Mental Health and Benefits Handbook 1st edition - with new materialPart 3: Key topics Chapter 15: Supporting evidence
Back to previous
Chapter illustrations ()
Loading image navigation...
No image index could be found for this publication.
Close this Panel
Chapter 15: Supporting evidence
Key facts
    •Supporting evidence about your mental health problem, and the impact it has on your life, can help you to get the right decision about your entitlement to benefits.
    •A decision maker can seek out further evidence before deciding your entitlement, but this might rarely happen in practice. It is usually best to provide supporting evidence yourself.
    •Useful supporting evidence can include medical evidence (eg, doctors’ reports and proof of medication) but also evidence from non-medical professionals (eg, a social care needs assessment), evidence from other third parties (eg, supporting letters from family or friends) and your own evidence about your condition (eg, a diary or personal statement).
    •You can usually get free copies of existing documents by making a ‘subject access request’ to the organisation that holds them. You can also request new supporting evidence.
    •How you submit evidence depends on which benefit you are applying for and which stage you are at in the application process.
    •When deciding your entitlement to benefit, a decision maker will weigh up the available evidence. If there are contradictions in the evidence, it is a good idea for you to explain why.
1. When you might need supporting evidence
Many of the benefits discussed in this Handbook have a health assessment process. This process normally starts with you filling in a form to describe your health problem or disability and its impact on your life. For some benefits, this is followed by an assessment with a healthcare professional 1A doctor, nurse, paramedic, physiotherapist or occupational therapist who carries out assessments..
What you write on the form and say in an assessment are both important types of evidence for decision makers. This evidence can sometimes be enough on its own for you to be awarded benefit.1R(I) 2/51
However, in practice, it is more usual for a benefit claim to be successful where there is ‘supporting evidence’. This can include, but is not limited to, medical evidence.
Supporting evidence can be useful at various stages in the benefit application process, including:
    •at the very start of a claim – eg, attached to your claim form or questionnaire;
    •on an ‘award review’ or reassessment, to help show that a mental health problem has continued or deteriorated;
    •to help you challenge a benefit decision through mandatory reconsideration 2The requirement to have a decision looked at again by the DWP before you can make an appeal., redetermination or appeal;
    •to support a request for a remote or home-based assessment (see here) or a particular kind of appeal hearing (see here);
    •to help you show ‘good cause’ or ‘good reason’ for missing a deadline, not attending an assessment, or not taking part in work-related activity.
A decision maker can actively seek out this evidence but for most benefits this is rare and it is best to provide supporting evidence yourself. The situation may be slightly different for adult disability payment (ADP) and child disability payment (CDP) in Scotland (see here for ADP and here for CDP).
What advisers say: supporting evidence
‘Putting in extra supporting evidence at the claim stage can and does make a difference to your chances. If you put in extra supporting evidence at the claim stage but you do not get the decision you were hoping for, you may feel that all your hard work was wasted. However, the evidence you have provided is still valuable at the mandatory reconsideration and appeal stages.’
‘I read a lot of stuff which suggests that all supporting evidence will be helpful. However, I have seen cases where evidence works against somebody – quite often because, for example, a consultant’s clinic letter is very upbeat, telling your GP how well you’re doing, focusing on the positives. Even the word ‘stable’ in that letter can be used by a decision maker as part of their reasoning for refusing your benefit claim. People need to be selective about what evidence they do send.’
 
