Sample Esa Appeal Letter Template (Page 3 of 3) in pdf

Sample Esa Appeal Letter Template Page 3

Sample ESA appeal letter

Date

Insert your address

Department of Works and Pensions

(Insert benefit office address on the decision letter)

Dear Sir/Madam

My National Insurance Number:

I refer to your letter of (insert date………..) and the decision that I am not entitled to

Employment & Support Allowance because I did not score enough points on the recent

medical assessment. I wish to appeal against this decision.

I disagree with the decision because the medical assessment appears not to have taken

into account the extent to which my medical condition limits my daily activities. For

example, (insert details of the activities that apply to you).

A sick note is enclosed. Please re-instate my Employment & Support Allowance payments

pending the outcome of my appeal.

I plan to obtain reports from my GP and other health professionals in support of my

appeal. I will forward any further evidence to you as soon as it becomes available.

Thank you for your attention to this matter.

Yours faithfully

Full Name

Sample Esa Appeal Letter Template Page 3