Tribunal Hints and Tips

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Category: Benefits

Published on Sunday, 16 November 2008 16:31

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Shannon Dalshaug

Now that you've been turned down for benefit, you are probably wondering ‘Now what do I do?’ This document is aimed at helping you on the steps that you may have to take in order to take your decision to appeal. While this may seem a daunting prospect, there is a lot of help that you can take advantage of. Many people have already been down this route and succeeded.

Preparation and Choices

Initially you have some choices to make:

It cannot be stressed enough that getting some help and advice from an experienced adviser can save you a lot of stress and you will be helped to understand what is going to be the best decision for your personal circumstances.

Going to tribunal for any benefit is going to be stressful; however it will be your opportunity to tell how your life is affected and why you feel you meet the criteria for benefit.  If you choose not to appeal a refusal of benefit, you are guaranteed not to have a decision changed. Remember that an appeal panel can only look at how you were affected when you put the claim in - they cannot take into consideration any further problems you may have - this would have to be done through a new claim.

Tribunal Package
Once you have completed your appeal form, called a ‘gl24’ or write a letter as your formal appeal, you will receive a tribunal package (this may take a month or more) that has been prepared by the Department which outlines the following:

• dates of the decision
• what evidence they've used to make the decision
• the legislation involved for your benefit
• commissioner's decisions that are intended as guidance for decision makers and tribunals for making decisions.

In this tribunal package will also be a copy of your claim form, a copy of your appeal letter or gl24, and any GP or other medical reports that have been gathered to determine if you meet the entitlement criteria. 

This package can be intimidating to try and go through which is why it's best to try and get an experienced adviser to help guide you through this.  However if an adviser is not available to you, with time and patience you can do this yourself.

Reviewing the departments decision
What you will need to do is go through how the department has made their decision, and for IB you will need to see how many points you've been awarded if any. The key things you're trying to work out when going through the evidence is what evidence is it that you disagree with, and how can you demonstrate that you do meet the criteria for benefit. 

Now that you've worked out what it is that you need to prove, it's time to gather evidence from your GP or specialists, and from your carer's if you have any. 

With DLA, you need to focus on your personal care needs and your mobility needs; shopping and house work that you need help with do not count.  However if someone needs to go with you when you go shopping, this may count but will depend on your personal circumstances.

For IB, what they are going to look at is called a personal capability assessment/all works test or an own works test depending on your circumstances. Or put simply, how your disability prevents you from working.

Choice of hearing type
You will be given the option of having either a paper hearing or an oral hearing. 

The choice is yours; however keep in mind that if you choose a paper hearing, although this may seem less stressful at the time, the tribunal panel will be limited in what evidence is available to them on the day, the chances of winning a paper hearing are very low. 

With an oral hearing, although it is more stressful as you have to show up in person, and have to answer a lot of questions which may be very embarrassing to you, you have the ability to add anything you may have forgotten previously, and the tribunal will be able to see for themselves how you are affected. 

Tribunals are independent from the department for any benefit they come under the Lord Chancellor's Office.  For each benefit there will be a panel of people who will decide if you meet the criteria for an award.

DLA, AA, or the Disability Element of Working Tax Credit will have 3 panel members.  One is a legally qualified member, one is a medically qualified member and one is a disability qualified member.

For IB there will be 2 panel members.  One legally qualified and one medically qualified.

At some stage depending on how backlogged your Tribunal Appeals Service (TAS) is, you will be listed for your Appeal Hearing; you will receive another letter telling you of the date and time along with a form where you confirm if you'd like an oral or paper hearing, you add who your representative is if you have one (if you have one they'll be guiding you through this) and you can submit any evidence to support your claim. 

You will need to remember that with DLA they need to know what care and mobility needs you had at the time of the decision.  For a fresh claim for DLA, this will be a 9 month period of three months before and 6 months after the date of your claim. This can become confusing, and is one of the reasons that keeping a diary of your symptoms is suggested.

Day of Oral Hearing
On the day of the hearing you will go to the TAS in your local area, this may be at a court house or in a meeting room; it varies from area to area how they are dealt with.

