DLA - Mobility, Check .. Care Element .. hhhmm

[Thunda]

Hi there - first time poster here so go easy on me!

 

I'm writing actually on behalf of my wife. She suffered a serious back injury some 10 years ago at work, took some time off, but then went back to work and struggled on for 7 years or so before finally conceding as the pain in her back got worse and worse.

 

She went onto Incapacity benefit and eventually applied for DLA. She got knocked back the first time (long story!!) - but was awarded the Higher Rate Mobility in August time this year after a 2nd time of applying .. however, she got knocked back again for the care element.

 

This is what isn't really understood. She's been awarded HRM quite rightly - but the care element ....hhhmmmm .. she can't take the 5 steps from where she sits daily to the toilet without either being carried or heavily supported by myself .. Forget walking to the kitchen or the bathroom to cook a meal or bathe herself.

 

However, if I hoisted her on my back and carried her to the kitchen for instance and dumped her there - she could probably manage some of the tasks needed to cook a meal (I would of course have to carry her back to her seat) .. some of the tasks for short periods I may add ..

 

Now she seems to have been knocked back for the care element without them taking into account that she can barely walk .. Yes, she can stir a pan of beans once there (for a short while, at least) .. but we can't understand how they expect her to get to the oven in the first place or the toilet, to the bath, to the bedroom etc etc etc without help or support from me.

 

Now we've asked them to look again the care element side of it again and we should hear from them very shortly .. but, I'd like to ask those who've been through this process before - is this making sense or have we got the wrong idea about care allowance?

 

Also, if she gets knocked back again - do you think its worth taking it further to the tribunal?

 

Thanks in advance

[Bookworm]

Hmmm... I kind of see how they reached that conclusion (which doesn't mean I agree!) as you are helping her with the mobility side but she can actually care for herself, so the argument to the extreme would be that in a perfectly adapted home for example she could manage without a carer, in principle anyway.

 

The reality of course is that care and mobility often overlap anyway. It's ironic that if she needed help sitting on the toilet and get up again, that would come under care, but getting there is mobility.

 

How did she phrase the claim form? One would usually expect at least the minimum rate of care when someone gets high mobility and for them to flatly say no to it seems extreme, so yes definitely appeal. The proportion of claims overturned at tribunal is huge and so it is always worth it IMO.

 

Holler if you need help or if you want me to look at the claim form, see where you might have gone wrong. ;-) (in confidence of course!)

[Thunda]

Hi there Bookworm, thanks for your reply.

 

Obviously, I've not gone into details there - but there are other aspects to it.

 

Firstly, she suffers severe pain in her back and legs and regularly gets shooting pains down her legs which can cause them to buckle - certainly not wise if she's holding a pan of hot whatever ..

 

She can't really do anything that involves below the waist (due to having to bend) - therefore, she needs help with dressing and bathing .. she struggles to get into and out of bed as she isn't able to lift her legs without help .. etc etc ..

 

She's on a shedload of Morphine to try and manage the pain but seems like her dosage is having to increase week to week as she gets immune to its effects - naturally, this leaves her both nauseous all day and pretty monged out from its effects. Due to her condition, she's been diagnosed as depressed and just .. GAH .. constantly.

 

In the report that came back from the DLA - they claimed she does require "some help" in "some areas" but not enough to justify carers.

 

The forms were filled out with the help of the CAB so I would imagine all the right boxes were ticked and they made sure things were worded correctly. They themselves were amazed when we told them she'd been refused carers - as have a couple of other people who work in similar fields.

 

All the things above (and others) were mentioned but a big firm NO from the DLA.

 

So we've been left wondering if our understanding of Carers has been wrong or not .. Ok, if she isn't entitled to it, fair dues - no problem with that .. but it just seems strange that they claim she doesn't need help with her care yet that doesn't seem to match up to the reality on the ground ..

[Bookworm]

Do you work? Or do you care for her full-time? If yes, did you apply for Carer's Allowance at the same time as the DLA?

 

I'm trying to think sideways here, in that if you didn't, they would then think: "a-ha, she obviously can care for herself". It is of course possible that I am giving the DWP more credit than they deserve, assigning some serious thinking to their methodology.

