DLA Award

trubster

Hi all, new to this part of the site.

I am wondering if anyone can offer some advice on a situation I have found myself in. I have made a new claim for DLA for my daughter who has severe Autism as well as Severe Behavioral problems, Hyper mobility, Duane Syndrome and Sleep disorders.

I have just received the award notice (After only sending the form in 2 weeks ago!) and she has been awarded Middle Care Rate only. She is 3 years old so should have qualified for the mobility component.

I have reviewed the criteria of the Higher Rate Care and it says this is awarded if constant care is needed Day and Night (I take it as meaning over 20 minutes repeated twice or more) and I have messed up on the form. I had put down 5-60 Minutes for each item she needs help with



Now she certainly does fit the criteria of over 20 minutes repeated twice or more but I put 5-60 minutes repeated 1-10 times, this varies so much but every night the combined supervision she needs is certainly over the criteria.

I am also not sure why they decided not to award the Mobility component, I followed the advice on the Cerebra guide that said not to tick the distance boxes but state that she frequently and unpredictably refuses to walk and I explained how this affects her ability to walk.

Would an appeal be a wise choice or is this likely to fail because I put 5-60 minutes in the boxes rather than saying the overall care she needs is over 20 minutes?

Thanks in advance.

Brighty

You can only get high rate mobility (unable to walk) at 3, you'd probably be looking at getting low rate mobility, but you don't get that till 5.

Regarding the care side of things, might be worth asking for a reconsideration, you might get bumped up to high rate care, but could just as easily drop to low, but i think constant means pretty much constant, not just a few times a night. i'd say mid rate sounds about right.

FYI, mid rate care entitles you to apply for carers allowance on top, if you earn less than £110 a week from work.

Brighty

toomuchinfo

With regard to the mobility component low rate mobility starts at age 5. High rate mobility from 3 if she qualifies for that rate.

Possibly your 5-60 minutes wasn't specific enough.

You can ring and ask to speak to the decision maker who might then change their award.

Net Mums has a special needs forum where you can read other parents' experiences of getting decisions revised.

trubster

Thanks for the replies, I was reading this and I thought her situation matched this criteria. - Quoted from HERE

The day care criteria was awarded, but not the night.

To qualify for middle care the child must meet any one of the four rules listed below.

To qualify for high care the child must meet one of the day time rules and one of the night time rules listed below.

The two night time rules are:

Prolonged or repeated attention is needed at night in connection with bodily functions.

Prolonged means about 20 minutes and repeated is twice or more, we discussed the meaning of ‘attention’, ‘bodily functions’ and ‘night time’ above. For example if you have to be up at night time for more than 20 minutes to help a 14 year-old to get up, use the toilet and then get back to bed you could qualify under this rule. Soothing a child back to sleep can count as attention with a bodily function, but only if it is ‘substantially in excess of the sort of help that other children of the same age need.

The child needs watching over at night for a prolonged period or at frequent intervals to avoid substantial danger.

‘Watching over’ means someone being awake to watch over the child. Prolonged means about 20 minutes and repeated is twice or more, and we discussed the definition of ‘night time’ above. For example if a child wakes in the middle of the night, and you have to get up to watch over them because it is dangerous to leave them unsupervised, you could qualify under this rule.

I honestly can't see it being dropped to lower rate because she does need constant supervision and care throughout the day at home and nursery.

I will go and have a read on 'Net Mums' now (but I am not a Mum ) - (Sorry, couldn't resist it)

Brighty

trubster wrote: »

Thanks for the replies, I was reading this and I thought her situation matched this criteria. - Quoted from HERE

The day care criteria was awarded, but not the night.

To qualify for middle care the child must meet any one of the four rules listed below.

To qualify for high care the child must meet one of the day time rules and one of the night time rules listed below.



I honestly can't see it being dropped to lower rate because she does need constant supervision and care throughout the day at home and nursery.

