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DLA Appeal - Medical Evidence
I am assisting a client with a DLA appeal - although this isn’t my area of expertise.
My client suffers from severe depression and anxiety issues. His wife prompts and encourages him for most daily tasks, and if she wasn’t there, he is likely to stay in bed all day, not care for himself properly etc. He also has anxiety problems, and can “flip” at any time, and his wife would need to be there to make sure he stays calm. He suffers from panic attacks when he is outdoors and again can “flip” over small things, his wife would always be with him anywhere outside the village where he lives.
Because of the level of care/attention that he needs, both at home and outdoors, I felt he may be entitled to some DLA - I was hoping for mid rate care, low rate mobility. However, his DLA application was turned down completely due to no medical evidence about the need for care/attention. His GP had stated that he does not know of any effects on his self care, ability to get around (Q6 of GP Questionnaire)
We are currently appealing this decision and the appeal is due to be held in May. I have written to his Dr for more information/letter of support but the Dr has stated that he doesn’t feel that my client has any problems with self care / getting around.
My client doesn’t attend the GP very regularly, so it is unlikely that the GP would know much about his care needs. My client’s wife is always there and has never left her husband alone for any time, and ensures that my client doesn’t fall into any state of self-neglect, which appears to be needed before the GP is aware of any issues.
What is the likelihood of the DLA application/appeal being successful without medical evidence? Is there anything else I can use to help with this appeal? Any help would be greatly appreciated!
thanks for your reply Tony - my email here is . Any help you can offer would be great. I had asked my client to complete a diary when we first submitted the appeal, so hopefully we will have something there.
I have written to a psychiatriatrist that my client had been working with, but I have not had a response yet.
The evidence I could provide would be limited, so we will be going with the diary, my client appearing at the appeal, and if we get anything useful from the psychiatrist.
[ Edited: 18 Apr 2011 at 11:32 am by Dayna ]ha! i did notice but i just thought you were having a moment! our fax here is , many thanks.
[ Edited: 18 Apr 2011 at 11:32 am by Dayna ]Hi, any chance i could get a copy too please. Fax. 01224 522297
cheers
It’s not unusual for GP’s to know little about thier patients care and mobility needs, and just becuase the GP doesn’t know it doesn’t mean there aren’t any. That’s the value in the cleint actually going and sitting in front of the tribunal.
If the client has other health professionals, such as a CPN or social worker they are usually good sources of evidence. Consultants also may be able to help.
If there are no other health professionals then the question is one of maximising the validity of the claimant’s evidence.
We usually recommend a care needs diary, to be completed by the disabled person and the primary carer, and of course attendance at the appeal hearing by both of those usually pays dividends. Care needs checklists can also be helpful sometimes, and an internet search may turn up something. There may also be something in the breifcase area of RN.
Depending on the level of your knowledge and experience of the client you can also give evidence, although you do have to be careful about your role. Your evidence can only be limited to your own experience. I would tend to give evidence in the written submission such as “when we met the client she was confused and unable to concentrate. We had to explain things slowly and clearly and often found it necessary to repeat ourselves”, etc, etc.
If you post your email address, and if it would help, I’ll fax you a copy of our example care needs diary.
Could you send me a fax of your care needs diary too…pppllleeaaasee! I bet you wish you never wrote this now!!
Fax is 01708 874 724 much appreciated!
If your client has treatment from a consultant psychiatrist and a CPN (care-co-ordinator) or AMHP then they will have been assessed by mental health services as having an enhanced level CPA (care plan approach). There will be a care plan in place.
It is usual practice for the Disability and Carer’s Service to award DLA (HRC or MRC and LRM) in those circumstances. This is because if the client had no care needs then they wouldn’t have a care plan.
If there is a Pychiatrist but no CPN (AMHP) then they will be subject to standard care plan approach and getting DLA is a little more difficult in those circumstances.
There’s an example diary in the appendix to 9.12.19.3 in Advisernet Cookie. Mine isn’t anything special.
Oh ok i thought you had something better….thanks anyway.
With regards to GPs not knowing about how a clients condition affects their day-to-day care needs, this is quite handy:
http://www.rightsnet.org.uk/briefcase/summary/Significance-of-statement-in-a-GPs-report-that-a-claimants-ability-to-walk-/
Hi all
I just wanted to update you all on this one, the tribunal was held a week ago, and my client has been awarded DLA low rate care. It wasn’t what I felt he should get, but given a severe lack of medical evidence, and some of the questions asked and answered, I understand their reasons for awarding this rather than a higher rate.
Thanks for all your advice on this one.
D