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Cite as: [1999] NISSCSC C39/99(DLA)

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[1999] NISSCSC C39/99(DLA) (3 April 2000)


     

    Decision No: C39/99(DLA)

    SOCIAL SECURITY ADMINISTRATION (NORTHERN IRELAND) ACT 1992

    SOCIAL SECURITY (NORTHERN IRELAND) ORDER 1998

    DISABILITY LIVING ALLOWANCE

    Appeal to the Social Security Commissioner

    on a question law from the decision of

    Belfast Disability Appeal Tribunal

    dated 23 April 1999

    DECISION OF THE SOCIAL SECURITY COMMISSIONER

  1. This is an appeal by the claimant, with the leave of the Chairman, against the decision of the Tribunal to the effect that the claimant is not entitled to the care component of Disability Living Allowance from and including 27 July 1998.
  2. On 14 December 1995 the claimant made a claim for Disability Living Allowance. On 18 January 1996 an Adjudication Officer awarded the claimant the higher rate of the mobility component of Disability Living Allowance from and including 14 December 1995. The claimant then made a request for a review on 19 February 1998, on the grounds that she considered she was entitled to an additional award of the care component. The usual self-assessment forms were filled in by the claimant, a report was completed by Dr B..., the claimant's General Practitioner, and the claimant was examined by an Examining Medical Practitioner on 1 July 1998. On 27 July 1998 a different Adjudication Officer reviewed the decision of 18 January 1996 but did not revise it. A review application was then received on 24 September 1998. After a further letter was received from the claimant and a factual report was completed by Dr B..., on 13 January 1999 a different Adjudication Officer reviewed the decision of 27 July 1998 but did not revise it. The claimant then appealed.
  3. The Tribunal made the following findings of fact material to its decision in relation to the care component:-
  4. "[The claimant] is a 52 year old lady who suffers from a number

    of complaints including asthma, bowel problems and generalised

    joint pain. She also appears to suffer from depression. She

    has an ulcer also and is said to have classic symptoms of

    fibromyalgia. It is also alleged that she has osteoarthritis

    and osteoporosis.

    The Tribunal reject entirely her evidence as totally unreliable

    and totally exaggerated. They prefer the evidence of the

    Examining Medical Practitioner and accept his findings that

    there are no physical findings that should prevent her attending

    to all her own care needs both during the day and at night. The

    Tribunal find that she may well receive close attention by her

    family but they are not at all satisfied that this is necessary.

    The Tribunal find that she is and should be independent in

    relation to washing, dressing, toileting, getting in and out of

    bed, taking her medication and cooking.

    The Tribunal specifically reject the evidence of Dr Br... (sic)

    and prefer the evidence of the Examining Medical Practitioner

    whose opinion is clear and concise and leaves little room for

    doubt. The Tribunal noted that despite Dr Br...'s (sic) concern

    for her mental condition he had not referred her for any

    psychiatric help nor had he organised an occupational therapist.

    The Tribunal are satisfied that this lady is able to make a main

    meal for herself. She can make a cup of tea. She cannot

    accurately give any reason why she should not be able to

    organise and plan and carry out the basic task of making a main

    meal for herself if she had the ingredients. The Tribunal are

    likewise satisfied that she is totally independent at night.

    She may well prefer to have other people in the house with her

    but the Tribunal cannot find any reason why she should need

    someone with her. The Tribunal have also specifically considered

    the question of encouragement and reject her evidence in relation

    to this. They specifically find that she does not need any form

    of supervision or watching over. She is mentally competent and

    alert and in the opinion of the Tribunal capable of living an

    independent lifestyle."

  5. The Tribunal gave the following reasons for its decision in relation to the care component:-
  6. "The Tribunal have carefully listened to the evidence of [claimant]

    and regrettably feel that this has been totally over exaggerated.

    They have considered in detail her evidence in the submission.

    They have contrasted the evidence of Dr Br... (sic) with that of

    the Examining Medical Practitioner. They have preferred totally

    the evidence of the Examining Medical Practitioner. They have

    also examined in great detail the General Practitioner's notes

    and records which do not appear to substantiate the degree of

    disability outlined by [claimant] but rather supports the view

    of the Examining Medical Practitioner. The Tribunal have found

    that this lady is capable of looking after her own care needs

    both during the day and at night. She does not need anyone to

    be awake with her. She may prefer to have help from her family

    but she does not need encouragement nor does she need supervision.

    The Tribunal have rejected her evidence regarding a main meal and

    cannot find any reason why she should not be capable of making a

    main meal for herself. They are likewise satisfied that there

    is no question of her needing assistance at night-time or anyone

    to watch over her.

    Accordingly for these reasons she is not entitled to high, middle

    or low rate care component Disability Living Allowance.

    The Tribunal find this is the current position and was the position

    as at the 27th July 1998 and there were no grounds to review this

    decision.

