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You are here: BAILII >> Databases >> Northern Ireland - Social Security and Child Support Commissioners' Decisions >> [2009] NISSCSC C012_08_09(DLA) (15 January 2009) URL: http://www.bailii.org/nie/cases/NISSCSC/2009/C012_08_09(DLA).html Cite as: [2009] NISSCSC C012_08_09(DLA), [2009] NISSCSC C12_8_9(DLA) |
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[2009] NISSCSC C012_08_09(DLA)
Decision No: C12/08-09(DLA)
Background
'Appeal disallowed.
The appellant is not entitled to the care component of DLA from and including 24.3.07''Appeal disallowed.
The appellant is not entitled to the mobility component of DLA from and including 24.3.07'
(i) work was taken into account in the decision;
(ii) error in the report.
The proceedings before the Social Security Commissioner
(i) (in connection with the first submitted ground) that while there was agreement that participation in full-time employment does not preclude entitlement to DLA, the evidence concerning work was not the deciding factor in the appeal tribunal's decision which had placed a greater emphasis on the medical evidence available to it; and
(ii) (in connection with the second submitted ground) that the statement regarding referral to a consultant had to be seen in context.
The error of law
'… it follows from our reasoning … that the appeal tribunal has jurisdiction, on appeal, to decide whether the outcome arrived at by that decision (i.e. either to change or not to change the original decision) was correct. This will or may involve deciding (a) whether one of the statutory supersession grounds (whether the one relied upon by the decision-maker or not) applied and (b) if so whether the original decision ought to be changed.'
'Appeal disallowed.
The appellant is not entitled to the care component of DLA from and including 24.3.07''Appeal disallowed.
The appellant is not entitled to the mobility component of DLA from and including 24.3.07'
'Appellant requested a supersession on 26.10.06 …'
Thereafter, the remainder of the statement of reasons is taken up with an assessment of the evidence available to the appeal tribunal, some limited findings in fact, and a conclusion that:
'… in the light of all the evidence, that [sic] Appellant did not have any disability sufficiently severe to merit an award of Disability Living Allowance.'
(i) that the appeal tribunal has addressed the issue of whether the Department had a legal and evidential basis for reconsidering and changing its earlier decision; and
(ii) the effective date from which any new decision should take effect.
(i) the record of proceedings indicates that the appeal tribunal had considered the appeal submission and accompanying documents;
(ii) the appeal submission outlined the basis on which the previous decision of the Department had been superseded;
(iii) the record of proceedings also indicates that the appellant's representative had made a submission that there had been no relevant change in her circumstances;
(iv) the statement of reasons notes that the appellant had requested a supersession;
(v) the statement of reasons finishes by concluding that the appellant did not satisfy the conditions of entitlement to DLA;
(vi) in light of (i) to (v) above that:
'The tribunal did not specifically refer to the grounds for supersession in the conclusion to its statement of reasons. While it may have been preferable for it to have done so, I would submit that in concluding that no award of Disability Living Allowance was appropriate it is implicit that the Tribunal considered that grounds for supersession existed to remove the award namely a relevant change of circumstances.'
The other grounds raised by the appellant
(i) work was taken into account in the decision;
(ii) error in the report.
(i) (in connection with the first submitted ground) that while there was agreement that participation in full-time employment does not preclude entitlement to DLA, the evidence concerning work was not the deciding factor in the appeal tribunal's decision which had placed a greater emphasis on the medical evidence available to it; and
(ii) (in connection with the second submitted ground) that the statement regarding referral to a consultant had to be seen in context.
'That approach is that Regulation 12(1)(a) does not prevent a decision maker from taking into account in determining a claimant's physical condition, the place of and nature of a claimant's employment. The sub-paragraph does, however, prevent a decision maker, where a person is found to satisfy the other conditions, from having regard to the nature or place of his employment, in deciding whether or not he is entitled to the component.
21. To give a couple of examples - a decision maker could take into account the fact that a person is employed as a professional footballer in deciding whether or not the physical conditions for the mobility component were satisfied. He could not, in, say, the case of a concert pianist find those conditions to be satisfied but say that because the nature of the employment does not necessitate walking, the allowance is not to be awarded.'
'… able to walk but is so severely disabled physically or mentally that, disregarding any ability he may have to use routes which are familiar to him on his own, he cannot take advantage of the faculty out of doors without guidance or supervision from another person most of the time.'