1     R(I) 2/51 »
2. Types of evidence and how to get them
Types of evidence
There is a range of supporting evidence you can use to give a full picture of your mental health problem and its impact. The following is not an exhaustive list.
Appointment letter
Benefit forms and leaflets often state that you do not need to provide appointment letters as supporting evidence. However, you might decide to do so if you think the letter is useful – eg, as evidence that you have been referred to a particular professional or for a certain kind of treatment.
Assessment provider’s report
Also known as a ‘consultation report’, this is prepared by a contracted assessment provider on behalf of the DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. or Social Security Scotland 2A Scottish government department that pays many devolved benefits in Scotland. (SSS).
As well as your latest assessment report for the relevant benefit, you can get copies of older reports for the same benefit, and reports produced for other benefits. All of these have the potential to be useful supporting evidence, particularly when different assessors have taken different views about your needs.1For example, GD v SSWP (PIP) [2017] UKUT 415 (AAC); SE v SSWP (PIP) [2021] UKUT 79 (AAC)
You can get copies of these reports by making a subject access request (see here).2For the DWP, you can make an online request at secure.dwp.gov.uk/personal-information-request/name. For SSS, use socialsecurity.gov.scot/contact/subject-access. If your benefit is administered by SSS, you should receive a copy of your assessment report with your determination notice.3SSS, Adult Disability Payment Consultations: what happens after the consultation, 29 August 2022, available at mygov.scot
 
1     For example, GD v SSWP (PIP) [2017] UKUT 415 (AAC); SE v SSWP (PIP) [2021] UKUT 79 (AAC) »
2     For the DWP, you can make an online request at secure.dwp.gov.uk/personal-information-request/name. For SSS, use socialsecurity.gov.scot/contact/subject-access. »
3     SSS, Adult Disability Payment Consultations: what happens after the consultation, 29 August 2022, available at mygov.scot »
Audio recording of a benefit assessment
Many benefit assessments can be audio recorded. There are different rules for different benefits, and you often need to request this in advance (see here, or for adult disability payment in Scotland, see here).
These recordings can be useful evidence when you disagree with what is written in an assessment provider’s report.
Diary
Sometimes the best way for a decision maker or the tribunal to get a picture of your needs is for you (or someone supporting you) to keep a diary to record your symptoms and the help you need. This can be particularly useful if your symptoms are variable.
Keeping a diary
You do not need to keep your diary in any particular form. You might want to use a page for each day. Even if you can manage to keep a diary only for a few days, it can help to paint a picture for a decision maker. Ideally, though, keep your diary for long enough to show how your condition varies. If your have ‘good’ and ‘bad’ periods during the day, try to keep a detailed diary for at least two or three full days. If you tend to have good days and bad days, a period of one or two weeks might be enough to show a pattern. If you tend to have good weeks and bad weeks, you may need to keep a diary for longer to show this.
If keeping a detailed diary feels overwhelming, you might decide to keep a record only of the activities you find most difficult – eg, a ‘leaving the house’ diary, a ‘social contact’ diary, and/or a ‘showering and dressing’ diary.
Fit note
This is usually needed as part of the work capability assessment 1An assessment of whether, because of a health condition or disability, someone has limited capability for work/work-related activity. process for universal credit and employment and support allowance, but may not be strong evidence for other benefits. There is more information about getting a fit note on here.
Friend and family evidence
Some forms include a page which asks for a statement from somebody who knows you well. Others do not but it can be useful to provide one anyway, particularly if you have had limited support from professionals. Your friend or family member may also give spoken evidence at a benefit tribunal hearing (see here).1For example, MA v SSWP (PIP) [2017] UKUT 351 (AAC)
What advisers say: friend and family evidence
‘There can be a wrong assumption that if you are not in contact with a GP or a community mental health team then your mental health issues can’t be that bad, without awareness of how stretched mental health services are and of how long people have to wait (including people who health services may consider to have significant difficulties). A GP honestly may not know that much about how you are affected day to day. That is when the evidence of a close friend or support worker can really count.’
‘Sometimes the DWP can seem to underrate non-medical evidence, but it does get listened to eventually even if you have to wait until an appeal.’
 