    The Tribunal were concerned about the mobility component in this

    matter in view of the distances [claimant] indicated she could

    walk in her claim form and also in view of some of the notes and

    some of the entries in the General Practitioner's notes and

    records regarding treadmill tests. However they have decided not

    to take any action in relation to same."

  7. The Chairman of the Tribunal made the following record of proceedings:-
  8. "[Claimant] appeared accompanied by her son and represented by

    Mr Hughes from the Citizens Advice Bureau. Mr Cassidy appeared

    for the Agency. The Chairman introduced the panel and explained

    the procedure. All parties were given an opportunity to consider

    the General Practitioner's notes and records. Mr Cassidy did so.

    However the appellant and her representative indicated that they

    did not wish to see the notes.

    The Chairman then explained the history of this matter. This

    lady had high rate mobility from and including 14 December 1995

    and had sought an out of time review for the care component.

    All parties agreed that the issue before the Tribunal was whether

    or not there were grounds to review the Adjudication Officer's

    decision on the 27 July 1998. The Chairman went on to point out

    that if anything arose in the course of the Tribunal that would

    indicate that the mobility component should not be payable then

    it could be become an issue. All parties were given an opportunity

    to consider the implications of this and it was explained in some

    detail by the Chairman and [claimant] and her representative.

    Mr Hughes indicated that he had explained that to his client and

    that they wished to proceed. Accordingly the matter proceeded.

    Mr Hughes then made an opening statement in which he indicated that

    Doctor Br... (sic) was the person who knew his client the best. His

    client suffered from fibro-myalgia and osteoporosis and osteoarthritis.

    Both he and his client completely disagreed with the views of the

    Examining Medical Practitioner. The Chairman then asked him to

    exactly set out who had diagnosed osteoporosis and osteoarthritis as

    there was little or no evidence in the medical notes and records

    other than that there was a note to say on the 7th October 1996

    she had a normal bone scan and there was a small osteoarthritis

    at the base of one thumb. The Chairman then reviewed the evidence

    as set out in the General Practitioner's notes and records which

    were fairly extensive and pointed out that X-rays of her spine

    were normal. She also had an ultra scan which showed no

    abnormalities. Her hearing had been checked and was average for

    her age. She had been the subject of these tests in March '99 all

    of which were normal and the comments of the Doctor were that it

    was a classic case of fibromyalgia.

    The Chairman then asked Mr Hughes whether or not he wished to lead

    his client through his evidence or whether or not they wished the

    Tribunal to do so and he indicated he would prefer the Tribunal to

    ask the relevant questions.

    [Claimant] then gave evidence to say she lived in a ground floor flat,

    this is a one bedroom flat. She has 3 children, one daughter and 2

    sons all who live locally. The children take turns to help her out

    and they have a basic rota. Her daughter stays 4 nights and her sons

    the remainder of the time. The Chairman invited her to go through

    her daily routine on an average day. She indicated she got up at all

    different times, sometimes as early as 6.00 am and sometimes 6.30 am.

    She would take her painkillers and these are left out by her son

    beside her bed. She then takes her gum shield out. She has problems

    with her gums. She has very little interest or enthusiasm for

    getting up. She can get up herself but requires some help. This

    is due to pains. She says she has pains everywhere, in her face,

    arms, feet, knees and joints. Her joints in fact lock. She was

    asked exactly what the person does to get her up and she said

    whoever was there just helps her up. She cannot manage certain

    items of clothing for example, she has difficulty with buttons

    and tends to use clothes that have elastic in them. She cannot

    bend. She has no interest in washing and has to be encouraged

    to wash and clean herself. She has no enthusiasm or wish to go

    out. She was asked was this the situation all of the time and

    she said that sometimes she could manage. She has to have help

    both having a shower or bath. The Chairman enquired whether or

    not there were any aids in the house or whether or not she had

    been seen by an occupational therapist and apparently this has

    never been suggested to her and she has had no assessment.

    Mr Hughes interjected to say an occupational therapist would

    take a year. The Chairman asked what she did throughout the day

    and she said that she mainly watches television or reads. She

    could make herself a cup of tea and goes to Mass on a Sunday.

    She is always accompanied. On a Wednesday she goes to her

    mothers and again she is taken by one her family and her mother

    does not enjoy good health. She has been like this for the last

    4 or 5 months. She says she is rarely left on her own and if she

    was it would be for a maximum of 1 hour. The Chairman enquired

    what her problems were at night and she says she has problems

    undressing and getting out of bed and needs help. She has

    problems in bed and needs help to get turned. Sometimes she can

    manage on her own but only possibly once a month or something

    like that. When in bed she is uncomfortable and finds it

    difficult to sleep. Apparently she sleeps on 2 mattresses which

    are on the floor. There is no bed even in the spare room but a

    mattress on the floor and one of her sons sleeps there. There is

    a bed settee in the living room. During the night her older son

    would counsel her and talk to her. She went on to indicate that

    she was old at one stage that it would be as wise to keep a diary

    and she did keep a diary but it depressed her so much that she

    burnt it. She can take her own medication most of the time but

    has difficulties with the tops of bottles. She needs help going

    to the toilet and would have accidents on occasions.

