DLA Interview for "fraud"

JimW75

Hi all
To ask your advice on this situation - I have chronic asthma and bronchitis (not from smoking!) - my illness fluctuates dependent on the seasons weather and illnesses. I have been in hospital numerous times and once stopped breathing during an asthma attach which caused some mild damage to my heart. Recently I have started some new medication which seems to have eased some of my symptoms but I don't know weather this will be the same in winter time.
I am on DLA, but also work part time.
I recently got a letter from the DLA saying i was being investigated for fraudently claiming the benefit. When I attended the interview they said that although they acknowledged I was ill they did not think it was as bad as I claimed. I did point out that I was on new medication, and that my condition fluctuates and is not a static illness. I also pointed out that the claim form advised you to write down your symptoms when you are at your worst.
The interviewers then made me watch footage of me being filmed going shopping and going into work on the bus - at this time my car was broken so I had no other way of doing these things. They have said that they will investigate the case further but feel that Im not entitled to the amount I have been receiving.
It was a horrible experience and I feel awful and stressed about it. I feel like I have been filmed at a better time with my symptoms by people whose purpose is ti deal with fraud, not look at my illness. I do struggle and winter time is bad for me if I get a chest infection, when I need to use additional medication and oxygen.
Any advice would be great.
thank you

Confuseddot

Hi not sure I can add anything but it may help people to give better answers if you put what levels of DLA you currently receive.

jacques_chirac

How long have you been on the new medication?

Are you sure the application form tells you to describe your symptoms at their worst? I have just scanned through the form and cannot see where it states this.

stevenjhepburn

This thread might give you some more information.

Unfortunately I think you will find find that being able to go shopping and to work unassisted on a bus is a big flag that you may not eligible for DLA mobility.

You have said that you described your condition 'at its worst' when you also have a chest infection. If this is how you described it on your DLA application I do not think that is an accurate representation of your 'disability' - it's a representation of a temporary chest infection.

Think of it this way. Without considering the times when you have a chest infection, can you usually walk over 100m unaided, go shopping on your own and wash/dress/cook for yourself at home? If so, you are not entitled to DLA in my opinion.

Errata

The interviewers then made me watch footage of me being filmed going shopping and going into work on the bus

Something has given them cause to go to the trouble of filming you, they may have observed you on several occasions prior to the ones they filmed.

Pippin12

I'm pretty sure the forms don't ask you to describe yourself only at your worst. If your condition fluctuates then that's what you have to write unfortunately.

OP what levels of DLA are you claiming? Is there any possibility you can get medical evidence from GP/Specialist etc who can verify that your condition is as bad as you say? Hopefully that would help.

Torry_Quine

I have to agree with others here. The form shouldn't be filled for just your worse time if a fluctuating illness but should have more accurately described the fluctuation. To film you suggests that there was already a doubt about your claim.

kingfisherblue

On the form it does not advise you to describe your symptoms at their worst. It says to describe an average day. If a condition fluctuates, you should say that you are affected in this way on most days, but in that way on worse days, and that your worse days occur X amount of times per week or month. Filling in your form describing only your worst days implies that you are affected in that particular way most or all of the time, unless you have specifically stated that you are describing your worst days only - in which case, you would be asked about your average days and how often your worst days occur.

It does sound as though you are being investigated for benefit fraud, and if you have described your worst days only, then it is entirely possible that you have committed fraud. I would imagine that your only defence is to show the instructions on the form stating to include your worst days only, but since the forms do not state this, you are in a sticky situation.

Although you may need to use oxygen during winter, you might not meet the criteria for DLA, as you need to have had the care and/or mobility needs for three months, and expect to have them for a further six months. If you are only on oxygen intermittently, or for a couple of months a year, this would not meet the criteria. However, as you may have other care needs, you may still meet other criteria, but the award amount could be incorrect.

Incidentally, I don't think you are deliberately filmed at a time when you are going through a good spell - after all, the investigators don't know when you are feeling well or not. It won't necessarily be the fact that you used public transport, but is more likely to be how far you walked to get the bus, and how far at the end of your journey, as well as the way you walked, the speed, whether you needed to stop, etc. Just to illustrate what I mean, my son can walk, but he is in constant pain, walks very slowly and stops frequently. It was difficult to take his wheelchair onto the fields when fruit picking today, so we walked with him - very slowly, with numerous stops. He then sat down on the ground to pick the fruit from the lower parts of the bushes, as his limbs ached so much. He is now lying on the settee, having taken painkillers, because his legs hurt so much. He enjoyed fruit picking though, and is delighted with his blackcurrants!

kingfisherblue

JimW75 wrote: »

Hi all
To ask your advice on this situation - I have chronic asthma and bronchitis (not from smoking!) - my illness fluctuates dependent on the seasons weather and illnesses. I have been in hospital numerous times and once stopped breathing during an asthma attach which caused some mild damage to my heart. Recently I have started some new medication which seems to have eased some of my symptoms but I don't know weather this will be the same in winter time.
I am on DLA, but also work part time.
I recently got a letter from the DLA saying i was being investigated for fraudently claiming the benefit. When I attended the interview they said that although they acknowledged I was ill they did not think it was as bad as I claimed. I did point out that I was on new medication, and that my condition fluctuates and is not a static illness. I also pointed out that the claim form advised you to write down your symptoms when you are at your worst.
The interviewers then made me watch footage of me being filmed going shopping and going into work on the bus - at this time my car was broken so I had no other way of doing these things. They have said that they will investigate the case further but feel that Im not entitled to the amount I have been receiving.
It was a horrible experience and I feel awful and stressed about it. I feel like I have been filmed at a better time with my symptoms by people whose purpose is ti deal with fraud, not look at my illness. I do struggle and winter time is bad for me if I get a chest infection, when I need to use additional medication and oxygen.
Any advice would be great.
thank you

Quoted for future reference

Troutwrestler

I thought when applying for dla, and certainly when I completely my forms I didn't just start my worst days, I told them what my worst days were like and how often I had these type of days. But to only tell them about your worst days isn't a true representation hence why they are looking into your claim

benefitbaby

You should seek legal advice immediately from a social security lawyer (if you can find one) or an experienced benefit specialist.

DLA entitlement is based on how your condition affects you for 'the period throughout which...' basically they have to look at how your health affects you for a minimum of 9 months and whether you meet the criteria more often than not.

Your walking to the bus is all well and good however the law requires that they take into account the speed of walking, manner, time, distance WITHOUT severe discomfort. Many people push through pain to keep walking because they have no choice, likewise many people will struggle to wash, bathe etc because they have no-one to help them however the law clearly says you are eligible for DLA if help would reasonably be required (no help actually needed).

I urge you to take the offensive, get advice about DLA eligibility so you can ascertain if you were eligible during the period in question. Get medical evidence, witness statements from family, friends, co-workers etc describing what they have seen. Provide all this to the fraud investigators.

And... remember to be prosecuted for benefit fraud the DWP have to show beyond reasonable doubt that you knowingly and dishonestly misrepresented your difficulties or purposefully failed to disclose an improvement you knew (or reasonably ought to have known) would affect your entitlement. This is a high burden to discharge and based on what you have said, whilst you naively filled out the form on the worst day (never do this again!) was this with dishonest intent? It doesn't sound like it.

Get that specialist advice now