1     For example, MA v SSWP (PIP) [2017] UKUT 351 (AAC) »
GP patient summary
You can ask your GP’s surgery for a printed summary of the records it holds about you, or you can apply for this online.1See nhs.uk/using-the-nhs/about-the-nhs/how-to-get-your-medical-records This document is now widely known as a ‘summary care record’ and can be among the easiest medical evidence to get hold of. It comes in different formats, ranging from a short summary of your diagnosed problems and medications to a longer record including consultation notes, letters and other documents that your GP holds about you. You may decide to ask for a patient summary that includes at least 12 months’ consultation notes and documents.
Someone supporting you can make the request on your behalf, with your consent (see here).
 
1     See nhs.uk/using-the-nhs/about-the-nhs/how-to-get-your-medical-records »
Hospital discharge sheet
This can be useful evidence about when, why, and for how long you have been admitted to hospital, and any care or treatment plans that have been made on discharge. If you have lost a hospital discharge sheet, ask your GP for a copy (see above) or make a subject access request (see here) to the relevant hospital trust or health board.
Mental health tribunal papers
If you have been subject to a section (see here) and applied to a mental health tribunal, various reports might have been prepared that can also be used as supporting evidence for a benefit claim. You can ask the solicitor who represented you for copies. If you were not represented by a solicitor, you could ask the hospital where you were last detained whether they have copies or whether they can tell you where to get copies.
Personal statement
If a benefit form does not give you the opportunity to describe your mental health problems clearly or in a holistic way, you might decide to do so in a supporting statement. You have a lot of freedom about what this could contain but it is usually best to keep it to one or two pages. You might mention the symptoms you have, how long you have had them, how they vary, and the impact of any treatments or medications.
Prescription list
You do not necessarily need to be prescribed medication to qualify for health-related benefits, and the type or dose should not be taken as conclusive evidence of your difficulties, but it will certainly be considered as part of the decision-making process.1For example, PM v SSWP (PIP) [2017] UKUT 154 (AAC), as interpreted in PIP AG, para 1.6.36
 