    In relation to cooking she says that she can make a cup of tea

    for herself but there would be no question for her being able to

    chop or peel or organise a meal. She would not have the

    necessary concentration. She would need encouraged to do this.

    She could not possibly organise it. She felt that cooking was

    out of the question.

    Mrs L… Tribunal Member enquired whether or not she could

    turn on taps and she said that she could. She also enquired

    whether or not she was able to brush her teeth and she said that

    she could. The panel Doctor enquired exactly what difficulties

    she has with her grip and why could she not hold the potatoes

    and peel same. She says that her hands lock and are very painful.

    Mr Cassidy for the Agency had no questions and relied on the

    submission in the papers. In relation to the mobility issue he

    said he had noted various matters which were cause for concern

    but he would leave the matter to the Tribunal.

    The Chairman invited [claimant] and her son and Mr Hughes to

    comment on the Examining Medical Practitioners report and said

    they simply disagreed with same and reiterated the point that

    the up to date report from Dr Br... (sic) dated 22 April 1999,

    which had been handed in to the Tribunal, was much more reliable.

    The chairman indicated that the last word really should go to

    [claimant] or Mr Hughes again relied on his submission dated 22

    April 1999 which was handed in.

    No one had anything further to add."

  9. The unanimous decision of the Tribunal was in the following terms:-
  10. "Care component disallowed from and including 27 July 1998."

  11. The mobility component was specifically not considered by the Tribunal so, as I understand it, the existing award of higher rate mobility component still continues.
  12. The claimant who is represented by Ms Slevin of the Law Centre (NI) sought leave to appeal to a Commissioner on the following grounds:-
  13. "It is respectfully submitted that the decision of the tribunal

    was erroneous in law as the tribunal failed to make adequate

    findings of fact or to give a proper statement of reasons for

    its decision.

    It submitted that the tribunal erred in failing to make a

    finding of fact as to whether it rejected the evidence of

    Dr B... and the claimant that she suffers from a nervous

    debility. The EMP in his report fails to consider the issue

    of nervous debility and its implications for [claimant's]

    care requirements.

    The tribunal state in their finding of fact material to the

    decision that they preferred the evidence of the EMP over the

    evidence of Dr B... and the specifically note in the reasons

    for the decision that they accept the EMP's findings, "that

    there are no physical findings that should prevent her attending

    to all her own care needs both during the day and at night."

    They also state in the findings of fact material to their decision

    that, "the tribunal noted that despite Dr B...'s concern for

    her mental condition he had not referred her to any psychiatric

    help nor had he organised an occupational therapist."

    It is submitted that the tribunal should have gone beyond this

    to state expressly whether they rejected the evidence that

    [claimant] suffered from a nervous debility.

    It is submitted that the tribunal erred in failing to give

    adequate weight to Dr B...'s very detailed report of 22 April

    1999. Dr B... went to some length to stress at the beginning

    of the report that he had known [claimant] for over 30 years,

    and that she was well known to him. Dr B... also proceeded to

    give special significance to [claimant's] nervous debility, which

    he confirmed to be genuine, and he took great care to support

    [claimant's] application for an award of the care component.

    It also submitted that the tribunal erred in law in reaching the

    conclusion that [claimant] was not entitled to the lowest rate

    of the care component in relation to the cooking test. The

    tribunal failed to deal adequately with [claimant's] evidence of

    past accidents when cooking, and of her inability to plan or

    prepare a main cooked meal due to her nervous debility."

  14. Leave to appeal was granted by a Chairman on 22 September 1999.
  15. Mrs Gunning, the Adjudication Officer (now the Departmental Official), made the following submission in writing by letter dated 22 November 1999:-
  16. "Miss Slevin contends that the tribunal failed to make adequate

    findings of fact or give proper reasons for its decision. In

    particular she contends that the tribunal should have specifically

    stated why it rejected the evidence that [claimant] suffered from

    a nervous debility and failed to deal adequately with her evidence

    of past accidents when cooking and her inability to plan or prepare

    a main cooked meal due to her nervous debility.

    The question before the tribunal was whether [claimant] satisfied

    the conditions of entitlement to the care component of disability

    living allowance. The record of proceedings shows that the

    tribunal considered Dr B...'s letter, the report of the examining

    medical practitioner, [claimant's] own evidence and her medical

    notes and records. It is clear from the decision why the tribunal

    rejected [claimant's] evidence and that of Dr B... and preferred

    the opinion of the examining medical practitioner. I submit the

    tribunal considered the relevant criteria and applied the correct

    test and that there is no error of law in the tribunal's decision.

