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Adult disability payment

430 replies

Mumtotwoxo · 30/11/2022 00:30

Looking for advice on this benefit.
I applied for this just over 2 months ago, I sent 3 forms of proof of illness and had a video call appointment to confirm identity.
I called social security Scotland to check my process of claim and they say it’s awaiting a case manager.
Does anyone know how long I’ll be waiting for a decision?
Seems a very long, drawn out process.

OP posts:
Thread gallery
8
Rosscameasdoody · 07/12/2023 19:11

Piseag123 · 18/11/2023 18:29

@Lovelyjubbbly

Understanding a review decision

A new decision following a review is called a determination.
When Social Security Scotland confirm that they will make changes to your Adult Disability Payment, they'll let you know:

If the award will stop, reduce or increase following a review, Social Security Scotland will tell you why.

Indefinite awardsYou may be given an indefinite award if:

  • your needs are highly unlikely to change
  • you're awarded the enhanced rate of both the daily living and mobility components of Adult Disability Payment
This means your award will not be reviewed in the future unless you tell us that something has changed……. This is off of the website…hope it helps 🌷

The tell you on the website that an indefinite award will not be reviewed unless you report a change. But in effect they will review it every ten years. You won’t necessarily know about this unless they send you a review form. They mostly use a ‘light touch’ approach and will write to the healthcare professionals you named on your application for evidence that your condition is ongoing and unchanged. So important that you make sure your medical records are kept up to date.

Wizwiz · 08/12/2023 08:03

@Rosscameasdoody no I didn’t seek advice. I think I will be for the appeal though. Anything else I should consider?

thanks

Zanatdy · 08/12/2023 08:24

It can be a long wait. Friend claimed DLA for her autistic DD and has been waiting since September. Really needs it as she’s only able to attend school for 2.5hrs a day as school can’t cope with her so she’s paying a lot for a childminder. They keep texting to say it’s still waiting in a queue

Interested in this thread?

Then you might like threads about this subject:

Rosscameasdoody · 09/12/2023 21:40

Wizwiz · 08/12/2023 08:03

@Rosscameasdoody no I didn’t seek advice. I think I will be for the appeal though. Anything else I should consider?

thanks

Really just that any new medical or other evidence you submit for the appeal should support the reasons for your appeal, and be as relevant as possible to the descriptors for the activities you’re disputing. And that you can’t introduce any aspect of your condition at appeal that wasn’t in your original application and assessment. The tribunal will only consider facts in evidence at the time of the award decision. At present 70% of appeals are successful on the same medical evidence used for the original claim. Please feel free to PM me if you want more specific advice and I’ll gladly help if I can. Good luck.

Allyballybee445 · 12/12/2023 11:43

I received my back payment and my notice of determination letter today and I am totally shocked I expected to receive something for mobility and nothing for daily living and I have received the opposite.
They gave me 4 points for moving around and nothing for planning and following journeys based on the fact there are no mental health referrals.
I have no idea why a mental health referral is needed for balance and coordination issues
Not sure if I should just accept the out come received or go for a redetermination as I do not want to chance losing what I have been awarded,
If I do decide to go for redetermination and lose the award would I be expected to repay the back payment ?

Piseag123 · 12/12/2023 18:25

@Allyballybee445 glad to hear that you received word back and also your backdated payment as I know that you had been waiting quite a while!! Maybe @Rosscameasdoody could advise you with regards to what you do next, or it might be worthwhile asking Voiceability for advice too! Apologises that I’m not being of much help my last day of my 56 day redetermination period is up on Thursday, so I will be contacting them if I haven’t heard anything tomorrow! Best of luck 🌷

Rosscameasdoody · 13/12/2023 07:34

Allyballybee445 · 12/12/2023 11:43

I received my back payment and my notice of determination letter today and I am totally shocked I expected to receive something for mobility and nothing for daily living and I have received the opposite.
They gave me 4 points for moving around and nothing for planning and following journeys based on the fact there are no mental health referrals.
I have no idea why a mental health referral is needed for balance and coordination issues
Not sure if I should just accept the out come received or go for a redetermination as I do not want to chance losing what I have been awarded,
If I do decide to go for redetermination and lose the award would I be expected to repay the back payment ?

