Child Disability Payment decision making guide
Can the individual be described as virtually unable to walk?
Virtually unable to walk means: "unable to walk to any appreciable extent or practically unable to walk" considering the:
- speed the individual is able to walk
- manner of walking
- time taken to walk a particular distance
- distance the individual can walk
without beginning to experience severe discomfort (COP regs, reg.13(2)(a)(ii)).
Each case should be considered on its own facts taking into account the other elements set out below. It may be said that if an individual is able to walk 80 - 100 metres at an average speed, in a reasonable manner, without severe discomfort they are unlikely to meet the test of being virtually unable to walk.
It is important to note that the individual's ability to walk before beginning to experience severe discomfort is relevant.
Distance
There is no fixed distance an individual should not be able to walk beyond to satisfy the test of being virtually unable to walk.
Severe discomfort
It is important to note that severe discomfort is not the same as severe pain. Mild to moderate pain may amount to severe discomfort, depending on its nature. Discomfort can come from, but is not limited to:
- fatigue
- breathlessness
- pain
- tingling and similar sensations
- spasms and similar unintended movements
- dizziness, vertigo and similar sensations
Severe discomfort can begin as soon as the individual starts walking. In these cases, the case manager can determine that the individual meets the test of being virtually unable to walk.
Many individuals will begin to experience discomfort at some stage when walking. Case managers should consider at what point, considering time taken and distance, that the individual begins to experience severe discomfort.
The individual does not have to stop walking due to the discomfort as soon as it becomes significant. However, the need to stop walking due to discomfort will be an indication that it is significant.
Case managers should consider the impact of the individual's condition both when walking and for a time after walking. An individual who:
- can walk for five minutes at a reasonable pace
- but could not repeat this within a reasonable amount of time
may be said to meet the test of being virtually unable to walk.
Relevance of stops
Individuals may describe having to stop at various intervals while walking. If so, case managers should consider the impact this has on the distance the individual can walk without experiencing severe discomfort. It is important to remember that if an individual both:
- needs to stop walking due to severe discomfort
- is unable to continue
their walking ability should only be considered up until the onset of severe discomfort.
Individuals may recover sufficiently after a stop to continue walking without severe discomfort. In these cases, any further distance they can walk is relevant to considering their mobility.
Factors to take into account to decide if the individual is virtually unable to walk are (COP regs, reg.13(2)(a)(ii)):
- the distance an individual can walk before needing to stop
- the length of time they need to stop
- the frequency of their need to stop
- the distance they can walk between each stop
The time, speed and manner of walking, discussed below, should be considered.
Kendal is 11and has juvenile rheumatoid arthritis in his left knee and ankle, causing pain and stiffness. The pain is particularly severe when KendaI's joints are stiff in the morning. When Kendal begins walking after a significant period of rest he experiences severe discomfort. He has to stop after a few minutes of walking at a slow pace to rest and gently stretch his leg as recommended by his physio. After five minutes, Kendal is able to continue walking at a slightly slower pace, in a reasonable manner, for around 20 minutes. After this, he will stop to sit down and rest for at least half an hour.
The case manager determines that Kendal is not entitled to the higher rate of the mobility component.
Joshua is 15 and has scoliosis, which is curvature of the spine. This has greatly restricted his lung capacity. He also has severe asthma which is poorly controlled. Joshua finds walking very difficult as he becomes extremely out of breath after only mild exertion. He can walk for a couple of minutes at a slow pace before needing to stop and catch his breath for at least 5 minutes. He often needs to take his inhaler multiple times during each break. It takes Joshua longer to recover each time he needs to stop and his pace becomes slower the longer he walks. Excluding breaks, the most Joshua is ever able to walk is 10 minutes.
Joshua may be able to cover a reasonable distance in 10 minutes at a slow pace. However, he satisfies the test of being virtually unable to walk due to the:
- frequency of his need to rest
- time it takes him to recover
- need for him to take his inhaler
- breathlessness he experiences when walking.
The case manager determines that Joshua is entitled to the higher rate of the mobility component.
