Could you be entitled to Disability Living Allowance?
One aspect the Advocacy Service provides is support completing Disability Living Allowance (DLA) claim forms. Completing a DLA form can be a very difficult experience for individuals and families because the questions ask families to focus in detail on what they or their child cannot do. Completing DLA forms can also be very time-consuming.
This information sheet covers the general principles and requirements for making a successful claim. It provides details on DLA, how it is assessed and explains the different components that need satisfying in order to make a successful claim. It provides an understanding of the DLA and the process.
What is Disability Living Allowance?
DLA is a tax-free and non means-tested social security benefit available to children with disabilities who are under the age of 16. It has two parts: a care component and a mobility component.
There are disability criteria which have to be met in order to qualify for DLA. The extent of a person’s disabilities and how they affect them will determine the rate of benefit that they will be awarded. The decision-maker at the benefits agency will look at the information in the claim form to get a picture of how a person’s disabilities affect them. They will also look at any other evidence given. This may come from their GP, a carer or relative.
What are the principles behind the Disability Living Allowance?
The principle behind the benefit is that the additional costs arising from disability should be met by society as a whole and not by the individual with a disability or their family. Individuals up to the age of 16 years old can apply for this benefit.
Each person is affected differently and it is the effect the disease has on the individual that is assessed. This is why one person receives one level of benefit and another person with the same MPS or related disease receives another level.
How can I claim Disability Living Allowance?
A claim for DLA is made on the official forms. Families can request a form from the Department of Work and Pensions, or they can download the form to complete from the below website.
Alternatively, the Disability Living Allowance helpline can be contacted on:
Telephone: 0800 121 4600 Textphone: 0800 121 4523 Relay UK (if you cannot hear or speak on the phone): 18001 then 0800 121 4600 Monday to Friday, 9am to 5pm
For families living in Northern Ireland, the contact details are:
Phone: 0800 587 0912 Textphone number: 0800 012 1574 (for deaf or hard of hearing users and customers with speech difficulties)
What about renewal claims?
The Benefits Agency will usually send a renewal form about six months before the award expires. Most awards of DLA are for a limited period of time and can vary greatly in length.
A new claim will be dealt with by the local Disability Benefits Centre. Firstly, the decision-maker will decide whether an individual satisfies the non-disability tests (about their age and residency in Great Britain etc). The decision-maker will take into consideration all the information in the claim form to get a picture of how the disabilities affect the person. Then they will decide whether they need any further information about the claim. The decision-maker may choose to contact the individual’s doctor or specialist metabolic consultant. Finally the decision-maker will decide whether or not an individual is entitled to benefit, at what rate and for how long.
It is important that claimants consider which doctors are named on the form as they may be approached. The GP’s details are always needed but it may be that they have little contact with the individual or do not know enough about the condition to complete the form accurately. This is particularly the case with rare diseases. This makes it very important to include the most appropriate hospital doctor on the form, e.g.
doctors who are able to fully and accurately describe the effects of the disease on the individual.
How long will I have to wait for a decision?
The DWP will usually make a decision about a new claim within a few weeks, but depending on their ability decisions can take longer than a few weeks. This tends to be the case for review claims. The decision may take longer due to the COVID-19 pandemic. Any successful award will be dated from the time the Department of Work and Pensions received the claim form, or from the date you ordered your form, if you return this within the timescale set.
The decision is always sent in writing and may provide a short summary of how the decision was arrived at and will state how long the benefit has been awarded for.
There are Regulations in place to guides the decision making for Disability Living Allowance. Please see the detail below about the levels of benefit and their criteria’s. Should you disagree with the decision, there are further processes you can follow.
Can I appeal?
If you feel the correct benefit level has not been chosen, you have one month from when they wrote to you to contact the Department of Work and Pensions to request a Mandatory Reconsideration. If for any reason your award notice does not state the reasons as to why the said benefit level was chosen, your first step should be to request these details.
You can request a mandatory reconsideration by calling or writing to the Department of Work and Pensions. When you contact the Department of Work and Pensions, you will need to explain why you think their decision was wrong and you may need to submit further evidence.
