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Northern Ireland - Social Security and Child Support Commissioners' Decisions |
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You are here: BAILII >> Databases >> Northern Ireland - Social Security and Child Support Commissioners' Decisions >> [1997] NISSCSC C35/97(DLA) (28 July 1997) URL: http://www.bailii.org/nie/cases/NISSCSC/1997/C35_97(DLA).html Cite as: [1997] NISSCSC C35/97(DLA) |
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[1997] NISSCSC C35/97(DLA) (28 July 1997)
Decision No: C35/97(DLA)
DECISION OF THE SOCIAL SECURITY COMMISSIONER
Mobility ComponentBackground
"He was allowed low rate mobility 22 April 1992 - 21 April 1996.In his 1992 D.L.A.1 he did not claim mobility as such but under
care said that he had light heads and would fall or stumble as
he had no control over his movements. He told an Examining
Medical Practitioner on 2 April 1993 he could walk 2 miles at a
normal pace and would have no difficulties and needed no guidance/
supervision. The Examining Medical Practitioner accepted this.
Despite this, Adjudication Officer decided on review he would
need supervised walking out of doors due to hypos on 4 August 1992,
31 January 1993 and 10 February 1993. In his 1994 renewal he said
his mobility had not changed. One further hypo on 17 August 1993.
On 16 February 1994 Dr G( said he had occasional hypos, usually no warning and he could walk a good distance, there was no reason not to
walk far and no help was needed from another person. On
16 February 1993 he had said there usually was a warning and walking
ability was fair. Mobility Component was allowed for another 2 years
to 21 April 1996. Renewal from and including 22 April 1996 was
disallowed and this is his appeal."
Care Component
Background
"In 1992 he needed help to inject insulin, 30-45 minutes morningand evening. He had no other attention or supervision needs.
He told the Examining Medical Practitioner he could get up and
dress, move indoors, had 2 hypos a year, bathed when someone was
in the house, manage his own medication and meals and cooking, he
could undress and go to bed, he had had 4 hospital admissions,
he could manage alone in bed and at night and no hypos at night.
On renewal he confirmed no change in this condition. On latest
renewal there is no change except he says he needs supervised
day and night 7 days a week due to hypos."
and made findings of fact and reasons for decision as follows:-
Mobility Component
Findings of fact
"He can walk 1/2 mile comfortably. He says when walking 4-6 or7 days a week he gets hypos, is confused and disorientated with
no warning, he does not know where he is or what is happening.
He says he uses his glucometer before walking but still gets
hypo within 10 minutes or 1/2 mile. We do not accept this. We
do not accept his diabetes is so unstable and so poorly controlled.
If it were he would have been provided with glucagon. We do not
believe he has only gone out alone once or twice in 7 years. We
do not accept he gets no warning - he carried glucose and
carbohydrate with him to take and has had no hospital admission
from the street. He did not mention these problems in previous
claims. He is not severely depressed."
Reasons for Decision
"He is not limited in terms of time, distance, manner, exertion etc.He is diabetic and says therefore he requires guidance or supervision
all the time he is walking out of doors on unfamiliar routes. We
do not accept this as a general proposition for diabetics nor in
his particular case. We do not accept he gets sudden, out of blue
hypos with no warning or so little warning he cannot take action such
as sitting down and taking glucose carbohydrate which he carries with
him.
We do not accept he requires guidance or supervision due to his
depression.
We feel the earlier awards of the Mobility Component were
unjustified."
Care Component
Findings
"He can attend to all his own bodily functions (we accept hisevidence on this point).
He can safely be left unsupervised for 3 hours at a time by day
and so does not receive continual supervision. We do not accept
that it is nevertheless reasonably required.
We accept that he receives no supervision from 11.00/11.30 pm to
7.00/7.30 am every night. We do not accept that nevertheless it
is reasonably required.
The presence of a neighbour in another flat or at the end of a
telephone is not in our opinion continual supervision.
We do not accept he is unable to prepare a main cooked meal. This
is evident from his evidence that he would not starve and from
the General Practitioner reports."
Reasons for Decision
"This man is able to test his own blood and urine and to administerhis own insulin injections. It seems to us that by doing so he
should be able to monitor and control his blood sugars and avoid
hypos. We believe he does so. We do not believe he is having
4,5,6 or 7 hypos per week because we note his medication has not
been changed since 3 March 1994 and his insulin has not been
increased and he has not been supplied with glucagon which has
been available for 20 years. Continual supervision is neither
received nor reasonably required either generally for diabetics
or in this particular case. We do not see why he cannot prepare
a main cooked meal for himself. He can attend to all his own
bodily functions day and night."
The Tribunal recorded the various documents which it considered: namely previous claim papers, written submission from the Citizens Advice Bureau and two letters from Dr W( of 20 December 1995 and 5 July 1996.
"... Mr T( states in his self-assessment form for DisabilityLiving Allowance that he requires regular/constant supervision
throughout the day and night because of his unstable condition and
unpredictability of the onset of an attack. Mr T( stated that
he had been admitted to hospital following a blackout on 26.06.94,
27.12.94, 12.04.95, 06.05.95 and 14.06.95. Mr T( states that
he has blackouts 4 or more times a week during which he becomes
physically weak, his energy is drained, he is confused and
disorientated and he tends to fall.
As already stated in this submission there is a substantial
difference of opinion between 2 general practitioners in the same
practice, with regards to Mr T('s condition. I would
respectfully ask the Tribunal to consider these medical reports
and any GP and/or hospital notes that may be available on the
day of the Tribunal and to decide on the balance of probabilities
which of the conflicting medical opinions is correct. Where
the Tribunal decides that one of the conflicting medical opinions
is to be preferred to the other, then it should say why it prefers
such opinion. (See unreported decision CM/406/92)."
It is clear that the Tribunal ignored this submission completely.
(Signed): C C G McNally
COMMISSIONER
28 July 1997