal Independent Payment: No Entitlement  
Section 1:  
Appeal Tribunal Reference Number 
SC111/11/11111   
Personal Details 
Mr John Jones 
Address XXX 
Name and addresses of any other 
N/A 
respondents and their representatives (if 
any) 
Name and address of Appointee (if 
N/A  
applicable)  
 
Date of Birth 
XX/XX/XX 
National Insurance Number 
QQ158761C 
Benefit Personal 
Independence 
Payment 
Date of Outcome Decision 
07/06/2013 
Date Outcome Decision Notified 
10/06/2013 
Date of Mandatory Reconsideration 
10/07/2013 
Decision 
 
Date Mandatory Reconsideration Notified 
11/07/2013 

Date of Appeal Request 02/08/2013 
Decision Maker’s name 
xxx 
Address where documents for the 
St Martins House 
Decision Maker may be sent or delivered 
Bootle BC 
Stanley Precinct 
Bootle 
Liverpool 
L69 9BN 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
--- 
15/08/2013  N/A 
DWP Appeal Response 
1-7 30/07/2013 
02/08/2013 Appeal 
request 
8 02/08/2013 
03/08/2013 
HMCTS request for a response 
(DL6) 
9-42  
13/04/2013 18/04/2013  “How 
your disability affects you" 
(PIP2) form 
43-46 13/04/2013 
26/04/2013 
Evidence from claimant 
(prescription) 
47-50  
25/04/2013  26/04/2013 
Report from Hospital Consultant 
51-70 07/05/2013 
23/05/2013 
Health Professional Consultation 
Report 
71-75 07/06/2013 
 
New 
Claim 
decision and notification 
76-77 02/07/13 
 
Mandatory 
Reconsideration 
Decision and notification 
Section 3: The decision under appeal 
Mr Jones is not entitled to Personal Independence Payment. 
Section 4: The facts of the case 
Mr Jones has asthma and a heart condition. 
 
 
A valid claim for Personal Independence Payment was accepted by phone on 
13/04/2013. 
 
A "How your disability affects you" PIP2 form was received on 18/04/2013. Mr 
Jones indicated that he has problems preparing food, eating and drinking 
washing and bathing, dressing and undressing, mixing with other people, 
making decisions about money and occasionally going out (Page Nos 9-42). 
 
Evidence (copy of a prescription) from the claimant was received on 
26/04/2013 (Page Nos 43-46). 
 
A report from the claimant’s Consultant at the hospital was received on 
26/04/2013 (Page Nos 47-50). 
 
A face to face consultation took place on 07/05/2013 (Page Nos 51-70). 
 

The Health Professional recommended that Mr Jones needs to use an aid or 
appliance to be able to prepare or cook a simple meal and needs to also use 
an aid or appliance to wash or bathe. The Decision Maker considered Mr 
Jones claim of 13/04/13 and taking all the available evidence into account 
decided that although Mr Jones has been awarded 4 points for daily living he 
does not satisfy the disability threshold criteria.  
 
The Disability Threshold Criteria is the minimum number of points someone 
must score to be awarded Personal Independence Payment. Where a total of 
between 8 to 11 points is scored for either Daily Living component or the 
Mobility component the person will be awarded each component of Personal 
Independence Payment at the standard rate. Where a total of 12 points or 
more is scored for either Daily Living component or the Mobility component 
the person will be awarded each component of Personal Independence 
Payment at the enhanced rate.  
 
Therefore Mr Jones was not entitled to Personal Independence Payment from 
13/04/2013. The reasons for the decision are included in the decision letter 
dated 07/06/2013 (Pages 71-75). 
 
The Decision Maker telephoned Mr Jones on 19/06/2013, to explain the 
decision. Mr Jones was not satisfied with the explanation. He stated that he 
would consider an Appeal but would refer to his notification and the Website, 
before deciding whether or not to proceed with a dispute. He did not present 
any additional information.  
 
Mr Jones telephoned on 27/06/2013 to request a mandatory reconsideration 
and the Decision Maker contacted him to discuss this further. He told the 
decision Maker he needs actual help to cook a meal and not just an aid. It 
takes him about 20 minutes to dress. He struggles to move about, cannot 
walk any distance without distress. He needs to use the toilet more than he 
used to but does not know why. He needs someone with him all the time 
because of the heart pains. 
 
The Decision Maker reconsidered but did not change the original decision 
(Pages  76-77)  
 
On 02/08/2013 Mr Jones lodged an appeal against the decision that he is not 
entitled to Personal Independence Payment on the grounds that the original 
decision was unfair as he doesn’t agree with the outcome of the descriptors 
(Page Nos 1-7). 
Section 5: The Decision Maker’s response 
I oppose this appeal for the following reasons:  
 
Personal Independence Payment is intended to help towards some of the 
extra costs arising from ill-health or disability. It is based on how a person’s 
condition affects them, not the condition they have. There are two 
components of Personal Independence Payment – Daily Living and Mobility. 
Each component can be paid at standard rate, or enhanced rate for those with 

the greatest needs.The decision was made in accordance with the Welfare 
Reform Act 2013 Part 4 Social Security (Personal Independence Payment) 
Regulations 2013 
 
Entitlement to Personal Independence Payment is determined by a decision 
maker taking into account all the available evidence including an assessment 
of the individual’s needs carried out by a health professional who considered 
the claimant’s ability to carry out certain activities.– see Table pages 6-10  
which list the activities which are considered. Points can be awarded for each 
of these activities.  The specific legislation for the areas under dispute is the 
Social Security (Personal Independence Payment) Regulations 2013, 
Regulation 4 (assessment) and Regulations 5, 6 (scoring), and Schedule 1 
(list of descriptors against the set of activities for Daily Living and Mobility) 
 
Mr Jones is 25. He has had asthma since 12 and breathing difficulties since 
February 2012. He underwent heart surgery due to a pectus bar in the heart 
on 08/11/2012.  He takes medication prescribed by his GP and undergoes 
physiotherapy.  
 
Mr Jones declared in writing, and at the assessment, that he does not need 
help to manage his treatment or his toilet needs and can communicate and 
read without help. Accordingly no points have been awarded under these 
activities.  
 
He stated that he needs help to cook a simple meal because he struggles to 
lift heavy objects and he confirmed this again in his reconsideration request. 
The Decision Maker has, however, accepted that Mr Jones can prepare or 
cook a simple meal with the use of aids and has confirmed the award of 2 
points for this activity is appropriate. 
 
In the PIP2 Mr Jones states that he needs prompting to eat and drink as it is 
too much effort to prepare a meal. However at the assessment he stated that 
he has no problems taking nutrition. The Decision Maker has not therefore 
awarded any points for this activity.  
 
He stated he has difficulty with any heavy activities due to breathlessness and 
fatigue. He stated that he needed a bath seat to enable him to take a shower. 
The Decision Maker has accepted that due to breathlessness Mr Jones needs 
to use an aid to help him shower and has awarded 2 points.  
 
Mr Jones states that he occasionally requires help with putting socks on 
however as the majority of the time he can do this unaided, the Decision 
Maker has therefore not awarded any points for this activity. 
 
Mr Jones explained that he cannot be bothered to see friends and has 
become anxious. He stays in his room due to the physical affects of his 
condition and his friends come to see him. Throughout the consultation Mr 
Jones demonstrated good eye contact and did not appear stressed. The 
Decision Maker has decided that he is able to engage with other people 
unaided.  

 
He calculates the payment of bills but relies on someone else to actually pay 
the bills. He is therefore able to make budgeting decisions unaided. 
 
Although Mr Jones has scored 4 points, he is still not entitled to Personal 
Independence Payments because he did not meet the disability threshold of 8 
points for the Daily Living component.  
 
On his PIP 2 Mr Jones explained his walking is variable and he can walk 50 to 
200 metres, his legs give way and he gets out of breath. He explained to the 
Health Professional that he likes to go for a walk at midday. He manages to 
walk for about 20 mins, stopping regularly every few minutes to sit and catch 
his breath. His girlfriend will accompany him if necessary. 
 
However at the assessment it was noted that his peak flow readings are 
within normal range for his height and he walked unaided more than 200 
metres to the interview and managed a flight of stairs. 
 
The Health Professional was of the opinion that with sufficient rest he would 
be able to repeat this walk and, as later pointed out by Mr Jones, he did have 
to rest after the assessment, before undertaking the return journey of 200 
metres or more to his car. Additionally, his consultant has advised him to 
increase his walking, as able, which suggests that the extra effort needed will 
have long term beneficial effects.  
 
Having regard to this, the Decision Maker has decided that Mr Jones can 
stand and then move for more than 200 metres either aided or unaided.   
 
He said that he sometimes needed help going out because he gets anxious 
and stressed. Mr Jones was offered medication and counselling but declined 
this. He attended the assessment alone and did not appear unduly distressed. 
He made good eye contact throughout the consultation. 
 
As there was no evidence to show that he had any overwhelming 
psychological condition the decision maker decided that he can plan and 
follow the route of a journey unaided. 
 
As Mr Jones did not score any points for mobility he is not entitled to the 
mobility component of Personal Independence Payment. 
 
Conclusion 
The Tribunal is asked to dismiss this appeal and confirm the Secretary of 
State’s decision. 
 
The descriptors and points awarded for each activity are in bold and 
underlined in the table below. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 

www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Daily Living Activities 
Activity 1 – Preparing food 
1A 
I‘ve decided you can prepare and cook a simple meal unaided. 

1B 
I‘ve decided you need an aid or appliance to prepare or cook a 

simple meal. 
1C 
I’ve decided you can’t cook a simple meal using a conventional 

cooker but you can do so using a microwave. 
1D 
I’ve decided you need prompting from another person to 

prepare or cook a simple meal. 
1E 
I’ve decided you need supervision or assistance from another 

person to prepare or cook a simple meal. 
1F 
I’ve decided you can’t prepare and cook food. 

 
Activity 2 – Taking nutrition 
2A 
I’ve decided you can eat and drink unaided. 

2B 
I’ve decided you need an aid or appliance, or supervision from 

another person to eat and drink, or you need assistance from 
another person to cut up food. 
2C 
I’ve decided you need a therapeutic source to be able to take 

nutrition. 
2D 
I’ve decided you need prompting from another person to eat 

and drink. 
2E 
I’ve decided you need assistance from another person to 

manage a therapeutic source that enables you to take nutrition. 
2F 
I’ve decided you need another person to get food and drink to 
10 
your mouth. 
Activity 3 - Managing therapy or monitoring a health condition 
3A 
I’ve decided you can either manage medication / therapy or 

monitor your health condition unaided, or you don’t need to. 
3B 
I’ve decided you either need an aid or appliance to manage 

your medication, or you need supervision, prompting or 
assistance from another person to manage your medication or 
monitor your health condition. 
 
3C 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes no more than 3.5 hours a week. 
3D 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 3.5 hours a week but no more than 7 
hours. 
3E 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 

therapy takes more than 7 hours a week but no more than 14 
hours. 
3F 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 14 hours a week. 
Activity 4 – Washing and bathing 
4A 
I’ve decided you can wash and bathe unaided. 

4B 
I’ve decided you need an aid or appliance to wash or bathe.   

4C 
I’ve decided you need supervision or prompting from another 

person to wash or bathe. 
 
4D 
I’ve decided you need assistance from another person to wash 

either your hair or your body below the waist. 
4E 
I’ve decided you need assistance from another person to be 

able to get in or out of a bath or shower. 
4F 
I’ve decided you need assistance from another person to wash 

your body between the shoulders and waist. 
4G 
I’ve decided you can’t wash and bathe at all and need someone  8 
else to wash your entire body. 
Activity 5 – Managing toilet needs or incontinence 
5A 
I’ve decided you can manage your toilet needs or incontinence 

unaided. 
5B 
I’ve decided you need an aid or appliance to manage your toilet  2 
needs or incontinence. 
5C 
I’ve decided you need supervision or prompting from another 

person to manage your toilet needs. 
5D 
I’ve decided you need assistance from another person to 

manage your toilet needs. 
5E 
I’ve decided you need assistance from another person to 

manage your bladder or bowel incontinence. 
5F 
I’ve decided you need assistance from another person to 

manage your bladder and bowel incontinence. 
Activity 6 – Dressing and undressing 
6A 
I’ve decided you can dress and undress unaided. 

6B 
I’ve decided you need to use an aid or appliance to dress and 

undress. 
6C 
I’ve decided you either need another person to tell you to get 

dressed or undressed, how to do it or when to keep your 
clothes on, or that you need prompting or assistance to select 
appropriate clothing. 
 
6D 
I’ve decided you need assistance from another person to dress 

or undress your lower body. 
6E 
I’ve decided you need assistance from another person to dress 

or undress your upper body. 
6F 
I’ve decided you can’t dress or undress at all. 

Activity 7 - Communicating verbally 
7A 
I’ve decided you can express and understand verbal 


information unaided. 
7B 
I’ve decided you need an aid or appliance to be able to speak 

or hear. 
7C 
I’ve decided you can express and understand complex verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7D 
I’ve decided you can express and understand basic verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7E 
I’ve decided you cannot express or understand verbal 
12 
information at all, even with help from someone who is trained 
or experienced in helping people to communicate. 
Activity 8 – Reading and understanding signs, symbols and words 
8A 
I’ve decided you can read and understand basic and complex 

written information either unaided or using glasses or contact 
lenses. 
8B 
I’ve decided you need an aid or appliance, other than glasses 

or contact lenses, to read or understand either basic or complex 
written information. 
8C 
I’ve decided you need prompting from another person to read or  2 
understand complex written information.  
8D 
I’ve decided you need prompting from another person to read or  4 
understand basic written information. 
 
8E 
I’ve decided you can’t read or understand signs, symbols and 

words at all. 
Activity 9 – Engaging with other people face to face 
9A 
I’ve decided you can engage with other people unaided. 

9B 
I’ve decided you need to be prompted by another person to 

engage with other people. 
9C 
I’ve decided you can only engage with other people with 

support from someone who is trained or experienced in helping 
people to engage in social situations. 
9D 
I’ve decided you can’t engage with other people at all because 

doing so would cause you significant mental distress or you are 
likely to behave in a way which could harm you or another 
person 
Activity 10 - Making budgeting decisions 
10A  I’ve decided you can make complex budgeting decisions 

unaided. 
10B  I’ve decided you need prompting or assistance from another 

person to make complex budgeting decisions. 
10C  I’ve decided you can make simple budgeting decisions with 

prompting or assistance from another person. 
10D  I’ve decided you can’t make any budgeting decisions at all. 


Mobility Activities 
Activity 11 – Planning and following a journey 
11A  I’ve decided you can plan and follow the route of a journey 

unaided. 
11B  I’ve decided you need prompting from another person to 

undertake a journey to avoid causing you significant mental 
distress. 
11C  I’ve decided you can’t plan the route of a journey. 

11D  I’ve decided you can follow the route of an unfamiliar journey 
10 
with help from another person, assistance dog or orientation 
aid. 
11E  I’ve decided you can’t undertake any journey because it would 
10 
cause you significant mental distress. 
11F  I’ve decided you can’t follow the route of a familiar journey 
12 
without another person, assistance dog or orientation aid. 
Activity 12 – Moving around 
12A  I’ve decided you can stand and then move more than 200 

metres, either aided or unaided. 
 
12B  I’ve decided you can stand and then move more than 50 metres  4 
but no more than 200 metres, either aided or unaided. 
12C  I’ve decided you can stand and then move unaided more than 

20 metres but no more than 50 metres. 
12D  I’ve decided you can stand and then move using an aid or 
10 
appliance more than 20 metres but no more than 50 metres. 
12E  I’ve decided you can stand and then move more than 1 metre 
12 
but no more than 20 metres, either aided or unaided. 
12F
I’ve decided you cannot, either aided or unaided, stand or move  12 
 
  more than 1 metre.   
 
Example 7 - Income-based Jobseeker’s Allowance – Supersession 
because earnings in excess and recoverable overpayment 

Section 1: 
Personal Details: 
Miss Carol Kinder                          
48 Foxhall Rise                              
Coventry                                        
CV94 1QU 
National insurance number:                            ZZ100001C 
 
Benefit:                                                           Income-based jobseeker’s 
 allowance 
 
Date of outcome decision:                              04/11/---- 
 
Date decision notified: 
12/11/---- 
Date of mandatory reconsideration: 14/11/---- 
Date of appeal:                                               17/11/---- 
Decision maker’s name and address: 
 

Name and address of the decision maker’s   
representative (if any): 
Address where documents for the decision   
maker may be sent or delivered: 
Names and addresses of any other 
respondents and their representatives (if 
any): 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 
Pages (-) 
(--/--/--) 
(--/--/--) 
Original award decision 
Pages (-) 
(--/--/--) 
(--/--/--) Supersession 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Original disallowance decision 
Pages (-) 
(--/--/--) 
(--/--/--) Overpayment 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Extract of JSA1 claim form 
Pages (-) 
(--/--/--) 
(--/--/--) Claimant’s 
statement 
Pages (-) 
(--/--/--) 
(--/--/--) 
Sister’s bank statement 
Pages (-) 
(--/--/--) 
(--/--/--) 
Sainsbury’s bank statement 
Pages (-) 
(--/--/--) 
(--/--/--) Nationwide 
pass-book 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration / LT54 
Pages (-) 
(--/--/--) 
(--/--/--) 
Schedule 8 – JSA Regs 1996 
Section 3: The decisions under appeal 
Miss Kinder is not entitled to Jobseekers Allowance (Income Based) 
 
Miss Kinder has been overpaid Jobseekers Allowance of £562.12 for the 
period 31.8 – 10.11. This amount is recoverable. 
Section 4: The facts of the case: 
 
Miss Kinder is a 29 year old single woman living with her parents. She ceased 
an NVQ course in March ----. On 02/09/---- she claimed jobseeker’s allowance 
from 28/08/---- by completing form JSA1. She stated that she hadn’t worked in 
the 12 months before the claim and was supported by her parents. No capital 
was declared. JSA was awarded from and including 31/08/---- by a decision 
dated 22/09/---- (page(s) --). 
 
