DLA refused

Lleucu

Husband aged 60 has many health problems due to sarcoid, (or possibly long term steroids) heart surgery in February and long term problems in wound healing, on top of all of this, had stroke at beginning of August, excellent rehabilitation unit but left arm little movement at all and left leg very weak, can walk a few metres very slowly and can do virtually nothing at home. Ongoing OT and physio so some possibility of slight improvement. I am still trying to work part time but it is very hard and I have to get carers in when I am not here, at my own cost.

Filled in the DLA form (as we had both done many times for clients in previous jobs) and attached the assessment and care plan from the rehab unit which was comprehensive. It did include some long term targets but these were aspirational like driving.

We were astonished and very upset to receive a 'no', the basis of which is that 'your needs are likely to reduce'. I spoke to the helpline and have lodged an intention to appeal and also requested a review by the decisionmaker. I have contacted the health professionals who are willing to provide additional reports and I am doing a 'care diary' for the next week.

I have also written to our MP. The thing that puzzles me is the basis of the refusal (without medical evidence). It also concerns me that I have dealt with many situations of 'arguable DLA' at work and yet this situation seems so clear cut, I cannot believe that this has happened.

Any ideas about how to handle the review/appeal? And why has this happened??

rogerblack

Lleucu wrote: »

We were astonished and very upset to receive a 'no', the basis of which is that 'your needs are likely to reduce'.

This is a correct ground to refuse DLA on.
You're only entitled to DLA if you have met the tests for 3 months, and are likely to continue to meet them for 6 months.
If within 6 months, he's expected by the clinical team to improve beyond the point at which he would meet the tests, then he is not entitled to DLA, according to the rules.

(If it's not likely that he will improve this much, then you need to appeal.)

(The time periods do not apply for DLA granted under 'special rules' - largely for those with terminal diseases expected to live under 6 months)

moneybuster

you are not expected to get any better really.

my friend got a reply say her condition had not changed they refused her because they said she was now stable.:mad:

Lleucu

Update April 2012: he reapplied and was turned down 'because he can walk more than 50 metres' .

In fact in relation to mobility it would take about 5 - 8 minutes to walk 50 metres, and despite a new splint (private) causes foot to become very swollen. We have tried really hard to find the right orthotics but with no success. He can walk with a tripod about 200 metres but it takes a very long time and the next day he is completely exhausted.

In relation to care, he needs some help with personal care, completely impossible to cook a meal, suffers falls.

Turned down for both the care and mobility components, going to appeal with sheaves of references from Consultants, District Nurse, OT and Physio, any advice from recent appellants? What is an Appeal like and any top tips for success? MPs - any use, our MP has shown an interest - would it be worthwhile contacting him again?

(I must admit I am going a bitter and twisted phase, as both of us have spent our working lives with disabled people and many (who receive DLA) have far fewer needs than him in relation to the mobility component. Unfortunately I am still trying to work as well so life is pretty exhausting. Carers assessments etc - useless because we would not be financially eligible for anything. We are in the age group which is being really hammered by the Coalition. )

rogerblack

Lleucu wrote: »

What is an Appeal like and any top tips for success? )

I have recently undergone a tribunal for DLA, and been awarded low-rate care and mobility.

Assuming the decision was under 4 weeks ago.
Apply for a statement of reasons on the decision.

http://www.dwp.gov.uk/docs/dmgch61.pdf - this is the decision-makers guide for DLA/AA.

It's not too bad, though will take several reads to clarify the difference between attention, supervision, and ...

http://www.nacc.org.uk/downloads/disability/AdultGuide.pdf - this is a guide to applying for DLA.
It's for a different condition, but it contains much excellent good advice.

Once you've got the statement of reasons - and have understood the above documents - go through it, and refer specifically to the papers you supplied initially, and freshly with reasons why they disprove the arguments in the SOR.

You then will need to request an oral tribunal - this will be a panel of 3 people in some function room somewhere that you can make your case to.

What is the state of your last appeal?
Did you go ahead with it?

If not, a late appeal, in conjunction with this appeal, may be worth a try.

Lleucu

Thanks Roger.

Chronology:
August 2011 stroke
Oct 2011 applied - refused - may 'get better'
Feb 2012 reapplied - they said they would get in touch with GP
19 April 2012 refused, based on can walk more than 50 metres

The info you sent looks really helpful and gives many ideas as to how to present the appeal.

fogartyblue.

Lleucu wrote: »

Update April 2012: he reapplied and was turned down 'because he can walk more than 50 metres' .