 

Either way, make sure that if the review comes back negative (and it probably will ) you do take it to tribunal, I would rate your chances very high to get at the very least the low rate, although if you do have to see to her at night as well, that is what makes the difference between medium and high. The fact that she is on high amounts of morphine alone should give her a care element anyway, as someone on high levels of medication should get help with supervision.

 

I am really baffled on how they can refuse her on that short description you have given.

 

Make sure you update us and if you decide to go to tribunal, let us know and we'll help as much as we can with that.

 

Stay strong and best wishes to your lady.

[andie_303]

unfortunately with DLA and what i think is the biggest flaw in the system is that they people that decide claims aren't doctors or have any medical background - I would ask how anyone can judge medical claims without this - but thats the way it is apparently.

 

I was told by the CAB when I initally applied for DLA for my son its all about how you "word" your claim - they told me there are "key words" they look for in an application - if they are there BINGO!!

 

My CAB basically wrote my form replies for me - I told them the situation and they put it in language that would best get the claim accepted.

 

We got accepted first time which I believe is a rare feat nowadays.

 

It's sad that it all comes down to the use of the english language to determine suitability!

[Thunda]

I don't work no - I could probably only accept the "perfect job" .. just round the corner from where we live, flexi time, a couple of hours day, 30K a year .. .. I effectively need to be present 24/7 for her .. or as good as and can only really go out for a couple of hours max .. even if that means me just being there in case she needs something

 

I did apply for carers allowance at the same time - but they sent it back saying that whilst her DLA claim was being processed, then I'd have to wait .. I had been signing on for the last 6 months or so since she first put her claim in but of course was getting grief from the Job Center and the lady who was in charge of my JSA who totally understood the situation (and again, couldn't believe she'd been turned down for carers) - has helped a great deal by prolonging any "forced service" I'd have to do as she realises given the situation that I just can't do it .. Anyway, she's found a way where I can sign off and not really lose out money-wise and so I signed off a couple of weeks back ..

 

I am really baffled on how they can refuse her on that short description you have given.

 

Join the club! Even if its just the lowest rate - then at least its acknowledgement that she needs help ..

 

 

unfortunately with DLA and what i think is the biggest flaw in the system is that they people that decide claims aren't doctors or have any medical background - I would ask how anyone can judge medical claims without this - but thats the way it is apparently.

 

Hey Andie .. I think at times even the medical people struggle to help .. I kind of think her first application for DLA went against her .. For that one (a couple of years back) - they sent her for a medical .. the doctor was, shall we say, less than impressive .. He kept writing things down that were blatently untrue and totally opposite to what she was saying to him .. She attempted a couple of the tests he asked her do and gave up on them more or less straight away because she just couldn't do them .. he marked it down as "refused" ..

 

The CAB did a decent job with the forms .. my only issue with it is that 1 guy filled half the form in and someone had to step in to fill the second half in (the first guy came down ill) ..

 

We'll see what they say when they come back after reviewing it .. should be any day now .. been about 10 / 11 weeks since we asked them to look again at it ..

 

My only fear is that after reviewing it (this is just my natural "fear the worst" instinct kicking in!!) - is they downgrade the mobility!! .. Picking a motability car up on Friday!!!

[Deb T]

You mention the cooking part re your partner visiting the kitchen etc....The 'cooking test' is quite common when assessing the care component ..

 

To get on the first rung as in the low rate care component you need to show that your wife is so severely disabled, physically or mentally that she cannot prepare a cooked meal if she has the ingredients available. The meal in question is a labour intensive main meal for one person, freshly cooked on a traditional cooker...(it's a hypothetical test) You cannot argue that your wife doesn't know how to cook either, the test assumes that she does etc....The test on the whole is to see the big picture on her ability to do the above and having a good day/bad day does not apply....The criteria for the hypothetical cooking test is

Peel and chop vegetables

Use Taps

Use Cooking Utensils

Use a Cooker

Lift hot or heavy pans

drain vegetables

tell that the food is cooked properly etc...

