Unable or virtually unable to walk
61276
One of the conditions for entitlement to the higher rate mobility component is that the disabled person is unable or virtually unable to walk (see DMG 61255 1.). People are considered to be unable or virtually unable to walk if their physical condition is such that
The DM should not take account of where people live or the nature of their work.
Physical or mental disability
61280
The differences between mental and physical disability may not always be obvious but are distinctive. To count towards virtually unable to walk, a person’s disability must be physical. Any limitation in a person’s ability to walk must be because of a physical disablement not merely a physical manifestation of the person’s mental condition.
61281
In cases where a claimant’s inability or virtual inability to walk is caused by both physical and mental factors, the claimant is entitled to the higher rate of the mobility component if the physical disability is a material cause i.e. if its contribution to the inability or virtual inability to walk is more than de minimis (medical advice should be sought if there is any doubt). The physical cause must be one which is likely to be still current from the start date of and the preceding qualifying period award and throughout the period of the award, but it does not matter at what point in the chain of causation it comes e.g. the physical cause may be subsequent to a mental disability.
61282
Pain, dizziness or other symptoms are not a feature of the claimant’s “physical condition as a whole1” within the meaning of the legislation unless they have a physical cause. Difficulty in walking which results from pain, dizziness or other symptoms affecting physical functions which are found to have an entirely mental or psychological cause cannot therefore qualify a claimant for the higher rate of the mobility component of DLA.
61283
Chronic fatigue syndrome, which may also be called post-viral fatigue syndrome or myalgic encephalomyelitis, consists of a mixture of both physical and psychological factors. The lack of physical findings in the medical evidence is not sufficient to show that the limitation is entirely mental in origin. Chronic fatigue syndrome can involve a physical element that is capable of supporting an award of the mobility component at the higher rate even if it is not identifiable as such. The physical element present may support an award of the higher rate of the mobility component of DLA if
61284
Consideration should be given to the following
Example 1
Yasmin has arthritis which is the material cause of her walking disability and she is assessed as being physically able to walk 100 metres at a slow speed. However she also suffers from depression as a result which exacerbates her difficulties with walking. She can only walk 50 metres at a very slow speed. She would satisfy the conditions for being virtually unable to walk as her arthritis is a material physical cause.
Example 2
Basil has a verruca. This is a temporary condition which has minimal interference with walking and does not cause severe discomfort. He has difficulty walking however the effect is minimal and he would not satisfy the conditions for being virtually unable to walk.
Refusal/reluctance to walk
61290
People with behavioural problems often refuse to walk. Although most behavioural problems result from a mental disability, they can be the result of a reaction to a physical condition over which the person has no control. For example, children with Down’s syndrome may be virtually unable to walk or they may refuse to walk despite coaxing. But this does not mean that all people with Down’s syndrome are virtually unable to walk.
61291
The question the DM should consider is whether the person could not walk, rather than would not walk1. Advice from Medical Services may help in establishing whether a refusal to walk stems from a physical or mental disability (see DMG 61207 et seq) and the likely duration of any difficulty with walking.
Example 1
If a claimant, who had been walking perfectly satisfactorily decides to stop, but his refusal to continue further can be overcome with the promise of a reward or the threat of punishment the refusal to walk has not arisen from a physical condition over which he has no control.
Example 2
If a claimant refuses to walk to a particular destination e.g. school, the refusal to walk would not have arisen from a physical condition over which he has no control.
61292
People who sometimes refuse to walk as the result of a physical condition can be considered to be suffering from temporary paralysis. The DM should consider whether the frequency and extent of such a temporary paralysis means that they are virtually unable to walk1. It would be unlikely that a person would satisfy the conditions on this basis alone. Where a person refuses to walk on a couple of occasions a week but was otherwise able to walk normally taking a broad view (see DMG 61204) that person could not be described as virtually unable to walk.
Example 1
June suffers from Down’s syndrome and on one or two occasions a week refuses to walk. At other times her walking ability is unimpaired. Although June can be taken to be unable to walk at those times when she refused to walk (as this is attributable to a physical cause), because her walking ability at other times was unimpaired she does not satisfy the test.
Severe discomfort
61300
Severe discomfort must arise from the physical act of walking, but it is not necessary for the severe discomfort to first arise or to be increased by walking. If a claimant suffers from physical disablement which affects the physical act of walking, and which causes severe discomfort even when not walking, any walking accomplished despite the severe discomfort must be disregarded.
