DLA Information Pack

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Appendix 3 - Completing DLA forms for Renal Patients

Briefing Paper (of the Greater Manchester Renal Managed Clinical Network) - To assist doctors in completing DLA forms and in providing medical evidence for Renal Patients (reproduced with permission)

Author: Dr Simon Jenkins MBE FRCGP

Date: January 2003

1. In providing ‘medical’ information for patients applying for Disabled Living Allowance (DLA), doctors should be aware of the importance that their recorded opinions will have for the welfare of each individual concerned.
2. Patients with ESRF (End Stage Renal Failure) may minimize their disability as part of their coping mechanism to deal with a lifelong debilitating disease. Certifying doctors should be aware of this and ensure that patients’ disabilities are fully and accurately described.
3. The task of deciding patients’ eligibility for the DLA is the responsibility of the Benefits’ Agency based on the recommendation of their own medical advisors (this service is currently provided by Schlumber‑Sema, an ‘outsourced’ private company who is responsible for employing the medical advisors). The purpose of this agency is to protect public funds and to ensure that benefit is only paid to people who meet the strict criteria. Their opinions are necessarily based on ‘positive’ information. If important information is omitted by the ‘certifying doctor’, or if the doctor does not fully state the range and severity of the patient’s disability it may result in the Agency making a decision which will not be in the patient’s favour. Such patients will have to bear the financial consequences of loss of benefit in addition to the burden of their continuing ESRF. Failure to receive the DLA also affects eligibility for other benefits, such as transport costs, parking fees and facilities, and discounts for, and access to, many services open to disabled people.
4. Patients who are not awarded a DLA may appeal against the decision. At appeal, many appellants are successful when their full disability, often with supporting medical evidence, is revealed to the tribunal. If the information presented in the initial application had been full and complete, such patients would have avoided the trauma of the appeals procedure. Furthermore, the cost of such appeals to the Exchequer is not insignificant.
5. Where possible, the doctor should explain to the patient, the precise meaning of what he/she is certifying. It is often helpful to complete the form in the presence of the patient, so that patients can respond to further enquiry about their disability and any other co-morbidities that may be contributing to their impaired functioning.
6. Patients are required to inform the Benefits Agency when a significant change occurs in their condition. Patients generally improve following successful renal transplantation. However the time to recover form pre-transplant disability is variable. A commonly understood period is approximately one year but this may be more prolonged and is dependent upon the successful and continued functioning of the transplanted kidney, as well as co‑morbid conditions that may have occurred either pre or post transplantation. When such patients inform the Benefits Agency of their changed status, the information about their ability to carry out specific daily living tasks is usually provided by the patients themselves. Any additional medical information should record, not only details about their renal function but should also describe the disabilities arising from any co-morbidities as well as the side effects and problems associated with lifelong, often complex therapeutic regimes which necessarily include immunosuppression.

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only.

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