I will go and have a read on 'Net Mums' now (but I am not a Mum ) - (Sorry, couldn't resist it)

Wasn't aware of those rules, interesting. In that case i think the issue is as you say, that it needs to be 20mins or more, more than twice a night, and you put a min of 5mins and once a night

Brighty

trubster

This is the bit I was referring to (From Appendix 1 of the Cerebra guidance)

According to the criteria, she would fit the Higher Mobility component, rather than the lower.



but I think they may have gone down this route instead, and because she was only awarded the Middle rate, they did not award Mobility.

trubster

Brighty wrote: »

Wasn't aware of those rules, interesting. In that case i think the issue is as you say, that it needs to be 20mins or more, more than twice a night, and you put a min of 5mins and once a night

Brighty

Yup, that form is a killer and by time you get to Question 53.... I must admit, I didn't think the question through fully and I should have put a note in explaining the situation. She can get up 10 times in a night, she can get up only twice in a night (On a good night) but you can guarantee there will be at least an hour or two through the whole night that she needs comfort, supervision and calming down. I didn't want to put 1 - 10 @ 60 minutes which is why I put down 5-60 minutes.

So, because I messed up the question, would an appeal fail? what would be the best way to go with this?

Alice_Holt

Bit more info on high rate DLA mobility - (severe impairment) here:

http://www.disabilityrightsuk.org/disability-living-allowance-dla

http://www.autism.org.uk/about/benefits-care/benefits/children/dla-mobility-component.aspx


To get high rate mobility under the severe mental impairment rules you have to meet every one of the following points.

1. The child gets DLA high rate care. This means that if your child qualifies for none of the care component of DLA, or low or middle rate care, the ‘severe mental impairment’ criteria cannot be considered.



2. The child has a state of arrested development or incomplete physical development of the brain which results in severe impairment of intelligence and social functioning. We can split this rule into three parts to make it easier to consider:

(a) The child must have arrested or incomplete physical development of the brain. Where the child has a diagnosis of autism it should be accepted that they have arrested or incomplete physical development of the brain. If you are still going through the diagnostic process you might struggle to show that this point applies, however there are other diagnoses such as global development delay that could also be accepted as being arrested or incomplete development of the brain.

(b)The arrested development results in severe impairment of intelligence. This part of the criteria is the main reason that only a minority of children with autism qualify for high rate mobility, because many children with autism have average or near average intelligence and so do not meet this point. The impairment must be ‘severe’ and it must be the intelligence that is impaired. What sort of things are considered depends on the child’s age, but issues to consider are:

Does the child have a Learning Disability?
What sort of specialist educational provision does the child have?
Has the child been significantly delayed in meeting developmental milestones such as developing speech, feeding themselves, toileting etc?
Does the child understand danger (in a way appropriate to their age)?
What difficulty do they have applying the intelligence that they do have to the real world?


(c) The arrested development results in severe impairment of social functioning. This part of the criteria is usually straightforward to meet because it so obviously applies to autism. The child’s ability and interest in playing with other children is relevant to this.



3. The Severe Behavioural Problems Rule

(a) The child has disruptive behaviour which is extreme. For this part give examples about the extreme and disruptive behaviour. All behaviour is relevant, not just how the child is when outdoors.

(b) Due to the disruptive behaviour the child regularly requires another person to intervene and physically restrain the child in order to prevent the child causing physical injury to himself or others or damaging property.

For this part give examples of when and how you have to restrain the child. Again it is not just things that happen outdoors that count. Give examples from at home and school as well. Physical restraint means physically stopping the child from doing something, so holding a child’s hand to physically hold them back them from doing something that would cause injury could count, but holding a child’s hand to keep them calm would probably not count.

(c) The disruptive behaviour is so unpredictable that the child requires another person to be present and watching over them whenever they are awake. Explain why someone needs to be with the child all of the time, and explain what dangerous thing could happen if they were left in a room on their own.