 

To be able to cook your wife needs to be able to manage both the physical tasks such as lifting pans, carrying/bending etc and using kitchen equipment...for her to qualify the lower rate she needs to show that her disability makes her unable to perform the tasks needed to cook the meal

 

If she has chronic back pain it may be seen as unreasonable for her to prepare the meal and then sit waiting for it to cook...but this alone isn't an automatic qualification for the lower rate etc...

 

I could go on but rather than do so might I advise you on a book that is worth it's weight in gold and then some. It is detailed, it is helpful and it sets out the guidelines for a plethora of benefits and what is required to qualify etc.

 

It's called

Welfare benefits and tax credits handbook, 2008/2009 version and it costs £36 and with over 1500 pages it gives excellent value for money. You can pick up a copy from any good store such as Amazon or order it via Waterstones etc..... The ISBN number is 978-1-906076-12-2 It is compiled by the Child Poverty Action Group ...

 

Buy it and you won't look back

Edited October 28, 2009 by Deb T

[Thunda]

Hey Deb - thanks for your reply

 

Ultimately, we're not overly bothered if she doesn't get the Care side of things - if she's not eligible, then fine - no problems with that .. Its just really understanding why she get turned down in the first place ..

 

Looking at the list you put above - I know myself that she would fail 2 or 3 straight off and without me thinking about it - its obviously down to her whether she could or couldn't do the others ..

 

We live in a small flat - this is both good and bad. Good that everyplace she would need to be (living room, kitchen, bathroom, bedroom) - is a very short distance from each other which puts less pressure on her (and me - I have a dodgy hip as it is!) if she has to go somewhere. The bad side of this is that there is no way, for instance, she could use a wheelchair to get around as it would be impossible to manuever even if I was pushing it, let alone under her steam by itself.

 

As such, she needs to make do with crutches and with my support .. An occupational therapist came to visit a few months back to see if there was anything they could provide and they did help in a couple of areas - a chair for instance which is kept in the kitchen if she is ever in there - but, the problems with it is she still needs help getting in and out of it and still can't do the lifting, bending and manauvering around the kitchen ..

 

But really, the kitchen element isn't really a problem for us on a day to day basis - I tend to just do the cooking anyway ...

 

Its things like toiletry needs where the issue is. She can't get there herself without help, struggles to sit down and get back up again and then back out. She's fine doing her business there, but the rest of it - forget it. The OT gave her a toilet aid to try and help her to sit and stand, but it just doesn't work for her - she needs me to help her up and down.

 

Bathing the same. Shes fine once in the bath, for instance, but everything else is a major struggle. She can bathe her top half fine, but anything where she needs stretch her arms - so anything below waist or washing hair - she can't do. Dressing, likewise .. below the waist she needs my help.

 

I could go on and on ... but I think you get the picture .. And this is why I can't understand why she got knocked back for the carers. Ok, I have nothing to compare her against - I don't know of anybody who currently get carers so can't say whether she is better or worse and nor am I aware whats needed to qualify for low, mid or high ..

[3333333]

Like others have said I think alot is down to your wording, what as your Wife been diagnosed with, regarding her back?

[MrHistory]

"I have nothing to compare her against - I don't know of anybody who currently get carers so can't say whether she is better or worse and nor am I aware whats needed to qualify for low, mid or high .."

 

I get lower rate care and i can run up twenty flights of stairs if need be, I can do most things normal people can do as mine is a mental health problem, i'm as shocked as most here your wife should be getting the middle if not the higher rate, Usually mobility and care go together, Over the years of helping people claim DLA they have always got both, Not much help i know but i really hope you fight this and get all the benifits you are entitled to.

 

ps: forgot to say i get the lower care as i'm unable to prepare and cook a dinner, And thats only on some days not every day.

[Thunda]

Like others have said I think alot is down to your wording, what as your Wife been diagnosed with, regarding her back?

 

She has a Sacrailic Joint Dysfunction after a work accident some 10 years back .. Had numerous treatments that haven't worked and her condition is getting worse and worse.

 

I get lower rate care and i can run up twenty flights of stairs if need be, I can do most things normal people can do as mine is a mental health problem, i'm as shocked as most here your wife should be getting the middle if not the higher rate, Usually mobility and care go together, Over the years of helping people claim DLA they have always got both, Not much help i know but i really hope you fight this and get all the benifits you are entitled to.

