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.