You will be met by the clerk to the appeals service, they will explain how your tribunal is made up, the names of your panel members, and they will also remind you that TAS is independent from the department (DLA).  The clerk will ask if you'd like to look over your medical records, if you have a representative with you, then they will probably want to take a look through to see what evidence they can find to support your care and mobility needs. You can do this yourself if you'd like, but it's not something to worry too much about if you don't feel settled enough to be able to do this as you should have a fairly good idea of what information is being held in your records. 

When the Tribunal is ready to hear your case, the clerk to the appeals service will take you into the room. You will be greeted by the chair person who will introduce the panel and will again reassure you that the TAS is independent.  The chair person will go over briefly how the hearing will proceed.  DLA may have a representative at your tribunal hearing, they do in a random selection of cases in some areas, and in other areas they have one more frequently; this will depend on your area.

The tribunal will then go through a series of questions they need to establish a number of things.

1. What is your condition/disability, how long have you had the condition, and how long is your condition expected to last? For DLA it's 3 months before your claim and at least 6 months after.
2. How does your condition affect your ability to care for yourself?  If you have personal care needs they need to find out what level is correct for your circumstances (low, middle or High) and they have to decide if the care needs you claim are reasonable to expect for a person with your condition in your personal circumstances.  The tribunal needs to consider what guidance they have been given by previous commissioner's decisions that are intended to help illustrate how the legislation for DLA is intended to be interpreted.
3. Mobility, again there are a number of issues they need information about.
4. Can you walk?  If No, High Mobility provided you can benefit from the award. (For example a person in a coma would be unlikely to qualify as they would gain no benefit from having the additional help for mobility)

If you can walk, how far you can walk without severe discomfort; how you walk; do you limp, shuffle or have an abnormal gait, how quickly or slowly can you walk?  If you can only manage a very small distance without severe discomfort, you may be considered virtually unable to walk and may qualify for High Rate Mobility   If you are able to walk but do not meet the criteria for virtually unable to walk you may qualify for low rate mobility. If you need physical support from someone when you are outside or if you need supervision to prevent danger to yourself and others, or if you need someone to reassure and encourage you while you are outside to assist with mental ill health issues.

When answering the questions from the tribunal, remember not to minimise the impact your condition has on your life.  Your FM will affect you in the way that it does, and will have the impact on your life that only you can truly understand.  Some people are mildly affected and may not have enough care or mobility needs often enough to qualify for DLA, others may be severely affected both night and day, and may be considered virtually unable to walk and be awarded high rate care and high rate mobility or any of the combinations of the levels of award. 

After the questions have been asked and answered you can have an opportunity to add anything that might have been missed regarding your care or mobility needs.  At this time, it may be appropriate to summarise your issues briefly for the tribunal so they have a clear understanding of how your illness/disability impacts on your daily life.

For your Incapacity Benefit tribunal your panel members will go through a series of questions that will help them determine whether you are fit to return to your previous work or to any form of work at all.  If your illness is physical you will need to be awarded 15 points in order to be deemed unfit for work.  If your illness is a mental health issue you will need to be awarded 10 points.  If you have a combination of physical ill health and mental ill health you will need to reach 15 points by a combination of both types of points.

Tribunal Decision

DISCLAIMER: Please be advised this guide is for information only.  We strongly advise that you receive help from your local benefits advice centre for any benefit applications or appeals. 

***There is no guarantee that following the advice provided will result in an award of benefit.***

When speaking about your claim, you must claim only the symptoms you as an individual have. 
Each person with Fibromyalgia has symptoms individual to them, and may have additional conditions and  symptoms.  You have to fill out application forms as honestly and as accurately as possible.

The DWP (DLA/IB/AA/ESA or other benefits) and the Tribunal Appeals Service tribunal panel have the ability to award a continuation of an award at the same level.  To change any component that they have awarded at the level they believe is suitable for each individuals circumstances and condition(s),they can also reduce your award or remove it completely and they can decide what dates your award will begin and/or end based upon the evidence for each case/person.

Help on specific benefit questions can also be accessed through FMAUK’s benefits helpline.