Disability Living Allowance - criteria

Promised I would do a blog post about DLA so here it is.

Firstly, if you are under 65 when granted DLA you stay on it after 65. You don't need to apply for Attendance Allowance. However, if you are over 65 when you first apply, you need to apply for AA, not DLA.

There are two elements to DLA: care and mobility.

CARE: You have care needs if you need help with washing, eating, dressing, going to the toilet or communicating your needs.

You need someone to supervise so you are not a danger to yourself or others.

If you are on dialysis and you need someone to be with your when you undertake dialysis. This must be at least twice a week and if done as an outpatient, you will only get DLA provided no member of the hospital staff helps you with the treatment or supervises it.

You need someone to help you lead a normal life.

You do not actually have to be getting help for your care needs to qualify for DLA as long as you have a care need, it does not matter whether you are actually getting care or not.

CARE COMPONENT is paid at 3 different rates:

LOWER Rate - if you need help with cooking a main meal or care for a significant part of the day.

MIDDLE Rate: If you need frequent care throughout the day OR night or continual supervision,.

HIGHER Rate: If you need frequent care or supervision throughout the day AND night or if you are terminally ill.

MOBILITY: Paid at two different rates - higher and lower.

LOWER Rate: If you cannot walk outdoors on an unfamiliar route without guidance or supervision from someone most of the time.

Example: Mental health problems which affect your ability to walk:

Learning difficulties, dementia, blind or partially sighted (But if severe visual impairment would qualify for the higher rate as from April 2011), deaf and not learned to cope with traffic, epileptic, panic attacks, phobias or obsessive behaviour or have no sense of danger, severe agoraphobia.

HIGHER Rate: Your difficulties with walking are caused by a physical disability or you have severe learning difficulties or severe behavioural problems.

Also, you may get the higher rate if you cannot walk at all, can only walk a short distance without severe discomfort or could become very ill if you try to walk.

Most people with RA would find walking either very difficult with severe discomfort or not be able to walk at all and need wheelchair assistance.

You don't actually have to show you are receiving help with your mobility needs to get the mobility component of DLA so long as you can show that you need it.

This is where when filling in the form, you do need to set out how bad you are on various days- this is not misleading - it is letting DWP know how bad your situation is and that you need help.

REFUSAL OF DLA: You can challenge the decision. You can ask for it to be looked at again or you can appeal. This has to be done within 1 month (28 days) of the decision. To do this, you need to get expert advice as there is a risk your DLA could be stopped or reduced. This is where CAB is so useful to claimants.

You will receive a letter from DLA about the decision. You can then ask for a written statement of reasons either by post, e mail or telephone. Again do this within a month.

When a decision is looked at again or appealed, the decision to grant benefit can be changed to either increase or decrease the amount of benefit or found not to be entitled to benefit at all. If already on DLA, and the benefit is reduced, then you could be asked to repay the overpayment.

Time for appealing is also one month. The time runs from the date of the decision letter being sent or given to the claimant. Time limits are very tight.

If there has been a change of circumstances, e.g. either a refusal of benefit or the granting of a lower amount, and the claimant's health has deteriorated you can ask for it to be looked at again. This has to be done within one month of meeting the qualifying conditions for the higher rate.

Awards of DLA at any level may be investigated by the DWP at any time to check whether you are still receiving the right amount of benefit. You have a duty to supply any information that may be requested that could affect your entitlement to benefit. Failure to do so, could result in benefit being suspended or terminated. This is where a medical report from GP or Consultant could be very useful.

I take the view that if your situation has improved for say a number of months, i.e.more than 6 months, you must let the DWP know as this would be a change to be notified to them. My view of temporary improvements e.g. a steroid injection gives you a month of reasonable health, or your anti tnf finally kicks in and gives you some relief for a week or two, is that this is not sufficient to say your situation has improved to the extent you no longer need DLA. The downside to that is you would then have to keep reapplying in what would be a series of ups and downs over which you have no control. Normally you must have care or supervision needs or walking difficulties for at least 3 months and they must also be likely to continue for at least another 6 months.

If anyone needs assistance with DLA applications, appeals, etc then please do contact your local CAB who can assist with this.

LavendarLady x

16 Replies

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  • Great blog ll some good info there thanks x X

  • That Blogg will be a fantastic help to anyone considering applying for DLA. Many people get confused and put off by the amount of paperwork they have to fill in, they need to persevere on this and your Blogg will certainly help.

    Thank you LavendarLady.

    Take care

    mand xx

  • Really good blog. I am waiting for the decision on mine they wrote and said they are contacting my consultant so fingers crossed.

    Good to know the different levels of DLA

    Marnie x

  • Thanks.. I had already decided that if the need arises.. I will use your great knowledge/ professional services

    Alison... in hoping your fees arent too high? xx

  • Really useful, and helpful blog. Many thanks. I am just about to embark on filling out the form, thats probably what made me take to my bed. Just working up to it now.

