Child Disability Payment decision making guide
Does walking cause exertion leading to danger to life or deterioration in health?
An individual is entitled to the higher rate of the mobility component if the exertion required to walk would lead to either (COP regs, reg.13(2)(a)(iii)):
- danger to the individual's life
- a serious deterioration in the individual's health, from which there would be no recovery, or from which recovery would take a significant period of time
Walking must significantly worsen the individual's condition for the impact to amount to causing a serious deterioration in an individual's health.
Increased pain, discomfort, fatigue or breathlessness will not meet the definition.
Any stress or deterioration in the individual's mental health is not a relevant consideration.
Needing significant medical intervention indicates a serious deterioration in the individual's health. Examples are surgery or a prolonged course of treatment not usually required by the individual.
Case managers should decide if the period of time is significant. They can take the nature of the recovery into account. For example, constant bed rest for 3 months is likely to have a greater impact on the individual than a longer period when they need crutches to walk.
Recovery periods of weeks or months are relevant as opposed to hours or days.
The period of recovery can be shorter than would otherwise be needed to meet the test if the individual needs significant medical intervention to recover.
Sarah is 6 years old and has spina bifida. Muscle weakness in Sarah's legs affects her ability to keep her legs aligned when walking. This can cause additional pressure on her joints. Sarah wears splints which help with this to an extent. However, she still finds walking tiring and describes having sore legs afterwards. Sarah can only walk very short distances, at a slow pace with an altered gait. The wear and tear caused to Sarah's knees may cause her to develop osteoarthritis in adulthood.
Sarah's circumstances would not amount to a serious deterioration in her health. This is because the potential for damage to her joints is remote. This is unlikely to lead to either a danger to life or a serious deterioration in Sarah's health from which there would be no recovery.
However, the case manager takes into account Sarah's pain and tiredness determines she is virtually unable to walk determines that Sarah is entitled to the higher rate of the mobility component.
Freddie is 10 and has Epidermolysis Bullosa Simplex. This causes the skin on his hands and feet to be fragile and prone to tearing and blisters as a result of mild physical activity. The damage to Freddie's skin means he is at a greatly increased risk of developing infections and he is often prescribed antibiotics.
The repeated trauma caused to Freddie's hands and feet causes thick scar tissue to develop. This may restrict the movement of his fingers and toes and require surgical management. Freddie is advised to only walk short distances and to limit doing so outside in order to protect the skin on his feet.
There is short and long term damage that would be caused to Freddie's feet, including the risk of infection, by him walking. This means he satisfies the test of a serious danger to health from which recovery would take a significant period of time.
The case manager determines that Freddie is entitled to the higher rate of the mobility component.