As a result of a computer scan of building society and bank accounts it came 
to light that Miss Kinder had a building society account and a  
bank 
account which together exceeded £16,000: 
- at the date of the claim she had £10,143 in a Nationwide Building Society 
account and £6,352 in a Sainsbury’s bank account (page(s) [ - ]). 
 
She was interviewed and gave a statement saying that she did not regarded 
the £10,143 in the Nationwide Building Society account as being available to 
her, as her parents had deposited the money for her to use when she marries.  

She said that the money in the Sainsbury’s account -- was built up over many 
years by payments made to her by her sister.  
 
The facts were put to a decision maker who decided that Miss Kinder was not 
entitled to income-based jobseeker’s allowance because her capital exceeded 
£16,000. The decision to award Jobseekers Allowance was revised on the 
basis that the decision maker was ignorant of the material fact that the 
claimant had undeclared capital. Her entitlement terminated effective from the 
date of the original decision 
 
The decision maker next decided that there had been an overpayment 
Jobseekers Allowance for the whole period. This amounted to £562.12, which 
was recoverable. 
 
Mrs Kinder applied for mandatory reconsideration on x date. Again she 
explained that she did not believe the money could in law be said to belong to 
her. Every penny was a gift from her parents or her sister. Having offered no 
new evidence the application was refused. 
 
Miss Kinder appealed on x date.            
 
 
Section 5 
The decision maker’s response: 
The decision maker opposes the appellant’s case. 
 
The issues which arise in this appeal are: 
  Did Miss Kinder fail to declare her capital when she claimed Jobseekers 
Allowance? This includes consideration as to whether the capital 
belonged to her. 
  If she did, was this a misrepresentation of her circumstances such that 
the Secretary of State was entitled to recover any overpayment 
consequent on this misrepresentation? 
 
Failure to declare the capital 
Miss Kinder has not disputed the amounts which were in her bank and 
building society accounts at the date of claim for Jobseekers Allowance. She 
disputes the conclusion that the money was hers. 
 
For the Secretary of State to be able to treat any capital as belonging to a 
claimant he must show that the claimant is the “beneficial owner”. If he is not 
then it is disregarded. For example, if the money is held in Trust and it is not 
available to the claimant to use then the claimant would not be the beneficial 
owner. 
 
The jobseeker’s allowance entitlement decision 
Section 13(1) of the Jobseekers Act 1995 Regulation 107 (a) of the 
Jobseekers Allowance Regulations 1996 
 

In Miss Kinder’s case no such ambiguity arises. The money was in her 
accounts and was hers to spend as and when she wanted to do so. That her 
intention was to use it for a future wedding or to finance her time as a student 
is of no relevance. The money had not been borrowed off her parents or sister 
and there was no suggestion that there was a contract, in fact or implied, that 
it had to be re-paid. In the eyes of the law: (i) the money belonged to Miss 
Kinder; (ii) it was in benefit terms capital; (iii) she should have declared it, as 
the Jobseeker’s Allowance claim form told her to, when she claimed – in 
signing the claim form’s declaration she was declaring that the information on 
the form was true and complete; and crucially it was over £16,000 which 
meant that at the date of claim there was no entitlement to Jobseekers 
Allowance (IB). 
 
The overpayment 
Having decided that Miss Kinder had capital over £16,000 which she should 
have declared and thereby had no entitlement to Jobseekers Allowance (IB), 
the Secretary of State’s next consideration was the resulting overpayment.  
 
The calculation was straightforward. All the Jobseekers Allowance paid  
to 
Miss Kinder was overpaid. Please see the Schedule at Annex A. 
 
The next question was whether the overpayment was recoverable from Miss 
Kinder. The law states that where any person, either fraudulently or otherwise, 
misrepresents, or fails to disclose, any material facts which results in an 
overpayment of benefit, the Secretary of State is entitled to recover the 
amount of the overpayment, providing the benefit award has been revised or 
superseded. 
Section 71 Social Security Administration Act 1992. 
 
The Secretary of State having revised the original decision on the basis that 
Miss Kinder had misrepresented her circumstances, decided that there had 
been an overpayment of Jobseekers Allowance (IB) and that this was 
recoverable. Further, that she was solely responsible for the overpayment 
occurring and it was therefore recoverable from her. 
 
It is accepted that Miss Kinder did not set out to deliberately mislead the 
Secretary of State. However, this does not save her from the effect of her 
misrepresentation. The law is plain and unambiguous and covers innocent as 
well as fraudulent misrepresentation. 
 
I request that the Tribunal dismiss the appeal.  
 
SCHEDULE: 
Period Benefit Weekly Amounts 
Period
 Benefi
 Weekly 
 
 
 
 
 

amount

From
To Week
Day
Paid Payabl
Overpaid Total 
 
 



31/08/
01/09/
0 2 
£54.65 
£00.00 
£54.65  £15.62 

---- ---- 
02/09/
10/11/
10 0 £54.65 
£00.00 
£54.65  £546.5
---- 
---- 

 
 
 
 
 
 
 
 
 
    
    Gross £562.1
Overpaymen 2 

 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
 
Example 8 - Employment and Support Allowance  – Claimant’s 
income exceeds the applicable amount 

Section 1: 
Personal Details: 
Mr John Deed                                
19 Denby Street                             
Wolverhampton                              
WV22 19QX 
National insurance number:           
National insurance number:                            ZZ100001D  
Benefit:                                                           ZZ100001D 
Date of outcome decision:                              15 February ---- 
Date decision notified: 
15 February ---- 
Date of mandatory reconsideration: 15 
February 
Date of appeal:                                               24 February ---- 
Decision maker’s name and address: 
 
Name and address of the decision maker’s   
representative (if any): 
Address where documents for the decision   
maker may be sent or delivered: 
Names and addresses of any other 
respondents and their representatives (if 
any): 
Section 2:  Schedule of evidence 
 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
 
 
Response 
Pages (-) 
(--/--/--) 
(--/--/--) 
The letter of appeal and supporting 
evidence 

Pages (-) 
(--/--/--) 
(--/--/--) 
Form MI 12 
Pages (-) 
(--/--/--) 
(--/--/--) Form 
A6 
Pages (-) 
(--/--/--) 
(--/--/--) 
Disablement details 
Pages (-) 
(--/--/--) 
(--/--/--) Disallowance 
decision 
Pages (-) 
(--/--/--) 
(--/--/--) 
Record of mandatory 
reconsideration / LT54 
Section 3: The decision under appeal 
 
Mr John Deed is not entitled to Income Support.  
 
Section 4: The facts of the case: 
Mr Deed claimed IS on 7 June ----. He was 55 and divorced. 
 
At the date of claim he was in receipt of ESA (contributory) of £66.15 and 
industrial injuries benefit of £24.02 per week; he also had an  occupational 
pension from Rolls Royce of £36.97 per week. 
 
He had re-mortgaged with Halifax PLC on 10 September 2003, when he 
borrowed £40,000; £30,000 was to buy the dwelling occupied as the home, 
the balance was spent as follows: 
  - £3,200 for a central heating system, he replaced old electric  
 
 
storage heaters with gas central heating; 
  £2,000 for a kitchen and bathroom upgrade – he later explained that the 
existing bath was cracked and the toilet leaked and that the cost of the 
bathroom including plumbing and installation was £1,000; the kitchen 
was an upgrade 
  £1,000 on wood flooring, the existing carpets were worn and were 
replaced with wooden flooring; 
  £1,400 to relocate his daughter and grand-daughter. 
 
The decision maker decided that interest was to be allowed only on the 
£30,000 to buy the dwelling occupied as the home and £1,000 for the 
bathroom work.  
 
On x date the decision was made that Mr Deed was not entitled to income 
support as his income exceeded his applicable amount – see page x 
 
On x date Mr Deed applied for a mandatory reconsideration. He explained 
that the re-mortgage was for improvements that were greatly needed to his 
home because of his disability and health. The decision maker acknowledged 
that the work was needed but nevertheless as the improvements made fell 
outside what was allowed by the regulations he refused the application  
 
Mr Deed appealed on x date. 
 
Section 5: The decision maker’s response 
The decision maker opposes the appellant’s case. 

 
The key issue in this appeal is whether the work done with the borrowed 
money falls within the definition of “loans for repairs and improvements to the 
dwelling occupied as the home” and can thereby qualify for help with the 
interest charges. 
 
In law "repairs and improvements" means major repairs necessary to maintain 
the fabric of the dwelling occupied as the home undertaken with a view to 
improving its fitness for occupation. It includes the following: 
  provision of a fixed bath, shower, wash basin, sink or lavatory, and 
necessary associated plumbing, including the provision of hot water 
not connected to a central heating system; 
  repairs to existing heating systems 
  damp proofing measures 
  provision of ventilation and natural lighting 
  provision or improvement of drainage facilities 
  provision of facilities for storing, preparing and cooking food 
  provision of insulation of the dwelling occupied as the home 
  provision of electric lighting and sockets 
  provision of storage facilities for fuel and refuse 
  repairs of unsafe structural defects 
  adapting a dwelling for the special needs of a disabled person, or 
  provision of separate sleeping accommodation for children of different 
sexes aged 10 or over who are part of the same family as the claimant, 
but under age 20. 
 
Paragraph 16 of Schedule 3 to the Income Support (General) 
Regulations 1987  
 
The decision maker agreed that the cost of the bathroom was covered. The 
kitchen costs were not allowed because they were deemed to be cosmetic – 
the kitchen functioned adequately for Mr Deeds’s needs. It was accepted that 
it may have needed modernising but of itself that does not bring the cost 
within the law. And the law does not allow for replacing carpet with wooden 
tiles; nor does it provide for giving gifts to relatives. 
 
The decision maker did consider whether the improvements could be 
considered as disability adaptations related to Mr Deeds’s industrial injury. 
However, he concluded that the level of Mr Deeds’s disablement at 14% did 
not support that being the reason for the expenditure. 
 
Accordingly help with interest was only given for £31,000 of the £40,000 loan. 
 
I request that the appeal is dismissed. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 

Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 9 -Universal Credit – New Partner 
Section 1:  
Personal Details 
Mrs A Atkinson 
90 Spring Avenue 
Town 
County 
Postcode 
National Insurance Number AA000000A 
Benefit Universal 
Credit 
Date of Outcome Decision 
10/07/2013 
 
Date Outcome Decision Notified 
10/07/2013 
 
Date of mandatory reconsideration 15/07/2013 
Date of Appeal 
24/07/2013` 
Decision Makers Name and Address 
Beth Smith 
Wigan 
Postcode 
Name and address of decision makers 
N/A 
representative (if any) 
Address where documents for the 
Wigan 
decision maker may be sent or 
Postcode 
delivered 
 
Name and addresses of any other 
N/A 
respondents and their representatives 
 
(if any) 
Name and address of Appointee (if 
N/A 
applicable) 
 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
18/07/2013  19/07/2013 
Letter of Appeal request and 
supporting evidence 
Pages (-) 
22/07/2013  23/07/2013 
HMCTS request for response 
Pages (-) 
03/05/2013  05/05/2013 
UC claim form 
Pages (-) 
10/05/2013  10/05/2013 
Declaration of claimant’s work 
search intention/activity.  
Pages (-) 
14/05/2013  14/05/2013 
New Claim initial decision 
Pages (-) 
03/07/2013  04/07/2013 
Change of circumstances letter 
 
Pages (-) 
10/07/2013  10/07/2013 
Disallowance outcome decision 
 
Pages ( 
15/07/2013  15/07/2013 
Record of mandatory 

Reconsideration request / LT54 
Pages ( 
17/07/2013  17/07/2013 
Record of explanation 
Section 3: The decision under appeal 
 
Mrs Atkinson is entitled to Universal Credit of £x per month.  
 
Section 4:  The facts of the case 
A claim from Mrs Atkinson for Universal Credit was received on 03/05/2013. 
(Not included) 
 
It was decided that Mrs Atkinson was entitled to Universal Credit from 
03/05/2013.  
 
Mrs Atkinson notified us on 08/07/2013 that she now had a partner and was 
working. 
 
A decision maker re-assessed her entitlement. A revised decision including 
these changes of circumstances was made on 10/07/2013. (Pages Nos 10-
12). Mrs Atkinson was notified of the outcome of this decision. 
 
Mrs Atkinson requested a mandatory reconsideration on 15/07/2013. (Page 
No 13) 
 
The Decision Maker telephoned Mrs Atkinson on 17/07/2013 to gather any 
further evidence and discuss the application. (Not included) 
 
The application was refused. The reasons for the mandatory reconsideration 
decision are included as pages Nos 14-16. 
Section 5:  The Decision Maker’s response 
The Decision Maker opposes the appellant’s case. 
 
It would be appropriate for the case to be disposed of without a hearing. 
 
Mr Maple has no recourse to public funds because he is not a GB citizen. 
Accordingly Mrs Atkinson can only be entitled to UC as single person.  
 
In deciding the level of her UC award Mr Maple is treated as a member of Mrs 
Atkinson’s household. Accordingly his capital of £10,000 must be taken into 
account. This means that a tariff income must be applied to £4,000 (the 
balance after the first £6,000 is disregarded).  
 
The law does not allow people with no recourse to public funds to receive 
benefits in this country, either as a claimant or as part of a couple. The capital 
in the household must be taken into account when calculating entitlement to 
Universal Credit.  
 
Universal Credit Regulations 3(3) (Couples), regulation 18 (Capital Limit)  
 

The regulations state that a person who is a member of a couple may make a 
claim as a single person if the other member of the couple does not meet the 
basic conditions. In a case where the claimant is a member of a couple, but 
makes a claim as a single person, the claimant’s capital is to be treated as 
including the capital of the other member of the couple. 
 
Universal Credit Main scheme regulation 3(3) Couples and regulation 18 
(Capital limit) 
 
Mrs Atkinson has her own income from her employment. In calculating her 
take home pay we deduct tax, national insurance and pension contributions. 
Fees for membership of a trade union are not an allowable expense.  
 
In disputing the decision, Mrs Atkinson accepts that her partner, Mr Maple, is 
not a GB citizen and has no recourse to public funds. However, she does not 
believe that Mr Maple’s capital of £10,000.00 should be taken into account 
when assessing her award of Universal Credit; it is simply unfair when he is 
not himself paid any Universal Credit. She also believes that her union fees 
should not be included in her take-home pay as they are an expense she 
would not have unless she was working. 
 
The regulations state how earned income is to be calculated and what is 
allowable as deductions are permitted. The regulations do not specify trade 
union membership fees as permissible deductions. 
Universal Credit Main scheme regulation 55 
 
On both issues the law is against Mrs Atkinson.  
 
I request that the appeal is dismissed. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 10 - Disablement benefit appeal – Disallowance of IIDB 
because an earlier assessment of disablement has not been 
increased 

Section 1: 
Personal Details 
Mr Jeremy Butcher 
15 Hazlebank Walk  
Leeds  
LS17 4HR 
National Insurance Number 
ZZ000001A 
Benefit 
Industrial injuries disablement 

benefit 
Date of Outcome Decision 
9 September ---- 
Date Outcome Decision Notified 
10 September ---- 
Date of mandatory reconsideration 
12 September ---- 
Date of Appeal 
16 September ---- 
Decision Makers Name and Address 
 
Name and address of decision makers 
 
representative (if any) 
Address where documents for the 
 
decision maker may be sent or 
delivered 
Name and addresses of any other 
 
respondents and their representatives 
(if any) 
Name and address of Appointee (if 
 
applicable) 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
[--/--/----] 
[--/--/----] Response 
Pages (-) 
[--/--/----] 
[--/--/----] 
The letter of appeal and supporting 
evidence 
Pages (-) 
[--/--/----] 
[--/--/----] Previous 
disability 
assessments 
Pages (-) 
[--/--/----] 
[--/--/----] Disallowance 
decision 
Pages (-) 
[--/--/----] 
[--/--/----] 
Record of Mandatory 
reconsideration / LT54 
 
Pages (-) 
[--/--/----] 
[--/--/----] 
Report from doctor 
Section 3: The decision under appeal 
 
Mr Butcher is not entitled to industrial injuries disablement benefit.  
 
