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UK Social Security and Child Support Commissioners' Decisions |
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You are here: BAILII >> Databases >> UK Social Security and Child Support Commissioners' Decisions >> [2007] UKSSCSC CSDLA_637_2006 (20 March 2007) URL: http://www.bailii.org/uk/cases/UKSSCSC/2007/CSDLA_637_2006.html Cite as: [2007] UKSSCSC CSDLA_637_2006 |
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[2007] UKSSCSC CSDLA_637_2006 (20 March 2007)
THE SOCIAL SECURITY COMMISSIONERS
Commissioner's Case No: CSDLA/637/2006
SOCIAL SECURITY ACT 1998
APPEAL FROM THE APPEAL TRIBUNAL UPON A QUESTION OF LAW
COMMISSIONER: L T PARKER
Oral Hearing
Appellant: Secretary of State
Respondent: Sandra Martin as appointee for Patricia Martin
Tribunal: Glasgow Tribunal Case No: U/05/896/2005/01313
DECISION OF SOCIAL SECURITY COMMISSIONER
Decision
The issues
"(1) Subject to the following provisions of this regulation, for the purposes of section 10 [of the Social Security Act 1998], the cases and circumstances in which a decision may be superseded under that section are set out in paragraphs (2) to (4).
(2) A decision under section 10 may be made on the Secretary of State's … own initiative or on an application made for the purpose on the basis that the decision to be superseded -
(a) is one in respect of which –
(i) there has been a relevant change of circumstances since the decision had effect …
(b) is a decision of the Secretary of State … and-
(i) the decision was erroneous in point of law, or it was made in ignorance of, or was based upon a mistake as to, some material fact …
(c) is a decision of an appeal tribunal or of a Commissioner-
(i) that was made in ignorance of, or was based upon a mistake as to, some material fact; …"
(a) the tribunal did not give clear reasons why there had been no reduction of care needs such that a serious question was now raised as to whether the claimant was still entitled to the highest rate care component of DLA,
(b) the tribunal failed to make adequate findings about what was the change in care needs compared to those which, on a balance of probabilities, were found by the appeal tribunal in 2001 to underpin the statement on the latter's decision notice that "frequent attention throughout the day and prolonged attention at night" were required,
(c) the tribunal did not use the right test to assess whether there had been a relevant change of circumstances under regulation 6(2)(a)(i) of the regulations?
Oral hearing
Background
"The claimant has obesity, acanthosis nigricans, polycystic ovaries, type A insulin resistance and diabetes mellitus. Her medical conditions constitute a rare clinical syndrome in which diabetes is due to absence/reduction of cellular insulin receptors. Treatment with insulin injections is ineffective and she receives metformin. The course of her medical condition is uncertain but it is likely that as she gets older metabolic problems will be encountered.
Her mother … made a claim to Disability Living Allowance on her behalf and she was awarded the middle rate of the care component and the lowest [sic] rate of the mobility component from 2 August 1992 to 2 September 1994. On application for extension of that award … a further award was refused. This decision was appealed to a Tribunal which awarded the middle rate of the care component and the lowest [sic] rate of the mobility component from 3 September 1994 to 21 September 1998. When she applied for extension of that award … her application was disallowed. An appeal … resulted in an award by a Tribunal on 9 November 1999 of the highest rate of the care component and the lowest [sic] rate of the mobility component for the period 22 September 1998 to 21 September 2002.
… On 27 September 2000 the claimant's appointee advised the Benefits Agency that the claimant had started work and a letter … confirmed that she was employed by [a data firm] in the capacity of telemarketing from 9.30 am until 1.00 pm Monday to Friday and the job involved calling people by telephone and carrying out surveys. The job did not involve lifting, bending, stretching or walking and no special adaptations had been made to her working environment. … Arrangements were made by the Secretary of State for the claimant to be examined by an examining medical practitioner and on receipt of his report dated 30 November 2000 a decision maker considered there had been some improvement in the claimant's conditions with a reduction in care needs and the Tribunal's decision of 9 November 1999 was superseded and benefit disallowed from and including 19 December 2000 … This decision was appealed and by decision dated 15 June 2001 a Tribunal reinstated the award of the lower rate of the mobility component and the highest rate of the care component, but for an indefinite period.
