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Forum Home  →  Discussion  →  Work capability issues and ESA  →  Thread

Variable condition & inability to predict when it will impact

Jo_Smith
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Citizens Advice Hillingdon

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Hi guys; how do I deal with the “majority of the time” concept when client condition is so variable that averaging it would be quite difficult? Do I still try to average? Example; client never knows when his gout would affect him. It may limit his activities for few weeks, affecting him totally throughout this time, but then it may go away completely for few weeks.

ROBBO
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My understanding is that Reg 7 talks of ‘over 50% of the days of the required period’ ie three months preceding, nine months after.

That said, is it telling that the Gout Society don’t seem to suggest appropriate benefit claims?

http://www.ukgoutsociety.org/

Sorry…talking about PIP, of course.

[ Edited: 9 Nov 2018 at 11:26 am by ROBBO ]
Jo_Smith
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Thanks ROBBO.
My mistake for not clarifying; it’s about ESA

BC Welfare Rights
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Without getting all Brexity, IMHO the majority of the time means the majority of the time… If it is not the majority of the time and the points don’t stack up, then you are looking at Reg 29.

[ Edited: 9 Nov 2018 at 09:16 pm by BC Welfare Rights ]
WRT Case Worker
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I’ve always taken the Majority of Time as being more than 50% (more likely than not or on the BOP)

See also Reg 34(2) [2008] for Majority of Occasions

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Tom B (WRAMAS)
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Although it might not be possible to predict future occurrences; would it be possible to give a recent history that helps to identify whether descriptor satisfied on sufficient days. If client doesn’t have a specific record of this, could they look back through diary/calendar for occasions/events which might jog memory, prescriptions issued etc?

Jo_Smith
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Thanks guys, majority it is then, as per it’s normal meaning.
I’ll work through the past occurances with the client.

Benny Fitzpatrick
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“It may limit his activities for few weeks, affecting him totally throughout this time, but then it may go away completely for few weeks.”

What exactly do you mean by “affecting him totally”? I know from personal experience that gout tends to affect the extremities, such as feet and hands, and during flare-ups it can be excruciatingly painful. However, In my case it is not what I would call “Totally” debilitating, and I would certainly not consider myself incapable of work as a result of it, (although it can render me “virtually unable to walk”).

I think the way to go is to ask how many days he has been “totally” incapacitated in the last year, ask is that typical, and go from there in terms of number of days he is affected.

(In my case, flare-ups happen, on average about twice a year, and last 3-4 days at a time. I presume your client has a more serious case.)

ClairemHodgson
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Jo_Smith - 12 November 2018 11:43 AM

Thanks guys, majority it is then, as per it’s normal meaning.
I’ll work through the past occurances with the client.

which are presumably evidenced in his GP notes, which he can request and get for free post GDPR.

Jo_Smith
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Absolutely, Claire, notes requested under GDPR.
But…this is one of those clients who do not engage with various services, leaving a trail of evidence which can be then requested.
So what we get from GP might be very meagre because my client “does not believe” in going to his GP and instead self-medicates with alcohol.

Benny, from what client tells me his gout is indeed pretty severe. It is compounded by his alcohol addiction (known gout trigger) and apparently does render him “useless”, as in so much pain in feet or hands. So when I said “totally” I meant cannot do anything reliably or without pain during these days.

Thanks for comments everyone x

ClairemHodgson
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Jo_Smith - 13 November 2018 02:43 PM

So what we get from GP might be very meagre because my client “does not believe” in going to his GP and instead self-medicates with alcohol.

oh dear.  not surprising he’s in a bad way.