Section 4: The facts of the case 
Jeremy Butcher is a 53 year old man who was working as a fitter on 7 
December 1982 when, in a pressurised room, the pressure rose quickly and 
damaged the hearing in his left ear. 
 
On 27 October 1989 he claimed Industrial Injuries Disablement Benefit  
as 
a result of that accident. 
 
The following assessments for the 1982 accident have been made in  
this 
Case: 
Date 
Assessment 
From - To 
Provisional/Final AMA/MAT/MA 
20.6.1990 2% 
10.12.1982 Final AMA 
- life 
07.8.1991 5% 
11.12.1990 Final 
MAT 

- life 
 
 
On 12.9.91 the Adjudication Officer decided Jeremy Butcher was not entitled 
to industrial injuries disablement benefit as the disablement was assessed at 
less than 14%. 
 
On 30 April ---- he applied for a supersession stating his hearing had 
deteriorated and the tinnitus had worsened since 989. He did not give a 
specific date from which his condition had changed. In support of his 
application he submitted a report from Dr Ward, a specialist in hyperbaric 
medicine dated 22.4.1997. [pages - ]. 
 
Following analysis of the audiometric test carried out on 23 July ----, he was 
examined by a medical adviser on 23 August ---- who reported that there had 
been no changes in the effects of the accident since the assessment of 7 
August 1991. [pages – ] 
 
On 9 September ---- after considering all the evidence and, in particular, the 
audiometric test of [--/--/----] and the report of the medical adviser dated [--/--/-
---], the decision maker decided that the assessment of 7 August 1991 should 
not be superseded as there had not been a relevant change of circumstances. 
The assessment of disablement remained at 5%.  
 
On x date Mr Butcher applied for a mandatory reconsideration. He said that 
as he is only 53 years his hearing should not have deteriorated to such a 
great extent, so the deterioration must be due to the 1982 accident. He 
provided no further medical evidence in support of his appeal. With no new 
evidence to consider the decision maker refused the application. 
 
Mr Butcher appealed against the decisions on 16 September - [pages ] 
 
 
Section 5 
The decision maker’s response: 
 
The decision maker opposes the appellant’s case. 
 It would be appropriate for the case to be disposed of without a hearing. 
 
The issue before the tribunal is whether or not there were grounds to 
supersede the decision of 7 August 1991 to give a 5% life assessment in 
respect of the industrial accident of 7 December 1982. And, if so, whether the 
extent of disablement is sufficient to award industrial injuries disablement 
benefit. 
 
Schedule 6 paras 6 & 7 of the Social Security Contributions and Benefits Act 
1992. 
 
The evidence provided by Mr Butcher in support of his application for a 
supersession on the grounds that his hearing had deteriorated, is a report 

from his specialist written in 1997. He presented no later evidence. 
 
The decision maker had before him the department’s analysis of an 
audiometric test carried out on 23 July and the results of a medical  services 
examination of 23 August.         
 
The department’s medical evidence did not suggest there had been any 
deterioration in Mr Butcher’s hearing. As this was up to date, the decision 
maker gave it more weight than the report provided by Mr Butcher and 
decided that there had been no deterioration in Mr Butcher’s hearing. 
Accordingly the grounds for supersession had not been shown.  
 
I request that the tribunal dismiss the appeal.  
 
Other matter 
 
If the tribunal find that there has been a relevant change of   circumstances it 
should identify what the change is and the date it occurred and determine the 
date from which the change takes effect. If the tribunal consider that the level 
of disablement is 14% or more it   needs to decide if that assessment should 
be  provisional or final 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 11 - Disability Living Allowance – disallowance of renewal 
claim 

Section 1: 
Personal Details 
Mr John Simpson                                
100 Milngavie Drive                             
Leeds                                                  
LS99 0AA 
National Insurance Number: 
ZZ000001A 
Date of birth at renewal:  
22 July ---- [note - the effective           
(Age 16) 
date of renewal in this case was the 
claimant’s 16th birthday] 
Recipient:                                                  Miss Doreen Astles 
Benefit: 
Disability living allowance 
Effective date of renewal: 
22 July ---- 
Date of outcome decision: 
3 July ---- 
Date decision notified: 
3 July ---- 
Date of mandatory reconsideration: 
    5 July ---- 
Date of appeal:                                          25 July ---- 

 
Decision maker’s name and address: 
 
Name and address of the decision 
maker’s representative (if any): 
Address where documents for the 
decision maker may be sent or 
delivered: 
Names and addresses of any other 
respondents and their representatives 
(if any): 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
[--/--/----] 
[--/--/----] 
Documents relating to previous 
award 
Pages (-) 
[--/--/----] 
[--/--/----] Response 
Pages (-) 
[--/--/----] 
[--/--/----] 
Appeal letter from Miss Astles and 
supporting evidence 
Pages (-) 
[--/--/----] 
[--/--/----] Renewal 
claim 
Pages (-) 
[--/--/----] 
[--/--/----] Renewal 
decision 
Pages (-) 
[--/--/----] 
[--/--/----] Renewal 
claim 
Pages (-) 
[--/--/----] 
[--/--/----] 
Medical report from hospital 
Pages (-) 
[--/--/----] 
[--/--/----] Notification 
of 
the 
decision made on 03/07/---- 
Pages (-) 
[--/--/----] 
[--/--/----] Screen 
prints 
Pages (-) 
[--/--/----] 
[--/--/----] 
Request for mandatory 
Reconsideration / LT54 
Pages (-) 
[--/--/----] 
[--/--/----] Notification of mandatory 
reconsideration decision made on 
01/09/---- 
Pages (-) 
[--/--/----] 
[--/--/----] Screen 
prints 
Section 3: The decision under appeal 
 
Mr Simpson is not entitled to Disability Living Allowance. 
 
Section 4: The facts of the case: 
Mr Simpson, who has ADHD, was awarded DLA on 28.4.X:  
  lower rate of the mobility component because he needed someone to 
guide or supervise him when he was walking on routes that were 
unfamiliar. 
  middle rate of the care component because he needed to be constantly 
supervised, with or without short breaks, right through the 
 
day, so that he did not cause substantial danger to himself or others. 
 
This award was due to end on x date. 
 
On 23.5 Mr Simpson made a renewal claim for disability living allowance – 

page… 
 
The decision maker obtained a medical report from Mr Simpson's consultant. 
(Page(s) [ - ]) 
 
On 3.7 the decision was made that Mr Simpson was not entitled to DLA. On 
the basis of the latest evidence it was decided that his condition had improved 
and the grounds on which he had previously been awarded DLA no longer 
applied; there were no other grounds supporting an award. 
 
On 4.7 Miss Astles, Mr Simpson’s mother, applied for a mandatory 
reconsideration. The decision maker explained to her that the decision had 
been made on the basis of the consultant’s report. This indicated that Mr 
Simpson no longer required help with using unfamiliar routes; that the 
supervision he required had reduced considerably to the point where that 
which he did need no longer qualified him for even the lowest rate of the care 
component. She explained that the report had been prepared by a trainee and 
that he had never met her son. He had seriously underplayed her son’s 
condition.  
 
The decision maker decided that the report was credible and was an accurate 
assessment of Mr Simpson’s condition and its effect, and refused the 
application. 
 
A letter of appeal from Miss Astles, was received on 25/07/----. (Pages [ - ]) 
 
Section 5: The decision maker’s response 
The decision maker opposes the appellant’s case 
 
Issues raised by the appeal: 
 
  Miss Astles says that the medical evidence from the consultant is not an 
accurate assessment of Mr Simpson’s mobility and care needs. It is 
alleged that a trainee provided the consultant’s report to DLA.  She 
feels this is unfair as no one should be able to write a report on 
someone they have not met.  
 
The consultant’s report indicates that: 
  there are no medical or physical problems from the history given by Mr 
Simpson and that he has no need for help with getting around. That he 
has had no exacerbations of his condition in the previous 6 months, 
when last seen by Dr ------, the senior consultant, on 19/06/----. 
  the effect of Mr Simpson’s condition on his ability self care is minimal.   
 
The decision maker concluded that Mr Simpson was able to manage his 
personal care, by day and night, in his own time. That he was not at risk of 
substantial danger if left alone for short periods; that there was no need for 
continual supervision by day or that he needed watching over at night to avoid 
substantial danger. Further that Mr Simpson should be able to plan and 

prepare a simple main meal for one in his own time. 
 
The decision maker considered whether the fact that the report had been 
prepared by someone other than the senior consultant himself, compromised 
its finding. However, he decided that DR X was suitably qualified to write the 
report – he would have had access to all of Mr Simpson’s medical history – 
and therefore he could accept it as an accurate assessment of Mr Simpson’s 
mobility and care needs. He was not persuaded by Miss Astle’s argument that 
the report was flawed because he had never met Mr Simpson.  
 
Accordingly, he made the decision that Mr Simpson was not entitled to DLA. 
 
The Tribunal is asked to dismiss the appeal. 
 
The law used in making this decision  
Mobility Component 
Higher rate conditions 
 
To be entitled to the higher rate of the mobility component of disability living 
allowance a person must: 
  be unable to walk or virtually unable to walk because of a physical 
disability. 
 
Social Security Contributions & Benefits Act 1992, section 73; 
Social Security (Disability Living Allowance) Regulations 1991, 
regulation 12 
 
Lower rate conditions 
To get lower rate of the mobility component of disability living allowance a 
person must be so severely disabled, physically or mentally that they need 
guidance or supervision from another person for most of the time when 
walking out of doors. Any ability a person has to walk on familiar routes 
without guidance or supervision is not taken into account. 
A person who is able to walk is not to be taken as satisfying the condition of 
being so severely disabled physically or mentally, that he cannot take 
advantage of the faculty out of doors, without guidance or supervision from 
another person most of the time, if he does not take advantage of the faculty 
in such circumstances because of fear and anxiety. 
 
The above paragraph shall not apply where the fear or anxiety is 
  a symptom of a mental disability; and 
  so severe as to prevent the person from taking advantage of the faculty 
in such circumstances. 
 
Social Security Contributions & Benefits Act 1992, section 73 (1)(d) 
Social Security (Disability Living Allowance) Regulation 1991 regs 12(7) 
and (8). 
 
Unable or virtually unable to walk 
 

People are considered to satisfy this criterion if their physical condition is such 
that: 
 
  they are unable to walk at all; or 
  their ability to walk out of doors is so limited, as regard the distance over 
which or the speed over which or the length of time for which or the 
manner in which they can make progress on foot without severe 
discomfort, that they are virtually unable to walk; or 
  the effort needed to walk would put their life at risk or be likely to lead to 
a serious deterioration in their health. 
 
Where a person lives or works, or the nature of the work they do cannot be 
taken into account. 
Social Security (Disability Living Allowance) Regulations 1991, 
regulation 12 
 
Virtually unable to walk 
Virtually unable to walk means unable to walk to any appreciable extent or 
practically unable to walk. The base point is total inability to walk. This is 
extended to take in people who can technically walk but only to an 
insignificant extent. 
Social Security Commissioner's decisions R (M) 1/78 and R (M) 1/91 
 
Danger to life or serious deterioration in health 
The exertion required to walk is the only consideration when deciding whether 
a person satisfies this condition. 
Any serious deterioration in health is where there was a worsening of the 
condition from which: 
  they would never recover; or 
  they would recover after a significant period of time, for example 12 
months; or 
  recovery could only be made after medical intervention. 
Social Security Commissioner's decisions R (M) 3/78 and R (M) 1/98 
 
Aids and appliances 
People cannot normally be treated as unable or virtually unable to walk if they 
can use an artificial limb or aid to help them walk unless they are without both 
legs. 
Social Security (Disability Living Allowance) Regulations 1991, 
regulation 12(4) 
 
Guidance 
Guidance may be physically leading or directing the person or by oral 
suggestion or persuasion. 
 
Supervision 
For the lower rate of the mobility component supervision can be: 
(i) when another person is monitoring the disabled person's physical or mental 
state for signs that some intervention may be needed to encourage the 
person to continue walking; or 

(ii) checking the route ahead for obstacles, dangers or places or situations 
which may upset the person. 
Coaxing, encouraging, persuading or providing distraction by way of 
conversation may come within the meaning of "supervision". 
 
Care Component 
Lowest rate conditions 
To get disability living allowance for help with personal care at the lowest rate 
a person must be so severely disabled physically or mentally that they: 
  need attention with bodily functions for a significant portion of the day; 
or 
  if aged over 16, are unable to prepare a cooked main meal. 
Social Security Contributions & Benefits Act 1992, section 72(1)(a) 
 
Day conditions 
To satisfy the day care conditions for disability living allowance for help with 
personal care a person must need from another person either: 
  frequent attention with bodily functions throughout the day; or 
  continual supervision throughout the day to avoid substantial danger to 
themselves or others. 
Social Security Contribution & Benefits Act 1992, section 72(1)(b) 
 
Night conditions 
To satisfy the night care conditions for disability living allowance for help with 
personal care a person must be so severely disabled physically or mentally 
that they need from another person either: 
  prolonged or repeated attention at night in connection with bodily 
functions; or 
  someone to be awake during the night for a prolonged period or at 
frequent intervals in order to avoid substantial danger to themselves or 
others. 
Note: there are special conditions for some people on renal dialysis. 
Social Security Contributions & Benefits Act 1992, section 72(1)(c) 
 
Significant portion 
The word "significant portion" should be given its ordinary meaning of not 
negligible or trivial. It refers only to the length of time a person requires 
attention. What amounts to a "significant portion of the day" depends largely 
on a person's individual circumstances. An hour may be considered 
reasonable in many cases. 
 
Bodily functions include such things as: 
 eating and drinking 
  washing and dressing 
  using the toilet 
Help with bodily functions does not normally include help with domestic 
duties, for example, shopping, cooking, or cleaning, but it could, for example, 
include help with laundry where this forms part of a continuous episode of 
attention of a personal and intimate nature in connection with a bodily 

function. 
Social Security Commissioner's decision R (A) 2/80 Appendix, Cockburn 
v Secretary of State for Social Security 
 
Attention is some personal service of an active nature, which is reasonably 
required in connection with bodily functions and is given in the physical 
presence of the severely disabled person. This can include help by means of 
the spoken word, for example, persuading a person to do something like 
eating, or warning a visually impaired person of danger outdoors. Attention to 
enable a disabled person to take part in a reasonable level of social activity 
can be included. 
Social Security Commissioner's decision R (A) 2/80 Appendix, Secretary 
of State for Social Security v Fairey 
Social Security (Disability Living Allowance) Regulations 1991, 
regulation 10C 
 
Unable to cook a main meal 
This is a hypothetical test of whether a person has the ability to perform the 
various tasks necessary to make a meal, if they had the ingredients. This 
includes the mental ability to plan a meal. It has nothing to do with a person’s 
actual domestic arrangements. 
Social Security Commissioner's decision R (DLA) 2/95 
 
Frequent throughout the day 
Frequent means several times, not once or twice. Attention must be required 
throughout the day. The ordinary definition of frequent is "occurring often or in 
close succession". Whether attention is given frequently depends on the 
length of time which passes between each spell of attention. A person cannot 
get the middle or highest rates of the care component of disability living 
allowance if the only help they need is with getting in and out of bed, or if they 
only need a little help when dressing and undressing in the morning and at 
night. 
Social Security Commissioner's decision R (A) 2/80 Appendix 
 
Continual means going on all the time, subject to brief interruptions only. 
Supervision means staying close to people in order to be able to prevent or 
deal with substantial danger. It often means having to stay in the same room. 
Just being on hand does not count as supervision unless someone needs to 
be there to prevent a serious accident or other danger that is likely to happen. 
People who are mentally competent should be expected to arrange for 
supervision when undertaking any potentially dangerous activity such as 
bathing and so would not necessarily need continual supervision. 
Social Security Commissioner's decision R (A) 1/88 Appendix and R (A) 5/90 
 
Substantial danger 
The phrase "substantial danger" should not be too narrowly construed. 
Substantial danger can result from a fall, exposure, neglect and in many other 
circumstances. 
The word "substantial" is left to discretion in each case. 
Social Security Commissioner's decision R (A) 1/73 

 
Watching over means that another person has to stay awake at frequent 
intervals or for a prolonged period during the night to be able to intervene and 
prevent or deal with substantial danger. It is not enough for the attendant to 
be asleep and ready to wake up and intervene when required. 
 