 

ps: forgot to say i get the lower care as i'm unable to prepare and cook a dinner, And thats only on some days not every day.

 

Well she struggles to walk up one flight of stairs - let alone run!!

 

Part of the problem (I think, anyway) - is that the pain comes and goes .. I tend to think it goes in a 4 week cycle .. She'll have a week where things are "ok" .. OK for her, not maybe for a able-bodied person .. she can wander about and cook meals, bathe, dress, get into and out of bed etc etc .. However, she is still in pain - but not enough to be debilitating.

 

She'll then have a week where she's starting to struggle .. the pain is worse .. she's getting shooting pains down her legs .. she's starting to hobble about .. although she can still get about with the help of her crutches, she tends to just sit and rest as much as she can ..

 

This then goes into the Pain Week .. she can basically do nothing .. She sits 4 paces from the bathroom door, but can't make the walk and needs me to lift and help as much as I can. She can't get into / out of bed, can only stand for 30 seconds at most, can't bend or crouch, the slightest movement or twist leaves her swearing and gasping in pain etc etc ..

 

After this week she has a week of taking everything easing - very similar to the week before Pain Week .. resting up, taking things very easy, not doing anything silly ..

 

And then the cycle starts again ..

 

So its 1 "ok" week .. 1 bad week .. 1 very very bad week .. 1 bad week ... rinse and repeat ..

 

****************

 

She received her letter back from the review from the DLA this morning ... No .. the decision hasn't been changed .. High Rate Mobility .. No Care element ..

 

Bugga ..

Edited November 2, 2009 by Thunda

[Deb T]

Then you must appeal and request an appeal where you and your wife get to go to the appeal hearing, it may be difficult for her to get there but it will at least demonstrate her disability if she is struggling etc.

 

[sir fussalot]

Thunda.

 

You MUST appeal.

 

by your wife getting the HRM you are half way there.

 

Youare not getting the care componant now, so you have nothing to lose.....you can only gain.

 

I was laid-up several years ago (no internet in those day's) so I bought several books from C-pag. One of them was the "Adjudicating Officers Handbook", best books I ever bought...

 

Adjudicating Officers, (the people who make the decisions on awards) etc.

 

get bonus's for disalowed claims

 

Appeals are nothing to be scared of... Your wifes condition sounds simlar to mine. Good day's, so you TRY and move a bit..or do something until it hurts. Then in a day or two the pain starts and knocks you back again.......vicious circle!

 

The DWP do get things wrong, and you have certainly come to the right site for support and help.

 

C.A.B. are helpful souls and do a FANTASTIC job BUT, at the end of the day they are usually volunteers., and believe me they can be wrong as well. DHS issues are really complex, as has already been stated.

 

Don't believe "the bloke in the pub" who knows somebody who is getting this that and the other. Every case IS different.

 

Best of Luck........

 

sir fussalot

Edited November 3, 2009 by sir fussalot

[dpick]

I totally agree with sir fussalots post above.

 

I have the same condition as your wife though my injury was caused by RTA in 2004 and the hospital said I had to apply then as I would not improve. I got full mobility straight off but was refused any help with care. I asked my local disability group if they could help, with their help I appealed and ended going to an appeals tribunal where I was awarded middle rate care as well as high rate mobility( DLA had said I could lose mobility if I appealed and lost).

 

please appeal you should have this for you wife.

 

dpick

[jo1lygrngiant]

re the bathing, could you have a word with the OT, regarding a wet room?, I know it isnt all that much help regarding the bathing aspect, but it really helped me with not being able to get in / out of the bath even for a shower. The entire process took approx 12 months from start to finish. But is well worth the time and effort involved.

 

Also has your wife been to a Pain Management Group?, This is started with your GP. I went on mine bout 4 years ago, and found it really does help.

 

Just a couple of ideas, that may or may not be of any use to you

 

Hope your wife started feeling better

be safe

jgg

[Audon]

Youare not getting the care componant now, so you have nothing to lose.....you can only gain.

 

I believe they re assess the whole application, so it can also go down and also for a shorter time.