    Many thanks

    Julie xx

  • When filling in the form, do it very carefully and check it thoroughly before sending it off.

    Alison, will keep my fees down specially for you!

    LavendarLady x

  • It is important to stress that a Consultant or GP must support you in an application, please check with your GP first.

  • Hi all, the DWP will usually contact the GP for a report once the application has gone in. They will then get a report from the consultant if needed although my GP when doing her report, also sent a copy of the latest report from my consultant as well. I did tell my GP I was applying so she was forewarned that a report would be requested.

    LavendarLady x

  • If you are about to embark on the task tortuous of filling in DLA forms, could I suggest that you contact the experts at benefitsandwork.co.uk who will give you professional help to fill in your DLA forms.

  • Great blog Lavendar Lady :)

    In my experience an application goes smoother if YOU get the evidence from the GP/Consultant , as there seems to be a trend at the moment whereby the DWP only ask for GP/Consultants statements of facts, at the reconsideration/appeal stage.

    Asking for a written statement of reasons is great to do if you don't think you can get additional evidence or get an appointment with an adviser within the month . Asking for a written statement of reasons will give you an extra 14 days .

    The month time limit is very strict , however a late appeal can be put in . The eligibility criteria to be able to do this are very strict ..again .. see an adviser at an Advice Centre .

    Benefits and work guides are good , however there is a membership fee , and all the information is available for free elsewhere. There is no substitute for face to face advice and help from a specialist adviser from an advice or law centre.

    Good appeal resource.

    advicenow.org.uk/advicenow-...

    Be aware that this is all due to change to Personal Independence Payments ...

    disabilityalliance.org/dlat...

    Rich

  • Hi Rich, unfortunately, not all GPs/consultants will let you have a report! And if they do, you will have to pay for it - could be quite a lot of money. But if the DWP ask for it, they pay for it.

    Personal Independence Payments are being considered by the Govt but there is so much opposition from patient groups, disability groups etc that I anticipate it will either be delayed or watered down considerably or not put into place.

    If you get CAB to help with the forms, it is free.

    Thanks for including the other web sites - anything that helps with these wretched forms is good.

    There is also direct.gov where you can download information packs, application forms etc. and they have a help line as well.

    LL

  • Must admit if my GP' refused , i would leave the surgery as i consider that as part of my treatment .GP's can charge the DWP for DLA "statement of facts" but cannot for ESA .

    At my CAB we come across that on a daily basis , where the DWP do not ask for GP/Consultant statement until at reconsideration stage hence leaving their patients with the stress of having to appeal.

    Fully aware of the Welfare Reform Bill as i am a SP coordinator for the Bureau , and attended the "Hardest Hit" March in May .

    nras.healthunlocked.com/blo...

    There are a number of more local "Hardest Hit" events coming up in October.. see here

    thehardesthit.wordpress.com...

    and make your voice heard.

    Rich :)

  • Hi Rich, good for you going on the March. Hope eventually it will do some good but given the track record of governments so far as listening is concerned, I do wonder.

    I'm a generalist adviser with the Bureau but also a qualified lawyer and have dealt with this sort of thing as part of my job.

    Had a look at the website but couldn't see anything in East Anglia. I certainly couldn't manage a march - I can barely walk some days!

    I did do social policy when first joined the bureau but my manager decided with my background, I was more use seeing clients!

    LavendarLady

  • Hi, i applied and was refused. I work full time at a desk job, and i can walk most days,I use the car more than walking. Have instances where cannot bend ankles properly, have pain but can still walk, take painkillers. To qualify do I need to be practically immobile? x

  • Hio Shoebox, Part of the criteria for DLA is loss of mobility either severe in which case you qualify for the higher rate or less so in which case you get the lower rate. It sounds from what you have said, that you are not so bad that you need DLA for any reason.

    Did you consider challenging the decision - see my main blog above for the time limits and did you ask for a written statement of reasons?

    Also of course,PIPs will be taking the place of DLA in about 2013/15 I understand, and anyone of working age from 16 - 64 will have to go onto a PIP.

    Anyone over the age of 65 who is in receipt of DLA is not being considered to go onto PIPS at present. As the Government is desparate to save money that may change once they see how the initial programme roles out.

    LavendarLady x

  • I'm a bit confused here regarding DLA v PIP. PIP has taken over from DLA in that if you are a new applicant or under 65 you will be called in for a medical or renewal medical. Now if you are 65 and over and already receive DLA you will not be called in for a medical unless that changes in the future. So in a nutshell keep with DLA if you are 65 and over. I also understand that you can't switch to AL either. I maybe wrong but that's what was in a notification I received when this was all changing. If my medical needs have changed I would ask for a review but it would be under the PIP rules....no thank you. I doubt very much under the stringent rules of PIP that I would get anything so it's a case of don't rock the boat!

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