DLA - Yes, ok.... ***WON***

[ErikaPNP]

DLA. If it weren't so ridiculous it would be laughable. My child was awarded DLA for LRC because apparently my child requires help for "about an hour a day in total". Ok. Fine. The low rate care part wasn't what got me - it was this "hour a day" shenanigans that got me worked up. It made no sense to me based on the mountain of documents I sent them which verified the care my child requires and the specialists involved. There were also statements from professionals involved in my child's care. I had studied in depth the DMG, the legislation set by parliament and case law and could find no reason why they would reach a conclusion of one hour a day, and so I sent off for a written statement of reasons for their decision.

 

They have come back with the chestnut that they wrote to the consultant who told them that my child has no SLT difficulties, could dress, eat and drink and toilet independently. They said that my child required some supervision needs which qualified for LRC but these were for activities in school which were "predictable".

 

1. The consultant saw my child on one occasion about a year before I applied for DLA. During the visit, the consultant did not witness my child dress, eat, drink or go to the toilet. She did ask about these activities and I told her that my child needs help in all of these areas. My child only spoke to say "yes" and "bye". The consultant witnessed my child scribbling, struggling up a set of stairs (and falling down them), trying to walk on tip toe (and falling over), unable to balance on one foot, and maniupulating toys which she had no idea "how" to play with. From all of this, the consultant felt my child needed expert help and referred child for OT. Yet alledgedly the report from the consultant to DLA says different.

 

2. My child does not attend school. My child goes to nursery. For two hours a day. The nursery referred my child to SLT.

 

3. The SLT and the OT have provided activities for my child to do to assist in development which take up a good few hours of the day in addition to the help my child already needs. Yet DLA think she has no SLT issues and can dress/feed/drink and toilet independently. What do they think SLT and OT are for? Decoration? A social chat? They are NHS services. You can't get them unless you really need them.

 

4. They did not contact my child's current healthcare professionals (OT and SLT) or her secondary care giver (professional too) they contacted someone who has seen my child once, and over one year ago. The statements provided by my child's professionals with the claim form, who see child on a regular basis and witness child's needs and provide therapy to assist with those needs, as well as information provided by me appears to have been swept aside and instead they have relied on the view of someone who only saw my child once, over a year ago for about 1 1/2 hours.

 

5. They did not say why child did not meet the night time condition.

 

I feel an appeal coming on! I can't wait to see the actual report from the consultant. Based on the very fact that the consultant referred my child for expert help to be ongoing, I cannot see why the consultant would say child does not have these needs. I have a feeling that bits have been "cherry picked" from the consultant's report and applied incorrectly to the facts of the claim. Either that or the consultant's report was very off and possibly based on another child because it certainly doesn't match up to what actually happned at the meeting and doesn't explain what a consultant would refer for further help if there were only supervisory needs.

 

Mind you, I suppose I should be shell shocked that she qualified for anything at all, given the track record of DLA for turning claims down. Hmmm....oral hearing or paper appeal....wonder what I will choose....

[jack1966]

Hello, can i ask, what does the abbreviations of SLT and OT stand for ?

[postggj]

Ot Is Prob Occupational Therapist

 

Slt

 

Speech And Language Threapy

 

I TAKE IT WE ARE TALKING ABOUT ATOS AGAIN

[ErikaPNP]

Yes Postggj for SLT and OT.

 

No ATOS are not involved at all. Yet.

[honeybee13]

Hi Erika. I'm sorry but not too surprised to hear that. Please tell us when you have the consultant's report, this can't be right, can it? Very interesting if you catch Atos lying, of course.

 

I'm sure you'll win through, but what a pain having to go through it.

 

HB x

[honeybee13]

Just saw your last post. Not Atos, the DWP then? HB x

[ErikaPNP]

Yes. DWP have taken an NHS consultant's report and told me that the consultant said these things. Which in effect means they don't believe the word of three healthcare professionals (two NHS), or a child minder, or the statements made by two other people who know my child well, or me - the child's mother. So the words of one person (allegedly) who has seen my child on one occasion and a long time ago, is taken over the word of 7 - yes, seven others, three of whom are also professionals who specilaise in the fields of care my child requires and whom deal with my child regularly - two on a daily basis.

 

They don't believe 7 people. They haven't stated that but they have implied it. Well guess what? I don't believe them in regard to the consultant report. Given the report that I got from the consultant at the time of assessment, either the consultant has based the DWP report on the wrong patient, or the DWP have taken her comments completely out of perspective, which is why I am itching to see what the report actually states. We'll see.