1     For example, PM v SSWP (PIP) [2017] UKUT 154 (AAC), as interpreted in PIP AG, para 1.6.36 »
Report from a specialist doctor
You are normally sent a copy of any report produced by a specialist doctor you have seen – eg, a psychiatrist or psychologist. If you have attended an appointment with a specialist, but do not have a copy of their report, you should be able to get this from your GP or by making a subject access request (see here).
Report from another medical professional
A report from, for example, a community psychiatric nurse (CPN), an occupational therapist or a child’s health visitor may provide more detailed information about the impact of a mental health problem on day-to-day life than a report from a doctor, which is likely to focus on symptoms and treatment.
What advisers say: community psychiatric nurses
‘Probably the people I [ask for evidence] most often are CPNs because they have very regular contact with their patients, usually in their homes. If you have been seeing somebody in their home every two or three weeks for six months or more there is a lot you can say about their day-to-day life and their ability to go out.’
Social care evidence
For adults, this could include a needs assessment, a care and support plan, or other documents from your local authority’s social care department. These can be particularly useful evidence for disability benefit claims because social care looks at many of the same day-to-day needs that are considered for those benefits – eg, needing support to prepare meals, wash or get dressed. You can request a needs assessment by calling your local authority, or online at gov.uk/apply-needs-assessment-social-services.
For children, social care evidence could include an education, health and care plan (EHCP) or a statement of special educational needs.
What advisers say: care plans and school reports
‘It can be worth looking over care plans and school reports carefully before using them as evidence. [Professionals writing social care plans] may limit themselves to writing about needs and support that the local authority’s budget can cover. School reports often want to focus on the positives and ways in which a child does manage to participate and overcome difficulties, without always explaining that the participation may be limited or only be with support and encouragement.’
Supporting letters
In addition to the evidence listed above, you could ask for a new supporting letter from anyone with specific knowledge about your mental health problem or about the needs you have as a result. This might include a:
    •care co-ordinator;
    •CPN;
    •counsellor;
    •employer;
    •family member or friend;
    •GP;
    •landlord;
    •occupational therapist;
    •psychiatrist;
    •psychological therapist;
    •psychologist;
    •social worker;
    •special educational needs co-ordinator;
    •specialist substance abuse worker;
    •support worker;
    •teacher;
    •volunteer – eg, a befriender.
What to ask for in a supporting letter
Ask anyone who writes a supporting letter to comment on the criteria that you are being assessed against. For example, if you are asking your CPN to write a supporting letter for personal independence payment (PIP), give them a copy of the PIP activities and descriptors and ask them to write specifically about these.
Always ask the writer to comment on the variability of your condition. There are different rules about variability for different benefits, but as a general rule it is important to explain whether you have good and bad days, times of day, or periods during the year.
The letter must be dated. The writer should ideally say which period their comments cover – eg, if their letter is dated February but describes symptoms that they know you have had for 18 months.
Different people can comment on different aspects of your mental health problem and needs. You might find that a GP refuses to write about your home life, which they have not observed in person, while a befriender might not feel comfortable writing about your diagnosis or treatment, because they are not medically trained. It is usually a good idea to seek evidence from a few different sources, if you can, to give a full picture of your mental health problem and its impact.
Ask that the supporting letter is sent to you, not directly to the DWP, SSS or the tribunal. This gives you a chance to check that you are satisfied with its contents before you submit it.
Note: some benefit forms and information leaflets discourage you from seeking new supporting letters from doctors. It is true that there might be a charge for this kind of letter and you might get stronger medical evidence by making a subject access request (see here). However, new supporting letters can often be useful – eg, where there is no other up-to-date medical evidence, where you do not have a diagnosis (see here) and the doctor can confirm your symptoms, or where specific questions have been raised by a decision maker about your treatment plan.
What advisers say: asking for a supporting letter
‘You could include a summary of how you feel that the descriptors apply to you. A friend or adviser could help you prepare this. That may give [the person you are asking for a letter] a better understanding of how the scoring system works and inform their own view of what they might include. Sometimes, busy professionals may not have the time to write a full letter, but they may be willing to comment on your summary.’
Old, new and undated evidence
Recent evidence is useful because it is most likely to be accepted as up to date. However, there are many reasons why you might not have recent evidence – eg, because your condition is longterm and your symptoms and treatment have not changed.1See, for example, PIP AG, para 1.8.12 In this situation, it may be worth providing your older evidence, and you might also consider requesting a new supporting letter from a key professional (see here).
Sometimes you receive new evidence after a decision has been made – eg, a new consultant’s report. If this relates to symptoms you were already having at the date of the decision, or variability or risks that existed at that time, it can be useful evidence for challenging the decision (see here for an example).2R(DLA) 2/01; R(DLA) 3/01; CJSA/2375/2000; KK v Liverpool City Council (HB) [2020] UKUT 80 (AAC) However, if the evidence is clearly about changes that happened after the date of the decision, it is unlikely to be accepted as supporting evidence when you challenge the decision.3s12(8)(b) SSA 1998; R(DLA) 4/05 You might decide instead to use it as supporting evidence for a new claim or for a supersession 1A method of changing a benefit decision some time after it was made, often because of a change in circumstances. request (see here, or here for adult disability payment/child disability payment in Scotland).
As the date of evidence is so important, you should avoid submitting undated evidence.
 
1     See, for example, PIP AG, para 1.8.12 »
2     R(DLA) 2/01; R(DLA) 3/01; CJSA/2375/2000; KK v Liverpool City Council (HB) [2020] UKUT 80 (AAC) »
3     s12(8)(b) SSA 1998; R(DLA) 4/05 »
Subject access requests
If you need to get hold of an existing document, you can normally do this free of charge by making a subject access request to the organisation that has it or produced it. For example, you can request a consultant’s letter by making a subject access request to the relevant hospital trust or health board, or request a copy of your social care needs assessment by making a subject access request to your local authority. There may be special contact details or an online form for making the request, which are found on the relevant organisation’s website. You should usually get a response within one month. Further information is available from the Information Commissioner’s Office.1ico.org.uk/your-data-matters/your-right-to-get-copies-of-your-data
Someone supporting you can make a subject access request on your behalf, with your consent (see here).
 
