Posted by Andrew on 31/10/2013, 1:24 pm, in reply to "employment and support allowance"

Hi Andy, I am no expert on this but I do think that because your GP has your record, which shows three hospital visits, s/he should be able to give you a note explaining why you cannot leave the house, that you are awaiting CBT therapy, and how it qualifies you for benefit. The following document was put together about ten years ago, and the regulations may have changed, but it does provide useful information to show your GP and a benefits assessor. Avoidant Paruresis (Shy Bladder Syndrome) – Disability Discrimination Act Bold typeface is used for extracts from the Income Data Services Handbook on Disability Discrimination. Italics are used for my comments, as agreed with the Citizen’s Advice Bureau. Definition A person has a disability if he or she has “a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities”. Long term A disability is considered to be long term if: · it has lasted at least 12 months · will last at least another 12 months, or · is likely to last for the rest of the individual’s life. This is specific to each individual. It is common to find that the condition began in childhood or in teenage years. Less commonly it can begin in adult life. Individuals have usually had the condition for many years, or decades. It is likely to continue for the rest of the individual’s life. Physical or mental Though the symptom – the inability to urinate in social situations – is physical, the cause of this is mental, being a social phobia whereby the individual becomes severely anxious in the presence, or the perceived presence, or others. This causes the sympathetic nervous system, which is not under conscious or voluntary control, to shut down the urinary system. Thus though the individual wishes to urinate, the body will not allow it to happen. If a location deemed safe by the individual for urination is not found, severe discomfort results, leading to pain, distress and eventual hospitalisation for catheterisation A mental illness must be clinically well recognised. ....which is recognised by a respected body of medical opinion. This condition is recorded in psychological reference works (1) as an example of a social phobia. However due to the shame and embarrassment felt by sufferers, they rarely admit to it, resulting in a major proportion of the medical fraternity never coming across a case. However social phobia itself is a well recognised condition. For this reason, expert evidence is often required. The Charity’s Honorary Consultant is a Professor who is a chartered psychologist and a registered psychotherapist. Degree to which the person is affected This condition exists across a wide range from mild to severe. Mild cases - i.e. where a male is not always successful at a urinal but can manage in a cubicle - is unlikely to be considered a disability. A severe case – where the individual, male or female, can urinate only at home, and even there can be negatively affected by the presence of visitors – has a self-evidently disabling effect on their ability to carry out normal day-to-day activities. Due to this range, an individual’s position on the range needs to be determined. Because of the social triggers to the condition, a person who manages with day-to-day tasks can find themselves effectively disabled by specific situations e.g. being asked to provide a urine sample for a drug test under controlled conditions, or having to urinate in a shared prison cell. Substantial adverse effect The emphasis is on the effect the impairment has, not on the severity of the impairment itself. The fact that the individual can carry out activities does not mean that his ability to carry them out has not been impaired. Experience shows that disabled people often adjust their lives and circumstances to enable them to cope for themselves. ...... to live on their own. Take a severe case of SBS, who can urinate only at home. If away from home in a social situation, or if at home with visitors, he is unable to empty his bladder. If kept in this situation, he would require emergency hospitalisation for catheterisation. This is uncontrollable, and it is mental. If forced into such situations, there would be a substantial risk to his mental health. The anxiety caused by being in such a situation would severely diminish his ability to concentrate on and to perform tasks. Take a moderate case, who can cope with a social working conditions, but who cannot produce a urine sample for a drug test, and so is threatened with dismissal. In this case the impairment seems slight, but the effect in the specific drug testing scenario is severe, because the potential impact is the loss of his or her job. Normal day-to-day activities The DDA Act protects individuals whose ability to carry out normal day-to-day activities is impaired. ....an impairment must affect one of the following: ........continence....... Continence is defined as the ability to control one’s bladder or bowel. An incontinent person (an enuretic) has no or little control over the bladder resulting in involuntary evacuation. A paruretic has no or little control over the bladder resulting in involuntary retention. References (1) Williams and Degenhardt "Paruresis: a Survey of a Disorder of Micturition" Journal of General Psychology, 1954, 51, 19-29. UK ParuresisTrust Registered Charity 1109541 PO Box 182, Kendal, LA9 9AE

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