Articles on Medical Diseases and Conditions

Tag: Driving

  • Finances: Benefits

    Sources of help

    The most obvious written source is the Disability Rights Handbook. This is updated every April and published by the Disability Alliance (see Appendix 2). This guide is very readable but, unless you are familiar with interpreting legislation, you should still seek advice from other sources.

    • The Benefits Agency handles social security payments for the
    Department of Social Security.
    • Your local Citizens Advice is the best source of detailed and impartial information available; there are bureaux across the United Kingdom – the telephone directory will list the address and phone number of your local office, or you can contact the national bureau listed in Appendix 1. They will try to answer questions on almost any issues of concern to you, but will direct you to more appropriate sources of help and advice if you need any.
    • Your local authority’s welfare rights advisor.
    • Welfare advisors at your local branch of the MS Society.
    • The Post Office, particularly larger branches and regional offices, stock a wide range of government forms and leaflets, which are normally prominently displayed. These include leaflets detailing entitlements to health care under the National Health Service, family benefit and disability allowances. Contact addresses and telephone numbers are given for further information in each of these leaflets.
    • Your local Employment Service Office (Job Centre) will also stock a range of helpful information, including a pack of employment- related publications that cover most issues related to employment and benefit entitlements. Staff will usually be able to answer specific questions that you have, although you may have to book an appointment in advance.

    Stopping work

    Benefits available will depend very much on your personal circum- stances, the extent of your disability from MS, the nature of your occupation and any health insurance and/or early retirement pensions provision, amongst other factors. This is why you need careful and detailed impartial advice from someone who is able to go through all the aspects of your situation, and point out both the short- and long-term financial consequences of any decision you make.
    The first important consideration is whether you are likely to consider a different type of work to that you have been doing, either now or in the future. If you are younger, a considerable way from normal retirement age, this is a crucial issue. Of course the work might be part-time rather than full-time, or involve being self-employed rather than employed. Although MS, as we have said, is very unpredictable, it may be worth discussing your medical outlook with your doctor, particularly regarding your skills and abilities related to the symptoms and any disabilities that you may have now. As a medical assessment of your situation is likely to prove crucial to some of the financial and other benefits you could receive, the role of your doctor – GP or specialist – will be important.
    Second, if you have decided that you would like to retire, probably on the grounds of ill-health or disability, then you need to work out how best this can be undertaken. It would be sensible to seek the advice of your Trade Union, if you belong to one, or your professional body, and/or to seek advice from Citizens Advice, before taking any action. How you leave your work – taking early retirement on grounds of ill-health, resigning or being dismissed – also affects the financial benefits for which you may be eligible. Some of these depend on what pension arrangements you might have. You should find out all this from your employer’s personnel department or the relevant pensions company. Your employer should help you to retire at the most opportune time for you to gain financially
    If you find yourself being peremptorily or unfairly dismissed, you need to seek further advice immediately from your Trade Union, professional body or Citizens Advice. In these circumstances, if you have been employed by your employer for longer than 2 years, you can pursue your case through an industrial tribunal – but again seek advice.
    Third, you need to think through carefully the financial consequences of your retirement in the light of your eligibility for a range of benefits. This will depend on many factors. You will need to be realistic about your current and future financial commitments. You may also have to consider your family, as to whether other members of your household are or can be earning, even if you cannot. Even if you have taken early retirement, and thus possibly have an occupational pension, you may still qualify for various means-tested benefits. These may depend not only on your current income, but on your National Insurance Contribution record and your degree of disability. You may be eligible for some or all of these benefits:

    • Incapacity Benefit
    • Severe Disablement Allowance
    • Disability Living Allowance (see Multiple Sclerosis – the ‘at your fingertips’ guide in Appendix 2).

    If you do not have an occupational pension you may be eligible for other means-tested benefits, such as:

    • Income Support
    • Housing Benefit
    • Council Tax Benefit.

    If you are eligible for Income Support, then you also become eligible for a wide range of other benefits, such as:

    • free prescriptions
    • free dental treatment
    • free school meals for your school-age children.

    Help for services and equipment

    If you need a particular piece of equipment, a particular service or a holiday, there are funds held by trade unions, professional organizations or charitable bodies for such purposes. Often there is a question of eligibility, but of a different kind than that for the Benefits Agency. You may have to be a current or former member of the organization concerned, or have some other characteristic that gives you entitlement
    – such as living in a particular area.
    The problem is often finding out which organizations you can apply to, for many local charities are small and are not widely advertised. However, there is a Charities Digest (your local library should have a copy) which lists many, although not all, sources of funds. Your local library, or Citizens Advice, may be able to give you some sources as well. There is also another directory called A Guide to Grants for Individuals in Need which contains a relatively comprehensive list of charities who provide support for individuals with certain eligibility criteria (see Appendix 1). The MS Society can help here too.