Section 11 on planning and following a journey is designed to assess for limitations on mobility due to mental health, cognitive and sensory impairments. You won’t score any points in this category if your mobility issues are physical and not affected by mental health issues - so the balance and co-ordination issues you describe would be considered in section 12, which assesses your ability to move around physically. Even with mental health issues it’s very difficult to score points in section 11 because you have to demonstrate that your problems are severe enough to cause significant distress if you were to undertake any of the activities described. It is possible to score from both sections 11 and 12 to secure an award but only where you can demonstrate physical and mental health issues affecting your mobility.

it sounds as though you have been assessed as being able to stand and move between 50 and 200 metres which scores 4 points and doesn’t meet the threshold for an award on mobility component - you would need at least 8 points for a standard award for which you would need to demonstrate that you can walk no more than between 20 and 50 metres. For the enhanced award you would need to show you cannot stand and move more than 20 metres, which scores 12 points.

For both the daily living and the mobility sections, your ability to carry out any activity has to consider whether you can do so reliably. This means that you can do so safely, to an acceptable standard, repeatedly and in reasonable time. Your use of aids and appliances or help/supervision from another person, as well as pain relief and it’s effects is considered in all activities.

’Safely’ means without harm to yourself or others and includes consideration of whether completing the activity would worsen your condition. ‘To an acceptable standard’ takes into account things like awkward gait, pain and exhaustion, the need to stop and rest, etc. ‘Repeatedly’ means as often as necessary throughout the day - in other words if you can’t repeat the distance as often as you reasonably need to or can only do it once in the day, then you are assessed as not being able to do it. ‘In a reasonable time’ means completing the activity in no more than twice the amount of time it would take a non disabled person to do it.

If any activity impacts on your ability to carry out another, that has to be considered too. So if, for example, you were so exhausted after washing or bathing that you had to rest before you could get dressed, this would be taken into account.

A redetermination request can result in losing the whole award, as the request goes to a different decision maker who will look at the whole award and may not agree with what the original decision maker has said. As far as I know any back pay awarded as a result of the original award, although technically an overpayment, is not recoverable from you. But I would check this with a benefits adviser to verify before you decide how to proceed.

Allyballybee445 · 13/12/2023 09:56

@Rosscameasdoody Thank you for the detailed explanation
I have a sensory impairment which contributes to the balance and dizziness issues I suffer from chronic left side facial migraines which affects my left eye the pain is excruciating this has caused a sensitivity to lights sounds and movements crowded places and fire and police sirens are terrifying for me.
I have seen mental health practitioners in the past but not via my GP it was via the dwp through a company called Ingeus when I was on the Work-related activity group of ESA 7 years ago.
My GP has never offered me any mental health support just lots of useless pills,

Allyballybee445 · 13/12/2023 09:57

@Piseag123 I hope you hear something soon the waiting is the worst part.

Piseag123 · 13/12/2023 18:27

Thanks @Allyballybee445 and also @Rosscameasdoody for responding👍. A wee update on my redetermination, I contacted today was told that the system was down and to phone back in an hour which I did do! No further forward as they couldn't tell me anything with regards to the progress of my redetermination I was told via web chat on the 4th of December that I should be hearing something within the 56 days as they were trying their hardest to stick to their schedule! However, my 56th day is Friday, although I had been told that is was the 14th of December during the web chat, I feel as if I’m in limbo as I haven’t received anything, no email, no text message! It is very stressful and not to mention very frustrating!! So I will contact again on Friday if I haven’t heard anything tomorrow this has been going on since June!! Thanks for listening!

Rocksdad · 13/12/2023 18:37

Just received a text and email saying my appeal has been accepted and SSS has til Jan 15 to respond. All my paperwork etc has been uploaded to the portal for me to read.
I can't actually be arsed with reading it as it's been a long year and don't want to focus on it anymore. It'll be what it'll be. I'm sure I'll read everything eventually.
I heard/read something recently saying it's about a 3 month process but I don't believe that. I'll let you know!

