DLA and Severe Anxiety- social integration - care component

I have currently a client who is on low rate mob on grounds of severe anxiety, panic attacks etc; difficulty coping with crowds etc, medication high.  Also suffers from “episodes” of depression. Has anyone ever had a case whereby attention provided by means of the spoken word, i.e. encouragement, motivation to go places has counted as attention for the care component, especially since going out would be part of the goal setting by his therapist?
As low rate mobility is for unfamiliar routes - attending medical appointments at his local hospital would e.g. be a major task for him even if he was familiar to the place, and he would not attend if on his own, and would require someone with him for reassurance, encouragement and to help him get things in perspective when he starts to get panicky - the panic thus affecting his thinking.  I have read the decision R(DLA) 1/07 which speaks about social integration. This is a bit of a long shot, I know, but was wondering what your opinions would be on this case,  whether there would be any valid arguments regarding the above.

Many thanks

Most of what your describing appears to be mobility. So you have to go to the base of bodily function. Recent case law on for example communication focuses on the physical impairment that causes the problem with communication. The quote from one case stated on a case of dislexia that the ability not to write or speak english could be a lack of knowledge as the commissioner compared it to his ability or not to speak Japanese. Better and higher argumnts backed up by case law considered the commisioners problem with an inability to speak japanses was a lack of knowledge, the appellant difficulties with english was due to a medical malfunction so actions related to their communicationcould count. You have to take the argument to the actions of bodily function when your client is out, communicsation with people, motivation to do basic tasks and what that involves etc. I find this from experience works well with sight impaired clients. But you raise a very valid point on the help reqired when out in familiar areas.  If you can make an argument it might be useful to then link it to other related care needs withthe issues of mobillisig in familiar areas to get that significant period..
good luck

Attention can be counted if it enables the person to lead a normal life (Mallinson) and it can be verbal.  However it has to be sufficiently intimate to count, i.e. that which can only normally be done in the claimant’s presence.  The problem with this kind of attention is that it might be insufficient on its own to qualify unless it can be aggregated with other forms of attention.  It is a question of fact in each case.  There is nothing to stop attention which counts as guidance for the mobility component as counting as attention in connection with a bodily function for the purposes of the care component (Mallinson/Fairey)   

The comments concerning learning Japanese come from CSDLA/427/2006 citing educational requirements for schoolchildren where the commissioner said:

“8.….It does not seem to me that interpretation of writing has anything to do with the bodily function of seeing. I can, for example, see Japanese or Arabic script but I cannot interpret it because I have never learned it…….The interpretation is learned through education. For someone with dyslexia the education process is more complex but it is education nonetheless….

9. ….Disability living allowance is not a form of publicly funded compensation for being disabled. It is a recognition of the additional cost of care of those who are disabled. When taken in that context it can be seen that additional educational requirements for the purpose of learning to read and write are of an entirely different nature to attention in connection with an impaired bodily function….”

However the commissioner in CDLA/1983/2006 (a case in which I was the rep) after rounding up the relevant case law said that CSDLA/427/2006 should not be followed.

Some excerpts fom submissions of mine that might be useful:

Regarding encouragement as part of the care component;

The decisions in Social Security Commisioners decision R(A) 2/80 Appendix, Cockburn v. Secretary of State for Social Security, CDLA/14696/1996 and CA/177/1988 hold that encouragement and stimulation can amount to attention in connection with bodily functions.

Regarding the intermittent nature of the depression;

In accordance with the decisions made in R(M)3/86 and CM171/1988 we ask that the tribunal apply their discretion based on the balance of probabilities as:
“it would not be unreasonable for an adjudicating authority to conclude that a person who has good and bad days has such an overall degree of disability that [s]he is virtually unable to walk within the meaning of the legislation.”
We submit that the case law mentioned above (R(M)3/86 and CM171/1988) be applied in respect of ******* care needs in accordance with the assertion in Moyna v. Secretary of State for Work and Pensions (2003) All ER 162 that:
“This principle may be applied in DLA (care and mobility)… cases where intermittent capacity is evident”

You could use this if there is any evidence of self-harm or a risk of suicide;

In the decision in Moran v. Secretary of State for Social Services (1987) it is stated that:
“supervision may be precautionary and anticipatory… the frequency of the event of danger is immaterial to the question whether supervision is continual so long as the risk of substantial danger arising is not too remote a possibility”

I know it might not exactly deal with the issues you mention but might help with arguments around them.

Thanks to all of you who replied to my original post, the points you all raised were useful, as was the commissioner decisions, and I will now review the case with these in mind.  Thanks again as I know everyone in the line of welfare work are exctremely busy!!

Regards

Annette