From: Martin C. Osment [osment.martinc@gmail.com]
Sent: 18 February 2011 17:38
To: DWP Consultation DLAReform
Subject: WheelchairDriver.com

Disability Living Allowance reform – consultation questions
You can respond to the consultation questions in this document and send it to us at consultation.dlareform@dwp.gsi.gov.uk 

1. What are the problems or barriers that prevent disabled people participating in society and leading independent, full and active lives? 

Your response:
Barriers can be considered to be:
- lack of access to facilities to enable one to live and work independently of others, just as if free from the disability;
- Lack of help and support readily available or on call when otherwise needed.


2. Is there anything else about Disability Living Allowance (DLA) that should stay the same?

Your response:
The concept of a mobility component and a care component is good. So is the concept of payment for carers. However, where a disabled person needs for example both a power wheelchair and a car, they can only get one or the other on the Motability scheme. Given the tardiness of Wheelchair services, and their inability to respond with proper solutions, should they not be abolished, and there be a capital grant for the purchase of a powerchair?


3. What are the main extra costs that disabled people face?

Your response:
Mobility – just basic moving around,
Transport, getting to other places,
Support - current services are too remote and inaccessible.
Personal Services, such as help with dressing, feeding, toileting, etc. 

4. The new benefit will have two rates for each component:
 Will having two rates per component make the benefit easier to understand and administer, while ensuring appropriate levels of support?
 What, if any, disadvantages or problems could having two rates per component cause?

Your response:
Making it simpler is good. However, if some recipients currently on the middle rates are forced onto the lower rates, might not that cause hardship? 


5. Should some health conditions or impairments mean an automatic entitlement to the benefit, or should all claims be based on the needs and circumstances of the individual applying?

Your response:
- Lifelong disablement and irreparable limb damage justify entitlement being automatic; all others may need assessment.


6. How do we prioritise support to those people least able to live full and active lives? Which activities are most essential for everyday life?


Your response:

- Mobility to perform the basic functions of eating, drinking, sleeping, communicating with others, and where possible, to do these for oneself. Preparation of food, hygiene and the like may need support.
- Travel for essential purposes such as medical visits and shopping, plus realistic socialising, and the opportunity to participate in the life of the community;



7. How can we best ensure that the new assessment appropriately takes account of variable and fluctuating conditions?

Your response:

Segment long (permanent) and short term conditions (operation recovery), and reassess the short term conditions on a timetable, and the long term ones upon client request.


8. Should the assessment of a disabled person’s ability take into account any aids and adaptations they use?
 What aids and adaptations should be included
 Should the assessment only take into account aids and adaptations where the person already has them or should we consider those that the person might be eligible for and can easily obtain?

Your response:
Assessment should be complete, including aid and adaptations, but also allowing for the provision of these, and extent to which they are successful.

A forum member adds:

If assessment designers think that aids and adaptations, e.g. wheelchair and callipers, mean you can now get around like anyone else, then that worries me. I find using a wheelchair a constant battle, frustration, and seriously limits my mobility. I can't spontaneously go to many places, I have to notify the train company at least 24 hours in advance every time I want to travel by train, I am humiliated by young mothers with buggies bigger than my wheelchair who won't move them, so I have to wait for a later bus, and possibly repeat the exercise. My trousers or jeans are ruined by my callipers within a week or two, etc. etc.

I think this comes about because of the number of people who seem to get a blue-badge, or even DLA by turning up at their GPs with a (probably borrowed) walking stick.

Please excuse the rant - its been a bad few days this past week. 
“”

9. How could we improve the process of applying for the benefit for individuals and make it a more positive experience? For example:
 How could we make the claim form easier to fill in?
 How can we improve information about the new benefit so that people are clear about what it is for and who is likely to qualify?

Your response:
- Don't ask questions that can clearly be answered from medical records - if a GP refers, then they should also provide the relevant medical information, which need then only be confirmed with the client.
- Give examples / case studies / make criteria crystal clear.


10. What supporting evidence will help provide a clear assessment of ability and who is best placed to provide this?

Your response:
- GP / Hospital Consultant + independent assessor, based upon GP/Client submissions.

11. An important part of the new process is likely to be a face-to-face discussion with a healthcare professional.
 What benefits or difficulties might this bring?
 Are there any circumstances in which it may be inappropriate to require a face-to-face meeting with a healthcare professional – either in an individual’s own home or another location? 

Your response:
- Good - no difficulties for genuine claimants.
- Not likely

12. How should the reviews be carried out? For example:
 What evidence and/or criteria should be used to set the frequency of reviews?
 Should there be different types of review depending on the needs of the individual and their impairment/condition?

Your response:
- see 10
- Yes, based upon longevity and severity of conditions.


13. The system for Personal Independence Payment will be easier for individuals to understand, so we expect people to be able to identify and report changes in their needs. However, we know that some people do not currently keep the Department informed. How can we encourage people to report changes in circumstances?

Your response:
- Require a brief annual return?

14. What types of advice and information are people applying for Personal Independence Payment likely to need and would it be helpful to provide this as part of the benefit claiming process?

Your response:
A clear introduction and scheme overview leaflet, delivered in English or Welsh only, by all available means. Yes - provide it. Do not translate for overseas visitors who come here to live off our benefits system.