Piseag123 · 13/12/2023 18:43

@Rocksdad can I ask when you first applied and did you receive any points, apologises if you’ve already answered this! TIA

Rocksdad · 13/12/2023 18:50

@Piseag123 Dec/Jan I think I sent it but Feb 9th is their date. 1st outcome 11pts in August. Redetermination 17pts in October. Submitted appeal 3 weeks ago.

I go into more detail a few pages back... Maybe with you actually haha :)

Piseag123 · 13/12/2023 19:01

@Rocksdad lol, you’re right as I have just literally finished reading the thread, sincere apologises as my brain is seriously frazzled with it all! I have sent 26 pieces of supporting info and like you I received all my info from them, all 177 pages worth, obviously they’ve sent not just duplicates but triplicates!! And this is only the redetermination stage, god knows what will happen if I have to go through to the appeal stage, which incidentally if I’m unsuccessful at this stage I will proceed with, thanks again @Rocksdad and I really do hope that your appeal is successful! 👍

Rosscameasdoody · 13/12/2023 19:05

Allyballybee445 · 13/12/2023 09:56

@Rosscameasdoody Thank you for the detailed explanation
I have a sensory impairment which contributes to the balance and dizziness issues I suffer from chronic left side facial migraines which affects my left eye the pain is excruciating this has caused a sensitivity to lights sounds and movements crowded places and fire and police sirens are terrifying for me.
I have seen mental health practitioners in the past but not via my GP it was via the dwp through a company called Ingeus when I was on the Work-related activity group of ESA 7 years ago.
My GP has never offered me any mental health support just lots of useless pills,

It woudn’t do you any good to try to get a mental health assessment for mobility at this stage as the redetermination and appeal processes won’t consider any new element of your disability outside what was used to make the original decision.

And it’s also worth noting that unless you can prove overwhelming distress you’re unlikely to be awarded the mobility component on mental health grounds. It’s really very difficult to secure it, and GP evidence wont be enough to do it. It’s usually only awarded where second line mental health treatment is ongoing - that’s consultant led psychiatric team involvement. That doesn’t sound appropriate to the symptoms you’re describing here - it still sounds physical and should be taken into account as affecting your ability in the moving around category.

You might want to look at getting better medical evidence to support that element of your condition and revisit how you actually describe the symptoms in your application - keeping in mind the points in my post like reliably, repeatedly, safely and in a timely manner etc. If you need any help with your redetermination or appeal, please do feel free to PM me and I’ll help if I can.

Rocksdad · 13/12/2023 19:10

@Piseag123 for sure it's a head f and I'm literally going thru with it to prove a point. Pages and pages of of a timeline with their lies and treatment of me and others, I even referred to this and more forums and how dangerous they are with the way they play with people.
The good thing about the appeal process, or so CAB told me, was that SSS/ADP have strict guidelines and criteria to meet when awarding points. But the panel don't need to. They look at the whole application and situation and make their judgement. And with the fiasco that this application has been, that's what I would rather. It's the final step so it's easier to accept and move on from, if that makes sense.
I actually sent a lot of my original supporting information back to them again but with everything I wanted to express highlighted and everything was referenced in the timeline etc. It's taken a long long time but thankfully I screen shot and record everything and I have hundreds of documents on the lap top so it was all easy to produce a whole packet to send back to them.

I hope you hear back soon. I heard from my re-determination on the 56th day.

Piseag123 · 13/12/2023 19:14

@Rocksdad many thanks, and yes like you said nothing to lose!! Hopefully I will hear either tomorrow or Friday and thanks again for taking the time to respond 👍

Rocksdad · 13/12/2023 19:18

@Piseag123 no worries. Thanks for the chat. Happy to share my account of it all. I wish I knew about this forum pre application and wish I knew about Voice ability before I submitted re-determination! Keep me updated and I'll do the same. The person above has great advice too. As well as a wicked username @Rosscameasdoody :))))

Piseag123 · 13/12/2023 19:27

@Rocksdad yes they do, and I will let you know how it goes, take care 👋🏻

Allyballybee445 · 13/12/2023 20:22

@Rosscameasdoody I have no interest in getting a mental health assessment at this point to be honest I would have probably declined had the doctor suggested it.
I have contacted voice ability hopefully they can help me better understand the deciphers,
I am just a bit perplexed as why the anxiety is a big thing but the cognitive and sensory aspects of my condition have been ignored.

