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Continuing health care funding appeal tribunal

(15 Posts)
Luckygirl Sun 22-Nov-20 15:00:26

As some of you might know I applied for CHCF for my OH and it was refused twice - I believe wrongly as much of the information upon which the decisions were based came from people who hardly knew him!

He died in February, but, the previous November I had appealed. This appeal has just come tp the top of the list at long last, but in order to put together my arguments I have had to go through his every problem in minute detail - a traumatic activity that I have found very upsetting.

I looked into having some sort of legal representation from an expert in the field, but this would cost me £1000. I also debated whether to leave it lie, as he is now not alive; but I do think that the whole process was conducted wrongly and feel I need to have the chance to get them to re=examine what went on. I also feel uncomfortable about the money - if they do grant the appeal they will owe me quite a bit of money which could go towards someone else's needs. But we virtually wiped out our savings to find his care and, as I am about to move house, it will help me to feel more financially secure.

My question is this: has anyone else on here ever attended one of these appeal tribunals? Any experiences that they might be able to pass on would be appreciated. In my case this will take place on zoom, given the current circumstances.

Jaxjacky Sun 22-Nov-20 15:42:04

I haven’t attended, but wish you loads of luck, I have had dealings with them.

GrannySomerset Sun 22-Nov-20 15:48:40

I can’t help but hope your appeal is successful. If your late DH wasn’t entitled to funding I can’t imagine who would be, given how ill he was and how great his need. I do hope someone with relevant experience is able to help you with this.

Luckygirl Sun 22-Nov-20 16:22:35

I so agree with you. I too kept thinking....well if not him then who?

Jane10 Sun 22-Nov-20 16:27:47

I really hope that justice will prevail for you and your late DH Luckygirl. I well remember the trials and tribulations you experienced in your attempts to find the best possible care for him. Good luck

Judy54 Sun 22-Nov-20 16:39:11

Hello Luckygirl firstly my condolences on the loss of your Husband, you really are going through a difficult time with your bereavement without the hassle of this appeal but please do persevere. My experience was some years ago in relation to my Mother who we were advised was not eligible for CHCF when she went into a care home. The criteria has not really changed in that if the person has a medical need (in my Mother's case terminal cancer) rather than a social need e.g. help with washing and dressing then they should be eligible for CHCF rather than being self funding. Just lay out the case about your Husband's health needs and what care he needed. All I can say is stick to you guns and be firm. I took my case up with the NHS after my Mother died and it took a lot of time and effort to cut through the red tape. Eventually the fees were recouped and distributed according to her will. Be strong and if you can ask a family member to support you in this. All the best flowers

Septimia Sun 22-Nov-20 16:43:01

If you do get some money, don't feel guilty. As you say, you spent your savings on your OH's needs. Anything you do get will offset any help you might have to ask for in the future, so will not deprive anyone else of anything.

silverlining48 Sun 22-Nov-20 17:16:24

My mother got continuing care because she met the very strict criteria and was regularly reviewed so have no experience of appeals, but I know something about CC from when I worked and it was always incredibly hard to get it agreed. Some people who I felt had a very strong case were refused and I struggled to understand why.

If your husband had a care manager SSD can provide the information required, but if Social Services did not assess at the time he went into the home it might be worth requesting a report and copy of his care plan from the nursing home where your husband was looked after. It might help. Wishing you luck.

midgey Sun 22-Nov-20 17:19:48

No useful advice but just wishing you luck!

Nortsat Sun 22-Nov-20 17:42:17

Luckygirl I have some experience of tribunals but not health care funding appeals.

Feel confident that you know these circumstances inside out and are therefore the best person to represent your husband and your self.
You have lived through this and so it’s real and present for you.

Be sure to ask for clarifications on anything you don’t understand and ask more than once if it’s still not clear.
Don’t apologise for anything.
The tribunal will give you time to say what you want to say, so take that time.
Remember when you’re speaking that the Tribunal members may be taking notes, so speak clearly and pause (to allow them to catch up).
If they ask long questions, clarify by saying ‘So are you asking me whether ‘so and so’ happened? (or whatever ...) so that you are clear about what they want.

Put all those ideas about being uncomfortable about the money out of your head. If they grant the appeal it will be because you are entitled to that money and you will deserve it.

Be strong (even if you don’t feel it). You have been through the worst that could happen with the dreadful illness and loss of your husband. You can deal with this.

Well done ... I am sure your husband would be very proud of you. Good luck and keep us updated. ?

Baggs Sun 22-Nov-20 17:49:28

Rooting for you, lucky. Good luck.

Hetty58 Sun 22-Nov-20 18:06:25

There are 'no win, no fee' solicitors who specialise in CHC funding (we used Farley Dwek) so I'd advise contacting one of them for legal support.

It's virtually impossible for anyone to succeed in claiming alone. Although people obviously qualify, the system is rigged to deny them help. It's a national disgrace. I'd have to continue fighting as a matter of principle.

Luckygirl Sun 22-Nov-20 19:19:27

Hetty58 - I so agree that the system is rigged to deny people the help they are entitled to. Unfortunately, because my OH has died, specialist solicitors will not take it on as no win no fee because they cannot meet the patient themselves and make a judgement on the merits of the case and have to rely on going back over the records, which are often (as in my OH's case) inaccurate.

There are so many instances where the CCG took the word of people who had met my OH briefly once over that of the family who of course knew exactly what was needed and what was going on.

The system is a disgrace - many people do not even get to the stage of getting turned down because they simply do not know that the funding exists. The whole system relies on this general ignorance.

Hetty58 Sun 22-Nov-20 20:25:23

Luckygirl, the system is ageist too. My mother was completely disabled and wheelchair bound by a stroke.

She had complex medical needs and fulfilled the criteria for CHC. It was pointed out to me, by medical staff, that a younger person with the same needs would qualify.

Although (officially) age has nothing to do with it, they seemed determined to assess her as not quite qualifying!

NfkDumpling Sun 22-Nov-20 20:36:42

Age UK helped my DM with advice when she applied for CC.

I hope you succeed. You are definitely entitled as much as anyone else. Good luck. XX