Example 1
Denise suffers Porphryia a condition that causes the skin to blister when exposed to sunlight. Although able to walk any exposure to sunlight triggered her condition. Denise's discomfort would not render her virtually unable to walk as it was being out of doors that caused the discomfort and it did not arise from the act of walking itself.
Example 2
Ahmed suffered serious multiple injuries in a road traffic accident. As a result Ahmed's foot is extremely painful and stiff and he is in severe discomfort all the time. The severe discomfort does not increase on walking but the nature of the pain alters. Ahmed suffers from a physical disablement which affects the physical act of walking and causes him severe discomfort even when not walking. Any walking Ahmed accomplishes despite the severe discomfort has to be discounted.
61301
A person who can walk only with severe discomfort is likely to suffer from effects such as pain and breathlessness1. The test is one of severe discomfort rather than of severe pain or distress2. The term "severe discomfort" does not apply to the refusal to walk where this is by conscious choice. But see DMG 61290 et seq.
"Pain" is medically defined as encompassing a wide range of intensities caused by stimulation of functionally specific peripheral nerve endings. "Discomfort" is not medically defined. Its ordinary meaning was the condition of being uncomfortable, uneasiness and thus might have different causes from pain. It described the sensation experienced from lesser levels of pain.
61303
The fact that someone suffers pain as a result of walking, or walks "in pain", does not automatically mean that he or she is walking with severe discomfort or is unable to walk without severe discomfort. The pain may be mild, moderate or severe, shortlived or chronic.
61304
Someone suffering severe pain is almost certainly suffering severe discomfort. But it does not follow that, because someone is not suffering severe pain, he or she is not suffering severe discomfort1. "Severe" is an evaluative term which might be contrasted with moderate or mild. Thus "mild pain" might not by itself cause a sufficient level of sensation to be "severe discomfort".
61305
The DM must decide for himself whether there is severe discomfort considering all the evidence, and perhaps taking into account other factors causing discomfort in addition to the pain.
61306
The test in DMG 61276 is of the person's ability to walk out of doors without severe discomfort, not the capacity to walk with severe discomfort. Any walking with severe discomfort is ignored.
Relevance of stops and severe discomfort
61309
If a stop is the absolute limit of the claimant’s capacity to walk then no issue of taking the test only to the first onset of severe discomfort arises. But if a claimant recovers after a period of rest and continues walking without severe discomfort, then the statutory test does not preclude such continued walking from being assessed.
61310
The DM must judge from the evidence such relevant factors as how far the claimant can initially walk without experiencing severe discomfort, how long any severe discomfort lasts before it subsides or, if he has paused to prevent such discomfort then the necessary duration of that pause, how frequently these halts recur if at all, and what is the total distance and time he can walk in this manner without severe discomfort. Time, speed, manner and distance of walking, achieved without severe discomfort, are therefore balanced in order to reach an overall judgement on whether the claimant is virtually unable to walk.
61311
If a claimant has to rest an hour between each set of walking before severe discomfort subsides, he or she is more likely to be virtually unable to walk than a claimant who requires only five minutes.
Conversely, if a claimant with morning stiffness through rheumatoid arthritis walks the first minute out of doors in severe discomfort, stops for four minutes in order to flex his limbs and thereafter is enabled to walk ten miles without severe discomfort at a reasonable pace and speed and without further halts, it is open to the DM to determine that the claimant is not virtually unable to walk.
Walking with support
61312
Where people can only walk with support from another person, they may satisfy the conditions for the higher rate mobility component. The DM should consider whether
61313
People cannot be treated as being unable or virtually unable to walk if they regularly use1 or could use2 an artificial limb or aid to help with walking unless they are without both legs (see DMG 61330 - 61331). A person who can only swing through on crutches is unable to walk and so may qualify for the higher rate of mobility component.
61314
The term 'swinging through' describes a method of propulsion leading to forward progression of the person, in which the upper body and arms, through the means of crutches, provide the main power of movement. This way of moving may be used by people in whom the function of either or both lower limbs is severely restricted. A report that an individual uses crutches does not mean by itself that they are swinging through. Many people who have had sprains, injuries, operative procedures to the leg may use elbow crutches as a support to walking on a temporary basis during recovery. Also some people with an arthritic or painful hip, knee or ankle joint may find a crutch easier to use than a walking stick on a long term basis e.g. an elbow crutch permits the use of the forearms and hands while the person remains supported.