    Children as carers

    There are a number of allowances that may be available, again depending on your eligibility, when you require the support of others for your care. Some benefits are payable to you, and others to those looking after you. There are, as usual, quite complicated eligibility rules about which you will almost certainly need to seek detailed advice. For example, if one of your children is looking after you on virtually a full-time basis (35 hours a week or more), and you have Disability Living Allowance at the middle or higher rate, or Attendance Allowance, then he or she may be eligible for Invalid Care Allowance. You yourself may be able to obtain Attendance Allowance, or the care component of Disability Living Allowance. The criteria for these allowances are very specific, and trying to help your children out might be difficult, without quite a lot of investigation and advice about your and their eligibility from either Citizens Advice or another impartial source of advice about disability.

    Mobility

    As part of the Disability Living Allowance, it may be possible to claim for the higher or lower rate mobility components to help with additional expenses incurred with your decreased mobility. If you are able to obtain the higher rate component in particular, then it opens the door for a range of other benefits. Both the components are open to people below the age of 65 (or 66 if the disability began at the age of 65). The tests for eligibility for this mobility component are increasingly stringent, and it is not possible to go into them in great detail here; you should seek advice about the criteria and their application to you from the MS Society. As someone with MS, to obtain the higher rate allowance, you will need to demonstrate, in the formal words of the regulations that your ‘physical condition as a whole’ is such that you are ‘unable to walk’, or are ‘virtually unable to walk’, or that ‘the exertion required to walk would constitute a danger to [your] life or be likely to lead to a serious deterioration in [your] health’.
    There are other criteria under which the higher rate can be claimed but they are unlikely to apply to people with MS. As you can see, the crucial issues in adjudicating any claim for people with MS, apart from when you literally cannot put one step in front of another, are likely to be the meaning of being ‘virtually unable to walk’, or the relationship of exertion in walking to a possible deterioration in health. In these cases, the assessment process and medical judgements are both critical – the variability of MS does not help. For the lower rate of mobility allowance, the major criterion is not so much whether you are physically able to walk, but whether you require someone most of the time to guide or supervise you, to enable you to walk outdoors.
    The Disability Rights Handbook published by the Disability Alliance Educational and Research Association has a comprehensive section describing in detail the requirements and procedures for claiming these benefits. You could also telephone or write to the Benefits Agency – which handles such claims for the Department of Social Security – for information on mobility allowances (see Appendix 1). Further help can be obtained through the MS Society’s Helpline (the Benefits Advisor) or your local DIAL (Disability Information and Advice Service). If their number is not available in your local telephone book, the Social Services Department of your local council should be able to provide it for you. There are appeal procedures if your claim is turned down. In any case it is very important that you monitor your situation so that, if your mobility decreases through the MS, or indeed through another cause, you claim for the appropriate allowance. Many relevant and useful local addresses can be found in your area telephone book, or the Yellow Pages or Thomson guides.

    Wheelchairs

    Under the NHS, both hand- and electric-powered wheelchairs are supplied and maintained free of charge for people who are disabled and whose need for a wheelchair is permanent. Although, in principle, any wheelchair can be supplied by the NHS, in practice the decision is made locally, where the circumstances of the individual and local resources will be taken into account. Since April 1996, powered wheelchairs can be provided by the NHS, if you need a wheelchair, cannot walk and cannot propel a wheelchair yourself. Again local decisions are made about provision of such wheelchairs, although it is anticipated that local decisions will fit with the broader national criteria. These include being able to handle the wheelchair safely, and being able to benefit from an improved quality of life in a wheelchair. If you already have a wheelchair, move to new area and do not meet the local criteria in that area, you can still keep your wheelchair – unless there are clinical reasons for withdrawing it. Attendant-controlled powered wheelchairs can also be issued where it is difficult for the person to be pushed outdoors – if the area is very hilly, if the person is heavy, or the attendant is elderly and unable to push a wheelchair manually.
    There are voucher schemes operated by NHS Trusts whereby people can contribute towards the costs of a more expensive wheelchair than a Trust would provide. Schemes either give responsibility to the Trust for repair and maintenance of the wheelchair, or allow you to take responsibility yourself. You may not be able to use this scheme to obtain a powered wheelchair, but it may be possible to use the Motability Scheme to obtain such a wheelchair. Wheelchairs, pavement vehicles (usually electrically operated wheelchairs or scooters), crutches and walking frames are exempt from VAT.
    The MS Society branches and HQ can offer advice on financial help for wheelchairs or even provide one in some cases.