Virtually Unable to Walk

This criteria is for children who have a physical disability which makes their ability to walk very limited. If behavioural issues are caused by something with a physical origin then these behavioural problems can be taken into account. It has been shown that autism is a disorder of brain development and so has a physical cause. If behaviour caused by autism means that a child’s practical, physical ability walk is so limited that they can be said to be ‘virtually unable to walk’ then they can qualify for high rate mobility under this rule.

Issues of safety, and the need for supervision and guidance, are not relevant to this part of the criteria. This criteria is not dependent on the child also being awarded high rate care.

Interruptions in walking, or refusing to walk, can be taken into account if it happens frequently enough to mean that on most days the child is very physically limited in how far they can walk. Although there is no set distance in the law below which you are considered ‘virtually unable to walk’, generally if the child is limited to less than approximately 50 metres they may qualify.

trubster

Alice_Holt wrote: »

To get high rate mobility under the severe mental impairment rules you have to meet every one of the following points.

1. The child gets DLA high rate care. This means that if your child qualifies for none of the care component of DLA, or low or middle rate care, the ‘severe mental impairment’ criteria cannot be considered.



2. The child has a state of arrested development or incomplete physical development of the brain which results in severe impairment of intelligence and social functioning. We can split this rule into three parts to make it easier to consider:

(a) The child must have arrested or incomplete physical development of the brain. Where the child has a diagnosis of autism it should be accepted that they have arrested or incomplete physical development of the brain. If you are still going through the diagnostic process you might struggle to show that this point applies, however there are other diagnoses such as global development delay that could also be accepted as being arrested or incomplete development of the brain.

(b)The arrested development results in severe impairment of intelligence. This part of the criteria is the main reason that only a minority of children with autism qualify for high rate mobility, because many children with autism have average or near average intelligence and so do not meet this point. The impairment must be ‘severe’ and it must be the intelligence that is impaired. What sort of things are considered depends on the child’s age, but issues to consider are:

Does the child have a Learning Disability?
What sort of specialist educational provision does the child have?
Has the child been significantly delayed in meeting developmental milestones such as developing speech, feeding themselves, toileting etc?
Does the child understand danger (in a way appropriate to their age)?
What difficulty do they have applying the intelligence that they do have to the real world?


(c) The arrested development results in severe impairment of social functioning. This part of the criteria is usually straightforward to meet because it so obviously applies to autism. The child’s ability and interest in playing with other children is relevant to this.



3. The Severe Behavioural Problems Rule

(a) The child has disruptive behaviour which is extreme. For this part give examples about the extreme and disruptive behaviour. All behaviour is relevant, not just how the child is when outdoors.

(b) Due to the disruptive behaviour the child regularly requires another person to intervene and physically restrain the child in order to prevent the child causing physical injury to himself or others or damaging property.

For this part give examples of when and how you have to restrain the child. Again it is not just things that happen outdoors that count. Give examples from at home and school as well. Physical restraint means physically stopping the child from doing something, so holding a child’s hand to physically hold them back them from doing something that would cause injury could count, but holding a child’s hand to keep them calm would probably not count.

(c) The disruptive behaviour is so unpredictable that the child requires another person to be present and watching over them whenever they are awake. Explain why someone needs to be with the child all of the time, and explain what dangerous thing could happen if they were left in a room on their own.

Everything in point 2 and 3 are met, so it looks like the "5-60" minutes has limited the award to Middle, which fails point 1 (Higher Care only).

FBaby

This criteria makes no sense at all in relation to a 3 yo!

Surely all 3yo need prompting to go to bed and it is fairly common for them to get up many times and have to be taken back before they finally settle, and of course they are not going to be aware of dangers, may wander if not supervised and many do have behavioural problems (scream/shouting/crying).

Tigsteroonie

Hi trubster,

Found your thread on NetMums, I've responded over there Hope it helps or at least gives reassurance.