The decision letter is on the table, and the score is lower than anyone in the house expected. Someone has already started a message that says the diagnosis was ignored. Someone else has googled the next step and found a clock. Mandatory reconsideration is that clock. Repeating the diagnosis louder is not how it is won.
PIP mandatory reconsideration is won, when it is won, on function: washing, cooking, leaving the house, walking. DWP is being asked to look again at the same claim. New noise is not the same as new evidence. The letter they need is the one that answers the descriptors they scored as zero, with a day attached.
The real question is whether you have evidence for the bits they disbelieved, or whether you only have the same clinic letters in a new envelope.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately.
What helps a PIP mandatory reconsideration
The short version is this. Bring what DWP actually asked for, and what the decision letter actually said. A GP can write to those questions after an assessment. They cannot promise the award. I will say that twice if I have to, because it is the sentence people come in hoping not to hear.
Here is the longer version.
Read the decision with a pen. Not the anger, the table. Which daily living descriptors were scored 0. Which mobility descriptors. What they wrote about reliability, prompting, and whether they thought you could do the thing most of the time. That paragraph is the brief. A pile of old clinic letters that never mention a bathroom is not a brief. I have sat with both on the desk. Only one of them changes the second look.
What I look at in clinic is the gap between the decision and the day. If they said you can prepare food, I want the kitchen. Standing. The hob. Whether someone has already taken the chips out of the oven after a burn last year. Whether meals have become toast because the rest is unsafe, not because you cannot be bothered, which is how it gets written when nobody asks. If they said you can wash, I want the bathroom, the time, the prompt, the crash afterwards. If they said you can go out, I want the last journey that actually happened, and the two that were cancelled, and what a bad day does to the next morning.
The pattern matters more than the single reading. A person who arrived on time, washed, and answered well for 30 minutes will be used, in a poor assessment, as proof that the rest of life looks like that. Clinic is a snapshot. Function is a week. I will examine what needs examining, and I will also take a typical Tuesday in order, then a bad Tuesday, and I will write the difference in ordinary English. Reliability is not a legal slogan. It is whether you can do the thing safely, to an acceptable standard, repeatedly, in a reasonable time. When this comes up in consultation, people describe the one time they managed, because they are trying to be fair. The decision maker never sees the five times they did not.
Bring the decision letter. Bring the original form if you still have it. Bring the medical evidence they already had, so I am not guessing what they ignored. Bring anything new that is actually new: a later clinic letter that describes function, an occupational therapy note, a fall, a hospital attendance, a change in treatment, a diary. New means it was not in front of them. Another copy of the same diagnosis is not new.
The piece most people miss is time. There is usually a month from the date on the letter. Not a month from when you felt able to open it. If you are already inside that window, say so on the first call. We can assess and write to the point. We cannot honestly promise a date if the diary is full and the evidence is a carrier bag. We say so.
Medical evidence, not a second argument
It is worth saying plainly: reconsideration is not a debate club. A long letter that says the assessor was rude, the appointment was short, and the diagnosis is serious will feel true in the kitchen and still fail to move the descriptors. I can record that an assessment was brief if you describe it, but I was not in that room. What I can do is examine you now and set out function now. That is the useful document.
I will not write that DWP was wrong. I will write what you can and cannot do, on the evidence of this assessment, and how that maps to the questions they have already asked. If the examination does not support the claim as put, I will say that in the room before anyone pays for a letter. You should hear it from me, not from the next envelope.
This is not advocacy. I have a duty to be honest. Families sometimes want a fighter. What they need is a witness who has actually looked.
When to come in sooner
Come in sooner if the date on the decision letter is already two weeks behind you. Bring the letter to Palmers Green. If you cannot travel, say that; a home visit is £250 in the day, £450 at night, and the house is often the better evidence anyway.
Come in sooner if the refusal turned on one or two descriptors you can actually describe, and nobody medical has ever written those down. That is the usual hole.
Do not use this appointment as the place to be when you are unsafe.
- Chest pain, stroke signs, severe breathlessness, heavy bleeding, a severe allergic reaction: 999.
- Sepsis symptoms, or a person who cannot be woken: 999.
- You are not safe tonight, or you have a plan to harm yourself: 999 or A&E.
- A new collapse, seizure, or head injury with confusion: A&E.
- A swollen leg with chest pain or breathlessness: 999.
- A child who is floppy, or a rash that does not fade: 999.
Forms can wait an evening. Those cannot.
How we approach this at Clinique Alpa
Call 020 8882 8088, or send a WhatsApp enquiry to 447742163571 without attaching records to the chat. Say that this is reconsideration evidence, and give the date on the letter. The fee is confirmed in writing before work begins. A 30 minute clinic appointment is £100 if you need advice first. A disability supporting letter is listed at £500 on the appointments and fees page. Revision of an existing letter starts at £100. A referral letter, if a specialist needs to see you as well, is £50 after assessment.
You are seen face to face. I read what you brought. I take the day. I examine. I write to the questions the decision actually posed. You get the letter to send. I do not send it to DWP for you, and I do not complete the reconsideration request as your representative. That is your claim, or your adviser’s.
The process for reports sits on the medical reports page. If Green Lanes is too far on a bad day, use the home visiting GP route and we will do the same work in the house.
If the window is short, bring the decision letter. Then describe the day they scored as if nothing were wrong.
Evidence written to the descriptors they scored, after a proper assessment. Read our fees page, or call 020 8882 8088. Clinic 30 minutes £100. Disability supporting letters listed at £500, confirmed in writing. In an emergency call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, GP and founder of Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.