HC Deb 26 July 1982 vol 28 cc382-4W

General

  1. 11. In assessing a claimant's walking capacity, it is necessary to take into account the use of appropriate prostheses or aids already supplied, or which could be supplied and which he is physically and mentally capable of using.
  2. 12. Inability or virtual inability to walk is not confined to disablement directly involving the lower limbs; it may also result from other forms of disablement, including those associated with cardiac and respiratory disorders (see paragraph 18).
  3. 13. The claimant must be unable or virtually unable to walk by reason of physical disablement. This is interpreted as the effective physical incapacity to walk. A claimant with true hysterical paralysis, as opposed to conscious exaggeration or 383 malingering, may be covered. Equally, a mentally handicapped child (or adult) who has never learnt to walk or whose walking capacity is seriously affected by his handicap may be covered but it is emphasised that the test relates to a capacity to walk. Those who can walk adequately but who have other problems are not covered. The person who only walks a short distance before being unable to move further, may be regarded as virtually unable to walk if this is not of his own volition. Psychiatric disorders such as schizophrenia and agoraphobia will not of themselves satisfy the criteria.

Unable to walk

  1. 14. This is a total inability to walk.

Virtually unable to walk

  1. 15. The intention behind this condition is to extend the "unable to walk" criterion so as to include in the scheme people who can walk to some degree but whose scope and quality of walking is so poor that it virtually amounts to an inability to walk, ie they cannot walk to any appreciable extent.
  2. 16. In assessing the degree of walking, no one factor (such as distance) is decisive. The time taken to achieve distance and the quality of the walking must be taken into account. Any walking which can be achieved only with severe pain or discomfort should be ignored.
  3. 17. In considering walking capacity "out of doors" no account should be taken of the terrain where the claimant lives (see paragraph 22). It is not intended to exclude, however, those claimants who can walk to some degree indoors but who have a restricted capacity out of doors because, for example, of liability to fall on uneven pavements, the need for a helping hand because of instability and the hazards of being jostled, etc.

Exertion

  1. 18. A person whose legs are capable of the physical movements of walking but who is prevented by other aspects of his physical condition from making use of them can satisfy the medical criteria. The Mobility Allowance Regulations provide that a claimant may be regarded as unable or virtually unable to walk if the exertion required to walk would constitute a danger to his life or would be likely to lead to a serious deterioration in his health. A severe cardio-respiratory cripple may be covered under this provision. It may also apply to a claimant with some other severe condition whose health is likely to be seriously affected by the exertion required to walk or to a claimant who has been medically advised to refrain from walking because of the danger to his health or life from the exertion required to walk.

SPECIAL PROBLEMS

General

  1. 19. Some examples of commoner conditions where inability or virtual inability to walk can arise are mentioned below.
    1. (a) Paraplegia with complete or almost complete paralysis of the legs. A lesser degree of paralysis where there is an additional factor, such as spastic paraplegia with scissors gait causing impaired balance.
    2. (b) In some cases of hemiplegia, despite one good leg, there may be the additional factor of severe impairment of balance, or impairment of mental capacity to re-learn or to cope with aids.
    3. (c) Neurological diseases such as multiple sclerosis, poliomyelitis, etc, causing a sever paraparesis. Other diseases of the central nervous system such as cerebellar ataxia causing a severe loss of balance or of co-ordination. Severe paraparesis due to diseases of the peripheral nervous system and of the muscles.
    4. (d) Amputees with complications such as bad scarring of the stump or peripheral vascular disease. (A young claimant with traumatic amputation who may have the physique and drive needed to benefit from early limb fitting and training will therefore not usually satisfy the 12 month requirement, whereas an older and unfit claimant with similar amputation may satisfy it (see also paragraph 25)).
    5. (e) Severe arthritis, or similar conditions, causing extreme difficulty and pain when attempting to make the movements required for walking.

Blindness and deafness

  1. 20. Blindness, defects of vision amounting to less than blindness, and defects of hearing will not of themselves satisfy the medical criteria. Where, however, such defects are severe 384 and the claimant also had some disablement which severely impairs his locomotor ability, they may enable an otherwise ineligible claimant to satisfy the criteria.

Epilepsy, Dialysis, etc.

  1. 21.A claimant, whose walking ability is intermittently impaired by a condition such as epilepsy or the effects of renal dialysis, cannot normally be said to be unable or virtually unable to walk throughout any period for which an award might be considered. In such cases, consideration should be given to other factors which may have a more continuous effect on inability to walk, such as impairment of balance, anaemia resulting in excessive tiredness caused by the effort of walking etc.