Constant Attendance Allowance

Successful claimants for Industrial Injuries Benefit at the 100% rate will be able to claim for Constant Attendance Allowance if they can show that their injury or disease requires them to have constant care and attention. The claimant will also have to show that attendance will be needed for a "prolonged period". The DWP considers 6 months or more to be a prolonged period

CAA is paid at four different weekly rates depending on how much care and attention the claimant needs-

• Part time (currently £26.35 per week)
• Normal maximum (currently £52.70 per week)
• Intermediate rate (currently £79.05 per week)
• Exceptional rate (currently £105.40 per week)

In order to qualify for the part time rate the claimant must show that he or she

• needs the help of an attendant at certain predictable times of the day for "routine attendance". Attendance should be needed for half a day or less and-
• is capable of being left alone for other periods

In order to qualify for the normal maximum rate the claimant must need attendance for more than half the day or at least twice during every night. The Decision Maker's Guide lists the following conditions as examples of when the normal maximum rate will apply-

• total blindness without added complications
• guiding vision with any single limb amputation
• loss of both arms with stumps from 11.5 cm below the elbow
• double leg amputations through or above the knee
• amputation of one leg and one arm where at least one amputation is above the knee or above the elbow
• paraplegia with incontinence largely controlled by the aid of appliances and considerable independence both in and outside the house (i.e. not practically housebound)
• other cases where the applicant is confined to bed or wheelchair but has good use to the upper limbs and is not incontinent
• severe mental disability, including epilepsy, when there is a large measure of physical control of actions
• severe respiratory disablement necessitating occasional night attendance.

In order to qualify for the intermediate rate the claimant must need a considerable amount of attendance either-

• during most of the day and regularly during part of the night (ie at least twice every night) or
• frequently throughout the night and part of the day.

The Decision Makers' Guide gives the following examples of instances when the intermediate rate "may" apply;

• total blindness with any single limb amputation or deafness to the extent of at least 60%
• both arms amputated with stumps from 20.5cm below the shoulder to less than 11.5 cm below the elbow.
• paraplegia with material incontinence when, although not bed ridden, a considerable amount of attendance is needed both day and night (for example needs help from bed to chair, and from chair to motorised vehicle) - almost housebound without help
incomplete quadriplegia when there is a little use in the upper limbs so that the applicant can do some things for themselves (such as feeding) but the upper limbs are still severely disabled. Bedsores, repeated urinary infections and considerable preventative skin care
• severe respiratory disablement necessitating regular night attendance but not all night.
• severe mental disability but able to do a few useful things such as feeding.

In order to qualify for the exceptional rate, the claimant must;

• be completely, or almost completely helpless; and
• need constant attendance day and night.

The Decision Makers' Guide gives the following examples of when the exceptional rate "may" apply;

• amputations of both arms above the elbow with stumps less than 20.5cm;
• quadriplegia with little or no use in the hands;
• paraplegia, almost completely bedridden, with little use in the upper limbs and paraplegia, almost completely bedridden, with little use in the upper limbs and severe incontinence leading to regular and considerable attendance both during the day and at night (for example tidal drainage, excessive laundry or persistent bedsores);
• complete respiratory cripple with intense dyspnoea and severe coughing bouts necessitating attention day and night;
• severe mental disability resulting in complete helplessness;
• both arms amputated at any level and amputation of leg or serious injury to leg when crutches cannot be used.

The DWP doctors will assess the claimant's need for care and attention whilst carrying out the disablement assessment for Industrial Injuries Benefit. The doctors will look at-

• the nature and amount of attendance that is needed
• whether the claimant is dependent on attendance for the necessities of life. Decision Makers are told to interpret this freely but are advised that "obvious" interpretations would include eating, drinking, sleeping, natural functions as "necessities of life"
• if the attendance is needed as a direct result of the relevant loss of faculty.

A visit to the claimant's home may be required to look at-

• What the claimant can do for himself.
• What help is needed during the day.
• How the claimant spends his time.
• The amount of time and type of attendance that is needed at night and the length of time taken to provide that attention on each occasion.
• The reasons for attendance during the night.
• What aids are available and used for moving around.
• Whether any special features have been incorporated in or added to the claimant's home.

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