    Driving

    There are a number of benefits for which you may be eligible as a driver. If you receive the higher rate mobility allowance you will be allowed to claim exemption from vehicle excise duty (road tax) on one vehicle. This exemption is given on condition that the vehicle is used ‘solely for the purposes of the disabled person’, so care must be taken as to the use of the vehicle. Nevertheless, it is likely that some commonsense latitude will be given.
    If you have the higher rate mobility allowance, you will be automatically eligible for the Blue Badge, which gives parking privileges, and also for access to the Motability Scheme (see below). You will also get VAT exemption on adaptations to make your car suitable for driving by you, as well as exemption on the repair, maintenance or replacement of these adaptations.
    Note that the mobility allowance does not count as income for these purposes. Furthermore arrears will not count as capital for means-tested benefits for up to 1 year after they are paid.

  • Mobility and managing everyday life: Driving

    Benefits available

    There are a number of benefits for which you may be eligible. If you receive the higher rate mobility allowance, you will be allowed to claim exemption from vehicle excise duty (road tax) on one vehicle. This exemption is given on condition that the vehicle is used ‘solely for the purposes of the disabled person’. Nevertheless, it is likely that some commonsense latitude will be given.
    If you have the higher rate mobility allowance, you will be automatically eligible for the Blue Badge, which gives parking privileges, and also for access to the Motability Scheme (see below). You will also get VAT exemption on adaptations to make your car suitable, as well as exemption on the repair, maintenance or replacement of these adaptations.

    Motability Scheme

    The Department of Transport has set up a Mobility Advice and Vehicle Information Service (MAVIS) to help people choose an appropriate car for their needs, and they will be able to give advice and assistance. This advice will cover appropriate vehicles and adaptations, as well as issues concerned with your suitability to drive – an issue that may concern many people with MS, especially in so far as eyesight may be affected, as well as the arm and leg movements necessary to control the vehicle, for which additional technical assistance may be needed.
    For people with MS who are receiving the higher rate mobility component of the Disability Living Allowance (DLA), the Motability Scheme can offer a good approach to the purchase of a new car, good used car or an electric wheelchair, through hire purchase. Alternatively, you can hire a car through the same scheme.

    Getting into and out of a car – possible adaptations

    One of the major problems for a disabled person is swinging round from outside the car into a passenger, or a driver’s seat, and of course getting out of the car in the same way. Depending on how much you want to spend, and exactly what your needs are, you could think either of a swivel cushion placed on the seat so that you can swing your legs into the car; or, more elaborately (and more expensively), replacing whole seats and their fittings so that the seat itself swivels; this allows you to back on to the seat from outside, or to rise from the seat to a standing position without having to manoeuvre in and out of the car.

    Ability to drive

    Licence
    You do have to notify the DVLA (Driver Vehicle and Licensing Agency) that you have MS, as it is one of the conditions that may affect your driving ability. If you contact them, you will receive a form PK1 (Application for Driving Licence/Notification of Driving Licence Holder’s State of Health) to complete and return. These forms may be available at your local Post Office. When it assesses your application, the DVLA will normally adopt a positive view, for it wishes to give drivers with a current or potential disability the best chance possible of keeping their licences – the key issue in this respect is public safety.
    Especially if you have been recently diagnosed, you are unlikely to lose your licence. The DVLA will consider the information that you have given on the form (PK1) and, if it believes that your driving ability is not a hazard to other road users, it will normally issue a 3-year licence. Your situation will be reviewed at the end of these 3 years. If you answer positively to any of the questions concerning health problems on form PK1, then you should send a covering letter explaining your situation, and why you believe that you are fit to drive. Without such a letter or explanation, the DVLA might withdraw your licence. It would also be worth talking to your doctor – GP or neurologist – about your driving ability. If they disagree with you about your capacity to drive, or between themselves, or you yourself have concerns about your driving ability, then you should arrange for an assessment at one of the special driving and mobility assessment centres, which you can find via the Department of Transport’s Mobility Advice and Vehicle Information Service (MAVIS) (see Appendix 1).