If you decide to appeal, the MPS Society can support you to put your views into writing. We ask you to phone us first to let us know that you will be appealing before you do a written appeal. We may be able to provide some further information about your child’s disease to support the reconsideration.
It is important to note that by asking the Department of Work and Pensions to re-look at the evidence and the decision, that your whole claim will be reviewed. Only in the instance where there is a lack of evidence supporting your the claim, a reduced benefit level may be given or the benefit removed completely.
Once you have received the Mandatory Reconsideration Notice, if you still feel the wrong decision has been made, you may be able to appeal further and apply to the HM Courts and Tribunal Service within one month of receiving the outcome of the mandatory reconsideration. An appeal may be heard at a later date, but this would depend on your reasons and circumstances for a late appeal.
Guidance on how to make an appeal will be contained within the Mandatory Reconsideration Notice.
The MPS Society can support you by representing you at a tribunal hearing. A tribunal consists of a hearing with a panel in which the claimant’s case is made as to why they meet the criteria for a higher level of benefit than that awarded. You may wish for the child to attend as well, but this would need careful consideration.
The panel usually consists of three people: a chairperson who is legally qualified, a doctor and a third member who has knowledge of disability issues. There will sometimes be a representative of the Benefits Agency who will put their case forward.
The appeal service itself is part of the judicial system and is independent of the Department of Work Pensions. The decision of the tribunal may be given on the day or you may receive the decision in writing after the hearing. Usually the appeal decision is final unless there is a fault in how the law has been applied.
If a family feel that the outcome of the decision is still incorrect, another Disability Living Allowance application can be made from after six months from when the original application was submitted.
What are the DLA levels and criteria?
There are two components that make up the DLA benefit, a Care Component and a Mobility Component.
The Care Component
Looks at the needs of the applicant compared to a typical child the same age and the frequency of the needs.
There are three levels rates of benefit for the care component, high, middle and low. Each level has a different amount of weekly benefit awarded, high being the largest amount, and low being the smallest. The higher the care for both day and night time care, the higher level of benefit is likely to be awarded.
The Social Security Contributions and Benefits Act 1992 provides more details of the criteria for each level of benefit. This document can be found here.
Put simply, if the applicant has significant care needs and requires continuous supervision both during the day and night time, they are likely to be awarded the highest rate of benefit for the care component. If the applicant has significant needs or continuous supervision either day or night, but not both, they are likely to be awarded middle rate benefit of the care component. People with less significant care needs may be awarded the low rate benefit for this component, if the DWP agree that the needs are greater than typical children of the same age.
The frequency of the needs will also impact on the decision, so it is important families are not minimizing the needs of the child. Use of language like such as sometimes, most of the time, occasionally, needs to reflect reality. When thinking of duration, ask yourself on average does my child have this need all of the time, more than half a year, month or week, or less than a week.
Whilst difficult, it is important for families to think about and provide specific examples of the support they naturally provide to the disabled child, which they may not give to a typical child.
The Mobility Component
There are two rates of the mobility component of DLA, high and low and as with the Care Component rates, high provides the largest amount of benefit and low provides the smallest amount of benefit. The highest level of benefit for this component provides eligibility for a Blue Badge application, and enables families to explore the Mobility scheme for the child with mobility difficulties.
Again, the Social Security Contributions and Benefits Act 1992 provides more details of the criteria for each level of benefit. This document can be found here.
The mobility component benefit is age dependent. No claims for this component can be made for children under the age of three, because most children under this age require a degree of support with their mobility.
Children that are between three and five years old are only entitled to claim for the benefit under this component if they are likely to meet the threshold for the high rate benefit of this component. This means they have to have significant mobility problems, such as being unable to walk, they are both deaf and blind, or are severely mentally impaired. Please note there are other criterion to meet if a child falls into these categories.
Children over the age of five years old can be awarded for either benefit level of the mobility component. Children that don’t have the above difficulties or don’t meet all of the above criteria, but still require a higher level of supervision to support their mobility compared to typical children of their age are likely to be awarded the lower rate benefit.
Read and download our factsheet on Disability Living Allowance below:
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