[2000] UKSSCSC CDLA_714_1998 (15 June 2000)
R(DLA) 4/01
Judge K. Machin QC CDLA/714/1998
Mr. J. Mesher CDLA/2560/1999
Mr. A. Lloyd -Davies CDLA/414/1999
15.6.00 CDLA/823/1999
Mobility component - lower rate - whether guidance or supervision also constituting attention or supervision for the purposes of the care component may be taken into account
Mobility component - pre-lingually deaf - whether guidance or supervision arising from fear and anxiety may be considered
In each of these four cases it was accepted that the claimant was, by any criteria, severely disabled, one of the claimants suffering from post-traumatic stress disorder, one suffering from epilepsy, and the other two having been profoundly deaf since birth. The question of whether severity of disablement is to be treated as a separate and additional test of entitlement or is to be judged by reference to the statutory criteria relating to care or mobility needs and as part of those criteria was therefore not in issue. In each case the claimant had been awarded some rate of the care component of disability living allowance. The main issue in these appeals, and one which had caused a divergence of views amongst Commissioners, was whether supervision or attention requirements which qualify or which might go towards qualifying a claimant for an award of the care component under section 72 of the Social Security Contributions and Benefits Act 1992 should or should not be taken into account when assessing the need for supervision or guidance under section 73(1)(d) of that Act. The other issues were whether the words "cannot take advantage of" should be subject to some implied qualification and, in the cases involving the pre-lingually deaf claimants: (i) whether any attention with the bodily function of hearing which counted towards potential entitlement to the care component should be disregarded; (ii) whether a pre-lingually deaf person with consequent severely impaired comprehension of English, who was too frightened or nervous to walk on unfamiliar routes and never did so unaccompanied, could ever be entitled to the lower rate of mobility component; and (iii) whether "guidance" included assistance with communication in order to ask for directions.
Held, in each case allowing the appeal, that:
- in determining whether a claimant cannot take advantage of the faculty of walking out of doors without guidance or supervision for most of the time, the fact that the guidance or supervision necessary, or elements of that guidance or supervision, may also constitute attention or supervision which qualifies, or could go towards qualifying, the claimant to entitlement to the care component is to be ignored (paragraph 14, and paragraphs 11 and 13 for the reasons for rejecting the submissions to the contrary on behalf of the Secretary of State) and Commissioners' decisions to the contrary, including CDLA/757/1994, are not to be followed;
- the application of the words "cannot take advantage of" in particular cases is left to the good sense of decision-makers and tribunals (para. 15);
- in relation to deaf claimants, and in particular the pre-lingually deaf: (i) attention with the bodily function of hearing is not to be disregarded (para. 17); (ii) fear or anxiety (not in itself amounting to a physical or mental disability) which results from the disablement may be taken into account (para. 18); and (iii) in some cases of a limited ability to communicate and to receive information, a need for guidance from another person most of the time may be made out (para. 19).
In case CDLA/2560/1998 the tribunal substituted its own decision awarding lower rate mobility component in addition to the existing award of middle rate care component (which was not in dispute); the tribunal remitted each of the other three cases for rehearing by a new tribunal.
DECISION OF A TRIBUNAL OF SOCIAL SECURITY COMMISSIONERS
(a) In appeal CDLA/714/1998 ("Case A"), the claimant's appeal against the decision of the Central London disability appeal tribunal dated 19 September 1996 is allowed. The tribunal's decision is set aside as erroneous in point of law, for the reasons given in paragraphs 21 to 23 below. The claimant's appeal against the adjudication officer's decision dated 7 July 1995 is referred to an appeal tribunal constituted under the Social Security Act 1998 and regulation 36(6) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 for determination in accordance with the directions given below (Social Security Act 1998, section 14(8)(b)).
