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Welfare Benefits

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Category: Information Booklets

Published on Tuesday, 13 May 2008 22:30

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This article has been extracted from the free Information booklet that FMA UK provides. To have this information presented in a professional A5 booklet, as well as the other articles please request one from the office. The material in this booklet is from an older version of the booklet, please check the link above for current content.

The two main welfare benefits that people with fibromyalgia may be able claim are Incapacity Benefit and Disability Living Allowance.  Neither fibromyalgia or any other illness is an open door to any benefit. What matters is how the illness affects you. It may be that you suffer from another problem as well as fibromyalgia; this should not matter as any judgement should be based on the amount of help required.

What the illness is, may however, have a bearing on deciding for how long you should be awarded a benefit. In recent times it has become far more difficult to get DLA or for it to be accepted that you cannot work. You may know of people who do not seem to  be as disabled as you are, who have been awarded one of these benefits whilst you are struggling to get anything. This unfortunately is not uncommon.

DLA
There are two components to DLA – mobility and care. Even if you only fill in details for one component the other will be looked at also. Therefore it is advisable to fill in both parts. The mobility component has a low and high rate. You cannot apply for one rate in particular, as it is up to the Adjudication Officer to decide which, if any, you qualify for. If you re-apply for DLA (either components) you could lose what you already have.

Mobility component
The main criterion here is whether you are unable or virtually unable to walk without severe discomfort.The problem for people with fibromyalgia is convincing someone of that severe discomfort and that it can prevent us walking very far. When assessing this for yourself, measure what is an average distance to walk for you and how long it takes to walk that distance (along the flat, not uphill or upstairs). This must be a very shortdistance and has been stated as being no more than 50 metres and probably less even on one of your better days. However any additional information that you give is very important.

Care component
One of the criteria for this part is whether or not you can cook a meal from raw meat and two raw vegetables for yourself on a regular basis, using a normal oven.
Other criteria concern your personal hands-on care requirements e.g. having a bath, washing your hair, getting out of a chair etc.. Housework needs and shopping are not considered for this benefit.

It is the amount of care you need that determines the rate at which you will qualify for the care component. Thus it is essential that you put down the amount of time that you need help for, even if it is only sometimes two minutes; the minutes add up!

If having read this you think you qualify for DLA, please do the following:

1. Keep a diary.
2. Contact your local Department for Works and Pension (formerly Benefits Agency) and ask for a claim pack.
3. Study the pack carefully, take measurements and make notes on a separate piece of paper.
4. Write down everything you suffer from e.g. Irritable Bowel, Raynaud’s Disease. Do not assume that the adjudication officer or even the doctor knows that they can be part of the fibromyalgia syndrome.
5. Go to or contact your local Citizen’s Advice Bureau, Welfare Rights office or disability agency such as DIAL and get help filling in the forms. This is essential.
6. Keep a copy.
7. If you are not successful you should ask for a review and failing that you can go to appeal. You have only one month in which to appeal.
8. Get help from the CAB or Welfare Rights for a review or appeal. Ask if someone from one of these organisations can represent you – if they can you have a considerably higher chance of winning your appeal (probably 30% higher). Please note it is now necessary to ask for an oral hearing if you wish to attend the hearing yourself.
9. If your appeal fails:
   • a)    You can apply again after 1 month. Prior to this they will look at your previous form.
   • b)    You will be told that you can appeal to the Commissioners. N.B. This can only be done on a point of law, not on the basis that you do not agree with the decision.

Incapacity benefit
The major concern with this benefit is the “All Work” test.

The aim of this questionnaire is to discover whether you are fit to do ANY work at all, not just the job you were doing. To pass it you must score 15 points. The questions deal with how far you can walk, how long you can sit down or stand up, climbing stairs, picking up objects, bowel and bladder control and mental problems.

If you receive one of these forms, please do not panic but follow these steps:

1. Go through the form carefully and make notes on all the areas you have problems with. Remember that if you say, for example, that you could walk 200 metres, this means for 5 consecutive days. Then ask yourself if this is actually the truth. If not make a note as to why not.
2. Go to or contact your local CAB or Welfare Rights office and get help in filling in the form. This is essential.

It is also very helpful if your doctor supports you, because if you are turned down, particularly for Incapacity Benefit, their support whilst you go to review or appeal will be important to you.
If you are already in the process with either of these benefits please firstly go to your local CAB or Welfare Rights for help. If you are then still having problems we will talk these through with you, but the Association cannot write letters to support your case, because each person is affected differently.

One of the most frequent comments we hear from people with fibromyalgia is, “The government does not recognise fibromyalgia.” This is not true. We have in writing that the government does recognise fibromyalgia and if you need this evidence please contact us. Fibromyalgia is also listed in a book that the Department for Works and Pensions doctors use for Incapacity Benefit and possibly for DLA.

The description is correct but in our opinion inadequate. It is often individual doctors’ lack of awareness of fibromyalgia that cause difficulties. A medical pack for professionals is available and will be posted directly to them on receipt of their details.