Prolonged and repeated means that someone must need help at night for 
more than a few minutes, or that it is needed several times. 'Prolonged' has 
been interpreted as meaning 20 minutes or more; 'repeated' as twice or more. 
Social Security Commissioner's decision R (A) 2/80 Appendix 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 12 - Attendance allowance – Disallowance of claim 
Section 1: 
Personal Details 
Mrs K Begum                                      
17 Horton Street                                  
Leeds                                                  
LS99 0AA 
National Insurance Number 
ZZ000001A 
Date of Birth:                                             5 August ---- 
Benefit Attendance 
allowance 
Date of claim: 
17 August ---- 
Date decision made:                                 1 November ---- 
Date decision notified: 
14 November ---- 
Date of mandatory reconsideration: 
18 November ---- 
Date of appeal:                                          4 March ---- 
Decision maker’s name and address: 
 
Name and address of the decision 
maker’s representative (if any): 
Address where documents for the 
decision maker may be sent or 
delivered: 
Names and addresses of any other 
respondents and their representatives 
(if any): 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
[--/--/----] 
[--/--/----] Response 
Pages (-) 
[--/--/----] 
[--/--/----] 
Appeal letter and supporting 

evidence 
 
Pages (-) 
[--/--/----] 
[--/--/----] 
New claim for attendance 
allowance 
Pages (-) 
[--/--/----] 
[--/--/----] 
Secretary of State’s 
certificate 
Pages (-) 
[--/--/----] 
[--/--/----] 
Medical report from GP 
Pages (-) 
[--/--/----] 
[--/--/----] 
Advice from Medical 
Services 
Pages (-) 
[--/--/----] 
[--/--/----] Disallowance 
decision 
Pages (-) 
[--/--/----] 
[--/--/----] 
Request for  Mandatory 
Reconsideration 
Pages (-) 
[--/--/----] 
[--/--/----] 
Record of mandatory 
reconsideration / LT54 
 
Section 3 : The decision under appeal 
 
Mrs Begum is not entitled to attendance allowance. 
 
Section 4: The facts of the case 
On 17/08/----Mrs Begum claimed attendance allowance. (Page(s) [ - ] ). The 
basis for her claim was that she suffered from joint pain, arthritis, shortness-of 
breath and chest pain. 
 
On 2/10/---- the Secretary of State issued a certificate. (Page(s) [ - ]) 
 
On 16/10/---- a medical report was completed by the appellant's GP. (Page(s) 
[ - ]) 
 
On 31/10/---- advice was obtained from the department’s Medical   Services. 
(Page(s) [ - ]). 
 
On 1/11/---- the claim was disallowed. It was notified to the appellant  
on 
14/11/- 
 
On 31/12/---- a late application for mandatory reconsideration was   received. 
The time for applying for revision was extended. (Page(s) 
 
On 26/01/---- the decision was reconsidered. Mrs Begum did not provide any 
new written evidence but clarified how her various medical problems affected 
her. The clarification of her condition not having told the decision maker 
anything new, and in the absence of new evidence, the application was 
refused. 
 
On 4/03/---- a letter of appeal was received. (Page(s) [ - ]) 
 
Section 5:  The decision maker’s response 
The decision maker opposes the appellant’s case.  

 
 
From the claim form submitted by Mrs Begum, supported by the report from 
her GP, it is apparent that Mrs Begum does have several medical conditions 
that are of relevance to the award of AA. 
 
Mrs Begum was on moderate medication for pain in her joints, but was not 
under specialist care or having physiotherapy. Mrs Begum said she suffered 
from incontinence but there is no medical evidence for this nor is she on 
medication. There is no medical evidence she is at risk of harm moving 
around her home and supervision is not required. She has some pain when 
so doing. She is fully able to self care both by day and night – not without 
some difficulty, but using appropriate aids as necessary. She is not prone to 
falls or stumbles and she is aware of common dangers.  
 
The advice from the department’s HCP said that she was able to self 
 
care; that she is not considered to be at serious risk of danger when 
 
left alone either day or night. 
 
No new evidence was presented at the mandatory reconsideration   stage. 
And the clarification Mrs Begum gave during that discussion did  
not 
change the value of the evidence already provided. 
 
The decision maker, whilst accepting that Mrs Begum’s medical problems did 
have an impact on her life, was not persuaded by her evidence when 
compared with that of the HCP. He concluded that she is able to self-care and 
thereby satisfy the conditions needed to be awarded AA.     
 
The Tribunal is requested to dismiss the appeal. 
 
The law used in making this decision  
Day conditions 
To satisfy the day care conditions for attendance allowance a person must be 
so severely disabled physically or mentally that they need either: 
  frequent attention with bodily functions throughout the day; or 
  continual supervision throughout the day to avoid substantial danger to 
themselves or others. 
Social Security Contribution & Benefits Act 1992, section 64(2) 
 
Night conditions 
To satisfy the night care conditions for attendance allowance a person must 
be so severely disabled physically or mentally that they need either: 
  prolonged or repeated attention at night in connection with bodily 
functions; or 
  someone to be awake during the night for a prolonged period or at 
frequent intervals in order to avoid substantial danger to themselves or 
others.  
Note: there are special conditions for some people on renal dialysis. 
Social Security Contributions & Benefits Act 1992, section 64(3) 
 

Bodily functions  
Include such things as: 
• eating and drinking 
• washing and dressing 
• using the toilet 
Help with bodily functions does not normally include help with domestic 
duties, for example, shopping, cooking, or, cleaning, but it could, for example, 
include help with laundry where this forms part of a continuous episode of 
attention of a personal and intimate nature in connection with a bodily 
function. 
Social Security Commissioner's decision R (A) 2/80 Appendix, Cockburn 
v Secretary of State for Social Security 
 
Attention  
Is some personal service of an active nature, which is reasonably required in 
connection with bodily functions and is given in the physical presence of the 
severely disabled person. This can include help by means of the spoken 
word, for example, persuading a person to do something like eating, or 
warning a visually impaired person of danger outdoors. Attention to enable a 
disabled person to take part in a reasonable level of social activity can be 
included. 
Social Security Commissioner's decision R (A) 2/80 Appendix, Security 
of State for Social Security v Fairey 
Social Security (Attendance Allowance) Regulations 1991, regulation 
8BA 
 
Frequent throughout the day 
Frequent means several times not once or twice. Attention must be required 
throughout the day. The ordinary definition of frequent is "occurring often or in 
close succession". Whether attention is given frequently depends on the 
length of time which passes between each spell of attention. A person cannot 
get attendance allowance if the only help they need is with getting in and out 
of bed, or if they only need a little help when dressing and undressing in the 
morning and at night. 
Social Security Commissioner's decision R (A) 2/80 Appendix 
 
Continual  
Means going on all the time, subject to brief interruptions only. 
 
Supervision  
Means staying close to people in order to be able to prevent or deal with 
substantial danger. It often means having to stay in the same room. Just 
being on hand does not count as supervision unless someone needs to be 
there to prevent a serious accident or other danger that is likely to happen. 
People who are mentally competent should be expected to arrange for 
supervision when undertaking any potentially dangerous activity such as 
bathing and so would not necessarily need continual supervision. 
Social Security Commissioner's decision R (A) 1/88 Appendix .and R (A) 
5/90 
 

Substantial danger 
The phrase "substantial danger" should not be too narrowly construed. 
Substantial danger can result from a fall, exposure, neglect and in many other 
circumstances.  
The word "substantial" is left to discretion in each case. 
Social Security Commissioner's decision R (A) 1/73 
 
Watching over  
Means that another person has to stay awake at frequent intervals or for a 
prolonged period during the night to be able to intervene and prevent or deal 
with substantial danger. It is not enough for the attendant to be asleep and 
ready to wake up and intervene when required. 
 
Prolonged and repeated  
Means that someone must need help at night for more than a few minutes, or 
that it is needed several times. 'Prolonged' has been interpreted as meaning 
20 minutes or more; 'repeated' as twice or more. 
Social Security Commissioner's decision R (A) 2/80 Appendix 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 13 - Carer’s Allowance  - Supersession of Award 
Section 1: 
Personal Details 
Lynne Green 
230 College Gardens 
New Malden 
Surrey 
KT3 6NT 
 
National Insurance Number AA000000C 
 
Benefit: Carer’s 
Allowance 
Date of outcome decision:   
 
Date of mandatory reconsideration: 
 
Date of appeal: 
 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s representative (if any): 
Address where documents for the 
 
decision maker may be sent or 
delivered: 
Names and addresses of any other 
 
respondents and their representatives 

(if any): 
 
The overpayment decision has been 
 
revised and as it is disadvantageous 
then the appeal does not lapse but now 
continues against this revised decision 
The reasons for the late appeal have 
 
been accepted by the Secretary of 
State.  Accordingly, the issue does not 
need to be considered by the tribunal. 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
[--/--/----] 
[--/--/----] Form 
GL24 
Pages (-) 
[--/--/----] 
[--/--/----] 
Extract from claim form 
Pages (-) 
[--/--/----] 
[--/--/----] 
Decision awarding CA 
Pages (-) 
[--/--/----] 
[--/--/----] Notification 
of start of employment 
Pages (-) 
[--/--/----] 
[--/--/----] DS1008X 
Pages (-) 
[--/--/----] 
[--/--/----] 
Record of notification from HMRC   
Pages (-) 
[--/--/----] 
[--/--/----] DS788X 
and earnings breakdown 
Pages (-) 
[--/--/----] 
[--/--/----] 
 Earnings schedule 
Pages (-) 
[--/--/----] 
[--/--/----] 
Disallowance decision (One of the 
decisions under appeal.) 
Pages (-) 
[--/--/----] 
[--/--/----] 
Prints of CA payments 
Pages (-) 
[--/--/----] 
[--/--/----] Original overpayment decision 
Pages (-) 
[--/--/----] 
[--/--/----] Revised 
overpayment decision 
Pages (-) 
[--/--/----] 
[--/--/----] 
Request for reconsideration 
Pages (-) 
[--/--/----] 
[--/--/----] Mandatory 
reconsideration decision  
/ LT54  
Pages (-) 
[--/--/----] 
[--/--/----] Overpayment 
Schedule 
Pages (-) 
[--/--/----] 
[--/--/----] Example 
of 
up-rating notifications 
Section 3: The Decision under appeal 
 
Mrs Rose has been overpaid CA, as per the attached Schedule, and that this 
is recoverable.  
 
Section 4: The facts of the Case 
 
Carer’s Allowance (CA) was awarded to Lynne Rose from and including 
04.06.01 because she was caring for Hannah Rose. 
 
On 31.12.06 Mrs Rose notified the CA unit that she had started work (pages ). 
Information obtained from her employer, Sainsbury’s, revealed that her 
earnings were below the statutory earnings limit, which at that time was 
£84.00 a week (pages ). The award of CA therefore was not affected by this 
change and payment of CA continued.  
 

On 26.05.12  the CA Unit received notification from Her Majesty’s Revenue & 
Customs (HMRC) national insurance recording system that in the in the 
2010/2011 tax year Mrs Rose had gross earnings of £5884.00 page. 
 
Further enquiries regarding the employment were made of Mrs Rose  (pages -
-----). She confirmed that she had been employed by Sainsbury’s since 
27.11.06, and earned £451.20 4 weekly. At this point all further payments of 
CA were suspended as there was now a doubt about her continuing 
entitlement.  
 
Further information supplied by Sainsbury confirmed that Mrs Rose’s 4 weekly 
earnings were on many occasions over the earnings limit. 
 
The decision made on 4.6.01 was superseded on the grounds of a  change of 
circumstances, namely that Mrs Rose’s earnings had  increased. Effectively 
the decision maker made a series of closed period supersessions to disallow 
CA for the following periods:   
 
05.02.07 to 16.08.09  
14.09.09 to 31.01.10  
01.03.10 to 31.01.11  
 
7.On 14.08.12, the Decision Maker further decided that the overpaid CA for 
the above periods, amounting to £10,241.95, was recoverable from Mrs Rose 
because she failed to disclose the changes in her earnings.  
 
8.On x date she applied for a mandatory reconsideration. Her ground was that 
the calculations are based on her monthly income when she believes her 
weekly income to be less than that amount for a significant period. The 
decision maker explained how the calculation was done but agreed to look at 
it again. Having done so he did not change the amount. The application was 
refused. 
 
9.A letter of appeal was received from Mrs Rose on 10.10.12. Although 
received late by HMCTS the Secretary of State has not objected to it being 
admitted. 
 
10.A decision maker looked at again at the calculation and revised the 
decision. The revised decision, see page x, was that Mrs Rose had been 
overpaid £x – more than the original decision. As this was not advantageous 
to her the appeal did not lapse. The decision was notified to Mrs Rose. She 
has made no further representations. The appeal is therefore against the 
original decision as revised.  
 
Section 5:  The decision maker’s response 
The decision maker opposes the appellant’s case. 
 
It would be appropriate for the case to be disposed of without a hearing.  
 

The only issue in this appeal is whether the calculation of the overpayment is 
correct. 
 
Social Security Benefit (Computation of Earnings) Regulations 1996, 
regulation 6(2)(a), 8, 10,  
 
Mrs Rose does not dispute that she did not inform the Secretary of State of 
the increase in her earnings above the maximum amount allowed for 
someone in receipt of CA – as she was legally obliged to do.  
 
Instead, she contends that the method of calculation is wrong because the 
Secretary of State has used her monthly and not her weekly  earnings. 
 
Mrs Rose is paid 4 weekly and not monthly.  
 
The law provides how weekly earnings are to be calculated when a  person is 
not paid weekly:  
 
 

when a person is not paid weekly the Decision Maker will work 
out the weekly amount. When the earnings are paid 4 weekly, as in this case, 
the Decision Maker will multiply by 7 then divide the resultant figure by 28. 
 
The law provides when the amount of a claimant's net earnings fluctuates and 
has changed more than once, or a claimant's regular pattern of work is such 
that he does not work every week, the earnings may be averaged. 
 
In this case Mrs Rose’s net earnings have fluctuated and changed more than 
once. However the Decision Maker has decided not to average Mrs Rose’s 
earnings as to do so would be disadvantageous to her. The average weekly 
earnings are shown on the schedule and they are all in excess of the earnings 
limit. If the decision maker applied these then the overpayment would also 
include the period from 18.12.06 to10.06.12. 
 
Mrs Rose incurs care costs of £25.00 per day in respect of her 2 children. 
These care costs cannot be allowed because they are paid to Mrs Rose’s 
parents. The law states that care costs cannot be allowed as an expense if 
they are paid to a close relative of either the claimant or the disabled person. 
 
Finally, I say above that Mrs Rose had a legal obligation to tell the Secretary 
of State if her circumstances changed. When she first claimed CA she would 
have been told this in her decision notification; she would also have been 
made aware of the earnings limit for CA. When benefits are uprated each year 
the same messages are sent to claimants. There is no question of Mrs Rose 
being unaware of her responsibility to report the change in her earnings. 
 
Turning to the recoverability of the overpayment.  Failure to disclose a 
material fact can be fraudulent or otherwise. Whilst there is no evidence that 
there was any fraudulent intent in this case, nonetheless Mrs Rose did not let 
the CA Unit know straight away that her earnings had increased as she had 
been instructed to do.  

  
In decision R(SB) 21/82, the Commissioner stated that if an overpayment 
occurred as a consequence of a failure to disclose and that there was a clear 
causal link between the two, the overpayment would be recoverable, 
because, had the claimant disclosed the fact, there would have been no 
overpayment. 
 
I request that the tribunal dismiss the appeal. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries. It 
can be accessed online 
via the DWP's website at http://www.dwp.gov.uk/publications/specialist-
guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP's 
website at http://www.dwp.gov.uk/publications/specialist-guides/decisions-of-
the-commisioners 
 
Example 14 - Employment and Support Allowance  – Claimant fails 
Work Capability Assessment 

Section 1 
Personal Details 
Mr Dave Edmonds 
99 Piccadilly Way 
Dudley 
DY99 10ZZ 
National Insurance Number 
ZZ000001A 
Benefit: 
Employment and support allowance 
Date of outcome decision:   
24 March ---- 
Date decision notified: 
26 March ---- 
Date of mandatory reconsideration: 
2 April ---- 
Date of appeal: 
4 April ---- 
Decision maker’s name and address: 
 
Name and address of the decision 
 
maker’s 
representative (if any): 
Address where documents for the 
 
decision maker 
may be sent or delivered: 
Names and addresses of any other 
 
respondents 
and their representatives (if any): 
 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Pages (-) 
[--/--/----] 
[--/--/----] Response 

Pages (-) 
[--/--/----] 
[--/--/----] 
Letter of appeal and supporting 
evidence 
Pages (-) 
[--/--/----] 
[--/--/----] 
ESA 50 - questionnaire 
Pages (-) 
[--/--/----] 
[--/--/----] 
ESA 85 – medical report 
Pages (-) 
[--/--/----] 
[--/--/----] Scoresheet 
Pages (-) 
[--/--/----] 
[--/--/----] Disallowance 
decision 
Pages (-) 
[--/--/----] 
[--/--/----] 
Record of mandatory 
reconsideration call 
Pages (-) 
[--/--/----] 
[--/--/----] Mandatory 
reconsideration 
decision 
/ LT54 
Pages (-) 
[--/--/----] 
[--/--/----] 
Schedule 2 – descriptors for limited 
capability  for work 
Pages (-) 
[--/--/----] 
[--/--/----] 
Schedule 3 – descriptors for limited 
capability for work related activity 
Section 3: The decision under appeal 
 
Mr Edmonds is not entitled to ESA. 
 
