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Challenging a benefit decision - asking for reconsideration
If you don't agree with the outcome of a decision made by the Social Security Agency (SSA) about your claim, you may want to challenge it.
To do this, you may first need to ask the SSA to look at their decision again. This is called asking for a reconsideration.
For SSA decisions made on or after 23 May 2016 you have to ask for mandatory reconsideration before you appeal it.
For SSA decisions made before 23 May 2016 you can ask for a reconsideration or you can appeal it.
This page tells you more about how to ask for a reconsideration of your benefit decision.
What is a reconsideration?
A mandatory reconsideration means that you ask the SSA to look at the decision about your benefit claim again.
If you think the decision is wrong, you can ask for it to be looked at again for any reason. You can ask for a reconsideration when you want to challenge:
- a decision made on a new claim, or
- a decision made to change your claim, or
- a decision made when you asked to change the claim.
A decision maker will look at the decision again and decide whether to change it or keep it the same. You will not be able to appeal against the decision until you know the outcome of the reconsideration.
Time limits for asking for a reconsideration
The decision notice must tell you the time limit for asking for the decision to be looked at again. For benefits paid by the SSA, you must ask for a reconsideration within one month of the date the decision was sent to you. This date will be written on the decision notice.
When the time limit can be extended
The decison letter should contain a written statement of reasons telling you why the decision has been made. If you don't receive this, you have the right to ask for a statement. The time limit for asking for a reconsideration will be longer if you have asked for a written statement of reasons:
- if the statement is sent to you within the month, you will have one month and 14 days from the date the decision was sent to challenge it
- if the statement is sent more than one month after the decision was sent, you have 14 days from the date the statement was sent to challenge it.
If you're not sure if the decision includes a written statement of reasons, it's important to ask for a reconsideration as soon as possible so you don’t miss the one-month deadline.
If you miss the time limit
If you miss the time limit to apply for a reconsideration, it can be extended by up to 13 months from the latest date you should have applied if the following conditions are met:
- you apply to the decision maker for an extension to the time limit, explaining why the application is late and why you want an extension. The application must give enough information for the decision maker to identify the decision you want to challenge
- you apply within 13 months of the latest date you should have applied for reconsideration
- the decision maker is satisfied that it is reasonable to extend the time limit
- there are special circumstances that meant you couldn't apply in time.
Also bear in mind that the longer you leave it after the deadline to apply for the reconsideration, the better your reasons for why it is late will have to be.
How to ask for a reconsideration
Check what it says in the letter or email telling you about the decision. It should set out the ways in which you can challenge the decision.
If the decision notice does not include a statement of reasons for the decision, you have a right to ask for one. You must ask for a statement within one calendar month of the date the decision was sent to you.
You must ask the office that made the decision to look at it again. The contact details will be on the decision letter.
You can ask for a reconsideration in writing, by phone or in person. There's no special form to fill in, you just need to write a letter. It is usually better to write so you have a record of why you disagree with the decision and proof that you asked for it to be looked at again. However, if you're getting close to the deadline, it's best to phone first and then confirm your phone call in writing.
Keep a copy of your letter or form and note the date you sent it. In your letter, explain why you think the decision is wrong and ask for it to be looked at again. Make sure you send copies of any further evidence you’ve got since you made your claim if it will help your case.
What happens when the decision maker reconsiders the decision?
Usually a different decision maker will look at the decision again. If it looks likely that based on the evidence they have, the decision is unlikely to change in your favour, the decision maker will phone you to discuss this. They will first try to contact you by telephone or by text message to make an appointment for a phonecall. This will give you time to prepare for the call and have someone with you, if you want.
The decision maker may ask you whether there is any further evidence you can give, or whether you can explain anything that is unclear about the claim.
If you do not want to be contacted by phone, you should say so when you request a reconsideration. You do not have to leave a phone number. If the decision maker needs to contact you for clarification or further information about your reconsideration, they will write to you.
If the decision maker can’t contact you or you do not reply to their letter they will make their decision based on the information they already have.
You must send any further evidence within one month from the date of the telephone conversation with the decision maker. The decision maker will wait to receive it before they continue looking at the decision. They may give you more time if it will be difficult to get the extra information. You must explain why you need more time before the time limit for asking for a reconsideration is up.
If you don’t return any evidence within the deadline you’ve agreed with the decision maker, they will make their decision without it.
What happens when the decision has been reconsidered?
When the decision has been looked at again it will either remain the same or be changed by revision. Revision means that if the decision is changed, you will get any backdated benefit you're owed to the date of the original decision.
For decisions made before 23 May 2016, the SSA will notify you of their decision by letter. The letter will tell you what your appeal rights are.
For decisions made on or after 23 May 2016, the SSA will send you two Mandatory Reconsideration Notices to notify you of the outcome of the reconsideration. One copy is for you and the other is to send to the Appeals Service if you want to make an appeal. You won’t be able to appeal without a Mandatory Reconsideration Notice. Details of your appeal rights will be included in the letter.
Claiming Employment and Support Allowance during a reconsideration
If you have been turned down for Employment and Support Allowance (ESA) and have asked for the decision to be reconsidered, you will not be paid ESA during the resconsideration. You can claim Jobseeker’s Allowance instead.
If you’ve been put in the work related activity group instead of the support group of ESA, you’ll continue to be paid ESA with the work-related component while you’re challenging that decision.