Carole Joliffe.May, 2002. Social work [online]. Seacroft Hospital, Leeds, UK. Available from http://www.cysticfibrosismedicine.com

Introduction

I'm not too sure if I actually like admitting that I am a Social Worker in the outside world as often peoples views have been tarnished by the incidences highlighted in the press when Social Workers have removed children, abused old people and are reported as generally making a real mess of things! However, Social Workers have to work within policies and procedures and make difficult decisions to protect vulnerable people. Decisions that improve a persons quality of life, or take them out of an abusive environment are never reported. Neither is it reported when Social Workers have stuck with someone, believed in them when others have not!

Now I've got that of my chest, so to speak, I'm going to take this opportunity to tell you what I get up to as a Social Worker at the Adult C.F. Unit here in Leeds.

There doesn't seem to be many generic social workers left, i.e. those who work with all sorts of people with a variety of problems. Social Workers nowadays either work solely with children and families, people with disabilities or with the elderly for example. Although I'm classed as being a "Specialist", working with people who have C.F., my practice is very much generic as I deal with a variety of people and tackle all sorts of issues.

The main topics I'm asked about are to do with benefits, (see separate section) , but I'm not just the benefits lady ! Housing, adaptations to homes, careers, blue badges (parking permits for people with disabilities), etc, etc, the list seems endless, are other issues I am happy to offer advice on. I'll have a go at anything, but as many of the things I'm asked about are steeped in legislation or have rules / regulations attached, I'll check things out or refer on if I can't help. There is an art to advocacy, I know my limitations!

BENEFITS

I actually enjoy having a good old battle with the Dept of Work and Pensions (formerly the Benefits Agency or D.H.S.S.), especially when I' m trying to maximise peoples income. It is important to remember that when applying for any benefit, each case is decided on an individual basis. I have listed below the main benefits people with illnesses or their carers could apply for.

DISABILITY LIVING ALLOWANCE (DLA)

DLA is the main benefit people with CF should apply for. There are two components:-

a) The mobility component, paid at the low or high rate.

b) The care component paid, at either, low, middle or high rate.

It is important to stress that the care component of DLA is awarded on the amount of care, supervision or attention a person needs, not just because they are ill or disabled. A person must prove that they need the care. It does not matter whether they actually get that help. Additionally, the mobility component is not awarded on the basis of how far it is to the CF Unit. For a person with CF to qualify he or she needs to prove that they are unable to walk, or virtually unable to walk or that the exertion required to walk would constitute a danger to life, or could lead to a serious deterioration in health. To qualify under the criteria of virtually unable to walk a person must experience 'severe discomfort'. 'Severe discomfort' is something subjective, but can include chest pain or severe breathlessness. Staff on the Unit are willing to write supporting letters, but please don't be offended when they say they can't support your claim for mobility, if you can run a marathon!!!!!!

SICKNESS BENEFITS.

At the moment benefits for people who are unable to work due to illness include Income Support and Incapacity Benefit. Severe Disablement Allowance has been abolished for all new claims.

INCOME SUPPORT (I.S.)

I.S. is a means tested benefit, not dependent on National Insurance contributions. It can be paid on its own or to top up other benefits or earnings. I.S. is for people who are not required to sign-on for work, e.g. people incapable of work due to ill health or disability or if a person can't work because they are caring for someone else. Depending on a persons circumstances, additional premiums can be added, eg:- If you are in receipt of the middle or high rate care of D.L.A., live alone and nobody claims Invalid Care Allowance for looking after you, on todays rate (May 2002) you would receive an additional £42.25 on your I.S.

INCAPACITY BENEFIT (IB)

IB is a non-means tested, for people unable to work due to ill health or disability. The qualifying criteria seems complex, but basically, if you have been sick for 28 weeks apply for IB.