    Accordingly I oppose the appeal."

  17. Ms Slevin made the following additional submission, by letter dated 21 December 1999:-
  18. "I would continue to submit that the tribunal's statement of

    reasons for the decision is inadequate, as it is unclear why

    the tribunal rejected [claimant] and her GP's detailed evidence

    of anxiety/a nervous debility.

    In the Findings of Fact material to the decision the tribunal

    found that,

    "She [claimant] also appears to suffer from depression"

    and that

    "The tribunal specifically reject the evidence of Dr

    Br... (sic) and prefer the evidence of the Examining

    Medical Practitioner whose opinion is clear and concise

    and leaves little room for doubt. The Tribunal noted

    that despite Dr Br...'s (sic) concern for her mental

    condition he had not referred her for any psychiatric

    help nor had he organised an occupational therapist"

    It submitted that the EMP's report failed to adequately address

    the question of anxiety and depression and that Dr Br...'s (sic)

    report addressed this issue in detail. The EMP simply found on

    p21, Part 8, "OVERALL FACTORS", "This is only partially due to

    physical factors". The tribunal failed to consider that Dr

    Br... (sic) had prescribed medication to [claimant] to treat her

    depression.

    In the absence of an explanation from the tribunal as to why

    they rejected Dr Br...'s (sic) evidence of her mental condition,

    [claimant] is left in the position where she cannot comprehend

    how this conclusion was arrived at.

    Accordingly I continue to submit that the tribunal's decision is

    erroneous and should be set aside."

  19. Having considered the circumstances of the case I am satisfied that the Appeal can properly be determined without a hearing.
  20. In my view it is clear that the Tribunal has rejected Dr B...'s evidence. It is also my view that the Tribunal was entitled so to do. The rejection of evidence in these circumstances is not a failure to make adequate findings of fact or a failure to give proper reasons for so deciding. It is not for a Commissioner to superimpose his or her views, if they differ from a Tribunal's, but a Commissioner's jurisdiction to set aside such a conclusion is dependent on a finding that there is an error in law and, in the circumstances, I find no error of law in the Tribunal's rejection of Dr B...'s evidence. The Tribunal was entitled to prefer the evidence of the Examining Medical Practitioner.
  21. Ms Slevin has made important submissions concerning the claimant's allegation that she suffers from a nervous debility. It must be remembered that it is not necessarily a consequence of nervous debility that a person needs attention, supervision or help in preparing a cooked main meal. Therefore, in my view, a Tribunal is not required to decide whether it accepts she suffers from such debility or not. I conclude that the Tribunal has not erred in law by failing to deal with this issue.
  22. Ms Slevin also has submitted that the Tribunal has erred in law by failing to give adequate weight to Dr B...'s very detailed report of 22 April 1999 which, inter alia, mentions anxiety and depression. As stated earlier in this decision, the Tribunal was entitled to reject the substantive conclusions set out in Dr B...'s evidence, in light of the other evidence in the case. Close examination of the report makes it clear that much of it is based on the claimant's own history. The Tribunal is entitled to take the view that her evidence to the Tribunal was much exaggerated and also to give little weight to the history of the claimant's condition set out in Dr B...'s report based on what she said to him. It is also noteworthy that the Tribunal, in effect, has stated that Dr B...'s pattern of treatment does not correspond with his concern for the claimant set out in the report. In my view, the Tribunal has not erred in law in dealing with this issue.
  23. Ms Slevin submitted that the Tribunal erred in reaching the conclusion that the claimant was not entitled to the lowest rate of the care component arising out of the cooking test. However, in my view, the Tribunal has dealt with this issue by concluding that the claimant's evidence is unreliable. There is no evidence, other than from herself, that she cannot cook a meal for herself. The Tribunal, therefore, was entitled to come to the conclusion that she could make a main meal for herself if she had the ingredients.
  24. Accordingly, in my view, Mrs Gunning is correct in her submissions that the issue was whether or not the claimant satisfied the conditions of entitlement to the care component of Disability Living Allowance. The Tribunal considered Dr B...'s letter, the report of the Examining Medical Practitioner, the claimant's own evidence and her medical notes and records. The Tribunal rejected the claimant's evidence and also that of Dr B.... It also accepted the opinion of the Examining Medical Practitioner. It seems to me that the Tribunal applied the correct tests and considered all the relevant criteria. A Commissioner is not entitled to interfere with a decision, such as the one made by the present Tribunal, unless there is an error of law. I find no such error and, therefore, I disallow the appeal.
  25. (Signed): J A H Martin

    CHIEF COMMISSIONER

    3 April 2000


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