Turned down for DLA/AA? Think you're not getting enough?
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'They've got it wrong!'
If you made a claim for DLA or AA and you didn't get the result you had hoped for, you don't have to give up.
You have three options:
- You could ask the benefits department to look at their decision again. They will call this a 'reconsideration'. This is a good idea if you have any new evidence you can send them. But it can take 8 -12 weeks - which is a long time to wait if it's unlikely they will change their mind. If they don't change their decision, you can still try option 2.
- You could appeal their decision. This means three experts who do not work for the DWP will look at your claim to see if the right decision was made. Appeals can be a little bit stressful, and take longer, but they are much more likely to be successful. You can minimise the amount of stress by getting as much help as you can, and by reading this guide. The DWP will always look at the decision again (option 1) as the first stage of an appeal.
- Or, if your condition has got worse since the date of their decision, you could make a new claim.
'They turned me down flat'
You may feel that you should just give up. After all, the DWP has said that you're not entitled, so maybe you're not. But they may be wrong - they often are. If so, you may be entitled to a lot more help than you are getting - and everybody should get what the law says they are entitled to. It is up to you what you choose to do, but remember you have nothing to lose.
'They’ve given me less than I think I should get'
You may feel that you shouldn't rock the boat. The decision could be changed for the worse as well as for the better. For example, if you've been given a low rate, it is possible that they will decide that an error was made and that you are not entitled to any help at all. On the other hand, you could be entitled to a lot more help than you are getting. If you can, see an adviser (this is an expert who can give you advice about your claim - for how to find one see 'What if I don't have an adviser?'). They will be able to tell you how likely this might be for you.
'I had to claim again and they gave me less than they did before'
You may still have a good case for the amount you used to get, but you may not have. That may be because you need less help than you used to, or it may be because the law has changed. If you are in this position, it is particularly important that you get advice (and not from the DWP!). If you haven't got an adviser, see 'What if I don't have an adviser?'.
Time limits
You need to act quickly as the time limits can be quite strict. You have one month from the date of the letter they sent you to appeal or ask them to look at it again.
If you need more time, phone the DWP and ask for a 'statement of reasons'.
This is an explanation of their decision. It's unlikely to tell you much, but it does give you another 14 days before the deadline.
If you are waiting to see an adviser but can't get an appointment before the month is up - ask for a statement of reasons (if 14 days will be enough) or for an appeal and say that you will give your reasons later.
If you are really not sure what to do - you may as well appeal. You can always withdraw it later.
'What if I don't have an adviser?'
Most people will be able to go to a local independent advice centre or CAB that helps with benefits problems (look in your Yellow Pages or phone Community Legal Advice to ask if there is one near you - see 'Useful contacts'). Sometimes there are services that you can access through your council, your GP, social worker or hospital, or community centre. There's no harm in asking - so call your council, and GP, and your social worker, hospital or community centre if you have one, and ask if there is a service for you.
You may be able to get help from an adviser over the phone. Community Legal Advice is a free and confidential advice service paid for by legal aid. If you live on a low income or benefits they can give you free advice over the telephone, help you prepare your case, and draft statements and letters with you.
There are also lots of charities who run advice services for particular groups - for example, Age Concern has local advice services for older people, RNID has a service for people who are deaf or hard of hearing, and Mind has an advice service for people with mental health problems. These organisations are often particularly good because they will already understand your condition and will have experience of helping people in a very similar situation. See ´Useful contacts´ for details of organisations that may be able to help you.
If you still can't find an adviser, don't worry - this guide will help.
Take all the help you can get!
If an adviser offers you any help with your appeal, take them up on it! Benefits advisers are specialists at helping people get what they are entitled to. They might offer to help you complete the appeal form, get evidence to support your case, or write a 'submission' for you (this is a letter to the panel that explains why you are entitled). Some may even be able to come to the hearing with you to argue your case in person.
If you can't get an adviser you may have to do some or all of these things yourself. But don't panic - we'll show you how.