(b) In appeal CDLA/2560/1998 ("Case B"), the claimant's appeal against the decision of the Swansea disability appeal tribunal dated 17 December 1997 is allowed. The tribunal's decision is set aside as erroneous in point of law, for the reasons given in paragraphs 24 and 25 below. It is expedient to substitute a decision on the claimant's appeal against the adjudication officer's decision issued on 21 March 1993, on the findings of fact made by the tribunal (Social Security Act 1998, section 14(8)(a)(i)). That decision is that the claimant is entitled to the middle rate of the care component of disability living allowance for the period from 25 June 1993 to 24 June 1998 and to the lower rate of the mobility component for the same period.
(c) In appeal CDLA/414/1999 ("Case C"), the claimant's appeal against the decision of the Oxford disability appeal tribunal dated 12 August 1998 is allowed. The tribunal's decision is set aside as erroneous in point of law, for the reasons given in paragraphs 26 to 28 below. The claimant's appeal against the adjudication officer's decision dated 4 February 1998 is referred to an appeal tribunal constituted under the Social Security Act 1998 and regulation 36(6) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 for determination in accordance with the directions given in paragraph 28 below (Social Security Act 1998, section 14(8)(b)).
(d) In appeal CDLA/823/1999 ("Case D"), the adjudication officer's appeal against the decision of the Oxford disability appeal tribunal dated 12 August 1998 is allowed. The tribunal's decision is set aside as erroneous in point of law, for the reasons given in paragraphs 29 to 34 below. The claimant's appeal against the adjudication officer's decision dated 23 July 1997 is referred to an appeal tribunal constituted under the Social Security Act 1998 and regulation 36(6) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 for determination in accordance with the directions given in paragraph 34 below (Social Security Act 1998, section 14(8)(b)).
Background
(1) In Case A the claimant, who comes from Somalia, suffered terrible injuries during the civil war in that country. However his principal disability is post-traumatic stress disorder arising from what happened to him and what he saw during that civil war. The tribunal awarded the claimant the highest rate of the care component for the period from 21 September 1994 to 20 September 1997 on the grounds that during the day he required continual supervision and at night he required someone to watch over him for a prolonged period or at repeated intervals, in each case to avoid substantial danger to himself. The tribunal disallowed the claimant's claim to the lower rate of the mobility component.
(2) In Case B the claimant suffers from epilepsy. The tribunal found that the claimant had tonic/clonic attacks, once or twice a fortnight, often without warning, as a result of which she fell. The tribunal further found that the claimant was at serious risk if she did not have someone with her to save her from the worst effects of her falls. The tribunal awarded the claimant the middle rate of the care component for the period from 25 June 1993 to 24 June 1998 on the grounds of her supervision needs, but disallowed her claim to the lower rate of the mobility component.
(3) In Case C the claimant has been profoundly deaf since birth. Her first language is British Sign Language. The tribunal found that she had a limited ability to read and write (although her own evidence suggested that her reading ability was not as limited as the tribunal found). The tribunal awarded her the lowest rate of care component from 2 October 1997 for life on the grounds that she required attention for a significant portion of the day, but by a majority disallowed her claim to the lower rate of the mobility component.
(4) In Case D the claimant has also been profoundly deaf since birth. The tribunal found that he had difficulty with written communication. The tribunal awarded the claimant the middle rate of the care component from 26 September 1996 for life on the grounds that he required frequent attention during the day and the lower rate of the mobility component for the same period on the grounds of his needs for guidance and supervision on unfamiliar routes.
Lower rate mobility component
"Subject to the provisions of this Act, a person shall be entitled to the mobility component of a disability living allowance for any period in which he is over the age of 5 and throughout which-
...
(d) he is able to walk but is so severely disabled physically or mentally that, disregarding any ability he may have to use routes which are familiar to him on his own, he cannot take advantage of the faculty out of doors without guidance or supervision from another person most of the time."
