ESA Mandatory Reconsideration Success Rates

In this article, we answer the following questions: “What is the ESA mandatory reconsideration success rate?” and are the ESA mandatory reconsideration outcomes.

What is the ESA Mandatory Reconsideration Success Rate?

The chances of getting a successful mandatory reconsideration for employment and support allowance (ESA) have plummeted from 70% to 12% since the system was introduced figures released by the DWP show. 

But the type of decision being challenged makes big difference, with fit for work decisions being very unlikely to be overturned compared with those fighting to be moved from the work-related activity group (WRAG) to the support group.

ESA mandatory reconsideration

Once an ESA claimant has entered the claim process, various decisions are made on their claim by a DWP Decision Maker (DM). 

Since October 2013, ESA claimants wishing to dispute a decision made on their claim are required to ask DWP to reconsider the decision before lodging an appeal with Her Majesty’s Courts and Tribunals Service (HMCTS).

This is called a ‘Mandatory Reconsideration’ (MR).

The purpose of a MR is to consider the grounds for the dispute and complete a full review of the initial decision. 

The reasons for MR include claimants: 

  • not agreeing with scoring of their WCA and the associated medical assessment outcome
  •  having not provided good reason for not attending their WCA, then providing additional evidence 
  • having failed to return their questionnaire – ESA50, then doing so 

During a MR all evidence will be fully reviewed by the DM including any new evidence supplied to support the MR.

The Decision Maker will use the evidence to decide whether or not to revise the original decision. 

The customer will then be informed as to the MR outcome.

Whatever the outcome of the MR, the claimant will be given the right of appeal. 

ESA mandatory reconsideration statistics

Following the introduction of MRs in October 2013, the first few quarters saw a sharp increase in the number of MR registrations made whilst the new process became established.

Since then there has been a slight overall upward trend. By the end of April 2016, 308,400 MRs had been raised by claimants to dispute ESA WCA decisions (this figure does not include IB reassessment claims). 

In the latest year to April 2016, there have been 12 thousand MRs registered each month on average.

Across the year to April 2016, the number of MRs registered each month has been increasing steadily from 9,400 in May 2015 to 13,600 in April 2016.

In total, 306,500 MRs had a decision made by the end of April 2016.

The majority of MR decisions were not revised by the DWP Decision Maker, with only 20% (58,700) being revised and allowed since their introduction in October 2013. 

Due to a combination of low numbers of registrations and time needed for new operational practices to settle down, the proportion of MR decisions that were initially revised and allowed was quite high (e.g. 44% in November 2013). 

However, now that these practices are established, the average number of decisions which have been revised and allowed (for the most recent year up to April 2016) is 11%. 

The most common reason for raising a Mandatory Reconsideration is when the customer disputes a Fit for Work (FFW) decision.

11% of these Mandatory Reconsiderations are subsequently revised (either revised and allowed or revised and disallowed). 

The term ‘Mandatory Reconsideration’ refers to the process where a claimant approaches DWP to dispute a decision on their claim.

Sometimes an earlier error is found or a claimant provides additional evidence following a decision on their ESA claim before an MR is raised. 

In such cases, the DWP Decision Maker (DM) will consider whether this additional evidence changes the original decision.

The DM will then choose to revise or not revise the decision accordingly. This is known as ‘reconsideration’. 

If the claimant still disagrees with the resulting decision, they can then raise a MR.

These ‘reconsiderations’ mimic MRs, but because they are easier to resolve, they are ‘revised’ at the earliest opportunity by the Benefit Centre instead of being sent to an independent Dispute Resolution team (DRT). 

ESA mandatory reconsideration outcomes

MR decisions can have various outcomes referring to whether or not the DM chooses to revise the decision under dispute; 

  • If a decision is categorized as ‘Not Revised’ this means that the decision the claimant is questioning has not been changed.  
  • If the decision under dispute is classed as ‘Revised – Allowed’ then the DM has changed the decision in the claimant’s favor. So someone found FFW would be awarded ESA or someone put in the Work-Related Activity Group (WRAG) claimant would be put in the Support Group (SG). 
  • If the decision is categorized as ‘Revised – Disallowed’, the DM, having reconsidered the decision, decides that the claimant is not entitled to ESA at all. This would apply where someone put in the WRAG seeks an ESA WCA Mandatory.

The primary reason for a claimant raising a MR is when they are found FFW following a medical assessment.

All MRs relating to this topic are categorized as ‘Customer disputes FFW decision’. 