How DLA and AA work
Whether or not you are entitled to DLA or AA is decided on how your illness affects you - not on your diagnosis.
Whether you are entitled to DLA or AA is based on whether you need help from another person to do every-day things like washing and dressing, enjoying pastimes, staying safe, or if you need help at night. For DLA, whether you are able to cook a proper meal by yourself is also considered.
It doesn't matter whether or not you get any help - lots of people manage on their own - what matters is if you should really have help. If doing daily activities like getting up or washing causes you pain, takes you a long time, puts you or somebody else in danger, or if you simply don't do it, then that counts as needing help.
These benefits are awarded at different rates. What rate you get depends on what you need help with and how often.
o To get the higher rate of either DLA or AA, you must need repeated help at night and during the day.
o To get the middle rate of care for DLA or the lower rate for AA (there is no middle rate for AA), you must need frequent help during the day, or for more than about 20 minutes at night, or someone with you most of the time to help you stay safe.
o To get the lower rate of DLA you must need help for about one hour (in one go or spread throughout the day), or need help to cook a proper meal.
o DLA also has a rate that deals with ability to walk and go places. You are likely to be entitled to the high rate of this mobility payment if you cannot walk or are virtually unable to. For example, if you struggle with even very short journeys such as walking around a supermarket. The lower rate of the mobility payment is for people who cannot go to places they don't know without help from somebody else.
What rate you get is based on specific things which can sometimes seem very unfair. When you are thinking about your case and whether or not you want to appeal, you have to look at what the criteria actually are - not what you think would be fair.
If you are going to appeal without help from an adviser you will need more information than we can supply here. See ´Useful contacts´ to find more detailed information. Some of the most useful information will be aimed at people with your disability or illness. Information about how to fill in a claim form will also be useful, as it will explain what is counted and the sorts of things you should focus on.
The Process
Step 1
o You receive the decision about your claim. You have been told that you are not entitled to anything or you think you have been given the wrong rate.
o You have one month to ask for an appeal or for the DWP to look at it again. (If one month has already passed, see 'What if I've missed the deadline?')
o Get advice if possible - see 'What if I haven't got an adviser?'
o You can skip step 2 and 3 and go straight to appeal.
Step 2
o Ask for the DWP to look again at their decision - see 'How to ask the DWP to look at their decision again' for details of how. (You can skip steps 2 and 3 go straight on to Step 4 if you prefer).
o The DWP will look at your claim form again to see if they can change the decision.
Step 3
o The DWP will tell you their decision. If their decision has been changed and you are happy with it, you can stop here. Otherwise you have 1 month to ask for an appeal.
Step 4
o Ask for an appeal (see 'How to ask for an appeal' for details of how)
o The DWP will look at your claim form again to see if they can change their decision. If they can, they will write to you with a new decision. If not, your appeal will be sent to the Tribunal Service.
Step 5
o The Tribunal Service will send you a form and a huge bundle of papers. (This can be very intimidating, but don’t panic). You must fill in the form and send it back within 14 days. See the next section for our advice.
Step 6
o You need to prepare for your appeal and get evidence. See ´What do I need to do before the hearing?´ for details.
Step 7
o You will be told the date of the hearing. Ideally, you should send in your evidence a week or two in advance.
Step 8
o Your appeal will be heard by an independent panel. They will make a new decision. See ´What should I do on the day?´ for details of what will happen and advice about what to do on the day.
o If you were successful, you will usually receive your money in 4-6 weeks.
'They say I don't need much help at all! How did they work that out?'
It can sometimes be very hard to understand how the DWP made their decision. The letter they send rarely explains very well, but it will say what they based their decision on.
They will usually look at a report from your GP or a doctor they sent to see you, as well as your claim form. It may be that you haven't put enough detail on your claim form. Or it could be that they don't accept what you have said, because of what is in the other reports.
How to ask the DWP to look at their decision again
You can ask over the phone or in writing. You must do it within one month of the date on the letter.
If you are going to do it over the phone, make a list of everything you want to say and tick them off as you say them.
