The guidelines for DWP assessors are clear that for any of the descriptors in section 11 to apply, the issues with planning and following a journey must originate in a mental health condition
Not for any/all of them, only b and e
Here are the guidelines in full to refresh your memory:
“Activity 11 – planning and following journeysThis 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 generally designed for limitations from physical problems. Cognitive impairment includes orientation (understanding of where, when and who the person is), attention, concentration and memory. Any issues with the ability to stand and then move are not applicable under activity 11, but under activity 12.
Regarding falls, consideration must be given to how the risk of falling manifests itself. Ordinarily the risk to a claimant’s safety arising from a physical inability to move safely would be applicable under activity 12. However, where the fall arises as a result of a sensory or cognitive impairment (for example, seizures associated with loss of consciousness) the risk of the fall to a claimant’s safety would be applicable under activity 11. When assessing which descriptor might apply, consideration also needs to be given to any risks to an individual arising during the “recovery” period (for example, any post ictal confusion).
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 of another person out of preference, is not sufficient.
Examples provided in this guidance are for illustrative purposes only and are not designed to be exhaustive.
Descriptor A (0 points): Can plan and follow the route of a journey unaidedWithin the assessment criteria, the ability to perform an activity unaided means without either the use of aids or appliances; or help from another person.
Descriptor B (4 points): Needs prompting to be able to undertake any journey to avoid overwhelming psychological distress to the claimantThis 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 undertake the journey. In practice, this is only likely to apply in the circumstance where someone needs prompting to set off on the journey, but would not need another person whilst on the journey itself.
‘Any journey’ means that in order to satisfy the descriptor on a day the person must require prompting when undertaking every single journey on that day to avoid OPD. 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’re unable to undertake other journeys without prompting during the same day. However, being able to start a journey at night time only is not considered to be undertaking a journey to an acceptable standard. Therefore, in these instances, descriptor E may be more 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 very 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.
Illustrative example:
The claimant becomes panicked before any journey and they’re only able to get out of the door if someone provides encouragement and reassurance that there are no dangers or threats as a result of going outside. However, once they’re out they’re able to follow a route independently without help. They would therefore satisfy mobility 1B.
If, however, a claimant can undertake any single journey on the majority of days in the required period without prompting, for example, regular visits to the local shop to collect the daily paper, or regularly collect their children from school without support then they’ll not satisfy this descriptor, even if they’re unable to set off on other journeys without prompting during the required period.
Descriptor C (8 points): Cannot plan the route of a journeyThis descriptor is most likely to apply 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.
Descriptor D (10 points): Cannot follow the route of an unfamiliar journey without another person, assistance dog or orientation aid.‘Follow the route” means make one’s way along a route to a destination. This involves more than just navigation of the route; it also includes making your way along the route reliably. Safety should be considered in respect of risks that relate to making ones’ way along a route (for example, tendency to wander into the road, inability to safely cross a road or risk of self-harm due to overwhelming psychological distress caused). For example, a claimant with a severe visual or profound hearing impairment may be at a substantial risk from traffic when crossing a road.
This descriptor is most likely to apply to claimants with cognitive, sensory or developmental impairments, or a mental health condition that results in overwhelming psychological distress, who cannot, due to their impairment, work out where to go, follow directions, follow a journey safely or deal with minor unexpected changes in their journey when it is unfamiliar. A claimant who suffers overwhelming psychological distress whilst on the unfamiliar journey and who needs to be accompanied to overcome the overwhelming psychological distress may satisfy descriptor 1d.
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.
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, road closure or train cancellation (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 minor 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 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).
Descriptor E (10 points): Cannot undertake any journey because it would cause overwhelming psychological distress to the claimantThis descriptor applies to claimants where undertaking any journey on the majority of days 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’re 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 being overwhelmed. The threshold is a very 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 (for example, severe agoraphobia, panic disorder or psychotic illness associated with severe paranoia) or cognitive impairments (for example, 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 due to overwhelming psychological distress, then 1E will be the applicable descriptor, even if there are occasions when they could follow a familiar route, if accompanied.
Descriptor F (12 points): Cannot follow the route of a familiar journey without another person, an assistance dog or an orientation aid.‘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 making ones’ way along a route (for example, tendency to wander into the road, inability to safely cross a road or risk of self-harm due to overwhelming psychological distress caused). For example, a claimant with a severe visual or profound hearing impairment may be at a substantial risk from traffic when crossing a road.
The familiar route does not need to be planned – it is familiar. Any significant diversions from that route are therefore irrelevant – it is no longer the familiar 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).
This descriptor is most likely to apply to claimants with cognitive, sensory or developmental impairments, or a mental health condition that results in overwhelming psychological distress, who cannot, due to their impairment, work out where to go, follow directions, follow a journey safely or deal with unexpected changes in their journey, even when the journey is familiar. A claimant who suffers overwhelming psychological distress whilst on the familiar journey and who needs to be accompanied to overcome the overwhelming psychological distress may satisfy descriptor 1F.
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 this descriptor. 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’re 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).”