hi everybody, this is my first post here so i hope you will bear with me.

i have a client who is currently getting lower rate care and been refused mobility. my client has depression and a history of self harm, and needs support outdoors and at various times throughout the day and evening. he has just sent in a renewal for DLA and they said he has been awarded the same rates with no changes, even though his condition has worstened. any help would be greatly appreciated.

i have kept copies of all the forms and if anybody needs more information i can pm it to them or post as needed.

thanks in advance.

A great big topic and not easy to answer. It is perfectly possible for soemone to get highest rate care and lower rate mobility for mental health problems, but not very easy. You need to get yourself familiar with the requirements of the law in order to ask for a review. I really recommend getting a copy of the Disability Handbook for guidance, it's brilliant and quite cheap!

think about what help he really ought to be getting as well as what he actually is getting. If he has regular support from any public body, see if you can get a letter from them.

It's never easy to predict what someone will get on DLA without knowing them well, because it's very individual, so you need plenty of facts and fit them into the legal rules.

Good luck

at the moment he is currently getting help and support from friends and family. he also attends daycare at a local hospital and is currently seeing a psychiatrist, but has not been admitted into hospital as an inpatient.

he is on medication and recently had one of his medications increased from 1 tablet a day to 5 tablets a day. i cant comment on his condition because i am not a doctor, but i would think that such a large increase would mean his condition has deteriorated.

thanks for your reply.

where or how can i get the Disability Handbook ?

Gary, I think,. from her description, Ariadne means the Disablity Allicance's Disability Rights Handbook you can get it here:

http://www.disabilityalliance.org/drh31.htm

DA also have a factsheet on DLA for people with mental health problems:

http://www.disabilityalliance.org/f2.htm


The Disability Handbook is a technical DWP publication and available online here, but I don't think that's what Ariadne means or that it will be of much use to you:

http://www.dwp.gov.uk/medical/guides_detailed.asp#dishnd

Also have a look at some of the materials in the SWOPSHOP area of Rightsnet which explain the DLA rules.

Thanks Paul, I did mean the DA book. Nor having a copy to hand, I couldn't remember the proper title.

More hints:

get an appeal in quickly, with written authority from your client. say you disagree because condition has deteriorated and award does not reflect needs, full details to follow. That buys you some time. Also, do ask in the letter for a copy of all evidence used to make the decision. They all too often in cases like this write to the calimant's GP who fills in a very unhelpful response because s/he knows nothing about medical condiiton which is being treated either by community mental health team, CPN, psychologist or hospital psychiatrist who knows him better. Then you can start getting your detailed subs together.

I'm no doctor either, but a five-fold increase in medication sounds huge to me. Was that before or after the decision date? Tribunals can't take into account changes after the date of decision, though you can argue that a deterioration may show vunlerability/variability at the date of the decision really!

firstly a BIG THANKS to everybody for all their help and quick replies, i have already asked them to send the extra info, but i didnt ask for the evidence used. this was a renewal for dla and i was just about ready to send off the extra info for a change of circumstances regarding meds, when i got the decision through the post. now i am awaiting the extra info and deciding whether to appeal or not. as far as helping with DLA claims goes i am very new to all this sort of thing, and in over my head. to clarify the situation with meds here are the details below

before dose change
------------------
1 venlafaxine 150mg per day
1 25mg quietiapine per day


after the dosage change
-----------------------
1 mirtazapine 30mg per day
quietiapine 25mg 5 tablets per day
1 venlafaxine 150mg per day

thanks
Garry

Garry, (sorry I misspelled your name before!) medication is probably not the key issue here, it is what help you client needs. The fact that your client's medication has increased may well show that his needs have increased, but it COULD be that he's now getting more apppropriate medication and is feeling better. I don't know because:

1) I'm not a doctor
2) I don't know your client

ideally you want

1) his original claim form
2) the claim form completed on renewal
3) any other evidence considered.

You then need to consider

a) which evidence (if any) really reflects his care and mobility needs now.
b) if none of it does, how you can get more accurate evidence, from your client, professionals who work with him or friends, carers and family.

It may well be worth seeing if he can get help from an experienced welfare rights adviser in your area. If you can't don't give up, you are trying all the right things and people on here will give you all the help they can.

with regards to the evidence the DLA used in their decision, i have already asked for a more detailed explanation of their decision. i didnt specifically ask for the evidence they used to make their decision, so does this mean i need to specifically ask for the evidence used in their decision ?

thanks again

Garry.

Gary,

Getting meaningful information out of the DBU can be a bit of a trial. I can remember when the DBU used to give very detailed reasons but nowadays I cannot get to the bottom of decisions unless I appeal.

You would do well therefore to follow ariadne's advice and put an appeal in now. Many experienced advisers do this if they think their client's have an arguable case. The major benefit of this is that your client (and you) will receive the "appeal submission" of the DBU. This will contain all the relevant evidence (its all the Tribunal will get from the DBU). You will finally be able to find out if the decision was:

a) half reasonable in light of evidence (i.e. if there is say a G.P. report that is unhelpful). (You can challenge this of course)
b) unreasonable due to a misinterpretation of the evidence.
c) unreasonable because the DBU decision maker just seems awkward.

whichever the case you can home in on the extra evidence you will need to convince a tribunal. In the event that the decision does seem reasonable you can always cancel the appeal at any stage - there is no penalty in doing this.

Hi Gary, i used to work for a mental Health NHS Trust, we had a medical evidence questionnaire proforma designed for Health Professionals to complete and give evidence on clients care, supervision needs and mobility issues relating to mental health. We used it to attach to new claims, renewals and scenarios like your clients i.e. prospective appeals.

if you want a copy of one which you can tailor to your own organisations needs. I'll email you one.

Andy

Most of our claims for DLA are successful. We mainly get client's awarded the middle or high rate care and the low rate for mobility. This is because we get good supporting evidence from the Community Mental Health teams.
Try writing to your client's psychiatrist for a letter of support.

Also have a look at the side effects of the medication, these may be relevant.
For example a common side effect of mirtazapine is weight gain. If this is effecting your client then ther diet will need careful monitoring which is attention in connection with the bodily function of eating.

The Pharmacy Services to Norfolk Mental Health Care HNS Trust produce a practical guide to drugs use in mental health called - Youe Medicines-any questions? which we find vry useful.

By the way, Quetiapine is an antipsychotic, main side effects are drowsiness and weight gain.
The other two drugs are antidepressants.

Main side efects for Venlafaxine are, Nausea, Headache,Drowsiness and dizziness. It carries a warning about not driving or using machinery.