You should give them as much detail as you can about why their decision was wrong. The sorts of things you should include are the same as if you are asking for an appeal - see the list below.
If you have any more evidence that you think will help (for example, a letter from your doctor, or social worker) send that too.
What next? You should hear back in 8-12 weeks. If they have changed their minds, congratulations! Your benefit will be backdated to the date they received your original claim form.
If they didn't change their decision or did, but didn't give you the amount you think you are entitled to, remember that you can still appeal. You need to tell them within one month.
Children
If you want to change a decision about your child's claim, you need to explain what needs your child has compared to the needs of other children the same age.
We recommend that you get as much help preparing for the appeal as possible. It can be very upsetting to have to explain all the difficulties your child has in detail. There are also extra problems about evidence. See ´Useful contacts´.
How to ask for an appeal
You need to tell them in writing that you wish to appeal within one month. The best way is by using the special form that comes in their leaflet 'If you think our decision is wrong' (see ´Useful contacts´).
Give your name, address, and National Insurance number and include the date of the decision you are appealing (see the letter they sent you). Send it to the address at the top of that letter. If you can, keep a photocopy.
On the form or letter you need to explain why their decision is wrong. Give them as much detail as you can.
You should include:
o What the symptoms or details of your condition are and describe the problems they cause. Remember, they probably don't know anything about your disability, and how it affects you or what help you should have. Don't just say that you have problems with your sight, or mental health - explain how it affects you day-to-day.
For example, a serious visual impairment might mean that you need help to get around inside or outside to avoid walking in to things. Or, your mental health condition might mean that you need a lot of reminding and encouragement to cook for yourself, or help to cook safely.
Don't be tempted to make light of your difficulties, even if you find some of the issues embarrassing, it is important that they understand how your condition really affects you.
If your condition varies, explain what it is like on a bad day.
o If you can't go to places you don't know on your own, explain why. This might be because you need help finding your way, or it might be because something might happen (you might have a seizure or a panic attack), or because you might put yourself or others in danger. Spell out exactly why somebody else is needed, and what they could do for you. If you never try to go to places you don't know on your own, explain why you don't.
o If anyone provides care for you, say what they do. This might mean physically helping you to get up, and to wash, and getting you food, or 'nagging' you to get up, and to wash or eat something. If you need anyone's help to take your medication (this might be by finding it and making sure it is the right one, reminding you to take it, or making sure you don't take too much) tell them, and say how frequently you are supposed to take it.
o If you have ever hurt yourself as a result of your condition - perhaps because you fell or had an accident, or hurt yourself on purpose, you need to put this down too. It is important that they know because some of the help you need may be in order to prevent the same thing happening again. If it has happened more than once, tell them how many times similar things have happened, and how having somebody with you could have stopped it happening or helped you afterwards.
o If you have ever put someone else in danger as a result of your condition (even if you didn't actually hurt them) you need to say so. For example, if you have hurt other people during a blackout (or might have), or if you heard voices telling you to hurt someone.
'What if I've missed the deadline?'
It is important not to delay - if you can get your appeal form to them within the month you should. If you don't have time to say everything you want to say before the deadline, you can tell them that you will send more information later.
You can still ask after the deadline, if the delay was unavoidable or a result of your disability. For example, perhaps you were unable to deal with it until now because you needed help to read it, or because you are too ill to deal with your post. Explain why it was impossible for you to ask them to look at their decision again until now.
What next?
When they receive your appeal form, the DWP will look again at their decision to see if it should be changed. If they do change it, they will write to tell you what they now think you are entitled to. If you don't think they are right this time either, you can ask for an appeal (again). This time you are appealing this latest decision, so you have another month to tell them you think they are wrong and why, and it all starts again.
If they don't change their decision, they will send your appeal to the independent Tribunal Service. You probably won't hear anything for several weeks. Then you will get sent a very big pack of papers.
´I´ve received a huge pack of papers! What do I do?´
´What do I need to do before the hearing?´
Writing useful evidence for Disability Living Allowance and Attendance Allowance appeals
´What should I do on the day?´