In fact in relation to mobility it would take about 5 - 8 minutes to walk 50 metres, and despite a new splint (private) causes foot to become very swollen. We have tried really hard to find the right orthotics but with no success. He can walk with a tripod about 200 metres but it takes a very long time and the next day he is completely exhausted.

In relation to care, he needs some help with personal care, completely impossible to cook a meal, suffers falls.

Turned down for both the care and mobility components, going to appeal with sheaves of references from Consultants, District Nurse, OT and Physio, any advice from recent appellants? What is an Appeal like and any top tips for success? MPs - any use, our MP has shown an interest - would it be worthwhile contacting him again?

(I must admit I am going a bitter and twisted phase, as both of us have spent our working lives with disabled people and many (who receive DLA) have far fewer needs than him in relation to the mobility component. Unfortunately I am still trying to work as well so life is pretty exhausting. Carers assessments etc - useless because we would not be financially eligible for anything. We are in the age group which is being really hammered by the Coalition. )

All benefits are much more difficult to access now. My wife's DLA claim was refused 3 times, never bothered to appeal as it was their word against hers and the many medical reports.
It was only after I obtained a SOR for the 3rd refusal that it became apparent that the reason for refusal was the GP report.

Notwithstanding a mountain of evidence, without the report in the terms that the DWP want to see you will get nowhere.

So I wrote out a long list of her problems, the reasons for them and how she tried to overcome them and dropped it off for it to be scanned into their computer system.

The 4th claim was awarded based entirely on the GP report!

Attendance Allowance, at one time accepted as the easiest to get, is now as hard to get an award for as DLA is.
Only last year it was awarded to someone that became dizzy when they stood up from sitting down too quick. It was recorded as happening twice over the past 20 years! Just on the GP evidence alone from the GP that this had happened was enough to grant the lower rate of AA (equivalent to MRC - DLA).
I wouldn't want to even attempt that same claim today - it would be a waste of time applying!

shegar

I cant offer you anymore advise that has been offered to you already, real good advise from other posters, I just want to say dont give up applying , likeyou say youve seen people out there with DLA that are not as bad as you ...........Its definately getting harder to qualify for the benefit.................Good luck.

Lleucu

Some success thanks to you all.

Chronology:
August 2011 stroke
Oct 2011 applied - refused - may 'get better'
Feb 2012 reapplied - they said they would get in touch with GP
19 April 2012 refused, based on can walk more than 50 metres
3 May 2012 after advice from Assembly Member (we are in Wales) sought a review sent off personal statements plus reports from Consultant, physio and district nurses.
15/6/2012 Care element awarded at low rate, mobility refused.

Now going for an Appeal on the mobility element seems very odd that this was refused as he can only walk with great pain and difficulty and slowly.

Thanks everybody will post our progress to you. :T

Anubis_2

When you have asked for a copy of evidence used when you have appealed, did this include a copy of a doctors report? If it id mentioned they based their decision on a report from your GP or specialist (together with other documents) you should have received a copy of such a report.

If you did, were the reports favourable or poorly filled in?

magsmorris

Sorry to hear about your problems it seems the people who do need it dont get it and folks who dont need it get it
A local lad to us had terminal cancer, has wife and young family and was due for renewal this guy worked till he could not work and anyway short of the story was he had all his benefits stopped and was put on jobseekers (car that was paid for with his mobilty taken back) and 3 weeks later died the systems a joke yet another local who to put it bluntly parties all weekend is on high rate care and high rate mobility well was till recently because he had claimed that he needed care 24hours a day but was caught under the new thing with your bus pass being scanned that he never used the care component on it so travelled every day into town himself and back again so they used that as the eveidence that he was lying and did not need 24 hour care folks like him dont need it and should not have it but folks like the other guy and yourselfs should not have to fight to get what they need best of luck hope you get it resolved and soon
love mags

Lleucu wrote: »

Some success thanks to you all.

Chronology:
August 2011 stroke
Oct 2011 applied - refused - may 'get better'
Feb 2012 reapplied - they said they would get in touch with GP
19 April 2012 refused, based on can walk more than 50 metres
3 May 2012 after advice from Assembly Member (we are in Wales) sought a review sent off personal statements plus reports from Consultant, physio and district nurses.
15/6/2012 Care element awarded at low rate, mobility refused.

Now going for an Appeal on the mobility element seems very odd that this was refused as he can only walk with great pain and difficulty and slowly.

Thanks everybody will post our progress to you. :T