[RaeUK]

Just wanted to pass on my best wishes, Erika. It has got to be incredibly frustrating!

Best wishes

Rae x

[mazbck]

Good Luck Erika

 

Ive seen medical reports about my son, the ESA one that we got when he was refused ESA and the one they used(supposed to be the same one) for his DLA and guess what!!!!!

 

There are discrepencies in them both, roll on 20th April for our Appeal and we shall see what happens there.

[mich7k]

Hi Erika its getting worse! I am still waiting for the appeal date for my son being waiting since January i called them yesterday only to be told they are waiting on an internal file to come back! They said my boy is no longer entitled to anything! Hope you get it sorted soon, ive got to get myself together for my sons tribunal.

Good luck

[paulb1310]

This might help ...

 

51. FURTHER EVIDENCE AND ADVICE

51.1 Contents Paragraph

Introduction 51.2

Sources of Further Evidence 51.3

Advice from Medical Services Doctors 51.4

51.2 Introduction

51.2.1 At various points in this book suggestions are made concerning the sources of further evidence which are most likely to be of assistance in particular types of case. The purpose of this chapter is to describe the various sources of further evidence and to indicate the sorts of information which can be obtained from each one. Providers of further evidence should not be asked to answer direct questions on whether the qualifying conditions for the benefit are satisfied. In general terms they can be asked for information which will fill gaps in the evidence which would otherwise be incomplete. They can also provide evidence which will help the adjudication officer deal with inconsistencies or contradictions in the information already held.

 

51.3 Sources of Further Evidence

 

51.3.1 General Practitioner Factual Reports (GPFRs)

 

(i) A special fee payable to individual GPs has been agreed whereby factual information based on a patient's clinical records will be provided.

 

The fee does not extend to the provision of an opinion and so, unless the information is already contained within the clinical records, the GP will not be in a position to provide it.

 

It has to be understood that individual entries in a patient's clinical record are relatively brief and will usually concentrate on diagnosis, clinical findings and treatment plan.

 

The records will not really contain any meaningful information relating to care and mobility needs. In general therefore GPFRs can provide useful information on the diagnosis and overall severity of a person's disabling conditions. It will not usually be appropriate to ask specific questions about the help a person requires unless there appears to be gross under-or over-representation of those in the claim pack.

 

(ii) Where a person has a number of different conditions which are being investigated and treated by a variety of hospital departments, the GP's records will be the place where all this information is co-ordinated. In these circumstances the GP may well be able to indicate the relative importance of the various conditions in terms of their effect on the patient's day to day life.

I think the actual guidance goes on to talk about consultants but if a GP is not expected to know much how much more does a consultant know? There is also good case law on reports from schools etc.

[ErikaPNP]

Well well well letter on the doormat today - WON!!

 

Child now has high rate care, and without the need for a tribunal. How pleased am I right now!

 

Can't believe how quick they have been, that must be a record.

[postggj]

one victory of many i hope

 

very happy for you

[loopinlouie]

Congratulations, got what needed xx

[loan_ranger]

I'm delighted to hear of your good result.

 

Regards, Paul.

[mazbck]

Well done Erika, brilliant result.

 

Maz

xxxxx

[pompeyfaith]

Erika,

 

Indeed a very well done so pleased for you.

 

Regards

 

PF

[honeybee13]

That's great, Erika. You deserve it. HB x

[ee-bee]

brilliant news

[Bookworm]

Can't believe I missed this thread!

 

Well, congrats, better late than never!

[sea-sidelady]

That is fantastic news Erika. Well done

[RaeUK]

Yay! Good news for you hunni. Very pleased.

Best wishes

Rae

[ErikaPNP]

Thanks guys!

 

I was all prepared for a lengthly wait and having to go to tribunal to argue case and point. Shame really, I was rather looking forward to pulling the decision to pieces in front of a tribunal.

 

I also knew she was entitled to HRC and was confident I'd secure it at tribunal as there was plenty evidence submitted with the claim form to support the case, but never thought for a minute they'd award it at reconsideration stage - I've seen so many other genuine cases fail the reconsideration stage, and thought we'd fall prey to it too. I thought if they changed it at all at the reconsideration stage they would probably increase it to MRC if we were lucky meaning I would have to go through the whole ugly process again.

 

But just goes to show that they do "put things right" in some cases without the need for a tribunal, and for that (and a DM with common sense who knows their job, second time around) I am very grateful.