 

Audon

[wotme]

speaking as a disabled lady like your wife (multiple back problems as well as other conditions) you should receive at least middle rate for care, my hubby does everything you have described and we get both middle rate care, high mobility and carers allowance for him

 

What people have said about how you word the lettering on the forms is true and I was told once by a PROPER Dla Doctor (you know that long ago time when proper medics were sent out) the dla will chance not giving people what they are entitled to just to see if they can get away with it.

 

Challenge the decision and I bet my cotton socks you will win in the end.

[Audon]

A few years ago (about 6 years or so) one of my friends worked for the CAB. He went to some processing centre where they look at applications for DLA (I think he said it was in Preston).

Apparently they systematically refuse a certain percentage of applications knowing that a large proportion of them will simply accept the refusal and not appeal, this saves the DWP a fortune.

Even on appeal they will refuse quite a lot of applicants. It is always worth going to a tribunal, not only is the success rate high but you also get the payment back dated to when you first applied for the review.

 

Always be wary of the claim being reduced though.

 

Audon

[Thunda]

Hi there

 

Well, its almost 14 months since I first posted here with the post right up top .. 14 months .. jeez .. and my wife finally went to her tribunal on Friday .. ha .. 14 months since that post .. 21 months since first applying for DLA.

 

Victory!

 

She got awarded Middle Care DLA .. We were in the tribunal room for 10 minutes .. that was it .. The doctor asked no questions at all .. The lady responsible for care asked a few .. most of it was the lawyer explaining the situation .. I think the moment they saw her struggling to even get into the room it was rubber stamped but they had to go through the motions.

 

Waited 21 months for a 10 minute tribunal ..

 

Big thanks to everyone who contributed to this thread and the advice and help that was offered.

 

An update on her condition : Another issue has been found .. I'm not sure on the details, but along with the Sacrailiac problem she also got an issue with a sack of nerves down near L5 in her back .. this actually showed up on a MRI scan back in March 09 but only got brought up May time this year .. after a bit of humming and aaarring from the specialist, he's offered her an operation where they'll cut away a bit of her back bone, put a little thing in there to relieve the pressure and then put everything back together again (I hope their better than me when I pull things apart and rebuild them!! ) .. She's awaiting a date for the Op.

 

Hopefully this will relieve a lot of her pain - although she'll still have the original Sacrailiac problem!

 

As a quick question - anyone have any idea how long after a successful tribunal it takes for the DLA to get their act together and act upon the result?

 

Cheers again ..

[dpick]

Hi after we went to tribunal we received confirmation letter in three weeks and back money was in bank account a week later.

 

dpick

[Thunda]

Thanks DPick .. bah, there goes a nice pre-xmas bonus .. will probably be early January then!

[Thunda]

Hey Oldestroker - She's on Oramorph .. and takes 2 10mg spoonfuls whenever needed .. I'm not 100% sure how much she takes daily, but 160mg + is certainly not out of the question. When she's told doctors this is how much she takes - they always tell her to cut it down .. but .. when she does, she suffers withdrawl symptoms and her pain becomes too much .. She also takes a whole pile of other drugs to go with it ..

[Deb T]

My next door neigbour takes Morphine as in Zomorph and takes 120mg a day, I know this because I sometimes collect it for him and have to sign

for it as it's a certain type of drug that requires a signature when it's been dispensed.

 

Oramorph is an oral version and it's lethal as in it acts very quickly and can be quite destablizing to start with, I would say that 160mg of Oramorph is extreme, you sure its

that much? and any doc that says it's a mile sedative is talking out of their botty...which given a competent doctor would most likely not say then then it's got to be one of the dwp's in-house ones.

[Thunda]

Hey Deb .. yeah, its not far off either way .. I don't help her administor her Oramorph so i myself don't keep tally - but according to her, its in that region. She knows she has to cut back and I think she has lately, but it will still be in the 120 to 160 range ..

 

And I agree that its NOT just like taking paracetemol. These DLA cronies will say anything, I suppose. As Deb says, you need to sign for it when you collect from the chemists due to its controlled nature. Its potent stuff.

[45002]

Any morphine based medications should always be taken with great care.

 

They are All Highly addictive............................

Edited December 15, 2010 by 45002
medications