By virtue of section 73(11)(b) a person who falls within section 73(1)(d) is entitled to the lower rate of the mobility component of disability living allowance. The predecessor of section 73(1)(d) (to be found in section 37ZC of the Social Security Act 1975, as inserted by the Disability Living Allowance and Disability Working Allowance Act 1991, the provisions of which came into force on 6 April 1992) was enacted, at least in part, in order to provide some relief from the effect of the decision of the House of Lords in Lees v. Secretary of State for Social Services [1985] 1 AC 930. It was there held that a woman who was blind, who suffered from a marked incapacity for spatial orientation and who could only walk outside with someone else to guide her was not virtually unable to walk and hence did not qualify for mobility allowance (the predecessor of the higher rate of the mobility component of disability living allowance). Such a claimant would now qualify for the lower rate of the mobility component. Section 73(1)(d), however, goes further than to provide relief for the physically disabled such as the claimant in Lees. It specifically provides that mental disability can also qualify a claimant for the lower rate of the mobility component. In the case of the higher rate of the mobility component only physical disabilities can be taken into account, unless the claimant falls within the narrowly defined category of persons described in section 73(3) (relating to those who are severely mentally impaired, display severe behavioural problems and are in receipt of the higher rate of the care component of disability living allowance). The lower rate of the mobility component is payable at a rate of roughly two-fifths of the higher rate.
The main issue
"(1) Subject to the provisions of this Act, a person shall be entitled to the care component of a disability living allowance for any period throughout which-
(a) he is so severely disabled physically or mentally that-
(i) he requires in connection with his bodily functions attention from another person for a significant portion of the day (whether during a single period or a number of periods); or
(ii) ... ; or
(b) he is so severely disabled physically or mentally that, by day, he requires from another person-
(i) frequent attention throughout the day in connection with his bodily functions; or
(ii) continual supervision throughout the day in order to avoid substantial danger to himself or others ..."
(Section 72(1)(a)(ii), relating to the cooked main meal test, and section 72(1)(c), relating to night-time needs, are not relevant for the purposes of these appeals). The division of opinion amongst Commissioners is illustrated by decisions (such as CDLA/757/1994) which hold that supervision taken into account for the purposes of entitlement to care component cannot, without more, qualify a claimant for entitlement to the lower rate of mobility component and decisions (such as CDLA/52/1994 and CDLA/3360/1995) which hold that such supervision can be so taken into account.
(a) Parliament clearly had in mind the decision of the Court of Appeal in Moran v. Secretary of State for Social Services (appendix to R(A) 1/88) when it used the word "supervision" in the predecessor to section 73(1)(d). In that case the Court of Appeal had held that supervision to avoid substantial danger to the claimant or others did not simply comprehend the moments when intervention was required but encompassed the notion of being on hand and ready to intervene when necessary.
(b) Supervision of the Moran type was clearly comprehended within section 73(1)(d), but the omission of the words "to avoid a substantial danger to [the claimant] or others" indicated that the objective of the supervision, other than the basic requirement that without it the claimant could not take advantage of the faculty of walking, was at large.
(c) It was clearly contemplated that the claimant might qualify for both the care component and the mobility component on the basis of the same underlying disability and notwithstanding that the need for supervision could be met by a single supervisor.
(d) There was nothing surprising in this conclusion since supervision outdoors requires the supervisor to accompany the claimant and hence to devote all, or substantially all, his time to the act of accompaniment, whilst in many cases in the home the supervisor, although supervising, could get on with other tasks.
(e) In the paradigm case of the serious epileptic, unless supervision is provided out of doors, the claimant will be exposed to substantial danger and accordingly "cannot" take advantage of the faculty of walking.
"Supervision was not a pre-requisite for [the claimant] exercising her power of walking; it was an additional advantage rendering her walking less open to risk. But section 73(1)(d) is not concerned with supervision to avoid danger to the claimant; that type of supervision is provided for under section 72(1)(b)(ii)".
(a) The words "guidance or supervision" without qualification would, as a matter of the ordinary use of language, comprehend supervision to avoid substantial danger to the claimant. There is no justification for excluding the type of supervision which is most likely to be required when a disabled individual is walking alone outside.
(b) There is nothing in the language of either section 72 or section 73 which dictates that attention or supervision requirements which are taken into account for the purposes of entitlement to the care component should not also be taken into account for the purposes of the lower rate of the mobility component.
