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Cite as: [1999] NISSCSC C17/99(DLA)

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[1999] NISSCSC C17/99(DLA) (30 June 1999)


     

    Decision No: C17/99(DLA)

    SOCIAL SECURITY ADMINISTRATION (NORTHERN IRELAND) ACT 1992

    SOCIAL SECURITY CONTRIBUTIONS AND BENEFITS

    (NORTHERN IRELAND) ACT 1992

    SOCIAL SECURITY (CONSEQUENTIAL PROVISIONS)

    (NORTHERN IRELAND) ACT 1992

    SOCIAL SECURITY (NORTHERN IRELAND) ORDER 1998

    DISABILITY LIVING ALLOWANCE

    Application by the claimant for leave to appeal

    and appeal to a Social Security Commissioner

    on a question of law from a Tribunal's decision

    dated 10 July 1996

    DECISION OF THE SOCIAL SECURITY COMMISSIONER

  1. This is an application by the claimant for leave to appeal against the decision of a Disability Appeal Tribunal (DAT) which held that claimant was not entitled to either component of the Disability Living Allowance (DLA).
  2. Briefly, the facts are that he made a claim for DLA in November 1995 on the grounds that he suffered from back pain, anxiety, depression and alcoholism. A report was received from his GP in January 1996, and as a result the Adjudication Officer decided he was not entitled to either component of DLA. This was confirmed by a different Adjudication Officer who reviewed the decision, but did not revise it. Claimant appealed to a DAT, his grounds of appeal were set out clearly as:
  3. "I am virtually unable to walk because of physical disability caused

    by low back ache, and severe pain in my left leg and foot. If the

    self assessment form claimed I could walk 400-500 yards this is

    incorrect because it should have been maximum 40 -50 yards only.

    The physical exertion used to get to the clinic to be examined and

    having to take off his shoe and put it on, by himself brought on a

    faint attack and he had to receive water and rest following the

    examination. Normally the shoes and socks are fitted by Mrs McC...

    in the morning but no help was given at the examination.

    I am currently a day patient in Armagh at St Lukes Hospital and attend

    Dr C( the consultant psychiatrist and also Mrs M( McS...

    a social worker. This is for counselling and therapy for alcohol

    dependency and severe behavioural problems.

    At night I have to be watched by my wife or children to stop me from

    going to the kitchen to get tablets for back pain, or ulcer tablets,

    or nerve tablets in case I take too many of them. During the day I

    am visited regularly by my wife who either calls on the house or

    sends someone to see if I am OK.

    I cannot cook any meals for myself and my wife leaves a sandwich in

    the fridge for me to eat if I feel hungry. I am not allowed to use

    the kitchen oven or cooker."

  4. The Tribunal dismissed the appeal and gave reasons as follows:-
  5. MOBILITY COMPONENT

    "We prefer the General Practitioner's evidence as being the more

    reliable as to appellant's walking ability. As the General

    Practitioner indicated that in his opinion, appellant could walk

    400-500 yards on level without severe discomfort and given

    appellant's medical complaints we believe that the appellant could

    walk a reasonable distance in reasonable time, speed and manner

    without severe discomfort on average terrain. No evidence that the

    exertion of walking would cause danger to life or serious

    deterioration to health. Tribunal also satisfied that appellant can

    take advantage of his walking faculty outdoors, most of the time,

    without guidance/supervision."

    CARE COMPONENT

    "The Tribunal did not accept appellant's evidence as to his

    limitations as reliable. We believe that the General Practitioner's

    opinion is a more accurate assessment as per his factual report

    attached to appeal submission. Accordingly, given appellant's

    medical condition we do not accept that he is so severely

    disabled, physically/mentally or as to require attention for a

    significant part of the day or frequent attention with bodily

    functions by day or prolonged/repeated attention with bodily

    functions by night. We appreciate the appellant's comments that

    he has never cooked or even made a cup of tea or boiled an egg.

    However, the fact that he has not done so does not mean that he

    could not do so. We find no physical or mental impairment which

    would prevent him from preparing a cooked main meal if he

    had the ingredients. We are also satisfied that appellant does

    not have night needs requiring any attention with bodily functions

    or someone to be awake for prolonged periods/frequent intervals to

    watch over him to avoid risk of substantial danger."

  6. In the findings of fact the Tribunal recorded "Attends Saint Luke's - there last Monday and going back next week. No other referrals to consultant/ specialists". In his evidence before the Tribunal the claimant said that his own GP referred him to a specialist for his leg problems and other pains, and that he had never discussed what he could do with his doctor. He discussed his problems with Doctor C(, the psychiatrist in Armagh.
  7. The claimant sought leave to appeal to the Commissioner and I arranged an oral hearing of that application. Before the oral hearing of the application, the Adjudication Officer made the following written comments:-
  8. "The tribunal decision relies on the evidence from Mr McC...'s

    general practitioner as being more accurate than his own account.

    In my submission it was open to the tribunal to come to this

    conclusion, especially in view of the fact that they had the

    opportunity of seeing Mr McC... and testing his evidence. I have

    the following reservations, however.

