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IIDB advice

CDV Adviser
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Nestor Financial Group Ltd

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Total Posts: 493

Joined: 20 January 2016

I’m looking for some expert advice on IIDB.

I have 2 clients, both have below elbow amputations of both arms. Both clients live alone and have carers.

First client receives:

IIDB - 100%
CAA - Exceptional Rate
ESDA

Second client receives:

IIDB - 100%
CAA - Full day rate.

So my questions are 1) which one is correct?; 2) what can I do about it as CAA cannot be appealed?

Any advice would be greatly appreciated.

Elliot Kent
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Shelter

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Joined: 14 July 2014

I’m certainly no expert on industrial injuries benefits, but in the absence of other replies.

The legislation on CAA is not especially specific, and as there are no appeals, there is no case law. This means that the guidance is very important - you can find the guidance at DMG Chapter 69 from 69310 on.

The guidance suggests that the normal maximum rate (£71.60) will usually be appropriate where there is “loss of both arms with stumps from 11.5cm below the elbow”, the intermediate rate (£107.40) where the claimant has “both arms amputated with stumps from 20.5cm below the shoulder to less than 11.5cm below the elbow”  and the exceptional rate (£143.20) where there are “amputation of both arms above the elbow with stumps less than 20.5cm”

You ask which decision is “correct”. Judging from the guidance, it may be that your client who gets the exceptional rate has been assessed fairly generously - as its a below elbow case - but obviously it may be that there are features of the case which justify this. It also isn’t the case that there are always right and wrong answers - there is an element of judgement involved and decision makers are allowed to disagree.

You have said that your second client gets the “full day rate” which I assume is the normal maximum rate as that is based on daytime needs only. That would explain why he isn’t getting the ESDA as it can only be awarded in conjunction with the two highest rates.

Decisions which cannot be appealed can be revised at any time, so if you can show some error in the decision, then you could apply for revision. An alternative might be to apply for PIP instead (as your client would presumably get ERDL to top up to £87.65)

CDV Adviser
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Nestor Financial Group Ltd

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Total Posts: 493

Joined: 20 January 2016

Thanks Elliot, that’s really helpful. I’m of the opinion that they have indeed been generous with the first client although the actual measurement below the elbow may be different for each client.