(c) If correct, Mr. Forsdick's main submissions would mean that decision-makers acting on behalf of the Secretary of State and tribunals would, in many cases, have to embark upon the difficult task of analysing what attention or supervision requirements were, or might be, covered by an award of the care component and of deducting those requirements from the aggregate of the requirements for supervision or guidance needed by the claimant when walking out of doors on unfamiliar routes. We do not consider, in the absence of clear statutory language, that it was intended that decision-makers or tribunals should have to embark upon such a fine analysis, involving an artificial dissection of the practical realities of the lives of claimants.
(d) Mr. Forsdick's main submissions could give rise to anomalies. For example, a claimant whose requirement for supervision to avoid substantial danger to himself or others was the same both indoors and out, was not continual but yet was required most of the time would, as we understand it, not only not qualify for the care component, but would also not qualify for the lower rate of the mobility component.
(e) Taken to its natural conclusion, Mr. Forsdick's argument on behalf of the Secretary of State would mean that a blind person (such as the claimant in Mallinson v. Secretary of State for Social Security [1994] 1 WLR 630) who required frequent attention with the bodily function of seeing while walking out of doors could not rely on those attention requirements for the purposes of entitlement of the lower rate of the mobility component. This could render section 73(1)(d) of nugatory effect for the blind, the one class of person for whom it is absolutely clear it was intended should be provided some relief, following the decision of the House of Lords in Lees.
(f) Section 73(1)(d) does not contain the words "cannot exercise the faculty of walking" but uses the words "cannot take advantage of the faculty of walking". We observed that the Commissioner in CDLA/757/1994 and Mr. Forsdick, in the re-formulation which we invited him to make, substituted the words " cannot exercise" for "take advantage of". We accept Mr. Drabble's submission that these last words are of wider import than "cannot exercise" and carry with them the connotation that the claimant is not able most of the time to walk over unfamiliar routes so as to be able to get to a desired destination whenever he wants to without the prescribed supervision or guidance.
(g) We note (from the printed cases) that a submission was made to the House of Lords both in Mallinson and in Fairey to the effect that attention which might be connected with entitlement to mobility component should be ignored when entitlement to the care component was under consideration. Such a submission was not accepted - see per Lord Woolf in Mallinson at 633 F and 635 A and per Lord Slynn in Fairey at 813 G-H. Although the converse proposition is in issue in the present appeals, "overlap" as a concept did not influence the majority reasoning in either decision of the House of Lords.
Implied qualification of "cannot take advantage of"
Other issues - the deaf
"It seems to me that the guidance being referred to in the Statute is not the guidance of a passing stranger from whom directions are asked but rather that of a guide who accompanies the claimant and without whose guidance the claimant cannot exercise the faculty of walking ... For my part I do not see how a person accompanying the claimant asking a stranger for directions on an unfamiliar route could be said to be giving guidance to the claimant. It is rather more in the way of a person with the claimant providing her with a substitute method of communication with a third party. On any proper view it is not guidance".
Mr. Forsdick further submitted that any guidance required by a deaf person could only arise when the person was lost or unsure as to which route to take and that that could never arise "most of the time" as required by the statute. We accept that in the case of many deaf people the requirement for guidance when on unfamiliar routes will be limited since they will be capable of studying maps, reading street signs or communicating with passers by, either in writing or by speaking and lip reading. However, in the case of those who are not only profoundly deaf, but also as a consequence of that or some other disability have no, or a very limited, ability to communicate (whether by speaking or writing) or to receive information (whether by reading or lip-reading) a requirement for guidance most of the time might be made out. Such claimants may need someone with them on unfamiliar routes to ensure that they do not get lost. Although the guide may only intervene occasionally, for example to indicate whether or when the claimant should take a turning, he will nonetheless be guiding (or possibly supervising) all of the time since otherwise the claimant will not know whether or when to change direction.
Case A
(a) In its findings of fact on the lower rate mobility component the tribunal found, at paragraph 3, "[The claimant] can walk out of doors while unaccompanied. He would not require guidance or supervision when out of doors in unfamiliar places". The tribunal further found, at paragraph 10, that "[the claimant], because of his mental problems, requires continual supervision throughout the day and also because of his dizziness he can fall. The tribunal considered that without continual supervision he would neglect himself, he would not get up and he would not eat."