Section 4: The facts of the case 
Mr Edmonds was born on 11 Sep 1961. He was awarded employment and 
support allowance from and including 07/01/---- on the basis that he was 
suffering from anxiety and depression. 
 
Mr Edmonds completed a questionnaire (form ESA50) on 02/02/----. Mr 
Edmonds indicated that he had no physical problems but did have mental 
health problems in the areas of memory and concentration, going out, coping 
with social situations and dealing with other people. (Pages [ - ].) 
 
On 13/03/---- Mr Edmonds underwent his WCA. The health care rofessional’s 
report (form ESA85), indicated that he had no physical problems but did have 
limitations going out as he needed to be  accompanied. (Pages [- ].) 
 
The decision maker carried out an assessment of Mr Edmonds’s  
capability 
for work taking all the available evidence into account – in this case this was 
only the HCP’s report. He decided that he scored 0points for the physical 
descriptors and 6 points for the mental descriptors.   
 
As Mr Edmond’s had not reached the necessary threshold required  for an 
award of ESA, that is, 15 points, on 24.3 the decision was made to supersede 
the original award and terminate Mr Edmond’s ESA –  effective from 24.3. 
 
Mr Edmonds applied for mandatory reconsideration by telephone stating that 
he disputed the decision. He was telephoned on 27/03/---- Mr Edmonds was 
asked if he had any further information and he  explained that his low 
confidence means that he feels unable to meet or talk to people and that he 
cannot cope with change. He did not feel that this was reflected in his 
WCA.(Pages [ - ]) 
 

The decision of 24/03/---- was reconsidered but not revised. (Pages [ -  
].) 
 
Mr Edmonds appealed. 
 
Section 5 :  The decision maker’s response 
The decision maker opposes the appellant’s case. 
 
It would be appropriate for the case to be disposed of without a hearing. 
 
1On 13/03/---- Mr Dave Edmonds was examined by a healthcare professional 
in connection with the work capability assessment. 
 
The decision maker considered the healthcare professional’s report and the 
other available evidence and decided that Mr Edmonds scored 0 points for the 
physical descriptors. This is not disputed.  
 
The decision maker also decided that Mr Edmonds scored 6 points for the 
mental descriptors. As he had not reached the 15 points threshold   his ESA 
award terminated on supersession. 
 
Welfare Reform Act 2007, sections 1, 2, Part 1 Schedule 1 (ESA C) 
 
Social Security (Employment & Support Allowance) Regulations 2008, reg 19, 
20, 25, 26, 29 & 30. 
 
The Social Security and Child Support (Decisions and Appeals) Regulations 
1999, regulation 6(2)(r) 
 
He has disputed the decision as he thinks he should have scored points for 
several other mental health activities: 
 
  he has very low concentration and confidence;    
  doesn’t feel like meeting or talking to people as his behaviour causes 
problems with himself and others;  
 
 
 
However, against this, is the information provided in the ESA50 and the 
 
HCP report. These indicate that Mr Edmonds: 
 
  has no problems with dressing, in the bathroom, maintaining  safety  in 
the bathroom. He is usually able to make meals for himself, do 
housework and tidy up.  
  feels comfortable in his flat, prefers to watch sport, nature programmes 
and documentaries on the television and also reads and does 
crosswords.  
  does not experience panic attacks, has no history of disruptive 
behaviour and enjoys visits from his family.  
  does not socialise outside the home but on a good day he uses the bus 
to go to the town centre to shop and pay bills. Other days he has to be 
accompanied or get someone else to do things. 

 
In the HCP’s opinion Mr Edmonds:  
 
  did have limitations going out as he frequently needs to be 
accompanied to places even with which he is familiar.  
 
  anxiety and depression was mild. He was reinforced in this view by the 
fact that Mr Edmond had not seen a specialist and the medication he 
used was low strength. 
 
5.The decision maker decided that the weight of the evidence was against Mr 
Edmonds. He accepted that he had limitations going out, hence the six points, 
but none of the other symptoms were such that they reached the necessary 
threshold for the relevant descriptors. Nothing discussed at the mandatory 
reconsideration stage shifted him from this view. 
 
In his letter of appeal Mr Edmonds reiterated that he had problems with 
memory and concentration, coping with change, coping with social situations, 
behaviour with other people, getting on with other people; his anxiety and 
depression he has meant he had very low confidence and doesn’t feel like 
meeting or talking to people. He   has also provided a medical certificate from 
his GP, dated 15.4.09,advising he should refrain from work for 8 weeks due to 
depression. (Pages [ - ]) 
 
The decision maker did not believe that there was anything new in   what was 
said; and was not persuaded that the medical certificate required that the 
original diagnosis in relation to the claimant’s depression should be increased 
from mild.  
 
I request that the tribunal dismiss the appeal. 
 
Other matter 
 
9.Should the tribunal decide that Mr Edmonds does have limited capability for 
work; I respectfully request that they decide whether or not Mr Edmonds has 
limited capability for work-related activity. 
 
If they determine that there is insufficient evidence, for example where there 
are no direct equivalent descriptors in the limited capability for work related 
activity schedule and insufficient evidence in the customer’s papers for a 
decision to be made, the tribunal is requested   to refer the case to the 
decision maker for determination. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 

 
Example 15 - Personal Independence Payment: No entitlement 
Section 1:  
Appeal Tribunal Reference Number 
SC222/22/2222 
Personal Details 
Mrs J. Clarke   
18 Rose Street  
Wolverhampton 
WX12  9RE 
Name and addresses of any other 
N/A 
respondents and their representatives 
(if any) 
Name and address of Appointee (if 
N/A 
applicable) 
Date of Birth 
xx/xx/xxxx 
National Insurance Number 
VO123456D 
Benefit 
Personal Independence Paymen 
Date of Outcome Decision 
23/05/13 
Date Outcome Decision Notified 
24/05/2013 
Date of Mandatory Reconsideration 
02/07/2013 
Decision 
 
Date Mandatory Reconsideration 
03/07/2013 
Notified 
Date of Appeal Request 09/07/2013 
Decision Makers Name 
Xxxx 
Address where documents for the 
St Martins House 
Decision Maker may be sent or 
Bootle BC 
delivered. 
Stanley Precinct 
Bootle 
Liverpool 
L69 9BN 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
-- 
15/07/2013  N/A 
DWP Appeal  response 
1 08/07/2013 
09/07/2013 Appeal 
request 
2 10/07/2013 
11/07/2103 
HMCTS request for Appeal 
response 
3-36 01/05/2013 
03/05/2013 
"How 
your disability affects you" 
(PIP2) form 
 
37 06/03/2013 
03/05/2013 
Consultant Anaesthetist Pain 
Management Service report   
38 11/03/2013 
03/05/2013 Clinical 
Matron report   
39 14/01/2013 
03/05/2013 
Consultant Occupational Health 
Physician report 
40 -46 
14/05/2013  15/05/2013 
Health Professional consultation  
report 

47-51 23/05/2013 
 
New 
Claim 
decision and notification 
52-53 17/06/2013 
18/06/2013 Mandatory 
Reconsideration 
request 
54 19/04/2013 
18/06/2013 
Letter 
from Consultant Spinal Neuro 
Surgeon 
55 undated 
18/06/2013 
Letter 
from 
GP 
56 undated 
18/06/2013 
List 
of medical contacts 
57-58 27/06/2013 
28/06/2013 
Supplementary Health Professional 
(HP) Advice note 
59-60 02/07/2013 
 
Mandatory Reconsideration 
decision and notification 
 
(LDO note: 3 versions to 
demonstrate the potential 
notification)  
Section 3: The decision under appeal 
 
Mrs Clarke is not entitled to Personal Independence Payment.  
 
Section 4: The facts of the case 
Mrs Clarke has an going back condition and is awaiting surgery.  
 
A valid claim for Personal Independence Payment was accepted by phone on 
18/04/2013. 
 
A "How your disability affects you" PIP2 form was received on 03/05/2013. 
Mrs Clarke indicated she needs help cooking, washing and bathing and 
dressing and undressing. She sometimes finds it difficult to mix with others 
due to distress and her walking ability is varied  (Pages 3 - 36) 
 
A Consultant Anaesthetist Pain Management Service report was received on 
03/05/2013 (Page 37)    
 
A Clinical Matron report was received on 03/05/2013 (Page 38)    
 
A Consultant Occupational Health Physician report was received on 
03/05/2013 (Page 39)    
 
During the consultation all the evidence provided was considered and the 
Health Professional recommended that Mrs Clarke needs to use an aid or 
appliance to be able to prepare or cook a simple meal and needs assistance 
from another person to get in and out of a bath or shower and assistance from 
another person to dress and undress her lower body. Mrs Clarke can stand 
and then move more than 50 metres but no more than 200 metres.   
 
The Decision Maker considered Mrs Clarke’s claim of the 18/04/2013 and 
decided that although Mrs Clarke has been awarded 7 points for daily living 
and 4 points for the mobility component she does not satisfy the disability 
threshold criteria.  

 
The Disability Threshold Criteria is the minimum number of points someone 
must score to be awarded Personal Independence Payment. Where a total of 
between 8 to 11 points is scored for either Daily Living component or the 
Mobility component the person will be awarded each component of Personal 
Independence Payment at the standard rate. Where a total of 12 points or 
more is scored for either Daily Living component or the Mobility component 
the person will be awarded each component of Personal Independence 
Payment at the enhanced rate.  
 
Therefore Mrs Clarke was not entitled to Personal Independence Payment 
from 18/04/13. The reasons for the decision are included in the decision letter 
dated 23/05/2013. (Pages 47-51) 
 
The Decision Maker made 3 unsuccessful attempts to telephone Mrs Clarke 
to explain the decision, once on 23/05/2013, and twice on 05/06/2013.  
 
A telephone call with Mrs Clarke took place on 07/06/2013. During this call 
Mrs Clarke stated that she has received a letter from her Consultant dated 
24/04/2013 giving a specific diagnosis of her conditions. She stated that her 
medications have increased. She also stated that the decision based on her 
needs at the time was understandable, but her needs increased on 
20/05/2013 when her injection started to wear off. She has been told she 
needs to consider a spinal operation but is afraid of this. Following this 
conversation Mrs Clarke wrote in requesting a mandatory Reconsideration on 
18/06/2013 (page 54-57).  
 
A Letter from the Consultant Spinal Neuro Surgeon was received from Mrs 
Clarke on 18/06/2013 (page no 58). 
 
A Letter from her GP was received from Mrs Clarke on 18/06/2013 (page no 
59).   
 
A list of medical contacts was received from Mrs Clarke on 18/06/2013 (page 
no 60).   
 
On receipt of the further evidence submitted with the mandatory 
reconsideration request, the Decision Maker referred the case to the Health 
Professional.  
 
The supplementary advice provided by the Health Professional on 28/06/2013 
was that the evidence did not support any change to his previous 
recommendations (Pages 61 – 62) 
 
On 02/07//13 the Decision Maker reconsidered the original decision but was 
unable to change the decision  (Pages 65 -66)  
 
On 09/07/13 Mrs Clarke lodged an appeal against the decision that she is not 
entitled to Personal Independence on the grounds that she does not agree 
with the Decision Maker’s decision as her ability to manage simple every days 

tasks were and are becoming more difficult. She stated this occurred between 
making the Personal Independence Payment claim and a decision being 
reached. (Page 1) 
 
Section 5: The Decision Maker’s response 
I oppose this appeal for the following reasons. 
 
Personal Independence Payment is intended to help towards some of the 
extra costs arising from ill-health or disability. It is based on how a person’s 
condition affects them, not the condition they have. There are two 
components of Personal Independence Payment  – Daily Living and Mobility. 
Each component can be paid at standard rate, or enhanced rate for those with 
the greatest needs.  
 
The decision was made in accordance with the Welfare Reform Act 2013 
Part 4 Social Security (Personal Independence Payment) Regulations 
2013 
 
Entitlement to Personal Independence Payment is determined by an 
assessment of the individual’s needs by a health professional to consider the 
ability to carry out certain activities.– the Table below list the activities which 
are considered. Points can be awarded for each of these activities.  A 
claimant must score a minimum of 8 points for either the Daily Living or 
Mobility components to quality for a standard rate award of either Daily Living 
or Mobility; and a minimum of 12 points to quality for higher rate.  
 
The specific legislation for the areas under dispute is the Social Security 
(Personal Independence Payment) Regulations 2013, Regulation 4 
(assessment) and Regulations 5, 6 (scoring), and Schedule 1 (list of 
descriptors against the set of activities for Daily Living and Mobility) 
 
Mrs Clarke is a 54 year old lady. She has an on going back condition and 
sciatica and is awaiting surgery. Mrs Clarke attends a Consultant Anaesthetist 
Pain Management Service and sees a Clinical Matron and a Consultant 
Occupational Health Physician. She takes strong medication for her pain. 
 
Mrs Clarke declared in writing that she suffers with pain in her back which is 
continually getting worse. Her condition and treatment are not in dispute. 
 
When submitting her "How your disability affects you" PIP2 form Mrs Clarke 
did not claim any needs relating to eating and drinking, managing treatments, 
managing toilet needs, communicating, reading and understanding, and 
making budgeting decisions. Accordingly no points have been awarded under 
these activities 
 
 
In the PIP2 she said she needed help sometimes to be able to prepare or 
cook a simple meal. She relies on family members to help with this on bad 
days when standing is difficult. The Decision Maker has accepted that Mrs 

Clarke can prepare or cook a simple meal with the use of an aid and has 
awarded 2 points for this activity. 
 
Mrs Clarke stated that she requires supervision and help to get in and out of 
the bath or the shower. The Decision Maker has accepted that Mrs Clarke 
would require assistance to get in and out of the bath or the shower and has 
awarded 3 points for this activity.   
 
Mrs Clarke stated that she needs help to dress and undress her lower body. 
The Decision Maker has accepted that Mrs Clarke would require assistance 
with dressing and undressing her lower body and has awarded 2 points for 
this activity 
 
Mrs Clarke stated that sometimes she finds it difficult to mix with others 
because of severe anxiety or distress. During the consultation Mrs Clarke was 
able to engage with the Health Professional and although her physical 
condition could make her feel self conscious she has no cognitive impairment 
or mental health issues which would restrict her ability to engage with other 
people unaided. The Decision Maker has accepted that Mrs Clarke can 
engage with other people unaided and has not therefore awarded any points 
for this activity.    
 
Mrs Clarke stated that she needs help to go out due to severe anxiety and 
distress. The Decision Maker has accepted that whilst Mrs Clarke’s physical 
symptoms could make her feel self conscious she is however able to socialise 
and has no mental health problems that would prevent her from being able to 
make and plan a journey unaided and has not therefore awarded any points 
for this activity.    
 
Mrs Clarke states in the PIP2 that the distance she can walk varies. On good 
days her walking is limited and she had fallen once. On bad days she feels so 
unsafe she does not go out at all. She stated that it takes her up to 20 to 30 
mins to undertake a short walk which used to take only 10 mins  The Decision 
Maker has accepted that due to severe pain and the effects of her pain control 
Mrs can stand and then move more than 50 meters but no more than 200 
metres, either aided or unaided  and has awarded 4 points for this activity       
 
In her appeal letter Mrs Clarke stated that her condition has deteriorated since 
her claim due to the fact she requires additional injections. Her pain level has 
increased and she has had another fall. Her increased medication affects her 
ability to function safely. She states she now finds it difficult to get out of a bed 
or chair and getting to the bathroom and to manage her lower clothing when 
using the toilet. Her condition varies from day to day. 
 
She also supplied supporting evidence from her Consultant Spinal 
Neurosurgeon which confirms her condition and suggests the need for spinal 
surgery and a letter from the Clinical Matron confirming her treatment.  
 
The Decision Maker considered all the new evidence supplied but did not 
consider that this supported any change in the points scored. 

 
Mrs Clarke has been awarded 7 points for the daily living component and 4 
points for the mobility component. Because she did not meet the disability 
threshold of 8 points for either the Daily Living or Mobility components she is 
not entitled to Personal Independence Payment.   
 
The assessment criteria cover 10 Daily Living and 2 Mobility activities. These 
activities give an overall picture of an individual's daily living and mobility 
needs. While I recognise you may have other needs, if these aren't covered 
by the assessment criteria, they can't be considered in deciding if you're 
eligible for benefit. 
 
Conclusion 
 
The Tribunal is asked to dismiss this appeal and confirm the Secretary of 
State’s decision. 
 
The descriptors and points awarded for each activity are in bold and 
underlined in the table below. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Daily Living Activities 
Activity 1 – Preparing food 
1A 
I‘ve decided you can prepare and cook a simple meal unaided. 

1B 
I‘ve decided you need an aid or appliance to prepare or cook a 

simple meal. 
1C 
I’ve decided you can’t cook a simple meal using a conventional 

cooker but you can do so using a microwave 
1D 
I’ve decided you need prompting from another person to 

prepare or cook a simple meal. 
1E 
I’ve decided you need supervision or assistance from another 

person to prepare or cook a simple meal. 
1F 
1F 
I’ve decided you can’t prepare and cook food. 

