INFORMATION ON APPEAL FOR DLA

[candyoscar]

I'm hoping someone will be able to offer some advice. I have been awarded HRC for my DD but have been refused mobility. She is nearly five but I was applying for HRM. What I would like to know is that I do not want to throw this back to the DWP and ask for another decision maker to have a look at my application. I want to go straight to appeal, is this allowed or do you have to let another decision maker have a look first? Any advice would be appreciated. Many thanks.

At the moment they seem to be recommending that you request reconsideration and appeal at the same time, I think to save admin time as most will end up going to appeal anyway. When you fill in the form, you should also write a covering letter stating that you are requesting reconsideration with a view to going to appeal if unsuccessful. In my case (IB) they phoned to check the process I was requesting but even though they backed down at reconsideration, the appeal papers had already been prepared. Not quite sure how that saves on admin time but there you go .

Many thanks streakybacon! What I would like to also know is that if I ask for another decision maker to have a look I run the risk of being downgraded to MRC, although the medical evidence that was submitted was justified in awarding HRC. If I go straight to appeal, they will leave what I have already been awarded HRC - hope this makes sense?

As far as I understand it (it seemed very complicated to me at the time, as though the DWP were making it up as they went along ), the reconsideration will happen whilst they're gathering together papers for appeal. It's not one path or the other, but the whole reconsideration/appeal process is joined up. Your claim will be reconsidered on the way to appeal and if they overturn the original decision in your favour, as happened in my case, then the appeal will be abandoned and your original award reinstated.

But as I said, there doesn't seem to be any rule about it these days so it's entirely possible that the process might be different in your case. I was given several conflicting descriptions of 'what happens next' whilst mine was underway, so I don't think you can be too sure in the current climate.

Hi Candyoscar

First of all, to clear up the 'risk' question, it doesn't matter if you ask for reconsideration or appeal, because either way they look at the claim afresh. So, whether you ask for reconsideration or appeal, they could decide that the original DM was erroneous in awarding HRC, and reduce to MRC or LRC. The risk of being downgraded is something that you need to balance between accepting the award, or pushing for HRM, not between reconsideration and appeal.

As an example, my DD was receiving HRC, no mobility, and her award ran out in the December. I had submitted renewal, as per DWP advice, early. In the August, she was awarded HRC, HRM from December. I phoned and was told that it was because I submitted renewal, and not supercession request. If I had asked for reconsideration/appealed, I ran the risk of losing a 3 year HRM award, for the sake of possibly gaining 18 weeks HRM. I decided that it wasn't worth the risk.

Streakybacon is right, that reconsideration is an automatic first step to appeal. You can request an appeal, but as part of processing the appeal pack, another DM will 'look again' anyway.

I think with HRM for a nearly 5 year old, you have to consider whether her case is 'clear cut' enough. There is no LRM for an under 5, so if you feel she is borderline, or probably meets the criteria for LRM more than HRM, you would be better waiting until she is 5 and asking for a supercession. However, do be aware that in doing that, they also look at the HRC award to check it is still valid. There is no escaping it!

Many thanks streakybacon and lougle for your detailed replies. They are very much appreciated. My Paed wrote a very strong letter to the DWP requesting HRM for my dd and they didn't even look at it according to the decision notice. It's something that I feel very strongly about so will proceed with the appeal. Many thanks both of you for your advice. These forums are great as I have no-one to talk to about these issues.

With HRM you have to be very clear that there are only 3 routes to getting the award:

-Unable to walk (this includes individuals who have had amputation above the ankle regardless of prosthesis).
-Virtually unable to walk given the time, manner, distance and speed that the claimant can walk without 'severe discomfort' (note that discomfort is not pain, and can be physical or emotional).
-Severe Mental and Social Impairment such that the claimant is a danger to him/herself or others and needs restraint or could need restraint (note that restraint can include a hand on the arm) to prevent this. (Note also that the risk of danger must be potential rather than theoretical, ie. there must be grounds to believe that the danger could happen). The claimant must also be in receipt of HRC.

Low Rate Care is for claimants who need a degree of guidance or supervision whilst in unfamiliar settings outdoors. Only awarded after age 5.

The difficulty many people whose children have SN have, is that they feel that their child is too severely 'disabled' to qualify just for LRM, but they don't neatly fit the criteria for HRM.

DD1 is in receipt of HRM. I argued that she fit the 'SMI' criteria, as we are unable to take her out without restraint of some sort for her own safety. She has no sense of danger, wouldn't hesistate to run in front of a car to get a stone, for example.

In the end, the DM decided that she fit the 'virtually unable to walk' criteria (she is wobbly and tires and can stumble/trip).