(b) These findings indicate that the tribunal failed to consider in relation to the lower rate of the mobility component whether the claimant needed supervision when in unfamiliar places out of doors because of the danger of dizziness and falls.
(c) The tribunal's reasons confirm the tribunal's erroneous approach. In paragraph 2 of those reasons the tribunal stated "[the claimant] suffers from post traumatic stress disorder but he can go out himself. He does get anxious while out of doors. He would not require guidance or supervision while out of doors. He gets anxious and distressed whether he is [in] a quiet environment or a town environment. He will go out himself to restaurants for his meals. The tribunal do not consider that he would require guidance or supervision while out of doors most of the time in unfamiliar places."
(d) However, the tribunal's reasons continued in paragraph 3 "... [the tribunal] considered that the supervision which [the claimant] required both indoors and outdoors was to prevent him doing something foolish and also because of the dizzy spells which amount to continual supervision throughout the day. There appears to be evidence that [the claimant] had dizzy spells and would fall, that he is also forgetful, that he suffers from paranoid delusions regarding people's possible intentions towards him. For these reasons the tribunal considered that he required continual supervision throughout the day."
(e) Again, the tribunal's finding that the claimant would not require guidance or supervision for the purposes of the mobility component is inconsistent with its findings relating to supervision requirements for the care component.
Case B
Case C
"Taking into account Halliday and the other decisions the care needs amounted to significant needs rather than frequent. The tribunal was satisfied that most of the time [the claimant] coped at home using BSL or the written word. However the tribunal was satisfied that there were sufficient significant occasions where she required help and therefore that the lowest rate of care component was appropriate".
The tribunal merely stated a conclusion and failed to explain why the claimant's attention needs did not satisfy the criteria for entitlement to the middle rate of the care component.
"4. Apart from deafness she has no other disabilities and is able to walk without problems.
- She is nervous in unfamiliar places and also in familiar places in the dark.
- She can ask directions in writing and able to use buses around Oxford."
In its reasons on this issue the majority of the tribunal stated that it
"... considered [the claimant] did not require guidance or supervision in walking unfamiliar places for most of the time. It considered she was able to cope reasonably well only showing nervousness rather than panic."
Apart from the fact that the tribunal did not deal with the evidence from the claimant to the effect that she never went to a place she was not familiar with on her own and that busy places where there were lots of people, and particularly traffic, made her nervous, we consider that it fell into error in holding that nervousness engendered by her physical disability could not be taken into account. As we have indicated above we consider that if nervousness or anxiety in unfamiliar places causes the claimant not to walk unaccompanied in such places most of the time and such nervousness or anxiety is a result of the claimant's disability, then the tribunal is entitled to take such nervousness or anxiety into account when considering whether the claimant can or cannot take advantage of the faculty of walking out of doors on unfamiliar routes without supervision or guidance most of the time.
Case D
"5. Can use a map.
- Relies on his son (hearing) if out walking in unfamiliar or unfamiliar places.
- Has a history of near misses [on] crossings and at work in unfamiliar areas.
- Has problems in London and other unfamiliar areas when walking scared by people brushing him and cars etc., coming from behind.
The tribunal's reasons, so far as material, were as follows:
"Although [the claimant] holds down his job as a carpenter and uses a car to work, his requirements for guidance or supervision are very great when he is working on an unfamiliar site and in unfamiliar towns. We were impressed by the assistance and comfort which he derives from the help given by his son.
We therefore found that from 26 [September] 1996 he needs guidance/supervision in walking for most of the time."
and the new tribunal must take into account all matters obtaining from the date of claim (26 September 1996) down to the date of the rehearing.
Date: 15 June 2000 (signed) Judge Kenneth Machin QC
Chief Commissioner
(signed) Mr. J. Mesher
Commissioner
(signed) Mr. A. Lloyd-Davies
Commissioner