questions about support group

I have some questions in relation to the Support Group Firstly some criteria pasted, then my questions below it

1. (d) Owing to a severe disorder of mood or behaviour, fails to clean own torso
(excluding own back) without receiving—
(i) physical assistance from someone else, or
(ii) regular prompting given by someone else in the claimant’s
presence.

Questions

Does (ii) bring into the possibility those who have severe enduring anxiety or depression that
they receive DLA care in relation to prompting ?

2. And in relation to the below criteria (read down)

a) Is the criteria at (a) where it says ANY personal action does this mean ALL personal action
that requires the facility of planning.organisation, problem solving or switching tasks ? In other words in relation to
those abilities the claimant is unable to do ANY of them rather than some such tasks requiring thise faculties ? . It seems to me that disabling levels of apathy or
inner distraction might apply here, so that if the person is so entrenched in their own anxieties. withdrawn or has pathological
levels of indecisiveness as a symptom of their condition, that might be relevant ?

)b and see criteria below in relation to my next series of questions

In relation to (c) 'Basic personal action' needing prompting one presumes this is a level of disability that might
include washing and dressing and cooking and in any manner of 'basics' of daily living ? 'Personal action ' seems to be regarded as
these things by the guide and I presume those self care/ phone answering features are 'basic' personal action and thus require the cause
to be 'severe disorder of mood or behaviour' These seem to include some things which would have attracted points in the Incapacity Benefit
PCA (yet would not have been sufficient for exemption) and also some things which would attract even the lower rate components
in DLA

One also presumes that 'severe disorder or mood of behaviour is mainly concerned with severity of the condition
rather that its 'category' ?

There is a distinction between personal action and basic personal action, and the personal action criteria (as distinct from the basic personal action ) does not specifiy
a need for a severe disorder of mood or behaviour, and so lesser degrees of mental impairment or behavioural
difficulty, short of requiring prompting, might qaulify ?

Additionally, where it states 'information about diagnosis, medication and level of healthcare practitioner
input should be consistent with severe disability "

Does this mean (say in a mental health case) that if the patient is not taking medication, or lacks a CPN or psychiatrist , that they have
little chance of passing this test ? It strikes me that a person might not be having much healthcare input when their
behavioural problem itself has caused a breakdown in the healthcare relationship, and / or medication is not
in progress due to the claimants /patients antipathy towards it or the clinicians view that long term medication
has not worked. In particular conditions such a Personality Disorders often lead to friction between patients and healthcare
services and are rarely suitable for drug treatment as an example. Or some patients just lose faith after years of trying with
their healthcare people and withdraw from services, or otherwise fearful of medication, of forgetful, do not participate in that.

Cases are not neatly tailored with all severe cases having bags of help. Mental health services in particular are overwhelmed.



2.3.1.12 Personal action
(a) Cannot initiate or sustain any personal action (which involves planning,
organisation, problem solving, prioritising or switching tasks);
(b) Cannot initiate or sustain personal action without requiring daily verbal
prompting given by someone else in the claimant’s presence; or
(c) Fails to initiate or sustain basic personal action without requiring daily
verbal prompting given by someone else in the claimant’s presence, owing to
a severe disorder of mood or behaviour.
This activity reflects the ability to initiate or sustain action without need for
external prompting. It is intended to reflect difficulties that may be encountered by
claimants with conditions such as severe depressive illness with resulting apathy,
or very severe levels of fatigue, or very severe levels of anxiety. It may be a
problem in some claimants with schizophrenia.
The level of disability in this category is severe. The disorder of mood must be
severe as indicated in the descriptor wording. Confirmation of this should be
sought, and information about diagnosis, medication and level of Healthcare
Practitioner input should be consistent with a severe disability. Personal action
may include self care, dressing, using the phone or other basic tasks.

Without dealing with the points you have raised, I agree (perhaps for the first time) with the overall thrust of your comments.

In relation to question 1(d)(2), I would concur that it does bring claimants into the possibility those who have severe enduring anxiety or depression, that they receive DLA care in relation to prompting? To my mind, it clearly implies something of a psychological test as opposed to a physical test.

In so far as question 2 is concerned, I consider that it involves all personal action that disabling levels of apathy or inner distraction might apply, so that if the person is so entrenched in their own anxieties, is withdrawn or has pathological levels of indecisiveness as a symptom of their condition, it may be relevant.

In my case, my CPN left and was not replaced because of the local health trust's policy. Likewise, my psychiatrist was informed that his role had changed and that it would lead to my discharge, not based upon clinical need, but because of cost-cutting measures by the health trust. Moreover, he had already indicated because I had been affected by chronic depression and anxiety for most of my life, there was nothing more he could do other than continue wwith drug therapy, which then became the responsibility of my GP. This was not because I had been cured, but because all the various treatments had been exhausted.

Another pertinent point is at what level does an illness/disability become severe? This has to be a subjective decision by a HCP which will inevitably lead to a perceived lack of uniformity.

Thanks for that. I am pleased that my translation of these criteria might be somewhere near the mark. Well at least one member seems to think so

I have particular concerns that the criteria places emphasis on severity being corroberated by healthcareimput/medication and so on, not that it is an arid rule but seen as an evidential indicator.

No doubt in some and perhaps cases the lack of a\ CPN or psychiatrist might well prove the difference between ending up in the WRAG and the Support Group and any claimant faced with this possibility might need to explain why they are outside of active regular specialist input.

I do find it interesting in a way that the support group in terms of some of these entry criteria can be satisfied (in theory) by a level of disability which would not meet the points criteria for the Incapacity Benefit PCA (its predecessor) That is peculiar but just an observation and not of any real value

One wonders if the SG criteria will be modified as a result of the review by Professor Harrington, if so whether it will amount to accessibility to more claimants given that lots of criticism has been made of the difficulty to get intio this group, including by the CAB

No doubt in some and perhaps cases the lack of a\ CPN or psychiatrist might well prove the difference between ending up in the WRAG and the Support Group and any claimant faced with this possibility might need to explain why they are outside of active regular specialist input

I am also very concerned about this! Just when will you be asked, in order to explain why you are not seeing anyone but your GP? I certainly wasn't asked at my ATOS assessment.

I am extremely worried that the appeal Tribunal will not ask me either.

Like you two (apologies if I am wrong) I have been left 'just' taking medication for years. All I get is a 5 min medication review once a year!

Best wishes,
Rachel

Even if you are not asked, you are at liberty to always pre empt thnis by raising it yourself, in your benefits forms or at hearings, because it is a 'natural' presumption that those receiving no or negligable medical input are the 'less severe' cases. In truth the opposite it often the case because past a certain point treatment is often ineffective or carries risks of dependency
(that goes for medication and talking treatments, so I have read)

and so it is perhaps neccesary to qaulify anything yopu think they might be influenced by, which they fail to explore

Hi, then I will certainly try to do this at my appeal.

I spoke out of turn once at the ATOS assessment and the nurse sighed loudly and ignored me. I'm afraid I clammed up!

Best wishes,
Rachel