Between September 2000 and August 2002 the claimant had two or three periods of employment in the capacity of receptionist/office person and in August 2002 she started a course in ladies hairdressing at college, which course continued until June 2004. In September 2004 she applied for a job … with [a car firm] …
… There was evidence from a [Miss H], an accountant employed by [the car firm] that the claimant had been employed between 20 September 2004 and 10 May 2005 as a receptionist/administrator, working Monday to Friday 8.30am until 5.30pm … and that the main reason for her dismissal was a very poor attitude towards her duties and a lack of application in her job. [Miss H] had stated that the claimant did not require to be helped in her duties, that she was unaware that the claimant had any disabilities, that the claimant did not have problems walking or rising from a seated position, that she had never witnessed or heard of the claimant falling or taking 'hypos', and that she was not aware that the claimant was on any medication … the claimant came to work and went home on the bus alone, that on her first day the claimant got on the wrong bus and had to walk approximately two miles to get to work; that the claimant attended a gym at lunchtimes, that she walked at a normal pace and that she never appeared breathless after walking … that the claimant's main duty was interacting with members of the public and other staff which she was able to do but in a very poor way, due to her poor attitude … that the claimant never needed help with going to the toilet and that there had been no adaptations made at work to cater for her … that the claimant had to be encouraged because of poor attitude and that she did not take much time off …
…[T]he claimant's mother was asked at interview about her daughter's entitlement to Disability Living Allowance. Her replies were to the effect that her daughter's condition had not improved … that her mobility was still restricted such that she could not walk far, her pace was slow, that she became breathless and 'sweaty', had pain in her legs and knees and required to stop and rest a lot … that her daughter could go to her work or college course on the bus lone [sic] although the tenor of her evidence was that this was a familiar route, the bus stop being across the road from the house … that she continued to have dizzy spells two or three times a week, that her daughter could manage in and out of a chair unaided, and could move around indoors without assistance, that she needed help in and out of a bath because of her size, although could wash herself when in the bath, but needed prompting and encouragement to do things because of poor concentration (which she maintained had resulted in her losing the various jobs she had undertaken since leaving school) and suffered from low mood resulting in the GP diagnosing clinical depression.
It is clear taking a broad view of the interview with the claimant's mother that she did not think her daughter's care/mobility needs had changed significantly … her daughter was trying to live a normal live [sic] as she had been encouraged to do, not only by her medical advisors, but also by Tribunal members … although in her opinion her daughter's efforts had not been entirely successful as she had been sacked from each job she started due to lack of concentration and had missed a lot of days whilst at the college course. Although her interview initially suggests less assistance was needed during the night because of irritable bowel syndrome, later … she states that her daughter still required help because of profuse sweating, which was a longstanding complaint.
On 25 August 2005 … the Secretary of State superseded the Tribunal's award of Disability Living Allowance with effect from 20 September 2004 … and decided that £3,612.50 had been overpaid and was recoverable …"
The tribunal decision
"The only material that was before the Tribunal that made the award superseded by the decision maker is the unfavourable EMP report.
How can the decision maker extrapolate from an unfavourable EMP report the findings of fact made by the Tribunal such that they can then say that there has been a mistake to [sic] the material fact or a change of circumstances.
Working itself is not a change of circumstances.
…
The department do not assert what has changed. This must be so given that they do not know the conditions under which the award was made.
To say that my client doesn't qualify now fails to answer the point made by the Commissioners. What we may have here is just a different opinion on the merits. It may be that the awarding Tribunal made an error of law but that of course cannot be a ground of supersession."