'12. If a claimant is unable to walk even on familiar routes without guidance or supervision, then it logically follows that he will also be unable to do so on unfamiliar ones; but the converse does not apply. It will depend upon the nature of the claimant's condition. If the complaint is of a bad left knee causing falls, then the difficulties are likely to be the same whether the route is familiar or unfamiliar; however if, for example, a claimant has genuine anxiety and panic, then what he is able to do on a familiar route does not necessarily govern his capacity on an unfamiliar one.'
Further, at paragraph 14, she stated:
'14. In consideration of the legal criteria for entitlement to lower mobility, there must be ignored any ability to use familiar routes, albeit not an inability. However, when considering whether the claimant is unable to walk on unfamiliar routes without guidance or supervision, it may be evidentially relevant to that question as a matter of fact what, if any, are his difficulties with familiar routes. When a claimant does not differentiate between problems on familiar and unfamiliar routes, and there is nothing inherent in his condition to suggest a relevant distinction, then if he is unable to satisfy a tribunal that he has the required difficulty on familiar routes, in a context where the onus of proof on all matters lies on him, a tribunal may legitimately infer that he therefore would not need guidance or supervision on unfamiliar routes either. It is not that an adjudicating authority is requiring as a matter of law that he has difficulties on familiar routes before it will accept entitlement to lower mobility but rather that, from all the evidence, when considering his capacity on unfamiliar routes, it makes deductions from the information about his ability on familiar ones. A tribunal usually has to so reason because a claimant often says that he never walks on unfamiliar routes, which is entirely understandable.'
'I consider the Department's submission to be correct in that the tribunal concluded that the ability to plan a journey, drive a car and therefore react to road conditions was indicative of clear headedness and competency. Such clear headedness and competency is a matter which is obviously relevant to the ability to walk on unfamiliar routes without guidance or supervision. I consider the Department to be correct that it was the possession of those abilities upon which the tribunal relied, not the claimant's ability to use familiar routes. When driving no matter whether a route is familiar or not there can be varying traffic conditions, emergency situations, pedestrians etc. The ability to drive even on familiar routes is evidence of clear headedness and competency. It is quite obvious from the tribunal's findings, where it specifically referred to the ability to walk on unfamiliar routes, that it has not misinterpreted the test for the lower rate of the mobility component. It has merely used the evidence of driving as showing clear headedness and competency indicative of ability to walk unsupervised and unaccompanied.'
'8. The task is to apply the test to the problems the claimant has. That is a question of fact, not law. The starting point, … , is what the claimant says in the claim form. To that must be added all other evidence. The tribunal's job, if there is a dispute, is to test for itself the claimant's abilities against the hypothetical test. It can do that by direct application – finding what difficulties the claimant actually has in cooking in the way he or she does so, if that happens. And it can do that by indirect application – finding what limits the claimant has on gripping, lifting, bending, planning or otherwise by reference to other activities the claimant does undertake such as eating, washing, driving, shopping, cleaning, being aware of danger, or any other physical or mental activity using the same bodily functions as are normally used in cooking. Having looked at all the available evidence, it must then, as the House of Lords expressly confirmed, take a broad judgmental view about whether the claimant's problems are such that the claimant is or is not able to meet the test for the relevant period, with input from all three members of the tribunal.'
'… Criticism is made of the appeal tribunal for enquiring about activities other than those relating to the claimant's care and mobility needs. It is perfectly proper for a tribunal to seek to build up a picture of an appellant's lifestyle and general level of ability. A tribunal is entitled to make findings and draw inferences as to care and mobility needs from the answers obtained. For example, someone who says that they are unable to cook a main meal may accept that they have hobbies involving many actions similar to those used in cooking. The ability to perform those actions may be directly relevant to the ability to cook. Again, it is not uncommon for appellants to claim that they need guidance and supervision when walking outside due to confusion but to admit that they are able to drive. In the present appeal we consider that the appeal tribunal made perfectly proper use of the information which it obtained and reached conclusions which it was entitled to reach.'
Guidance to the parties to the proceedings and the appeal tribunal
Grounds to supersede
'… DLA is a composite benefit and … once grounds for supersession have been established both components can be looked at. R2/95(DLA) and CIB/4751/2002 so indicate.'
'… it follows from our reasoning … that the appeal tribunal has jurisdiction, on appeal, to decide whether the outcome arrived at by that decision (i.e. either to change or not to change the original decision) was correct. This will or may involve deciding (a) whether one of the statutory supersession grounds (whether the one relied upon by the decision-maker or not) applied and (b) if so whether the original decision ought to be changed.'
Effective date of supersession
Further claims to Disability Living Allowance
Concessions made by the appellant's representative
(signed): K Mullan
Commissioner
15 January 2009