The second category ‘Customer failed to attend WCA, provide medical evidence or return questionnaire’ incorporates reasons where the claimant has failed to follow the required claim procedures.

The MR gives them an opportunity to explain why they didn’t comply.  

The third category is ‘Customer disputes ESA group’ and contains MRs where the claimant is already assigned to an ESA group.  

The final category is ‘Other/Unknown’ which encompasses all MR reasons that don’t fit in with the three main categories above and cases where the reason is not recorded.

Only 2% of cases currently fall into this category. 

ESA mandatory reconsideration success rates

Mandatory reconsiderations were introduced for employment and support allowance in October 2013.

By April 2016 there had been 308,400 mandatory reconsiderations requested.

The number registered each month is rising, up from 9,400 in May 2015 to 13,600 in April 2016.

A decision has been made in 306,500 mandatory reconsiderations for ESA in total.

Just 20% (58,700) of these resulted in the decision being changed.

Where a decision is changed this is overwhelmingly in favor of the claimant, with fewer than 2% being less favorable.

However, over time the number of decisions that have been changed has fallen so that now just 11% of decisions are being revised.

The fall in ESA mandatory reconsideration success rates has been dramatic.

  • In April 2014 70% of decisions were revised.
  • In April 2015 this had plummeted to 16.5%.
  • In April 2016 this had fallen further, to 12%.

The only explanation given for this by the DWP is that:

Due to a combination of low numbers of registrations and time needed for new operational practices to settle down, the proportion of MR decisions which were initially revised and allowed was quite high.

The most recent statistics 

The most recent statistics show that the success rate for those claimants who go on to appeal, on the other hand, has now reached 75% per, according to the new Ministry of Justice (MoJ) statistics.

The new MoJ figures also show for the period from April to June 2019 these that:

  • 71% of welfare benefit appeals overall had the initial decision revised in favor of the claimant;
  • disability living allowance appeals had a 67% success rate; and
  • universal credit appeals a 65% success rate.

Despite that just 15% of ESA mandatory reconsiderations lead to change in the award. 

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

Conclusions

In this article, we talked about the ESA mandatory Reconsideration success rates.

While ESA appeals have reached an impressive 75% rate of success, ESA mandatory reconsideration success rates are only 15%. 

The term ‘Mandatory Reconsideration’ refers to the process where a claimant approaches DWP to dispute a decision on their claim. 

Please feel free to leave any comments on the content or questions in the comments section below. 

FAQ about ESA mandatory reconsideration success

How long does ESA mandatory reconsideration take?

A mandatory reconsideration for ESA can take as little as 14 days in simple cases, but can also take much longer.

The DWP doesn’t have a precise timeline for taking a decision for your ESA claim.

What percentage of ESA mandatory reconsiderations are successful?

Just 15% of ESA mandatory reconsiderations lead to a change in the award. 

Do I still get ESA while appealing?

You won’t be paid ESA during your appeal if you claimed another benefit such as Jobseekers allowance during the reconsideration stage.

You’ll stay on the other benefit unless you withdraw your claim for it and contact the DWP and ask them to pay you ESA instead.

How long do ESA appeals take?

ESA appeals can take between four and 11 weeks, depending on how much evidence there is on your case. 

How many points do you need for the ESA support group?

In order to be put in the ESA support group, you have to answer yes to any of the 16 descriptors (questions) from the second part of the work capability assessment.

There are two parts to the work capability assessment. The first part scores points and 15 points gets you WRAG.

The second part is to qualify for the support group.

How does a mandatory reconsideration work?

Mandatory Reconsideration is the first step in challenging the DWP’s decision.

With a mandatory reconsideration, you are asking the Department for Work and Pensions (DWP) to look at their decision again.

You normally have to ask for Mandatory Reconsideration within one month of the decision date (the date on the decision letter).

Recommendations

  1. Employment and Support Allowance: A Guide to ESA for People with a Disability or Long Term Health Condition, Their Families, Carers and Advisors 
  2. Providing Employment Support for People With Long-Term Mental Illness: Choices, Resources, and Practical Strategies
  3. Positive Behavior Supports for Adults with Disabilities in Employment, Community, and Residential Settings
  4. An investigation into errors in Employment and Support Allowance
  5. Guide to Government Benefits: Social Security, Medicare, Medicaid, Unemployment Insurance, Disability

References 

Gov.uk

Employment and Support Allowance Work Capability Assessments: Mandatory Reconsideration registrations, decisions, and outcomes

Was this post helpful?

[Sassy_Social_Share type="standard"]