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You are here: BAILII >> Databases >> Northern Ireland - Social Security and Child Support Commissioners' Decisions >> [2009] NISSCSC C14_08_09(DLA) (07 May 2009) URL: http://www.bailii.org/nie/cases/NISSCSC/2009/C14_08_09(DLA).html Cite as: [2009] NISSCSC C14_08_09(DLA), [2009] NISSCSC C14_8_9(DLA) |
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[2009] NISSCSC C14_08_09(DLA) (14 May 2009)
Decision No: C14/08-09(DLA)
Background
(i) the written submissions prepared for the appeal tribunal hearing;
(ii) the appellant's general practitioner (GP) records; and
(iii) two further pieces of correspondence.
Proceedings before the Social Security Commissioner
Errors of law
"(i) making perverse or irrational findings on a matter or matters that were material to the outcome ('material matters');
(ii) failing to give reasons or any adequate reasons for findings on material matters;
(iii) failing to take into account and/or resolve conflicts of fact or opinion on material matters;
(iv) giving weight to immaterial matters;
(v) making a material misdirection of law on any material matter;
(vi) committing or permitting a procedural or other irregularity capable of making a material difference to the outcome or the fairness of proceedings; …
Each of these grounds for detecting any error of law contains the word 'material' (or 'immaterial'). Errors of law of which it can be said that they would have made no difference to the outcome do not matter."
The error of law in the present case
'1) The evidence of the substantial daily physical help and moral support which (the claimant) was said to receive from (…) and from (…) was exaggerated. The extent and intimacy of physical care said to be given was out of all proportion to the appellant's likely physical or mental needs arising from her diagnosed conditions.
2) Even if the evidence was not exaggerated and the help said to be given was largely given, that help was not reasonably required. (The claimant's) GP had indicated at Box 6 that (the claimant) could self-care "except when mood v. low". The GP's assessment of the appellant's care needs was preferred.
3) The content of some of the medical reports with the patient records was also inconsistent with the care requirements portrayed. For example, [Dr P…], a consultant physician wrote on 9.10.2003: "On examination – hear rate 80 b.p.m. regular. Cranial nerves were normal. Fields of vision were completely intact. No visual inattention. Speech was normal. The power in the right arm and hand was mildly reduced to about Grade 4, with power in all other groups Grade 5. Sensation seemed intact. No sensory inattention. There was no evidence of neglect. I found reflexes all difficult to elicit but no difference between the two sides. Plantars were definitely flexor both sides. Gait was normal, to my eye and balance was normal. Cardio exam was completely normal".
The reasons set out for the minority decision read as follows:
'The member in the minority considered that an award of the middle rate of the care component was justified on the evidence. This would have been on the basis of frequent daytime attention required from another for help with bodily functions. It was accepted that there was no real risk of self harm.
The reasons were:
1) The appellant's evidence was not self evidently contradictory in any particular. She had presented as a genuine person and her claims had been stoutly supported in writing by (…) and in person by (…). The majority too readily discounted the oral evidence. The GP's report had concluded (Page 7):
"Genuine case. Has been through a very difficult situation which is ongoing. Chronic pain makes mood worse."
2) The detail of daily physical help and encouragement to (the claimant) described in the handwritten letter from (…) was persuasive. (…)(…) had gone to some lengths to support the appeal and this should not be disregarded.
3) The appellant suffered daily pain inducing low mood for which she was attending psychiatric outpatients. The report from the [Dr P….] was almost 4 years old at the date of decision under review and it was a mistake to place too much emphasis on that report. In any case, difficulties in reaching a diagnosis precisely to explain (the claimant's) pain and weakness should not outweigh the evidence of daily living restrictions if that evidence seemed genuine. The medical records disclosed that fibromyalgia had been diagnosed by [Dr L…], a consultant physician in October 2003. The letter dated 22.1.0.2008 [sic] from Louisa Morrison a community psychiatric nurse, was closer in time to the date of decision and that letter referred to "ongoing support in the home environment in the form of a carer ".
(i) the majority had focused on an old report from a consultant physician dated 9.12.03;
(ii) the appellant's GP had also concluded in his report "Genuine case. Has been through a very difficult situation which is ongoing. Chronic pain makes mood worse", and that it had been reported that she suffered daily pain;
(iii) the two comments from the appellant's GP had not been considered together, by the majority, and had not been explored with the appellant to determine the extent of the care needs and help reasonably required throughout the day;
(iv) the appellant could not understand how the majority decision was reached when the minority member offered a reasoned argument and extent of care needs which demonstrated criteria for a middle rate of the care component.