Activity 2 – Taking nutrition 
2A 
I’ve decided you can eat and drink unaided. 

2B 
I’ve decided you need an aid or appliance, or supervision from 

another person to eat and drink, or you need assistance from 
another person to cut up food. 
2C 
I’ve decided you need a therapeutic source to be able to take 

nutrition. 
2D 
I’ve decided you need prompting from another person to eat 


and drink. 
2E 
I’ve decided you need assistance from another person to 

manage a therapeutic source that enables you to take nutrition. 
2F 
I’ve decided you need another person to get food and drink to 
10 
your mouth. 
Activity 3 - Managing therapy or monitoring a health condition 
3A 
I’ve decided you can either manage medication / therapy or 

monitor your health condition unaided, or you don’t need to. 
3B 
I’ve decided you either need an aid or appliance to manage 

your medication, or you need supervision, prompting or 
assistance from another person to manage your medication or 
monitor your health condition. 
3C 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes no more than 3.5 hours a week. 
3D 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 3.5 hours a week but no more than 7 
hours. 
3E 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 7 hours a week but no more than 14 
hours. 
3F 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 14 hours a week. 
Activity 4 – Washing and bathing 
4A 
I’ve decided you can wash and bathe unaided. 

4B 
I’ve decided you need an aid or appliance to wash or bathe. 

4C 
I’ve decided you need supervision or prompting from another 

person to wash or bathe. 
4D 
I’ve decided you need assistance from another person to wash 

either your hair or your body below the waist. 
4E 
I’ve decided you need assistance from another person to be 

able to get in or out of a bath or shower. 
4F 
I’ve decided you need assistance from another person to wash 

your body between the shoulders and waist. 
4G 
I’ve decided you can’t wash and bathe at all and need someone  8 
else to wash your entire body. 
Activity 5 – Managing toilet needs or incontinence 
5A 
I’ve decided you can manage your toilet needs or incontinence 

unaided. 
5B 
I’ve decided you need an aid or appliance to manage your toilet  2 
needs or incontinence. 
5C 
I’ve decided you need supervision or prompting from another 

person to manage your toilet needs. 
 
5D 
I’ve decided you need assistance from another person to 


manage your toilet needs.   
5E 
I’ve decided you need assistance from another person to 

manage your bladder or bowel incontinence. 
5F 
I’ve decided you need assistance from another person to 

manage your bladder and bowel incontinence. 
Activity 6 – Dressing and undressing 
6A 
I’ve decided you can dress and undress unaided. 

6B 
I’ve decided you need to use an aid or appliance to dress and 

undress. 
6C 
I’ve decided you either need another person to tell you to get 

dressed or undressed, how to do it or when to keep your 
clothes on, or that you need prompting or assistance to select 
appropriate clothing. 
6D 
I’ve decided you need assistance from another person to dress 

or undress your lower body. 
 
6E 
I’ve decided you need assistance from another person to dress 

or undress your upper body. 
6F 
I’ve decided you can’t dress or undress at all. 

Activity 7 - Communicating verbally 
7A 
I’ve decided you can express and understand verbal 

information unaided. 
7B 
I’ve decided you need an aid or appliance to be able to speak 

or hear. 
7C 
I’ve decided you can express and understand complex verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7D 
I’ve decided you can express and understand basic verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7E 
I’ve decided you cannot express or understand verbal 
12 
information at all, even with help from someone who is trained 
or experienced in helping people to communicate. 
Activity 8 – Reading and understanding signs, symbols and words 
8A 
I’ve decided you can read and understand basic and complex 

written information either unaided or using glasses or contact 
lenses. 
8B 
I’ve decided you need an aid or appliance, other than glasses 

or contact lenses, to read or understand either basic or complex 
written information. 
8C 
I’ve decided you need prompting from another person to read or  2 
understand complex written information.  
8D 
I’ve decided you need prompting from another person to read or  4 
understand basic written information. 
8E 
I’ve decided you can’t read or understand signs, symbols and 

words at all.   
Activity 9 – Engaging with other people face to face 
9A 
I’ve decided you can engage with other people unaided. 


9B 
I’ve decided you need to be prompted by another person to 

engage with other people. 
9C 
I’ve decided you can only engage with other people with 

support from someone who is trained or experienced in helping 
people to engage in social situations. 
9D 
I’ve decided you can’t engage with other people at all because 

doing so would cause you significant mental distress or you are 
likely to behave in a way which could harm you or another 
person. 
Activity 10 - Making budgeting decisions 
10A  I’ve decided you can make complex budgeting decisions 

unaided. 
10B  I’ve decided you need prompting or assistance from another 

person to make complex budgeting decisions. 
10C  I’ve decided you can make simple budgeting decisions with 

prompting or assistance from another person. 
10D  I’ve decided you can’t make any budgeting decisions at all. 

Mobility Activities 
Activity 11 – Planning and following a journey 
11A  I’ve decided you can plan and follow the route of a journey 

unaided.  
11B  I’ve decided you need prompting from another person to 

undertake a journey to avoid causing you significant mental 
distress. 
11C  I’ve decided you can’t plan the route of a journey. 

11D  I’ve decided you can follow the route of an unfamiliar journey 
10 
with help from another person, assistance dog or orientation 
 
aid. 
11E  I’ve decided you can’t undertake any journey because it would 
10 
cause you significant mental distress. 
 
11F  I’ve decided you can’t follow the route of a familiar journey 
12 
without another person, assistance dog or orientation aid. 
Activity 12 – Moving around 
12A  I’ve decided you can stand and then move more than 200 

metres, either aided or unaided. 
12B  I’ve decided you can stand and then move more than 50 metres  4 
but no more than 200 metres, either aided or unaided. 
12C  I’ve decided you can stand and then move unaided more than 

20 metres but no more than 50 metres.   
12D  I’ve decided you can stand and then move using an aid or 
10 
appliance more than 20 metres but no more than 50 metres. 
12E  I’ve decided you can stand and then move more than 1 metre 
12 
but no more than 20 metres, either aided or unaided.   
12F
I’ve decided you can stand and then move more than 1 metre 
12 
 
  but no more than 20 metres, either aided or unaided.   

Example 16 - Personal Independence Payment – No Entitlement 
Section 1:  
Appeal Tribunal Reference Number 
SC111/11/11111 
Personal Details 
Mrs Marharet Dali 
18 Reed Street  
Wolverhampton 
WX13 7ER 
Name and addresses of any other 
 
respondents and their representatives 
(if any) 
Name and address of Appointee (if 
N/A 
applicable) 
Date of Birth 
12/05/1949 
National Insurance Number 
MD158761B 
Benefit 
Personal Independence Payment 
Date of Outcome Decision 
03/07/2013 
Date Outcome Decision Notified 
04/07/2013 
Date of Mandatory Reconsideration 
02/08/2013 
Decision 
Date Mandatory Reconsideration 
06/09/2013 
Notified 
Date of Appeal Request 14/09/2013 
 
Decision Makers Name 
XXXX 
 
Address where documents for the 
St Martins House 
Decision Maker may be sent or 
Bootle BC 
delivered. 
Stanley Precinct 
Bootle 
Liverpool 
L69 9BN 
Section 2: Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
-- 
21/09/2013  N/A 
DWP Appeal Response 
1 14/09/2013 
14/09/2013 Appeal 
request 
2 15/09/2013 
16/09/2013 
HMCTS request for Appeal 
Response (DL6) 
3 - 31 
10/04/2013  11/04/2013 
"How your disability affects you" 
(PIP2) form 
32 – 51 
18/04/2013
19/04/2013 Health 
Professional consultation 
 
 
report 
52   
03/07/2013   
New Claim decision and notification 
 
53 02/08/2013 
03/08/2013 
Mandatory Reconsideration request 
54 
10/08/2013  11/08/2013 
GP Supporting letter 
 
55 – 58 
21/08/2013  21/08/2013 
Supplementary Consultation Report 

59 06/09/2013 
 
Mandatory Reconsideration 
decision and notification 
Section 3: The decision under appeal 
 
Mrs Dali is not entitled to Personal Independence Payment  
 
Section 4: The facts of the case 
Mrs Dali lives with her family and has suffered from Diabetes Mellitus and 
hypertension for approximately 3 years. 
 
A valid claim for Personal Independence Payment was accepted by phone on 
08/04/2013. 
 
A "How your disability affects you" PIP2 form was received on 11/04/2013. 
Mrs Dali indicated she has a problem with remembering to take her 
medication, preparing a meal, getting to the toilet and washing and dressing. 
(Pages 3 - 31) 
 
A  Face to Face consultation took place on 18/04/2013. In the opinion of the 
Health Professional Mrs Dali did not meet any of the Daily Living or Mobility 
Component descriptors. (Pages 32-51) 
 
The Decision Maker considered Mrs Dali’s claim of 08/04/2013 taking all 
available evidence into account and decided Mrs Dali did not meet any of the 
descriptors for Daily Living or Mobility Component and as a result was not 
entitled to Personal Independence Payment from 8/4/13. The reasons for the 
decision are included in the decision letter. (Pages52 ) 
 
The Decision Maker telephoned Mrs Dali on 10/07/2013 to explain the 
decision reasons.  
Mrs Dali was unhappy with the overall outcome of the decision dated 03/07/13 
and advised the decision maker she would consider her next steps. Mrs Dali 
did not present any additional information. .   
 
Mrs Dali requested a Mandatory Reconsideration on 03/08/2013 because she 
believed she met some of the descriptors for Daily Living. (Page 53) 
 
GP supporting letter was received on 11/08/2013. (Page 54) 
 
Supplementary advice was provided by the Health Professional on 
21/08/2013 recommending that Mrs Dali needs help with taking nutrition and 
with medication (Pages 55-58 ) 
 
On 06/09/2013 the Decision Maker reviewed the original decision and 
awarded 5 points for Daily Living.  However Mrs Dali remains not entitled to 
Personal Independence Payments from and including 08/04/2013 because 
she does not meet the disability threshold criteria. The reasons for the 
Mandatory Reconsideration decision are included in document. (Page 59) 
 

On 14/09/13 Mrs Dali lodged an appeal against the decision that she is not 
entitled to PIP on the grounds that she does not agree with the choice of 
descriptor under activities 2 and 3, and therefore she disputes the points 
awarded. 
 
 
Section 5: The Decision Maker’s response 
I oppose this appeal for the following reasons. 
 
Personal Independence Payment is intended to help towards some of the 
extra costs arising from ill-health or disability. It is based on how a person’s 
condition affects them, not the condition they have. There are two 
components of PIP – Daily Living and Mobility. Each component can be paid 
at standard rate, or enhanced rate for those with the greatest needs.  
 
The decision was made in accordance with the Welfare Reform Act 2013 
Part 4 Social Security (Personal Independence Payment) Regulations 
2013 
 
Entitlement to Personal Independence Payment is determined by an 
assessment of the individual’s needs by a health professional to consider the 
ability to carry out certain activities.– the Table below list the activities which 
are considered. Points can be awarded for each of these activities.  A 
claimant must score a minimum of 8 points for either the Daily Living or 
Mobility components to quality for a standard rate award of either Daily Living 
or Mobility; and a minimum of 12 points to quality for higher rate.  
 
The specific legislation for the areas under dispute is the Social Security 
(Personal Independence Payment) Regulations 2013, Regulation 4 
(assessment) and Regulations 5, 6 (scoring), and Schedule 1 (list of 
descriptors against the set of activities for Daily Living and Mobility) 
 
Mrs Dali is a 53 year old lady.  She has had type 2 diabetes for several years 
and raised blood pressure since the birth of her last child.  Mrs Dali takes 
various medications supplied by her GP and attends diabetic clinic at her local 
surgery once a week. Mrs Dali declared in writing and at the face to face 
consultation that she suffers with pain in her joints and back and also has 
slight visual and hearing loss. Her condition and treatment are not in dispute. 
 
When submitting her PIP2 Mrs Dali did not claim any needs relating to taking 
nutrition, communicating verbally, reading and understanding, engaging 
with other people, 
or making budgeting decisions. Accordingly no points 
have been awarded under these areas.  
 
In the PIP2 she said she needed help to wash, bathe and dress.  At the 
assessment centre she was able to climb on and off the couch and her joint 
movements were normal.  She was able to remove and replace some items of 
clothing unaided. She was also able to rise from a chair on several occasions.  
Given the level of mobility and flexibility shown by these actions, the Decision 

Maker considered that Mrs Dali does not satisfy any of the descriptors for 
washing and bathing, managing toilet needs or dressing and 
undressing.
  
 
Mrs Dali states in her PIP2 claim form she is unable to peel or chop food and 
so cannot make a meal.  At the consultation she showed a normal grip and 
dexterity and she confirmed she is able to knit and crochet. The Decision 
Maker therefore concluded, based on this evidence, that Mrs Dali is able to 
prepare a simple meal and so does not satisfy the descriptors for preparing a 
meal. 
 
As Mrs Dali scores no points for daily living she is not entitled to the daily 
living component. 
 
At the consultation Mrs Dali indicated she did not need help to plan or follow a 
journey although she would prefer to have someone with her.  For this reason 
therefore the Decision Maker has decided not to award any points for 
planning and following a journey.   
 
Mrs Dali states in her questionnaire she has problems walking and needs 
someone to hold her to help her keep her balance.  No medical evidence has 
been presented to show that she has any balance problems and no 
medication has been prescribed for this. Mrs Dali stated at her assessment 
that she can walk around the supermarket with the aid of a trolley and she 
was seen to walk around the consultation centre unaided.  
 
Given this level of mobility, in particular the fact that she can move around 
unaided, the Decision Maker has decided Mrs Dali does not satisfy the 
descriptors for moving around. 
 
As Mrs Dali scores no points for mobility she is not entitled to mobility 
component  
 
On her request for reconsideration Mrs Dali said she had needs in relation to 
taking nutrition, and managing therapy or monitoring health care. A GP’s letter 
was received which stated that Mrs Dali has never achieved good diabetic 
control. She had to be given tablets because she could not understand the 
importance of a correct diet and does not understand the need to take her 
tablets regularly or monitor her blood sugar. Her blood sugar remains high.  
Without her family’s support she would not eat appropriate foods and her 
diabetic control would deteriorate. Her daughter-in-law tells me that without 
supervision she would eat sweets all day and eat large portions of food. In 
order to try to keep her on a reasonable diet all food is prepared for her, and 
food and sweets locked away. 
 
The Decision Maker accepted Mrs Dali needs prompting to take nutrition and 
awarded 4 points for taking nutrition. The Decision Maker also accepted that 
she needs help or prompting to take medication and awarded 1 point for 
managing therapy or monitoring a health condition. Although the decision 
had revised the points scored, as it was only 5, it meant Mrs Dali was still not 

entitled to Personal Independence Payments because she did not meet the 
disability threshold of 8 points for either the Daily Living or Mobility 
components.  
 
In her appeal Mrs Dali explained that she does not believe that the correct 
points have been award under activity 2, taking nutrition. In order to score a 
higher level of points for this activity Mrs Dali would need assistance from 
another person to manage a therapeutic source to enable her to take nutrition. 
She is able to convey food or drink to her mouth without help. I do not accept 
therefore that Mrs Dali requires this level of support and I support the 
descriptor and points awarded.  
 
Mrs Dali also does not believe that the correct points have been awarded 
under activity 3 Managing therapy or monitoring a health condition. 
Although she has a history of poor compliance and her diabetes is not 
controlled, I do not accept that she requires any more help or prompting to 
manage therapy or monitor a health condition. 
 
Conclusion 
 
The Tribunal is asked to dismiss this appeal and confirm the Secretary of 
State’s decision. 
 
The descriptors and points awarded for each activity are in bold and 
underlined in the table below. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Daily Living Activities 
Activity 1 – Preparing food 
1A 
I‘ve decided you can prepare and cook a simple meal unaided. 

1B 
I‘ve decided you need an aid or appliance to prepare or cook a 

simple meal. 
 
1C 
I’ve decided you can’t cook a simple meal using a conventional 

cooker but you can do so using a microwave. 
1D 
I’ve decided you need prompting from another person to 

prepare or cook a simple meal. 
1E 
I’ve decided you need supervision or assistance from another 

person to prepare or cook a simple meal. 
1F 
I’ve decided you can’t prepare and cook food. 


Activity 2 – Taking nutrition 
2A 
I’ve decided you can eat and drink unaided. 

2B 
I’ve decided you need an aid or appliance, or supervision from 

another person to eat and drink, or you need assistance from 
another person to cut up food. 
 