    Judging your ability to drive
    Doctors consider driving ability in relation to problems with the use of your arms and legs, your eyesight or your reactions. It is clearly a matter of judgement by the GP or neurologist as to whether any of these or other consequences of MS do indeed affect your driving ability and, of course, one of the main problems with MS is its variability. One day you might be able to drive without any difficulty at all. On another day, through the onset of specific symptoms, it might be difficult, or unsafe, for you to do so. The problem both for you and your doctor is making a reasonable judgement.
    Driving a car may well be a lifeline for you. The key issue will be safety for you and other road users. Some other adaptations mentioned earlier might help you to continue driving. So, discuss the issue with your family and friends, and with people in the MS Society (see Appendix 1), who will be able to offer both support and information. In the end, the formal and probably best way to deal with the problem has to be through a driving assessment through a mobility assessment centre. During this assessment, not only your driving ability but also any vehicle adaptations will be considered. The driving assessment centre will write a report – this could be of particular value if, for example, the DVLA decides to rescind your licence, and you decide to appeal against the decision. There is a charge for a driving assessment and this may vary depending on the type of assessment required, so it is important to find out the cost when you arrange it.

    Appealing against a licence withdrawal
    There is an appeals procedure, but it can be lengthy and complex, and you need to seek advice and consider the likelihood of success, as well as the consequences of not succeeding. In any case, if you feel that you want to appeal, it is important that you register your intent to appeal to the DVLA as soon as possible. In the case of England and Wales, this has to be done within 6 months from the date of notification of the withdrawal of the licence, and in Scotland within 1 month of that date. You can withdraw your intent to appeal at any time. Appeals are heard in the local Magistrates Court in England and Wales, and in the Sheriff ’s Court in Scotland.
    You will almost certainly need some formal assistance to appeal, and you ought to bear in mind that it will be difficult to succeed without supporting evidence from your doctor and/or your formal driving assessment, which may not have been available to the DVLA at the time the original decision was made. It would be sensible to consult with someone who has experience of such cases, perhaps the Citizens Advice, your local DIAL (Disability Information and Advice Line) or your local branch of the MS Society who could refer you on to others, even a good lawyer, if necessary. Look in your local telephone book for their addresses. It is salutary to know that the DVLA has often in the past sought to recover its expenses from those who have appealed unsuccessfully, and this could amount to several hundred pounds. So you need to very sure of your grounds before appealing.

    Telling the insurance company
    Your insurance company cannot stop you holding a driving licence – only the DVLA or the Courts can do that. However, insurance companies do require that you disclose all material factors that may af fect your driving. MS is one of these factors. If you do not disclose the information, this may invalidate your insurance and, if you are not insured (at least on a third-party basis), you are not allowed to drive. So it is essential to tell your insurance company about your MS because, if you do not and then a legitimate claim arises which has nothing to do with the MS, you may find that you are in difficulty.
    Generally, as long as you have a valid driving licence, the most significant problem that you may face is a slightly increased insurance premium. Ask for several quotations from a number of companies to make sure that you are getting the best value. You also ought to read the small print on any policy proposal because you may need to be wary of unacceptable or difficult endorsements to the policy.
    You could also contact some of the insurance companies who are now specializing in insuring disabled drivers. A list is obtainable through RADAR (Mobility Fact Sheet No.6), which sets out these companies, and broadly what they offer (see Appendix 2). You might even lower your premium!

    Other transport

    We have already discussed the possibility of getting an outdoor electric wheelchair or an electric scooter (sometimes called pavement vehicles) which, depending on the terrain near where you live, could be of great help in giving you more independence and ability to travel reasonable distances for shopping or leisure activities.
    There are other forms of transport that you may find helpful, but these tend to vary according to which area you are living in. You can get in touch with the Social Services Department of your local authority for advice.

    • There are Dial-a-Ride minibus schemes, especially for people with mobility problems. Often you have to join the scheme first, and there might be a waiting list. However, when you have joined, you will be collected from your home and then dropped back again, often at a reasonable cost.
    • Some areas have taxi voucher schemes that give a number of low or no-cost journeys. These are usually in operation where people cannot take advantage of free or concessionary bus fares. Although taxi fares generally can be expensive, sometimes people do not realize how expensive maintaining a car is, and you could find that using taxis for short journeys compares very favourably.
    • For longer journeys outside your area, there are organizations such as Tripscope, which can help you plan such journeys, and from whom you may be able to obtain escorts if necessary.
    • Sometimes, other organizations, such as St John Ambulance Brigade and the British Red Cross, and local organizations and clubs, such as Rotary, Lions, Round Table and the Soroptomists can also provide escorts. Have a look in your local telephone book for their addresses.
    • Your local MS Society branch or region may be able to help.