Time
The length of time an individual can walk for without severe discomfort is another factor to consider. It is something about which individuals applying for CDP may be more likely to be able to provide information. As with distance, there are no fixed parameters on time relating to the virtually unable to walk test. Each application should be considered on its own facts.
Speed
It is possible to estimate an individual's walking speed if both length of time and distance an individual can walk for are available. The speed an individual can walk at should be considered in relation to the average speed at which a child or young person their age walks. Parents may often describe their child's pace of walking in relation to their siblings or peers.
Case managers should consider if the child or young person walks noticeably slower than other children of a similar age, in that they consistently walk at a slower pace behind or others have to adapt to the child's pace when walking with them. The time it takes an individual to cover a distance can also be considered. If the individual is only able to walk at around half the speed of their peers or it takes them twice as long to cover a distance, it is likely the individual is virtually unable to walk.
Jon is 12 years old and has cerebral palsy which affects all of his muscles, causes him difficulty with balance and coordination and makes his limbs move unpredictably.
He is able to walk at about half the speed of his peers. Jon has fallen on many occasions while walking outside due to his lack of balance. After walking for around 15 minutes Jon experiences pain in his ankles and fatigue.
Jon meets the test of being virtually unable to walk due to the manner and speed of his walking, the pain and fatigue he experiences and risk of falling.
The case manager determines that Jon is entitled to the higher rate of the mobility component.
Fatima is 14 years old and has fibromyalgia. It causes significant fatigue. Muscle and joint pains affect most of her body, particularly her legs and back. Fatima describes walking as "very sore". She is able to walk for short distances at a slower pace than her friends before the pain and fatigue become too severe for her to continue. After walking this far, Fatima is unable to walk again until she has rested for at least an hour.
Fatima is unable to walk at all after a short distance due to pain and fatigue. It is reasonable to expect that she is in severe discomfort before reaching that distance. The impact walking this distance has on Fatima is also significant as she needs to rest for at least an hour afterwards. This means that Fatima meets the test of being virtually unable to walk.
The case manager determines that Fatima is entitled to the higher rate of the mobility component.
Manner of walking
Manner of walking relates to how an individual walks. It includes consideration of walking that may be described as one of more of:
- limping
- shuffling
- tripping and falling
This list is not exhaustive.
Case managers should consider factors such as:
- if the individual experiences uncontrollable movements or tremors
- if walking requires significant physical exertion. This might include breathlessness, dizziness, nausea and exhaustion
Risk of falls
It is relevant to take into account an increased risk of falling when considering manner of walking. Case managers should decide if the risk of falling means the individual is virtually unable to walk.
Case managers should consider:
- likelihood of falling
- how predictable the falls are
- if anything can reasonably be done to avoid the risk of falls
- the frequency of falls
- the chances of serious injury arising from a fall
Ross is 12 and has dyspraxia and a visual impairment. Dyspraxia causes challenges with activities requiring coordination and movement. These conditions mean he frequently bumps into things and trips up when walking, especially when outdoors on unfamiliar routes. Ross has fallen to the ground as a result of tripping over things twice in the last six months. He was not seriously injured on either occasion.
Although Ross's coordination is affected, he is generally able to put his hands out to catch himself when he falls.
Ross is at an increased risk of falling due to his disability. However his falls only occurred infrequently, meaning the risk was fairly remote. These difficulties alone would not be enough for him to qualify for the higher rate of the mobility component.
More recently, however, Ross has had a serious fall where he fractured his hip. Therefore both Ross' risk of significant injury due to his disability is high and his manner of walking mean that he meets the test of being virtually unable to walk.
The case manager determines that Ross is entitled to the higher rate of the mobility component.
Saba is 14 and has Tourette's Syndrome, a neurological condition which causes involuntary vocal and physical ties. Saba experiences particularly severe physical ties numerous times a day involving her legs These cause involuntary movements in her legs and her muscles become rigid. The ties Saba experiences are unpredictable and cause her to fall to the floor. Saba is unable to prevent herself from falling. She has been injured a number of times due to falling and required hospital treatment as a result on three occasions over the past 2 years, twice having sustained a concussion and once a broken wrist.
The case manager determines that Saba is entitled to the higher rate of the mobility component.