Interesting. I don't deal with our local HVs as one of them is rather loopy and I'd rather not be in the same room with her ... ever.
So I can see where you are coming from.
It's not REQUIRED that you push for higher rate or mobility - DS2 actually qualifies for high rate as well as mobility, however, we are happy with the medium rate (covers additional expenses for him at this time) and wasn't up to the appeal for the higher rate (which, with the number of times and length of time he is up at night, he definitely qualifies!!). And we simply couldn't deal with more paperwork to apply for the mobility at this point. We'll review it next year and see where we are at. If we then decide we need to push harder, we'll do it then. I can't see putting myself through the stress right now when I have other concerns.
DS2 is 4yo and still uses pullups at night. Not sure if we could get nappies free through NHS, but if it means going through the HV, then it isn't happening at our house either. I'll just continue to purchase them.
Why does not pushing for more DLA mean you're "in denial?"
For us it simply means that we are choosing to focus our priorities on other things at the moment, and if it becomes a pressing need, then we'll focus more on that. It doesn't mean we're in denial, it means we are choosing our battles carefully IMO.
And that's important! Recognising limitations, and all that. (which actually is a significant symptom of NOT being in denial - knowing your limits)
More importantly though, did you get the card signed that you wanted?