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Welfare Benefit Appeal Letter

A completed fictional Personal Independence Payment mandatory reconsideration request explaining functional impact, evidence and tribunal timing without promising an award.

Jurisdiction: England and Wales - completed fictional worked example

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An editable Microsoft Word version is available from the interactive page.

Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# WELFARE BENEFIT APPEAL LETTER

Date: 20 January 2029

Parties: Aisha Rahman and Department for Work and Pensions

## 1. Applicant and subject

I, Aisha Rahman of 24 Beech Lane, Sheffield S11 8RX, request mandatory reconsideration of the PIP decision dated 4 January 2029, which awarded no points for either component. My National Insurance number is recorded on the enclosed secure form rather than in this copy.

## 2. Scope of request

I have fibromyalgia, postural orthostatic tachycardia syndrome and recurrent depression. On most days I cannot safely prepare a simple meal without sitting and dropping items; I need prompting to take medication and cannot reliably follow an unfamiliar journey because dizziness and panic cause me to turn back.

## 3. Facts and reasons

The assessment report says I cooked pasta unaided and travelled to the appointment. Those isolated events do not describe whether I can complete activities safely, repeatedly, to an acceptable standard and within a reasonable time, or the variation across the required period. On 13 of the last 20 days I needed my sister Leila to prepare food or prompt medication.

## 4. Information and adjustments

I attach my GP letter of 9 January, cardiology clinic letter of 15 December, prescription list, Leila's signed statement and a seven-day diary. I ask the decision maker to reconsider the relevant PIP descriptors using the evidence; I do not ask the department to accept a diagnosis alone as proof of points.

## 5. Response method

I seek an award for the daily-living and mobility activities supported by the evidence, backdated only as the regulations permit. I understand the decision maker may maintain, increase or reduce an award and that this letter is not a guarantee of entitlement.

## 6. Deadline and next steps

Please confirm receipt and issue the mandatory reconsideration notice. I understand a further appeal to the First-tier Tribunal (Social Entitlement Chamber) normally requires the notice and must meet the stated time limit, and I will obtain current DWP/tribunal guidance rather than rely on this example.

## 7. Signature and records

I authorise reasonable contact with the named clinicians for this decision and will tell DWP if my circumstances change. I certify that the account is truthful to the best of my knowledge and sign on 20 January 2029.

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