Rosscameasdoody · 13/12/2023 21:34

Allyballybee445 · 13/12/2023 20:22

@Rosscameasdoody I have no interest in getting a mental health assessment at this point to be honest I would have probably declined had the doctor suggested it.
I have contacted voice ability hopefully they can help me better understand the deciphers,
I am just a bit perplexed as why the anxiety is a big thing but the cognitive and sensory aspects of my condition have been ignored.

The assessment for cognitive and sensory disorders does fall within section 11, but as with the mental health assessment, the threshold for awards is very high - unreasonably so in my humble opinion. You have to demonstrate a very high level of impairment to score enough to secure any award.

I’ve copied and pasted in its entirety, the descriptors for section 11 mobility activities. The document also includes detailed guidelines on the factors considered when assessing a claimant. Sorry it’s so long and wordy but there are several references to cognitive and sensory impairments, so you may find the answers you’re looking for here. If you think I can help further, please do let me know.

Mobility activities

Activity 11 – Planning and following journeys

This activity considers a claimant’s ability to plan and follow the route of a journey. It is useful separately to consider:
• ability to plan the route of a journey in advance
• ability to leave the home and embark on a journey and
• ability to follow the intended route once they leave the home.

This activity is designed for limitations on mobility deriving from mental health,
cognitive and sensory impairments, whereas activity 12 is designed for limitations fromphysical problems. Cognitive impairment includes orientation (understanding of where,when and who the person is), attention,concentration and memory. Any issues with ability to stand and then move are not applicable under activity 11.

11d or 11f only apply where a claimant could not reliably make their way along a route without an accompanying person, assistance dog or orientation aid. The presence ofanother person for reassurance, or out of preference, is not sufficient.While a claimant who needs to be accompanied by another person to avoid overwhelming psychological distress (OPD) cannot satisfy 11d or 11f on that ground, it’s possible that the same underlying condition (e.g. bipolar disorder, psychotic illnesses) may cause cognitive impairment too (either intermittently, when making journeys, or more generally). If that is the case, then a claimant may satisfy 11d or 11f on grounds that, without being accompanied by another person, they could not reliably make their way along the route because of the cognitive impairment.

11f may apply, where a claimant regularly experiences uncontrolled or unpredictable seizures which result in prolonged confusion and disorientation so that they need to be accompanied (on the majority of days) in order to make their way safely along even a familiar route.

Descriptors.

A. Can plan and follow the route of a journey unaided. 0 points

Within the assessment criteria, the ability to perform an activity unaided means without either the use of aids or appliances; or help from another person. Can the claimant go out to make any single journey, without prompting mostdays? If so, mobility 1A is likely to apply. The majority of people with a seizure or blackout disorder will not require another person to accompany them, in order to make their way along a route out of doors safely. Those with well controlled seizure disorders or blackouts should be able to reliably go out alone, in which case 11a will apply.

B. Needs prompting to be able to undertake any journey to avoid
overwhelming psychological distress to the claimant. 4 points

This descriptor applies to claimants where undertaking any journey causes
overwhelming psychological distress (OPD) and where they need prompting
(‘prompting’ means reminding, encouraging or explaining by another person) on the majority of days to be able to go out and/or complete a journey.

Any journey’ means that in order to satisfy the descriptor on a day the person
must require prompting with every single journey on that day. If the person can
manage to leave the home to make a journey once without prompting then on
that day the descriptor is not satisfied. For example, a claimant who can make
visits to the local shop or collect their children from school without prompting on most days will not satisfy this descriptor, even if they are unable to undertake other journeys without prompting during the same day. However, being able to complete a journey at night time only is not considered to be completing a journey to an acceptable standard. Therefore, in these instances, descriptor E may bemore appropriate.