OTHER BENEFITS DISABLED PERSON'S TAX CREDIT

This benefit is aimed at people whose illness or disability puts them at a 'disadvantage of getting a job'. It is means-tested, so income (and partners' income) is taken into consideration. A person wishing to claim this benefit must work over 16 hours per week, receive DLA and be on a fairly low income. As usual (!) calculating the credit isn't easy. If you have any queries, phone the helpline on :- 08456055858, or look at the website at: http://www.inlandrevenue.gov.uk/dptc/calc_dptc.htm

WORKING FAMILIES TAX CREDIT

This tax credit is a means tested payment for working people on low wages who have children. (Single parents can apply.) Again, it's complex, so phone the Helpline on 08456095000, or look on the website at:- http://www.inlandrevenue.gov.uk/wftc/calc_wftc.htm

INVALID CARE ALLOWANCE

This benefit is for people who care for another person. They have to be under 65 years, spend 35 hours or more per week 'caring', must not earn more than £72 per week (once allowable expenses are deducted) and not be in full time education. A carer does not have to be related or live with the person they are looking after. The person being looked after however, must receive DLA care component at the middle or high rate.

STUDENTS AND BENEFITS

In some circumstances someone still at school, college or university, who has an illness or disability may be able to claim Income Support. It really is worth trying to claim because if I.S. is awarded, you may be then eligible for Housing Benefit which would go towards the cost of your rent, (but not if you live in halls of residence.)

NEW PERMITTED WORK RULES

This used to be called Therapeutic Work. It is possible to work whilst in receipt of Incapacity Benefit or Severe Disablement Allowance. It's worth taking a closer look at this because if you have had to stop working due to ill health, but you know that you could do a few hours each week, then why not get a small income as well as your benefit? As always , there are rules to follow. (see below)

a) Lower Limit = as many hours as a person wants, but earn no more than £20.

b) Higher Limit = work up to 16 hrs a week, earn no more than £66, for up to six months. You could work for an extra six months, (in total 12 months), but you will need a Personal Advisor, Job Broker or Disabled Employment Advisor to supervise this work.

c) Higher Limit Subsequent = Additional work can be done, but only after there has been a gap of 52 weeks after the last period of permitted work at the higher level.

d) Supported Permitted Work = As this is fairly new legislation, I'm even struggling to fully get to grips with this bit! If a person wants to work in the community or in a sheltered type environment, they can earn up to £66 per week, for an indefinite period. However, they must be receiving on-going support or supervision from a professional. Will a Social Worker Do? This also includes work done under medical supervision whilst a person is regularly attending a hospital. I do believe therefore, that someone with C.F. , in receipt of a sickness benefit, may come under this part of the legislation.

PRESCRIPTIONS

A person is automatically exempt from prescription charges if:

a) Under 16 years or under 19 years in full time education,

b) In receipt of Income Support, Income Based Job Seekers Allowance, you get a maximum award of working families' tax credit or disabled persons tax credit, or the amount taken off the maximum is £71 a week or less.

c) You are the partner or dependent child of someone who gets these benefits.

d) If you are not automatically exempt, then you will have to apply for a Medical Exemption Certificate (on a FP 92A form) if you suffer from certain additional medical conditions that are listed on the form. (eg diabetes)

e) An annual pre-payment certificate will save a person with CF money if they are not exempt from prescription charges. The CF Trust may help with the first certificate when a person is no longer exempt (e.g., on leaving college or starting work). They may also help if someone suddenly loses exemption (e.g., moving in with a partner when entitlement to IS ceases).

f) The NHS operates a scheme to help towards the cost of prescription charges if someone is on a low income. Contact the NHS Helpline on Tel: 0191 2035555 for more information or complete form HC1 available from dentists, opticians, Post Office & DSS.

TRAVELLING EXPENSES

A person may get help with travelling expenses if they are in receipt of Income Support, Income Based Job Seekers Allowance, and in some cases Working Families' Tax Credit , Disabled Persons Tax Credit, or if covered by the NHS low income scheme.

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