DLA being reclaimed

Richie-from-the-Boro

Refereed to an elective .. .. by a MH team or a specialist OP clinic won't change the way the numbers are calculated JustKeepSmiling.

For example if you were a paying patient in a private hospital you would not be covered by these rules, its because the state pays twice for your 'treatment and maintenance' that the rules are in place. One example for you would be, if you were in hospital for 12 months then the state would have paid for 12 months treatment and maintenance in hospital and you would have 12 months not-needed and unspent DLA sitting unused in a bank account also paid by the state.

I'm sure you can see that its not right for you to be paid twice for your [care element I assume] disability.

Anubis_2

JustKeepSmiling wrote: »

Thanks for all you help with this guys and gals.

I've been an inpatient for 5-10 days, then home anywhere from 1-3 weeks for a few months These are not admissions I have elected or can help and will continue until I get the proper consultant(s) reviews to assess how to help me. It's frustrating and upsetting for my family. So to have someone say because you are so disabled by your illness and we havent got you the help you need, and we can't treat you at home, we will penalise you feels a bit of a kick in the teeth to be honest!

Sorry for the rant - I'm back in hospital again.....


JKS x

Theoretically you need to add up the days you have spent in hospital in total in the last six months as there has been no 28 day break out of hospital from what you say.

When adding up, do NOT include the day you are admitted and the day you are discharged - only add the days inbetween.

Then, from that amount, deduct 28 days, and what is left is the overpayment they will take off you.

So, if you have had 56 days total, they they will deduct 28 days allowance. Additionally anyone who may receive carers for you will also have an overpayment of the same.

As Richie says, they can't be expected to pay twice. In the case of children though the rule is 12 weeks. I do think they should bring the adult one to 6 weeks, exactly half of the child one.

rogerblack

Anubis wrote: »

Theoretically you need to add up the days you have spent in hospital in total in the last six months as there has been no 28 day break out of hospital from what you say.

Can someone point to the regulation that specifies 28 days out of hospital?
http://www.dwp.gov.uk/docs/dmgch18.pdf - is the chapter referred to as to from the DLA DMG about how to determine if someone has been an in-patient.
This only states 18034 'if a patient is an in-patient should be judged on the facts of each case'.

The DLA DMG refers to this chapter (61652) when stating that it's to be used to determine what an inpatient is.

If the OP has in fact been at home for more than he's been in hospital, and there is no scheduled course of treatment, it seems at least arguable that they were not an in-patient.

Lacking guidance to the contrary of course.

Anubis_2

http://www.nhs.uk/CarersDirect/moneyandlegal/disabilitybenefits/Pages/DLAandAAclaimsandchanges.aspx

Click on Hospital stays

ETA: This is better http://www.turn2us.org.uk/information__resources/benefits/illness,_injury_and_disability/benefits_and_hospital.aspx

You need the PDF on regulations for hospital Stays while on benefits, as its specific to most benefits.

The 28 day linking rule for DLA does exist, I have it on a leaflet somewhere explaining it. I am going through the same issue myself.

rogerblack

Aha - http://www.legislation.gov.uk/uksi/1991/2890/regulation/10/made#text%3D%2228%20days%22

'... 2 or more distinct periods separated by an interval not exceeding 28 days, or by 2 or more such intervals shall be treated as a continuous period equal in duration to the total of such distinct periods and ending on the last day of the later or last such period;'

This seems to not quite read to me as what's been stated as above, though is clearly its source.

In other words - as I understand it - this means that if you're in and out of hospital, last coming out of hospital on March 31, but beginning (Say) in January 1, at no time in for 28 days, or out for 28 days, for a total of 24 days in hospital, then you should be treated as if you were in hospital for the 24 days prior to March 31.

You'd still be entitled from Jan 1 to March 7.

I find it odd that there seems to be no mention of this in the DMG. (that I can find)

The above legislation I don't think has been amended, though I may have missed something.

Anubis_2

Yes - they add the total days of being in hospital when there has been no 28 day break, and deduct 28 days.

So if the total number of days in hospital is 56, they deduct the month allowed from that (28 days) and the rest is overpayment. As I said, I am in a similar position and I was informed the same.

So, in your example, there would be no overpayment as its only 24 days.

Richie-from-the-Boro

- the thread is getting very technical after the fact
- the before the fact to establish is was the 28 day rule breached ?
- the Hospital should notify when the client goes in, and should also notify when the client goes out
- the client should themselves notify the DLA of their going in and out

rogerblack, where you go in terms of supersession or / remedy / whichever other route is first determined by the 28 day breach - see commissioners decision CA/3800/2006.