2C 
I’ve decided you need a therapeutic source to be able to take 

nutrition. 
2D 
I’ve decided you need prompting from another person to eat 

and drink. 
2E 
I’ve decided you need assistance from another person to 

manage a therapeutic source that enables you to take nutrition. 
2F 
I’ve decided you need another person to get food and drink to 
10 
your mouth. 
Activity 3 - Managing therapy or monitoring a health condition 
3A 
I’ve decided you can either manage medication / therapy or 

monitor your health condition unaided, or you don’t need to. 
3B 
I’ve decided you either need an aid or appliance to manage 

your medication, or you need supervision, prompting or 
assistance from another person to manage your medication or 
monitor your health condition. 
3C 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes no more than 3.5 hours a week.   
3D 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 3.5 hours a week but no more than 7 
hours. 
3E 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 7 hours a week but no more than 14 
hours. 
3F 
I’ve decided you need supervision, prompting or assistance 

from another person to manage your therapy and that this 
therapy takes more than 14 hours a week. 
Activity 4 – Washing and bathing 
4A 
I’ve decided you can wash and bathe unaided. 

4B 
I’ve decided you need an aid or appliance to wash or bathe. 

4C 
I’ve decided you need supervision or prompting from another 

person to wash or bathe. 
4D 
I’ve decided you need assistance from another person to wash 

either your hair or your body below the waist. 
4E 
I’ve decided you need assistance from another person to be 

able to get in or out of a bath or shower. 
4F 
I’ve decided you need assistance from another person to wash 

your body between the shoulders and waist. 
 
4G 
I’ve decided you can’t wash and bathe at all and need someone  8 
else to wash your entire body. 

Activity 5 – Managing toilet needs or incontinence 
5A 
I’ve decided you can manage your toilet needs or incontinence 

unaided. 
5B 
I’ve decided you need an aid or appliance to manage your toilet  2 
needs or incontinence. 
5C 
I’ve decided you need supervision or prompting from another 

person to manage your toilet needs. 
 
5D 
I’ve decided you need assistance from another person to 

manage your toilet needs. 
5E 
I’ve decided you need assistance from another person to 

manage your bladder or bowel incontinence. 
5F 
I’ve decided you need assistance from another person to 

manage your bladder and bowel incontinence. 
Activity 6 – Dressing and undressing 
6A 
I’ve decided you can dress and undress unaided. 

6B 
I’ve decided you need to use an aid or appliance to dress and 

undress. 
6C 
I’ve decided you either need another person to tell you to get 

dressed or undressed, how to do it or when to keep your 
clothes on, or that you need prompting or assistance to select 
appropriate clothing. 
6D 
I’ve decided you need assistance from another person to dress 

or undress your lower body 
6E 
I’ve decided you need assistance from another person to dress 

or undress your upper body. 
6F 
I’ve decided you can’t dress or undress at all.   

Activity 7 - Communicating verbally 
7A 
I’ve decided you can express and understand verbal 

information unaided. 
7B 
I’ve decided you need an aid or appliance to be able to speak 

or hear. 
7C 
I’ve decided you can express and understand complex verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7D 
I’ve decided you can express and understand complex verbal 

information with help from someone who is trained or 
experienced in helping people to communicate. 
7E 
I’ve decided you cannot express or understand verbal 
12 
information at all, even with help from someone who is trained 
or experienced in helping people to communicate. 
 
Activity 8 – Reading and understanding signs, symbols and words 
8A 
I’ve decided you can read and understand basic and complex 

written information either unaided or using glasses or contact 
lenses. 
8B 
I’ve decided you need an aid or appliance, other than glasses 

or contact lenses, to read or understand either basic or complex 

written information. 
8C 
I’ve decided you need prompting from another person to read or  2 
understand complex written information.  
8D 
I’ve decided you need prompting from another person to read or  4 
understand basic written information. 
8E 
I’ve decided you can’t read or understand signs, symbols and 

words at all. 
Activity 9 – Engaging with other people face to face 
9A 
I’ve decided you can engage with other people unaided. 

9B 
I’ve decided you need to be prompted by another person to 

engage with other people.   
9C 
I’ve decided you can only engage with other people with 

support from someone who is trained or experienced in helping 
people to engage in social situations. 
 
9D 
I’ve decided you can’t engage with other people at all because 

doing so would cause you significant mental distress or you are 
likely to behave in a way which could harm you or another 
person.  
Activity 10 - Making budgeting decisions 
10A  I’ve decided you can make complex budgeting decisions 

unaided.  
10B  I’ve decided you need prompting or assistance from another 

person to make complex budgeting decisions. 
10C  I’ve decided you can make simple budgeting decisions with 

prompting or assistance from another person. 
10D  I’ve decided you can’t make any budgeting decisions at all. 

Mobility Activities 
Activity 11 – Planning and following a journey 
11A  I’ve decided you can plan and follow the route of a journey 

unaided. 
11B  I’ve decided you need prompting from another person to 

undertake a journey to avoid causing you significant mental 
distress. 
11C  I’ve decided you can’t plan the route of a journey. 

11D  I’ve decided you can follow the route of an unfamiliar journey 
10 
with help from another person, assistance dog or orientation 
aid. 
11E  I’ve decided you can’t undertake any journey because it would 
10 
cause you significant mental distress. 
11F  I’ve decided you can’t follow the route of a familiar journey 
12 
without another person, assistance dog or orientation aid. 
 
Activity 12 – Moving around 
12A  I’ve decided you can stand and then move more than 200 

metres, either aided or unaided. 
12B  I’ve decided you can stand and then move more than 50 metres  4 
but no more than 200 metres, either aided or unaided. 

12C  I’ve decided you can stand and then move unaided more than 

20 metres but no more than 50 metres. 
12D  I’ve decided you can stand and then move using an aid or 
10 
appliance more than 20 metres but no more than 50 metres. 
12E  I’ve decided you can stand and then move more than 1 metre 
12 
but no more than 20 metres, either aided or unaided.   
12F
I’ve decided you cannot, either aided or unaided, stand or move  12 
 
  more than 1 metre.   
Example 17 - Universal Credit - Limited Capability for Work 
Section 1:  
Personal Details 
Ms Leda Swann 
7 Laconia Road 
Town 
County 
Postcode 
Date of Birth 
12/03/1972 
 
National Insurance Number AA000000A 
 
Name and address of Appointee (if 
N/A 
applicable) 
Benefit Universal 
Credit 
Date of Outcome Decision 
21/02/2014 
Date Outcome Decision Notified 
22/02/2014 
Date of Mandatory Reconsideration 
03/03/2014 
Decision 
Date Mandatory Reconsideration 
04/3/2014 
Notified 
Date of Appeal Request 08/03/2014 
Decision Makers Name and Address 
Beth Smith 
Wigan 
Postcode 
Name and address of decision makers 
N/A 
representative (if any) 
 
 
Address where documents for the 
Wigan 
decision maker may be sent or 
Postcode 
delivered 
Name and addresses of any other 
N/A 
respondents and their representatives 
(if any) 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Not 
08/03/2014 10/03/2014 Appeal 
request 
included 
Not 14/03/2014 
18/03/2014 
HMCTS request for response 

included  
Not 
01/11/2013  01/11/2013 
UC claim form 
included 
Not 
11/11/2013 11/11/2013  Declaration of claimant’s work 
included 
search intention/activity.  
13-18 11/03/2014 
11/03/2014 
Limited capability for work 
descriptors 
19-21 14/11/2013 
16/11/2013 
New Claim decision 
22 04/02/2014 
04/02/2014 
WCA 
summary 
23-25 07/02/2014 
09/02/2014 WCA 
decision 
26 11/02/2014 
17/02/2014 
Change of circs summary 
27-29 22/02/2014 
24/02/2014 
Supersession decision 
30 27/02/2014 
27/02/2014 
Mandatory Reconsideration request 
Not 
03/03/2014 03/03/2014  Record of explanation 
included 
31-34 03/03/2014 
05/03/2014 
Mandatory Reconsideration 
decision / LT54 
Section 3:  The decision under appeal 
  
Ms Swann’s UC is not to be increased to include the disability element 
because she failed her WCA.  
 
Section 4: The facts of the case 
A claim for Universal Credit was received on 01/11/2013. (Not included) 
 
It was decided that Ms Swann was entitled to Universal Credit from 
01/10/2013 (decision pages 19-21) 
 
On 30/03/2014 Ms Swann completed a LCW questionnaire in which she 
stated that she had a problem with her back which affected her ability to move 
around and that she had trouble with social situations due to depression and 
occasional anxiety attacks. (not included) 
 
On 02/04/2014 Ms Swann underwent a WCA. In the opinion of the Health 
Care Professional Ms Swann does not satisfy any of the physical or mental 
health descriptors. 
 
The Decision Maker carried out an assessment of Ms Swann’s capability for 
work taking into account all the available evidence and decided that she 
scored 0 points on the physical and 0 points on the mental descriptors. 
Accordingly, she did not have limited capability for work and was not awarded 
this element of Universal Credit. (not included) 
 
On 21/04/2014 a supersession decision was made that Ms Swann was not 
entitled to Limited Work Capability element as part of her claim to Universal 
Credit. (pages 27-29) 
 
Ms Swann requested a mandatory reconsideration on 27/04/2014. (Page 30) 

 
The Decision Maker telephoned Ms Swann on 02/05/2014 to discuss the 
application. (Not included) 
 
On 06/05/2014 the Decision Maker reconsidered the decision but did not 
change it. The reasons for this are included as pages 31-34.  
 
On 09/05/2014 Ms Swann appealed. 
Section 5:  The Decision Maker’s response 
The Decision Maker opposes the appellant’s case. 
 
Ms Swann completed a questionnaire in which she identified that she has 
difficulties with moving around and mental health activities. 
 
On 4th February 2014 Ms Swann was examined by a Healthcare Professional 
in connection with the Work Capability Assessment.  
 
Ms Swann reported that she had mental health problems and a long-term 
back problem. She reported that she has suffered form anxiety attacks. She 
was vague about the details of these and said that the last one was three 
months ago. She spoke normally and was able to hear conversational 
speech. She didn’t report any vision problems.  
 
In the opinion of the HCP she did not satisfy any of the physical or mental 
health descriptors. The decision maker agreed. 
 
During the mandatory reconsideration discussion Ms Swann repeated much 
of what she had put in the ESA 50 and what she had told the HCP. There was 
no new evidence. Accordingly that application was refused. 
 
Again her grounds for appealing reveal nothing new. 
 
The regulations state that the Limited Capability for Work assessment 
assesses the ability to perform specific physical activities and, where 
there is a mental illness to cope with day to day living. Points are 
awarded to reflect limitations and a score of 15 points is needed to 
satisfy the test.  
 
Universal Credit Regulations 38 – 44 
 
The Decision Maker’s conclusion, taking into account variability and reliability 
is that Ms Swann is unlikely to have significant difficulty mobilising, sitting and 
standing, using upper limbs, communicating with others, understanding 
others, getting around safely, controlling bowels and bladder, staying 
conscious when awake. Equally he doesn’t believe she has any mental health 
issues. Finally, he also considers it unlikely that finding Ms Swann not to have 
Limited Capability for Work would pose a risk to anyone’s health. The 
evidence on these issues provided in the HCP’s report is preferred to that 
provided by Ms Swann in her ESA 50 and the discussion at the MR stage. 

 
I request that the appeal is dismissed. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Example 18 - Universal Credit -  Sanction imposed due to not 
attending an arranged job interview 

Section 1:  
Personal Details 
Mr G Reynolds 
44 Gloria Street 
Town 
County 
Postcode 
Date of Birth 
12/03/1982 
National Insurance Number AA000000A 
Benefit Universal 
Credit 
Date of Outcome Decision 
04/06/2013 
Date Outcome Decision Notified 
05/06/2013 
Date of Mandatory Reconsideration 
10/06/2013 
Decision 
Date Mandatory Reconsideration 
10/06/2013 
Notified 
Date of Appeal Request 24/06/2013 
Decision Makers Name and Address 
Beth Smith 
Wigan 
Postcode 
Name and address of decision makers 
N/A 
representative (if any) 
 
Address where documents for the 
Wigan 
decision maker may be sent or 
Postcode 
delivered 
Name and addresses of any other 
N/A 
respondents and their representatives 
(if any) 
Name and address of Appointee (if 
N/A 
applicable) 
 
Section 2:  Schedule of evidence 
Page Nos 
Date of 
Date of 
Brief description of document 
document 
receipt/issue 
Not 
18/07/2013 19/07/2013 Appeal 
request 
included 

Not 
22/07/2013 23/07/2013  HMCTS request for response 
included 
Not 
15/04/2013  17/04/2013 
UC claim form 
included 
Not 
16/05/2013 18/05/2013  Declaration of claimant’s work 
included 
search intention/activity.  
 
6-7 17/04/2013 
17/04/2013 
New Claim decision 

 
 
Report that claimant did not attend 
interview 
9-11 05/06/2013 
05/06/2013 
Sanction 
decision 
12 10/06/2013 
10/06/2013 
Reconsideration request 
Not 
14/06/2013 14/06/2013  Record of explanation 
included 
13-15 14/06/2013 
14/06/2013 
Mandatory Reconsideration 
decision /  LT54 
 
 
 
 
 
 
 
 
 
 
 
 
Section 3:  The decision under appeal 
 
Mr Reynolds’s Universal Credit is to be subject to a sanction because he 
failed to attend a job interview.  
 
Section 4:  The facts of the case 
1A claim for Universal Credit was received on 03/05/2013. (Not included) 
 
It was decided that Mr Reynolds was entitled to Universal Credit from 
03/05/2013 
 
On 25.5 Mr Reynolds failed to attend a job interview. 
 
On 3.6 he was telephoned to ask why he didn’t attend.  
 
On 04/06/2013 a 91 day high level sanction was imposed with effect from 
03/06/2013 
 
The reasons for the decision are included as page Nos 9-11 
 
Mr Reynolds requested a mandatory reconsideration on 15/06/2013. (Page 
No 12) 
 
The Decision Maker telephoned Mr Reynolds on 16/06/2013 to discuss the 
application. (Not included) 
 
On 16/06/2013 the Decision Maker reconsidered the decision of 04/06/2013 
but did not change it. The reasons for this are included as pages Nos 13-15.  
 

Mr Reynolds appealed on 19.7.13  
 
Section 5: The Decision Maker’s response 
The Decision Maker opposes the appellant’s case.  
 
During a telephone call to Mr Reynolds on 03/06/2013 to ask why he had 
failed to attend the interview, he said that he had forgotten about it due to 
having a number of other job interviews at around the same time. Mr 
Reynolds said that he had had an interview on 24/05/2013 and that he was 
going over that in his mind while preparing for another interview on 
30/05/2013. Mr Reynolds said that this proved that he was looking for work.  
 
During the discussion of his mandatory reconsideration Mr Reynolds repeated 
the above. There was nothing new. 
 
The law says that as a condition of receiving Universal Credit the 
claimant must attend job interviews as arranged and take all reasonable 
action in for the purpose of obtaining paid work. 
 
Universal Credit Regulations, Regulation 94 
 
The regulations allow for time to carry out paid work, voluntary work, a work 
preparation requirement, or voluntary work preparation, or to deal with 
temporary childcare responsibilities, a domestic emergency, funeral 
arrangements or other temporary circumstances. The regulations do not 
specify claimant forgetfulness as a valid reason for not attending an interview. 
 
I request that the Tribunal dismiss the appeal. 
 
Access to statute and case law for appellants 
Copies of the law referred to in this response are available at some libraries.  
It can be accessed on-line via the DWPs website at 
www.dwp.gov.uk/publications/specialist-guides/law-volumes/ 
Reported decisions of The Upper Tribunal Office from 1991 can be accessed 
on-line via the DWP’s website at www.dwp.gov.uk/publications/specialist-
guides/decisions -of-the-commissioners/ 
 
Appendix 8  
Role of the Presenting Officer 
1.  The Presenting Officer (PO) functions before the FtT are to: 
  Give a summary of Department for Work and Pensions (DWP) case as 
set out in the appeal response 
  Assist the FtT with oral submissions on the law 
  Question the appellant’s case 
  Draw the FtTs attention to new points in the appellant’s favour, in 
particular where the appellant is unrepresented 
  Help the FtT to focus on the questions to be considered 

2.  The PO may also be called upon to:  
  Describe DWP procedures where these have a bearing on the appeal 
  Provide information about earlier claims/decisions 
  Deal with new points as directed (obtaining advice from DMA Leeds 
during an adjournment if necessary). 
3.  Before the hearing the POs should: 
  Identify which decision(s) is being appealed, clarifying the point with the 
appellant if necessary 
  Ensure they are familiar with the: 
  facts of the case 
  decision under appeal 
  grounds for the appeal 
  written appeal response 
  law (both legislation and case law) underpinning the decision. 
4.  In cases with a medical aspect to the appeal, ensure that they are familiar 
with the medical history of the appellant. 
5.   Where operational issues may be discussed or the decision-making 
history of the case is relevant, ensure they understand them. 
6.  Highlight or list separately the key issues and the points that the FtT 
should focus on. 
7.  Contact the original DM if: 
  The reasons for the decision are not clear 
  Relevant evidence appears to be missing from the papers 
  The Mandatory Reconsideration Notice (MRN) is missing 
  There is no clear evidence of a decision essential to the appeal, for 
example a supersession decision where the appeal concerns a 
requirement to repay an overpayment. 
8.  Revise or supersede, or arrange for a revision or a supersession to be 
carried out if the decision under appeal is wrong. If the decision is revised, 
ensure that the appeal is either lapsed or treated as an appeal against the 
revised decision. 
9.  Arrange for the attendance of a witness, if one is necessary or if the 
attendance of a witness has been directed by the FtT. 
The hearing 
10. When invited to speak, the PO should: 
  Describe the factual background to the decision 
  Explain the legal basis for the decision 
  State the appellant’s grounds for appeal 
  Explain why the decision is, in the DM’s view, correct 
  If there are any additional matters which should be brought to the FtTs 
attention, a later award for example, mention them at an early stage in 
the proceedings. 
11. If the response is deficient in some way, or the PO has not been able to 
have a decision corrected, they should say so at the outset of proceedings. 
12. Once the appellant has explained the grounds for appeal, the PO may, 
with the FtTs permission, put questions to the appellant and any witness. Any 
questions should be relevant and courteous. 