OPD means distress related to a mental health condition or intellectual or
cognitive impairment resulting in a severe anxiety state in which the symptoms
are so severe that the person cannot undertake a journey without being
overwhelmed. The threshold is a high one - a claimant who, without prompting, would be left feeling anxious, worried or emotional does not meet it. OPD may occur in conditions such as generalised anxiety disorder, panic disorder, dementia or agoraphobia. In cases of agoraphobia, going out provokes anxiety but may still be possible with prompting. If agoraphobia is so severe that the claimant is unable to go out even with support on the majority of days, descriptor E may be more appropriate.

Illustrative examples:

A claimant goes out to his local shop four days each week but needs to have his wife with him to cope with this journey. He will sometimes try to go to his weekly physiotherapy appointment alone if his wife is working, but this causes him severe anxiety (resulting in shaking uncontrollably, shortness of breath, faintness, nausea) and he has only managed this once in the last month; he cancelled the other appointments rather than make the trip alone. He can go out on most days but requires prompting / support to be able to do so and to avoid overwhelming psychological distress. He is only able to go out alone on occasion and very infrequently. He would therefore satisfy mobility 1B.

C. For reasons other than psychological distress, cannot plan the route
of a journey. 8 points

Applies to claimants with cognitive or developmental impairments who cannot
formulate a plan for their journey in advance using simple materials, such as bus route maps, phone apps or timetables. The route that is being planned is
unfamiliar – one does not need to plan a familiar route.

D. For reasons other than psychological distress, cannot follow the route
of an unfamiliar journey without another person, assistance dog or
orientation aid. 10 points

“Follow the route” means make one’s way along a route to a destination. This
involves more than just navigation of the route. Safety should be considered in
respect of risks that relate to following the route (tendency to wander into the
road, or inability safely to cross a road, if unaccompanied), for example, a
claimant with a severe visual or profound hearing impairment may be at
substantial risk from traffic when crossing a road.

Although psychological distress cannot contribute to the satisfaction of this descriptor if the claimant also has symptoms of cognitive or sensory impairment they may satisfy this descriptor. A person should only be considered able to follow an unfamiliar journey if they would be capable of using public transport – the assessment of which should focus on ability rather than choice, as the route has already been planned. Any significant diversions from that route are therefore irrelevant – it is no longer the planned route. However, making one’s way around road works, or a change of train platform (i.e. minor diversions) are part of being able to follow the route of a journey.

For example, a profoundly deaf person may need a person to accompany them to relay information, such as changes to a journey, due to disruptions. The descriptor refers to “an unfamiliar journey” rather than “any unfamiliar journey”. Accordingly, claimants can satisfy the descriptor by showing that they typically need to be accompanied by another person or an assistance dog or to
use an orientation aid on the majority of days when undertaking unfamiliar
journeys (it’s not necessary to show that they need such support for every
possible unfamiliar journey on most days).

Orientation aids are specialist aids. Ordinary satellite navigation systems such asthose found in mobile phones do not count as specialist. Maps or lists of
directions do not count as specialist. A long cane (as used by person with sight impairment) is an example of a specialist orientation aid (NB – a symbol cane, which is used to signal to others the person has some sight impairment, is not an orientation aid as it does not actually help the person orient themselves).

E. Cannot undertake any journey because it would cause overwhelming
psychological distress to the claimant. 10 Points

This descriptor applies to claimants where undertaking any journey causes
overwhelming psychological distress (OPD) despite being aided.
‘Any journey’ means that in order to satisfy the descriptor on any particular day
the person must not be able to manage to undertake a single journey. If the
person can manage to leave the home to undertake a journey once then on that day the descriptor is not satisfied, even if they are unable to undertake other journeys during the same day. Being able to complete a journey at night time only however, is not considered to be completing a journey to an acceptable standard. Therefore, in these instances, this descriptor may be appropriate. OPD means distress related to a mental health condition or intellectual or cognitive impairment resulting in a severe anxiety state in which the symptoms are so severe that the person cannot undertake a journey without beingoverwhelmed. The threshold is a high one - a claimant who is anxious, worried or emotional does not meet it.