    The general practitioner's evidence was far from being entirely

    against Mr McC..., identifying as it does alcoholism, low back

    pain, anxiety, and depression. Otherwise, the general practitioner

    was limited to answering specific questions on the enquiry form,

    all of which relate to physical ability. Given the predominately

    psychological nature of the disabilities, the Commissioner may wish

    to consider whether the findings recorded by the chairperson are

    adequate. There is nothing to indicate that the tribunal

    considered requirements which were other than physical, whereas

    the evidence points towards requirements which may be totally

    psychological in nature. An example is to be found on page 17

    of the self-assessment which reads "on bad days I would be so

    depressed I would have to get my food given to me or I would not

    eat at all..."

    In my submission the totality of the evidence raised the issue of

    requirements such as encouragement, which was accepted by the

    Northern Ireland Chief Commissioner as capable of amounting to

    attention with a bodily function in decision number

    C46/96(DLA). Commissioners have also approved of a variety of

    associated requirements, such as reassurance, cajoling,

    encouragement, support, and comfort, some of which may be

    relevant here. I submit that in cases which raise the issue

    of psychological requirements it must be incumbent on the

    tribunal to give full consideration to these needs and on

    the chairman to make sufficient findings to show the degree

    of consideration. The foregoing comments apply equally to the

    lower rate of the mobility component. See for example, decision

    number CDLA/1414/95."

  9. At the hearing the claimant was not present nor was he represented. The Adjudication Officer was represented by Mrs Gunning. Mrs Gunning said that on the self-assessment form the claimant did not state his psychological needs and the Tribunal made no findings of psychological needs, nor did it appear to take any evidence from the claimant about such needs, although he claimed extensive care needs. She said that claimant's GP confirmed that the claimant's main disabling conditions were recorded as anxiety, depression and alcoholism and in view of this she would have expected the Tribunal to have given consideration to claimant's psychological needs. However there is nothing in the Tribunal's findings or reasons to indicate that it did so. She also said that the GP found that he could walk between 400 - 500 yards. The claimant said on the self-assessment form that he got confused and muddled and gets anxious and confused when he is out on his own. She suggested that decision C34/98(DLA) in respect of guidance would certainly qualify the claimant to the lower rate mobility in respect of supervision.
  10. I have studied all the documents and have considered all that has been said in the various comments, such as "General Practitioner has not verified leg/ foot/hand pains" or "No other referrals to consultants/specialists". It was quite clear from the evidence that claimant was an alcoholic who suffered from anxiety and depression. There was evidence from a State Enrolled Nurse that he suffers from mood swings, depression and a poor sleep pattern. The claimant does not wash himself very often and hardly ever changes his clothes. In his claim form, claimant says that he takes fits of depression. He would cry and feel in bad form and be moody. He needed help to calm down and make him feel safe. He also said he needed help to go to the toilet and be lowered onto the toilet seat and helped to get up again. He needed help getting dressed and that he could not bend to put on his shoes and socks. He also drew the Tribunal's attention to this complaint in his application for his leave to appeal to the Tribunal.
  11. I have considered the findings of the Tribunal. It has found that he is anxious, depressed, suffers from alcoholism, back pain, and then goes on to find that he has no entitlement to DLA, all on the strength of a GP's report in form DLA389.
  12. I have considered the need for encouragement which is clearly evident by the fact that he seldom changes his clothes and never washes, and that he never makes a meal, or even boils the kettle. It is not sufficient for the Tribunal to say if he had the ingredients there is no reason why he could not do this. In fact, it is quite clear that he would need to be motivated and need encouragement and motivation to do the simplest task. The Tribunal clearly erred in not taking that into account as it also erred in not taking into account supervision which he required when out walking.
  13. At the hearing I granted leave to appeal. I am satisfied that I can give a decision without a further hearing. I find that the Tribunal erred as I have said above, I therefore allow the appeal set aside the decision of the Tribunal.
  14. I think it is a proper case in which I should give the decision, which the Tribunal should have given. I have had on previous occasions to refer to the inadequacy of form DLA389 in respect of someone who suffers from a mental illness and someone who is in claimant's position.
  15. As that was the only medical evidence which was before the Tribunal, it is obligatory on me to seek some evidence because my function, as the Tribunal's function, is inquisitorial. The Tribunal knew that he was treated by a Consultant Psychiatrist at St Luke's Hospital but passed that over by merely saying that there were no other referrals. I obtained a report from Doctor C(, the Consultant Psychiatrist at St Luke's Hospital. He records that the claimant continues to attend the addiction service regularly for individual counselling sessions and support group sessions, and he has attended 30 to 40 outpatient therapy sessions in the past 2 years and had two admissions. He records the claimant is an emotionally immature, uncommunicative man who is quite dependant on others. He is prone to anxiety and moodiness.

    The Tribunal rested its whole decision on the preferred GP's evidence. There was no evidence from the GP other than a reply to certain questions which were completely irrelevant to claimant's complaints. I am satisfied on the evidence that he needs guidance and supervision when out walking and he is therefore entitle to the lower rate mobility. He is also entitled to the lower rate care in respect of his inability to cook without being motivated.

  16. I therefore award the lower rate mobility and the lower rate care, from 27 November 1995.
  17. (Signed): C C G McNally

    COMMISSIONER

    30 June 1999


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