13. The PO should send any new evidence to HMCTS before the hearing if at 
all possible. If new evidence, new grounds of appeal, or unfamiliar case law is 
introduced by the appellant, the PO should ask for a short adjournment to 
consider whether: 
  it can be dealt with on the spot, or  
  an adjournment is necessary to enable a new written response to be 
made. 
14. If the new evidence suggests that the decision under appeal was wrong, 
the PO should readily submit that the appeal should succeed, or that a 
different decision should be made. 
15. The PO may be asked questions about the history of claims and should be 
ready to provide additional information. The PO should be ready to explain 
abbreviations and unusual terms, or to describe departmental procedures. 
16.  In summing up, the PO should remind the FtT of the questions to be 
considered. If there are points in the appellant’s favour which have been 
overlooked, the PO should draw attention to them. 
17. If, at the conclusion of the hearing, the decision under appeal appears to 
be correct, the PO should say so during any final observations to the FtT. 
18. If an adjournment is directed, the PO should ensure that any directions are 
precise as to what the FtT require and who should obtain it. It is particularly 
important that where additional medical evidence is requested, the questions 
to be answered are clear. 
After the hearing 
19. Where the appeal is successful, the PO should report back to the decision 
maker with a brief account of the reasons why the FtT came to its decision. 
20. Where the decision is given at the hearing, the PO should, if possible, 
check the decision to ensure that there are no obvious errors which could be 
corrected immediately. 
21. POs may be called upon to attend Tribunal User Group meetings arranged 
by HMCTS, where issues of concern to HMCTS customers are discussed. 
They might also be asked to participate in local PO network groups to share 
best practices. 
Appendix 9 – Example Schedule of Evidence 
Page No 
Date of 
Date of 
Brief description 
Document 
receipt/issue 
of document 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Appendix 10 – Request for First-tier Tribunal documents 
Appellant’s Details 
Other Party Details 

NINO : 
NINO: 
Surname: Surname: 
Other Names: 
Other Names: 
FtT Ref: 
FtT Ref: 
Other Ref 
 
Hearing Details: 
Hearing location: 
Hearing date 
Urgent – benefit suspended 
We are considering whether to apply for leave to appeal to the Upper Tribunal 
and are unable to complete our action on the information contained within the 
decision notice. 
 
Would you please therefore send us the FtT’s statement of material facts and 
reasons for the decision and a record of the proceedings. 
 
Signed: Date: 
Print Name: 
Section: 
Room: Site: 
Telephone  
 
 
Appendix 11 - Examples of appeals likely to raise difficult 
issues 
General – all benefits 
Complicated evidence or legislation 
New legislation or case law 
Serious errors in decision making process 
Difficult judgemental element 
Human rights 
Overpayments 
Late claim 
Fraud cases 
Vulnerable Customers 
AA/DLA 
SMI 
Persons subject to immigration control 
Benefit reduced following revision or supersession 
Whether the customer has a physical or mental disability (DLA mobility 
component only) 
Bereavement Benefit / Widow’s Benefit  
Date of death 
Date/validity of marriage 
Date/validity of civil partnership 
Carers Allowance 
Exportability of Benefit 
Retrospective disallowances because of non-declaration of earnings causing 
large overpayments. 
Subject to Immigration Control 

Compensation Recovery (CRU) 
Covered in General list  
Employment and Support Allowance (ESA) 
Vulnerable Customer 
Ancillary workers 
Asylum seekers/PFA/HRT 
Capital (including deprivation/diminishing capital) 
Employer’s sick pay 
Housing costs/high housing costs/re-mortgages 
Income 
Sanctions 
Polygamous marriages 
Relevant education 
Remunerative work 
Student income 
Membership of the household 
Temporary absence 
Trust funds 
IS/JSA 
Ancillary workers 
Asylum seekers/PFA/HRT 
Capital (including deprivation/diminishing capital) 
Compensation payments on termination of employment 
Customary holiday 
Employer’s sick pay 
Housing costs/high housing costs/re-mortgages 
Income 
Refusing to enter into a JSAG 
Availability and ASE 
Sanctions 
LTAHAW/LTACP 
Polygamous marriages 
Relevant education 
Remunerative work 
Student income 
Membership of the household 
Temporary absence 
Trust funds 
Industrial Injuries Disablement Benefit (IIDB) 
 
MAT 
Cases where assessment has been adjusted as a result of CRU / fraud 
investigation  
Posthumous cases 
Simultaneous appeals for one or more PD and/or accident 
Appeals for 2 Industrial accidents on the same day 
Appeals evidence containing potentially harmful medical evidence 
Claim for one PD received, but another one diagnosed (most commonly found 
in asbestos-related diseases) 
Copious and complicated evidence 

SSAT 
Cases involving CRU and / or Fraud evidence 
Stress cases 
REA cases, particularly those involving earnings and/ or regular employment 
issues. 
Simultaneous appeals for one or more PD and/or accident 
Maternity Allowance (MA) 
Late paid contributions and Small Earnings Exception Certificates 
Personal Independent Payment (PiP) 
Persons subject to immigration control 
Benefit reduced following revision 
Benefit reduced following planned intervention 
Benefit reduced following unplanned intervention 
Negative determination because of failure to provide information 
Negative determination because of failure to attend assessment 
Reassessment cases where PIP disallowed or awarded at a rate less than 
previous award of DLA (including rising 16s) 
Recovery from Estates (RFE) 
Failure to disclose details of estate/capitol after death 
Pension Credit / State Pension 
Date/Validity of Marriage 
Date/Validity of Civil Partnership 
Universal Credit 
Good cause for failure to return questionnaire or attend and submit to medical 
examination 
Multiple element appeals 
Appeal including WCA as well as other elements 
Joint claims where partner has a WCA 
See also IS/JSA (excluding ‘Refusing to enter into a JSAG’) 
 
Appendix 12 - Non disclosure of evidence 
To: HMCTS 
From: 
 
 
 
 
Date:  
SURNAME:  
OTHER NAMES: 
 
NINO:  
It is considered that disclosure of the evidence at pages [identify page 
numbers in unedited bundle] of the documents below should not be made to 
[identify party to whom evidence should not be disclosed] as it would be 
likely to cause them serious harm. 
 
This is because [give reasons e.g. evidence in harmful information page of 
GP report, advice from medical services, where a child or vulnerable adult 
would be at risk if they were identified]. 
 

The response and documents have not been sent to the appellant or 
representative. 
 
Please refer this appeal to the FtT for a ruling in accordance with rule 14 of 
The Tribunal Procedure (First-tier Tribunal) (Social Entitlement Chamber) 
Rules. 
 
Please notify this office of the outcome of the reference. 
 
 
Signature : 
 
Appendix 13 
REQUEST FOR CONSIDERATION OF AN APPEAL TO THE UPPER 
TRIBUNAL DMA  
 
Leeds, Room 1S25, Quarry House, Leeds LS2 7UB  
 
Senders name: 
Senders full address: 
 
 
 
Section: Floor 
No: 
 
Sender’s and Claimant’s phone nos: 
 
 
Claimant’s name: 
Claimant’s address: 
 
NINO:  
Benefit involved: (for example ESA, 
Subject involved: (for example LCW, 
JSA, IS, RP, UC) 
Overpayment, LTAHAW,) 
 
 
 
Is payment of benefit suspended? 
 
 
YES/NO (delete as appropriate) 
 
Have you included a copy of the 
If not, please say why: 
WSOR? 
YES/NO (delete as appropriate) 
 
Have you included a copy of the 
If not, please say why: 
Record of Proceedings? HMCTS 
 
should provide a copy of the Record 
of Proceedings with the WSOR. 
 
YES/NO (Delete as appropriate) 
 

On what date was the WSOR sent to 
Date: 
you by HMCTS? 
 
 
If you have exceeded the one 
 
calendar month time limit, please 
explain the delay in referring this case 
to DMA. 
 
Have you included a copy of the 
 
tribunal decision notice?  
YES/NO (delete as appropriate) 
 
Where applicable, please give an 
 
estimate of the amount of benefit 
involved: 
 
 
 
REQUEST FOR CONSIDERATION OF AN APPEAL TO THE UPPER 
TRIBUNAL DMA  
Leeds, Room 1S25 Quarry House, Leeds LS2 7UB  
Error of Law 
Please explain clearly what you consider is the Error of Law in this case: 
(For guidance on what constitutes an Error of Law please see below) 
Examples of what constitutes an Error of Law 

  The provisions of the act or regulations have been misinterpreted. 
   
  Benefit has been awarded in circumstances, or for an item, not provided 
for or specifically excluded by the act or regulations. 
   
  The decision is not supported by evidence. 
   
  The decision is such that no person acting judicially and properly 
instructed about the relevant law could have reached it. 
   
  There has been a breach of natural justice. 
   
  There are other errors in law, that is: 
 
  Taking irrelevant evidence into account or  
  Ignoring relevant evidence or 
  Giving reasons for decisions which imply faulty reasoning. 
 
Note: This list is not exhaustive 
 
 
 
 
 

 
 
 
 
 
Appendix 14 
Examples of cases suitable to request strike-out on the basis of 
‘no reasonable prospect of success’. 
1.  This list is not exhaustive but is a selection of situations that have been 
identified as the type of case that may be suitable for the DM to request strike-
out.  
2.  It covers as many benefits as possible. However, if a benefit is not listed it 
does not mean that a DM requested strike-out is not possible. The DM must 
decide whether any other type of case is suitable for requesting a strike-out, 
using the principles set out in this appendix 
Employment and Support Allowance 
Work Capability Assessment  
3.  Evidence indicates a physical medical condition where the claimant cannot 
score 15 points under the physical descriptors. Suitable referrals would mainly 
focus on those claimants that have been deemed by the DM only to satisfy 
one or two physical descriptors due to their physical medical condition. The 
available evidence should support the view that the claimant cannot score 15 
points. No case where the claimant has indicated that there are mental health 
issues should be put forward for consideration. 
Contribution condition  
4.  Appellant does not dispute their earnings but they believe they should be 
entitled to the contributory based element of the benefit. These conditions are 
laid out in law and must be met for a contributory based payment to be made. 
This would only be suitable where HMRC have made a decision confirming 
that the NI record is correct.  
ESA(C) - 365 days expiry 
5.  Claimant is appealing against ESA(C) expiry as 365 days ESA (C) already 
paid and cannot continue beyond this period.  
Age limitation  
6.  Decision not to pay IB/ESA cases where the appellant has attained State 
Pension age, and therefore the benefit cannot be paid beyond that date. 
Disability living allowance/attendance allowance 
Age limitation 
  DLA Higher rate mobility for children under 3 years of age.  
  DLA Lower rate mobility for children under 5 years of age. 
  Over 65 and DLA is requested. 

Age  
7.  A decision not to award DLA to a claimant who is over 65 (no recourse to 
DLA unless previously in receipt of DLA on 65th birthday and claims again 
within one year. Could be entitled to a mobility component). 
Backdating  
8.  A decision where there is no entitlement before the date of claim (i.e. no 
claim was made); or where there is no indication of a previous claim (i.e. no 
alleged earlier claim). 
Residence and presence  
9.  Disallowance re eligibility. Dates or other information (including 
exportability rules) may need clarifying before deciding it is appropriate to 
apply for an appeal to be struck out on grounds of no reasonable prospect of 
success. 
No physical disability  
10. Claiming higher rate mobility when there is no evidence of a physical 
disability (i.e. mental health issues only) when deeming provisions do not 
apply. 
Payability 
  Imprisonment – claimant is appealing against payability decision. 
Issues relating to dates, type of conviction etc - establish that there is 
no dispute as to the primary facts before deciding it is appropriate to 
apply for appeal to be struck out on grounds of no reasonable prospect 
of success. 
  Hospital/residential care – claimant is appealing against payability. 
Issues in respect of admittance, discharge dates, types of hospital 
funding, residential care funding arrangements - establish that there is 
no dispute as to the primary facts before deciding it is appropriate to 
apply for appeal to be struck out on grounds of no reasonable prospect 
of success. 
Change of circumstances/deterioration 
11. Can only apply if the change of circumstances or deterioration has 
occurred after the date of the decision being appealed. 
Carers allowance - Qualifying benefit 
12. No qualifying benefit in payment on a new claim. 
Jobseekers allowance - Good cause 
13. Decision is not to consider good cause where the claimant appeals against 
the specified time limit (5 days), in which they must provide an explanation for 
failure to attend a mandatory interview (usually fortnightly job review). They 
are not disputing that they did not respond within 5 days, but the only reason 
they provide is that they forgot their appointment. 
Income support 
Conditions of Entitlement  
14. Lone parents claiming IS when they no longer satisfy the “lone parent” 
conditions due to the changes in qualifying age for the youngest child.  

Deductions  
15. Decision to implement deductions at set rates, for example, fines that are 
deducted at a fixed rate cannot be changed, and claimants may appeal the 
amount being deducted because they consider it is too high. 
Industrial injuries disablement benefit 
Cannot claim within 3 years of a disallowance  
16. Claimant disallowed PD A10 and advised they cannot claim again within 3 
years but does claim again. Unless it can be waived to satisfy the 5 year time 
limit for making a claim, the 3 year period is set in law and cannot be altered. 
Not on prescribed list  
17. A decision where the claimant is claiming, with an illness not on the 
prescribed illness list, and who had been disallowed. 
Social fund 
Winter fuel payments 
18. A decision not to award a payment because: 
  the person applying has not attained the qualifying age 
  the person is in legal custody under sentence imposed by a court 
  the appeal is against the amount which is prescribed for the specific 
circumstances of the claimant. 
Sure start maternity grants 
19. A decision not to award a payment because: 
  the claimant (or partner) does not have an award of a qualifying benefit, 
and that is not in dispute 
  the claim is made outside the prescribed time limits  
Funeral payments 
20. A decision not to award a payment because: 
  the claimant or partner does not have an award of a qualifying benefit, 
or is not a person in respect of whom a second adult council tax rebate 
could be awarded 
  the claim is outside the prescribed time limits  
Retirement pension 
NI Contribution disputes  
21. Appeal is against a decision based on NI qualifying conditions, and where 
HMRC has given a formal decision confirming that the NI record is correct. 
Disputes involving paydays  
22. The claimant disputes non payment of RP for a part week, from the date 
they attained state pension age to the beginning of their first benefit week. 
Bereavement benefit, widowed parent’s allowance, bereavement 
allowance & bereavement payment 

Qualifying conditions not met 
23. A decision not to award benefit because: 
  there was no marriage 
  there were no/insufficient contributions, and that is not disputed 

  the cessation of widowed parent’s allowance where the qualifying child 
has attained the age at which there would be no entitlement to child 
benefit.  
52 week maximum period 
24. Appeals against the 52 week maximum period of an award of 
bereavement allowance. 
State pension credit - Conditions of entitlement 
25. A decision that there is no entitlement to SPC because the appellant has 
not reached the qualifying age for SPC.  
 
Appendix 15 
Request to HMCTS to strike-out an appeal on the grounds of ‘no 
reasonable prospect of success’. 

To: Her Majesty’s Courts and Tribunals Service 
 
Claimant’s Name: 
 
NINO:  
 
 
DOB: 
 
 
Address: 
 
 
 
Telephone  
Case Code   
 
 
Evidence considered in strike-out request 
Decision dated: 
 
Reconsideration dated: 
 
Appeal letter dated: 
 
Further evidence submitted 
 
Detailed reasons for our request to Strike-out: (a) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
Conclusion: 
In view of the above, I submit that this appeal should be struck-out, as it has 
no reasonable prospect of success. I refer this case to the First-tier Tribunal 
under rule 8(3) (c) of the Tribunal Procedure (First-tier Tribunal) (Social 
Entitlement Chamber)Rules 2008 
 
Staff Name:  
 
Office Name 
 
Notes for completion 
(a) This is where you would build your detailed argument.  For example AA 
Backdating – details of no previous claim date etc, quoting the 
regulation/legislation appropriate to show the claim cannot be awarded.