18 - Specified Disability: Back Pain and Depression

2014/18

Specified Disability: Back Pain and Depression

Background: The appellant, aged 49 years, is separated. He had been in receipt of Disability Allowance for ten years but, following a review of his claim, it was held that he was no longer eligible on medical grounds. At the time of the oral hearing, he was in receipt of a basic income under the Supplementary Welfare Allowance scheme.

In completing the ability/disability profile, his GP assessed the appellant as being affected in the following areas:

Bending/Kneeling/Squatting - affected to a mild degree
Mental Health/Behaviour - affected from a mild to a moderate degree
Sitting/Rising - affected from a mild to a moderate degree
Lifting/Carrying - affected to a moderate degree

An appeal was made on the appellant’s behalf by his solicitor, asserting that he was incapacitated and unable to take up employment because of his medical difficulties. Reference was made to surgeries performed on his back, a recent recommendation for ‘fusion’, and psychiatric difficulties resulting from constant pain and discomfort. Details were provided as to his daily medication and it was submitted that he was not in a position to provide medical reports due to financial difficulties. His solicitor stated that he was taken aback at a decision to terminate payment in the absence of an in-person medical examination.

Oral hearing: The appellant was accompanied by a relative. He asserted that he was not capable of performing any type of employment because of his back complaint and depression. He stated that he had had two operations performed on his back a number of years ago and had been advised by an Orthopaedic Consultant not have ‘back fusion’ at that stage because of the uncertainty of a successful outcome. Instead, he had been advised to learn to live with his condition. He reported that he had done so but while he has weeks when his back problem only affects him moderately, there are weeks when he cannot leave the bed/floor and must crawl to get to and from his kitchen/bathroom. He added that he has chronic episodes of pain some ten or fifteen times a year, when he is confined to bed/floor.

The appellant added that his condition and the fact that his long-term Disability Allowance entitlement had been discontinued had led to him being depressed. He stated that he had attempted suicide (confirmed by a letter from his G.P.) about six months previously and had been hospitalised for a few days. He reported that he was receiving counselling and did not have suicidal ideation at the time.

In conclusion, the appellant stated that he is incapable of performing any work at the present time. He referred to difficulties in standing, sitting and walking for long periods, and outlined the pain relief and anti-depressant medication prescribed by his G.P., as well as further medication which he imports and which his G.P. does not know about.

Comment/Conclusion: The Appeals Officer observed that the appellant appeared to walk with some difficulty and was uncomfortable sitting for the period of the hearing. He noted the appellant’s age, history of back surgeries, current diagnosis of continued back pain with the possibility of further back surgery and his mental state which had led to him attempting to take his life by means of an overdose. He noted also his G.P.’s letter of support and the evidence he had given at oral hearing. In addition, he took account of the fact that the appellant had been in receipt of Disability Allowance for ten years and he considered that there was nothing to indicate that his physical or mental state had improved significantly in the meantime. He concluded that the qualifying criteria were met.

Decision of the Appeals Officer: The appeal is allowed.

Decision reason(s): Disability Allowance may be paid where a person is substantially restricted in undertaking work which would otherwise be suitable with reference to their age, experience and qualifications and the specified disability must have continued for or be expected to continue for at least one year.

Having carefully examined all the medical evidence in this case, including evidence adduced at oral hearing, I have concluded that the appellant has established that he meets the qualifying conditions. In the circumstances, the appeal succeeds.