"We were not satisfied, on the balance of probabilities … that the claimant's … needs had significantly changed since the decision of the Tribunal awarding benefit on 15 June 2001. At the time that decision was made … the claimant had been working as a receptionist, which job involved the use of computers and telecommunications and notwithstanding the medical evidence in the papers, in particular the recent report from [EMP2], the Tribunal had awarded highest rate care and lowest rate mobility indefinitely. We were not satisfied from the evidence of [Miss H] and the recorded interview with the claimant's mother, that there had been any significant change in the claimant's care and mobility needs since June 2001 affording grounds to supersede the awarding decision.
…
It flows [sic] … from that decision that the appeal against the overpayment … should also be allowed."
Appeal to the Commissioner
What qualifies as a "relevant change of circumstances"
"… a change of circumstances must be such that the board giving the decision on review would need to give those circumstances serious consideration to the extent that they might well affect the board's decision … the change of circumstances does not have to produce a different outcome from that of the original decision before it can be said to be relevant."
Mr Bartos submits that, standing the claimant's full time work with no observed problem, these were circumstances which required the said serious consideration.
"… the new circumstances must not only be in their substance in the area of what is relevant but there must also be sufficiency with regard to quantity. It is thus not enough that the new circumstances relate to night attention …"
It may be considered doubtful whether Miss H's evidence is sufficient enough with regard to quantity and quality to suggest a relevant change.
"However, it is clear … that the tribunal did compare what the claimant herself had said about her condition in 1996 with what they found the facts to be in 1998 … There were two crucial points. Firstly, on the mobility component the claimant must be virtually unable to walk. It is an accepted benchmark of that ability to be able to walk for 50 metres. In 1996 she had said that she experienced severe discomfort as soon as she started walking. In 1998 she had said that on good days she could walk to the end of the road. The tribunal found that she could walk for 50 metres and then a further 50 metres after a rest. Secondly, for the higher rate care component the claimant must need prolonged or repeated attention at night. In 1996 she had said that she needed help getting to and using the lavatory. In 1998 she had given somewhat confusing answers to Dr. Spielmann but the first had been "I can get to the toilet and can use it by myself." The tribunal found that she did not need help day or night. The tribunal were not invited, and were not prepared uninvited, to hold that she had been mistaken or untruthful in what she had said in 1996. That being so, on the basis of those differences they were bound to conclude that there had been a change. That was a finding of fact which could not be challenged on appeal."
"… the appellant criticises the tribunal for not following the two stage process through properly. It did not first ask whether there were grounds for review and then ask whether the claimant was now entitled. It did not expressly compare the circumstances as they existed in 1996 with those as they existed in 1998."
A change must be demonstrated by a comparative exercise
"… the Commissioner was entitled to conclude that, notwithstanding the absence of express comparative language, the DAT found a material change in circumstances."
This does not inevitably imply that no factual comparison was necessary in order to show the relevant change in circumstances. The claimant in Hoare had originally requested a review which led to the award (given by a DM not a tribunal) later made subject to adverse review and revisal; that unfavourable outcome was then appealed to a tribunal where she argued that her evidence pointed rather to a deterioration since the original award than to an improvement. However, the disability appeal tribunal (DAT) concluded to the contrary; the DAT expressly said that it had considered all the evidence but that it based its findings on what she could and could not do in reliance on the most recent medical report.
"What the DAT permissibly found to be the present facts was only consistent with there having been a significant change of circumstances since [the original award]",
but this is in the context that it is probable the review request was available in the appeal papers and that from it the DAT could legitimately infer the original circumstances compatible with the award made and thus conclude that there had been a relevant change.
"If the matter was considered on the basis of relevant change of circumstances, a comparative exercise had to be performed."
"Where the factual basis of the adjudication officer's award is not known, it is sufficient for the tribunal to make findings of fact which show that the claimant is not entitled to the award."
But, in my judgement, the following sentence of Mr Commissioner Jacobs puts a different complexion on the preceding comments. He continues:
"These findings will show that there must have been either an error of fact or law made by the adjudication officer who made the award or a subsequent change of circumstances."
Adequacy of reasons
Summary
(signed)
L T PARKER
Commissioner
Date: 20 March 2007