This descriptor is likely to apply to claimants with severe mental health conditions (severe agoraphobia or panic disorder) or cognitive impairments (a person with dementia who may become very agitated and distressed when leaving home, to the extent that journeys outside the home can no longer be made either at all, or on the majority of days, even with the support of another person). A claimant who satisfies 1e cannot also satisfy 1f. If they cannot undertake a single journey on the majority of days, then 1e will be the applicable descriptor, even if there are occasions when they could follow a familiar route, if accompanied.

F. For reasons other than psychological distress, cannot follow the route of a familiar journey without another person, an assistance dog or an
orientation aid. 12 points

“Follow the route” means make one’s way along a route to a destination. This
involves more than just navigation of the route. Safety should be considered in
respect of risks that relate to following the route (e.g. tendency to wander into the road, or inability safely to cross a road, if unaccompanied), for example, a
claimant with a severe visual or profound hearing impairment may be at
substantial risk from traffic when crossing a road. The route has already been planned. Any significant diversions from that route are therefore irrelevant – it is no longer the planned route. However, making one’s way around road works, or a change of train platform (i.e. minor diversions) are part of being able to follow the route of a journey. The descriptor refers to “a familiar journey” rather than “any familiar journey”. Accordingly, claimants can satisfy the descriptor by showing that they typically need to be accompanied by another person or an assistance dog or to use an orientation aid on the majority of days when undertaking familiar journeys (it’s not necessary to show that they need such support for every possible familiar journey on most days).

Although psychological distress cannot contribute to the satisfaction of this
descriptor if the claimant also has symptoms of cognitive or sensory impairment they may satisfy this descriptor. A claimant who is actively suicidal or who is at substantial risk of exhibiting violent behaviour and who needs to be accompanied by another person to prevent them harming themselves or others when undertaking a journey would meet thisdescriptor. In cases such as this, the HP should look for evidence of suicidal thoughts and/or behaviour.

In cases of violent behaviour there must be evidence that they are unable to control their behaviour and that being accompanied by
another person, who can intervene if necessary, reduces a substantial risk of the person committing a violent act. Orientation aids are specialist aids. Ordinary satellite navigation systems such as those found in mobile phones do not count as specialist. Maps or lists of directions do not count as specialist. A long cane (as used by person with sight impairment) is an example of a specialist orientation aid (NB – a symbol cane, which is used to signal to others the person has some sight impairment, is not an orientation aid as it does not actually help the person orient themselves).

Piseag123 · 14/12/2023 15:18

Update R.E. Re-determination, received phone call from case manager today, 56 th deadline day was today and not tomorrow!! He informed me that my application was near the top of the pile and he has ensured me that it will be given his full attention, he will contact again me on Tuesday of next week when a decision will be made as he has to speak with the ‘in house’ medical person!! Although he is phoning on Tuesday he will not be able to inform me of what the decision is!! So still not sure what to think, thank you for listening!

Rocksdad · 14/12/2023 18:26

@Piseag123 that's good that they've at least called you and let you know - not like them to do what they say they'll do 😂
In my appeal portal I can see they had a case meeting about me and my application but I haven't read it yet as don't need wound up or to even think about it.

Hope they call back Tuesday and have managed to have the case conference between then and now!! 🤞

Piseag123 · 14/12/2023 19:25

Thanks @Rocksdad keeping fingers crossed for both of us 🤞

Allyballybee445 · 14/12/2023 19:51

@Rosscameasdoody That is a very complicated decipher list no way can I get my head around that although it does seem to sway towards mental health and I can see why not having a mental health referral or any supporting evidence I would be unlikely to get any points for this.
As I rarely leave the house as the thought of doing so distresses me and someone is with me when I do I felt I should have received some points for this. In hindsight I should have provided supporting evidence from friends and family but I am not sure if that would have made a difference.