1     ico.org.uk/your-data-matters/your-right-to-get-copies-of-your-data »
3. Submitting evidence
How you submit supporting evidence depends on the benefit and which stage you are at in the application process.
If you are attaching evidence to a claim form or questionnaire, there is usually a freepost envelope which makes it clear where this needs to be sent. However, if you are submitting evidence after returning your form, but before getting a decision, get advice on where you should send it – eg, to an assessment provider or to the relevant office of the DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. or Social Security Scotland 2A Scottish government department that pays many devolved benefits in Scotland. (SSS).
If you are challenging a decision through a mandatory reconsideration 3The requirement to have a decision looked at again by the DWP before you can make an appeal. or (for SSS benefits) redetermination request, you should normally send supporting evidence to the address given in your decision letter. For universal credit, you may be able to upload it through your online account.
If you are at the appeal stage, you normally need to send supporting evidence to the appropriate tribunal service. You can do this by post or email. The tribunal service then shares copies of your evidence with the relevant benefit agency.
Dos and don’ts of submitting evidence
Do write your name and national insurance number on each sheet of supporting evidence.
Do not send original documents – send copies.
Do not delay sending off a form or letter while you wait for supporting evidence if this means missing a deadline. Instead, explain in your form/letter what evidence you are waiting for and ask the decision maker to delay their decision if appropriate.
Do not take supporting evidence to your assessment or appeal hearing if you can provide it sooner. If you take evidence to an assessment, the assessor might not properly consider it – eg, if they do not have the facilities to make a photocopy. If you take evidence to an appeal hearing, the hearing might be adjourned to give the tribunal time to consider it or, exceptionally, the tribunal might decide not to consider it because it is late.1CIB/4253/2004; r15(2) TP(FT) Rules; r15(2) FTT(S) Rules
 
1     CIB/4253/2004; r15(2) TP(FT) Rules; r15(2) FTT(S) Rules »
4. Evidence and decision making
A decision maker should consider all of the evidence in your case but does not have to give it all equal weight. Factors that might determine weight include the training or qualifications of the person giving the evidence, how well they know you, and whether what they are saying is corroborated by other evidence. The decision maker should not automatically prefer an assessment provider’s report over other pieces of evidence.
If you notice conflicting evidence, you should take the opportunity to explain this. A decision maker needs to decide which evidence it accepts and your explanation can help.
A decision maker may have a finite amount of time in which to decide your claim, meaning you might get the best decision if you submit a limited amount of high-quality supporting evidence, rather than sending a large volume of evidence not all of which might be useful – eg, your full medical record. If you have to submit large amounts of evidence (eg, if you need to submit a long report in full), highlight the parts that are most relevant.
How the tribunal considers evidence
When deciding your appeal, the tribunal should consider all the evidence available.1CDLA/2014/2004 It should not restrict itself to accepting an assessment provider’s report.2CM/527/1992; CIB/3074/2003; AP v SSWP (PIP) [2016] UKUT 416 (AAC); CF v SSWP (PIP) [2017] UKUT 356 (AAC) If there is conflict between what is said in a report and what is written elsewhere (eg, on your claim form), it should not accept the evidence in the report without first listening to what you have to say.3CIB/5586/1999 The tribunal should be particularly careful not to accept automatically the findings in medical reports produced with the assistance of a computer programme.4CIB/476/2005; CIB/511/2005
 
1     CDLA/2014/2004 »
2     CM/527/1992; CIB/3074/2003; AP v SSWP (PIP) [2016] UKUT 416 (AAC); CF v SSWP (PIP) [2017] UKUT 356 (AAC) »
3     CIB/5586/1999 »
4     CIB/476/2005; CIB/511/2005 »