A member commented: The idea that someone who doesn't read English doesn't know anyone who could translate for them is stretching credibility to the limit. Offering information in multiple alternatives to English hinders integration and is an unjustified waste of money. I would go further than you, and suggest that English only is used. I find it difficult to believe that there is anyone in Wales who doesn't understand English when it is in their interest to do so. Surely if there is a demand for a Welsh version, then the Welsh Assembly, funded by general UK taxation, should be providing the service out of their budget. Printing information in anything other than English in the UK is difficult to justify, particularly in times of austerity. 


15. Could some form of requirement to access advice and support, where appropriate, help encourage the minority of claimants who might otherwise not take action? If so, what would be the key features of such a system, and what would need to be avoided?

Your response:
- a Central referral point would seem a good idea. NHS direct used to help with this.

16. How do disabled people currently fund their aids and adaptations? Should there be an option to use Personal Independence Payment to meet a one-off cost?

Your response:
- Generally, the majority (not all) of disabled seem to struggle to fund the high price of effective aids, often having to compromise price and performance. PIP for one off costs would be a good idea.

17. What are the key differences that we should take into account when assessing children?

Your response:
- Their parents and teachers are part of the equation, and should be engaged with as such.

18. How important or useful has DLA been at getting disabled people access to other services or entitlements? Are there things we can do to improve these passporting arrangements?

Your response:
Not aware of it doing so. Therefore needs improvement

A member added:

I am aware of several situations where the award of the Mobility component (higher rate) of DLA does provide access to other benefits. However, the system is clunky at present, with differing proofs being required.
For example, down in Bournemouth, where my mother-in-law lives, and where we regularly visit, free parking in council car parks and forestry commision parks is limited to just those people with DLA mobility component at the higher rate. Blue badges alone don't qualify for free parking, presumably because of the large number obtained via borrowed walking sticks, (see my earlier response.)
In council car parks, the "disabled" tax disc plus blue badge is the proof. For the forrestry commission site we use, you have to present the "disabled" tax disc in person and they then log your car registration number for the next 12 months.

I live about 25 miles from the M6 toll road, and they offer a valuable concession to drivers with higher-rate mobility DLA in that they sell you a three year pass. It isn't free, but is very valuable if you use the road every few weeks as I do. The proof they require is a photocopy of your award letter from DWP, plus photograph etc. I'm not sure how long this will last because I suspect people have been abusing it, judging by the extra checks they have been making in the past few months - the specific rules are very detailed, but easy to comply with if you don't abuse it. If we lose this concession it will be because of the Bxxxxxds who lend their passes and blue badges to friends and family.


19. What would be the implications for disabled people and service providers if it was not possible for Personal Independence Payment to be used as a passport to other benefits and services?

Your response:
- Sad breakdown in a communications opportunity

20. What different assessments for disability benefits or services could be combined and what information about the disabled person could be shared to minimise bureaucracy and duplication?

Your response:
- No view

21. What impact could our proposals have on the different equality groups (our initial assessment of which is on page 28) and what else should be considered in developing the policy?

Your response:
better targeting of support to the genuine needy, and a removal of payment to those who lack proper justification.

A member added:

Agreed. DLA is the only benefit I know that isn't means tested. If it were means tested, there would be too many hoops to jump through for people like me who are self-employed and whose income varies greatly from year to year - e.g. I lost money this past tax year. However, I don't think I would ever qualify for a means tested benefit because I have scrimped all my life to buy three properties which I rent out to effectively be my pension. They would probably be considered assets by the state, whose culture si prefer giving money to those who wasted money all their lives instead of saving and planning for their future. 


22. Is there anything else you would like to tell us about the proposals in this public consultation?

Your response:
A good step forward.

One member has commented:

“ Like many of us here, I have a chronic condition which has never been known to improve. I might die from it. I will certainly die with it. It is significantly disabling and it is degenerative. A condition such as this, therefore, may reasonably be considered to be lifelong and a claim accepted accordingly.

However, claimants with conditions which, no matter how disabling, have variable prognoses should be reviewed after a sensible period of time. An appropriate period of time might be arrived at by a wider, medical overview of the condition's behaviour UK-wide or worldwide. Likewise, claims for difficult to prove problems, such as "bad backs" for which no medical evidence or rationale can be found, should be more closely scrutinised and kept under regular review.

A major peeve for me is the way in which eligibility is decided. As I understand it, the criterion is not what a person has, but his own account of how what he has affects him. That is so wide open to abuse, it's insulting.

Let me offer just one, admittedly extreme example: Someone who has an extensive "port wine stain", or severe acne - cosmetic problems - may currently claim DLA if they are canny enough to claim that they are affected by that to the point where they are unable (or unwilling) to venture outside unaccompanied !

That criterion was even printed on the early Claim forms. I believe it may have been removed from the forms now, but is still applied by the assessors. The success of a DLA claim appears to depend too heavily on the claimant's aptitude for form-filling, his knowledge of the system and his persistence.

Other than that, I'd guess most of us know someone who can be seen sporting a surgical collar, or crutches, only on the rare days when they are called in for a review. On those days, the house-painting and tree-pruning has to take a back seat, obviously.
“” 

Responder: Dr. Martin Osment LLD MIEEE
Compiled on behalf of the www.wheelchairdriver.com forum's 315 members.


-- 
Best Wishes,
Martin
Martin Osment 
Tel: 07515 59 53 37
Fax: 0871 994 0012