'… the GP report indicates that (the claimant's) mood was reasonable/low at present, that she was a genuine case and that chronic pain makes mood worse. Clearly this evidence would lead to the conclusion that there were times when (the claimant's) mood was very low and at those times she could require help with her personal care. Before reaching any conclusion as to whether (the claimant) required any help with her personal care, the tribunal should, I submit, have investigated both the frequency and duration of those periods of low mood …
I also note that … the majority of the tribunal refer to a report from a Consultant Physician dated 9 October 2003. The decision under appeal in this case was the decision of 3 August 2007 which disallowed (the claimant's) award of personal care from 29 September 2007. Whilst the majority of the tribunal stated that the report of 9 October 2003 was inconsistent with the care needs stated it is I submit not unreasonable to assume that the personal care needs may have changed in that period. There is nothing in the reasons for its decision to explain how a report which was over 3 years old was accepted as being indicative of the current level of needs. For these reasons I submit that the tribunal has erred in law …'
In R2/04(DLA) a Tribunal of Commissioners, stated, at paragraph 22(5):
' … there will be cases where the medical evidence before a particular tribunal will be unsatisfactory or deficient in an important respect. It will often be open to the tribunal hearing such a case to reject the medical evidence for that reason. Indeed, it will sometimes be its duty to do so. However, and in either case, the tribunal cannot simply ignore medical evidence which is not obviously irrelevant. It must acknowledge its existence and explain its reasons for rejecting it, even if, as will often be appropriate, such reasons are fairly short. We repeat, the decision whether a person suffers from a particular medical condition is a matter for the tribunal. That body must have regard to the whole of the evidence, including the medical evidence. Where it rejects medical evidence it must, unless the reasons are otherwise apparent, explain why it does so. Anything less is likely to result in an appeal being brought on the grounds that the tribunal has not given adequate reasons or that its decision is against the weight of the evidence.'
'A Tribunal does have an inquisitorial role and as such the members of the Tribunal will usually play a more active part in the hearing than would a judge in a Court. This will often involve detailed questioning (which is often necessary to ascertain whether or not a person fulfils the very detailed conditions for Disability Living Allowance) and the raising of possible inconsistencies and other issues. So doing the Tribunal is not in breach of the rules of natural justice. I am unable to ascertain any such breach in this case though I regret that the claimant feels a sense of grievance with the manner in which the hearing was conducted. It might be helpful if claimants were more generally aware of the Tribunal's inquisitorial role. In this case it has not been alleged there was any omission from the record of proceedings and that record does indicate a full investigation as to whether or not the conditions were satisfied. It also indicates that the claimant and his representative put their case fully.'
The recording of reasons in 'majority' decisions
'(4) Subject to paragraph (4A), a party to the proceedings may apply in writing to the clerk to the appeal tribunal for a statement of the reasons for the tribunal's decision within one month of the sending or giving of the decision notice to every party to the proceedings or within such longer period as may be allowed in accordance with regulation 54 and following that application the chairman or, in the case of a tribunal which has only one member, that member, shall record a statement of the reasons and a copy of that statement shall be sent or given to every party to the proceedings as soon as may be practicable.
(i) The time at which a SORs for an appeal tribunal's decision is prepared varies from case to case.
(ii) In the majority of cases, following the making of the decision and preparation of the formal decision notice, the LQPM, in consultation with the other members of the appeal tribunal, in appeals where the constitution of the appeal tribunal extends beyond the LQPM, will prepare and record relevant findings of fact and draft reasons, and retain these in a judicial notebook, or other form. On receipt of an application for a SORs, under regulation 53(4), the LQPM will prepare the SORs, on the basis of the notes and drafts already available. The practice of preparation of findings of fact and draft reasons, immediately following the making of the decision has the dual advantages - the completion of that task when the issue(s) in the appeal are fresh in the minds of the members of the appeal tribunal; and the facilitation of the preparation of the 'full' SORs by the LQPM, when that is subsequently requested by a party to the proceedings.
(iii) In a minority of cases, and usually dependent on the custom of individual LQPMs, the findings of fact and 'full' SORs are both prepared and finalised on the day of the appeal tribunal hearing. These are then retained on file, ready to be issued to the party to the proceedings requesting them.
(i) be comprehensive in dealing with the issues raised by the appeal;
(ii) must include relevant findings in fact, where these differ from those of the majority,
(iii) provide an outline of the evidential assessment process which gave rise to those findings;
(iv) detail which evidence is accepted and preferred, and give reasons why;
(v) state, where necessary, why the dissenting member has adopted a particular interpretation of the law relevant to the issues in dispute; and
(vi) give reasons relevant to the dissenting member's view.
The reasons for the dissenting member's decision must never be drafted as a brief, sketchy add-on to more complete reasons for the majority.
Disposal
(signed): K Mullan
Commissioner
7 May 2009