Example
The classical example of a person who 'swings through' is someone who has had part of one lower limb amputated and who is not using prosthesis, or someone who has one lower limb in plaster. They propel themselves forwards using two crutches. Whilst bearing weight on both crutches the person swings their normal leg forward and puts it to the ground. Then bearing weight on this leg and the crutches, the impaired leg comes forward (follows through) usually without touching the ground. A further step is then taken forward with the normal leg and the cycle is repeated. In order to move forwards in this way the person uses the strength in the arms and upper body as the main means of propulsion.
The DM may ask Medical Services whether a person could walk with suitable artificial limbs or aids, and whether or not these are available. This does not apply to people without both legs (see DMG 61330 - 61331).
Virtually unable to walk
61316
Virtually unable to walk means unable to walk to any appreciable extent or practically unable to walk. The base point is a total inability to walk. It is extended to take in people who can technically walk but only to an insignificant extent.
61317
Whether a person is unable or virtually unable to walk depends on the person's ability to negotiate the types of pavement or road one would normally expect to find in the course of walking outdoors. No pavement or road is absolutely flat therefore a degree of “incline” and “decline” must be considered. The test is not whether the claimant can walk on unploughed land or over un-made roads or over pavements under repair. No account should be taken of exceptional hazards such as steep hills or rough terrain. The question of whether the person is able to lead a normal life is inappropriate.
61318
All aspects of a claimant’s walking ability must be considered, which result from physical disablement, and an evaluation of its quality then made. This is on the basis that firstly, walking achieved only with severe discomfort is discounted and secondly, that appropriate attention is paid to manner, speed, distance and time1. All factors must be viewed before the onset of severe discomfort.
61319
Distance is the total distance walked before the onset of severe discomfort (see also DMG 61309 et seq).
Example 1
In the absence of any significant indications as to the other three factors, if a claimant is unable to cover more than 25 to 30 metres without suffering severe discomfort, his walking ability is not ‘appreciable’ or ‘significant’; while if the distance is more than 80 or 100 metres, he is unlikely to count as ‘virtually unable to walk’.
Example 2
John has a walking ability of at least 125 metres (about 135 yards) with normal gait, little pain, without the use of a stick, one stop and some discomfort. John’s physical condition as a whole is not such that his ability to walk out of doors is so limited, as regards the distance, speed, length of time or the manner in which he can make progress on foot without severe discomfort, that he is virtually unable to walk.
61320
It is as important to consider quality of walking, as it is to consider quantity (ie distance). The stated distance may be less significant if it is clear that some of the distance can be achieved only at the expense of severe discomfort. If a person shuffles along, barely putting one foot in front of the other, his progress may be so poor in terms of speed and manner, to amount to virtually unable to walk.
61321
Speed is the pace the claimant walks at. Time is the total time it takes the claimant to walk the relevant distance (see also DMG 61309 et seq). As a guide the average person can walk in a minute
Example
Peter can only cover 50 metres in five minutes (or 100 metres in ten minutes). Progress at such a rate is so painfully slow as to amount to little more than shuffling. Most people could, literally, crawl 50 metres in less than five minutes. Even if he can walk 100 metres in five minutes - which is still extremely slow pace - the DM should consider how significant is his ability to walk. Regard must also be had to the words "without severe discomfort".
61322
Manner is the way the claimant walks with particular regard to his gait and balance.
Example
In overturning a tribunal’s decision, a Commissioner pointed out that there was evidence that the claimant would walk with a “stiff legged shuffling gait” and would make “a number of stops at varying distances”. He indicated that the tribunal should have considered specifically the manner in which the claimant was able to make progress on foot, and that it was a relevant factor to take into account alongside distance and severe discomfort.
Danger to life or serious deterioration in health
61325
The effort needed to walk is the only consideration when deciding whether a person satisfies the danger to life or serious deterioration in health test (see DMG 61276 3.). This could include a condition which was brought on or worsened by the effort needed to walk, for example certain heart conditions or haemophilia.
The test does not include factors not connected with the effort needed to walk. Potentially dangerous places such as busy roads, or risky situations which have nothing to do with the effort needed to walk should not be taken into account.
61327
To satisfy the test, someone who said that they fell when walking would need to show that the falling was due to the effort needed to walk. Similarly, people with epilepsy would need to show that any fits they experienced were brought on by the effort needed to walk, unless the fits were so frequent that the person could satisfy the virtually unable to walk test at DMG 61316.
61328
Any serious deterioration in health would be where there was a worsening of the person's condition from which
For example, a person would not be suffering any serious deterioration in their health if they recovered after a few days without the need for any medical intervention.
