Why are so many PIP decisions overturned at appeal?

Over 50% of PIP decisions taken to Tribunal result in the decision being overturned in the claimants favour. This percentage is even higher where the claimant has access to professional representation, for example, since 2021; the Hertfordshire Welfare Benefit Appeals project has a success rate of almost 90%.

The DWP have previously argued, the reason that such a high number of appeal cases are overturned is, the claimant provides new medical evidence, which challenges the basis of the original decision. This has the effect of putting the blame for incorrect decisions onto the client ‘If only they had told us this before……’

However, this argument did not correlate with my own experience of appeal decision making, where additional medical evidence played a role in a very small percentage of cases. Nor can it explain the statistics related to the award of 0 points at initial assessment. From 2022 – 2023, 86% of appeals, where the claimant was initially awarded 0 points, resulted in a change in the claimants’ favour, and of these 56% resulted in an award of enhanced rate PIP for at least one component*.

A recent response, from a DWP Minister, to a written question in parliament, showed that from 2021 to 2023, in over 70% of cases, the decision was overturned based on reliable oral evidence from the appellant, or where the Tribunal made a different decision on substantially the same facts.

Given the fact, the DWP will have had the opportunity to scrutinize the cases at the mandatory reconsideration stage; this suggests a system of health assessments, which is not fit for purpose.

For many years, I have been keen to find out how the DWP address inconsistencies and use Tribunal decisions to improve the standard of assessments. This information has previously been difficult to obtain, however the DWP have now confirmed that feedback from presenting officers is done on a case-by-case basis and only at a local level.

No evidence has been presented to demonstrate how this feedback is used to improve individual health care professionals practice, nor to show if feedback leads to an overall improvement in the standard of assessments and decision-making.

Trends are identified, but there are no plans to consolidate and publish the feedback. This lack of transparency means it is difficult to understand how identified trends drive strategic plans to improve assessments and decision-making. Without a clear strategic plan, setting out meaningful objectives for improvement it is difficult to see how the system will change.

*Appeals taken to Tribunal by Hertfordshire Welfare Benefit Appeals Project