What are disability-related expenses?
If you care for someone with a disability or a medical condition, there may be extra costs involved in helping them manage this called disability-related expenses.
There are many examples of these, as listed below, and they could vary from special dietary requirements to certain types of medication not available through the NHS.
Having a financial assessment
When a local authority or trust (in Northern Ireland) carries out an assessment of someone’s care needs, they will also need to carry out a financial assessment to see if they can potentially contribute towards their care costs. The amount varies but usually there is a flat rate that will be allocated by the council or trust to help cover extra disability-related expenses (for example £15-20 per week).
See below for more details...
You may find it difficult to talk about finances with the local authority, but it is important to be honest and open so that all your expenses are taken into account and your financial assessment is carried out properly and lawfully.
If you need support during the assessment, you can ask for a trusted friend or family member to be with you, or request an advocate be provided.
It’s important if someone is contributing a lot of money towards their care services provided by the council or trust. Many people don’t realise that they may be able to get a larger allowance for expenses that are linked to a disability or health condition.
It may be the case that the local authority’s or trust’s flat rate is not high enough to cover the disability-related expenses. These costs are not covered by the NHS or social services; they are paid for privately out of someone’s own finances.
Therefore, if you can demonstrate a higher level of disability-related expenses, it may bring down the amount that the council or trust charge for their care.
The Care Act statutory guidance in England states that the local authority must leave you with enough money ‘to pay for necessary disability-related expenditure (DRE) to meet needs which are not being met by the local authority’.
For example, if you are receiving a certain benefit (like Personal Independence Payment, Disability Living Allowance or Employment and Support Allowance), when carrying out a financial review, the local authority or trust should check whether adequate money is left over after your general needs are met to cover any other additional disability-related expenses (DRE) you have.
For more information on this, look up the guidance notes – see page 370.
The rules may vary depending on where you live in the UK so it’s advisable to ask your local authority or trust for their charging policy to have a better idea of their procedures.
- Certain medication and health-related purchases (including creams, pressure relief pads, etc)
- Incontinence pads/goods
- Personal Protective Equipment costs
- Chargeable aids and adaptations (which are not covered under a disabled facilities grant)
- Equipment for monitoring and communication (including smartphone/tablets)
- Accessible vehicle costs.
- Healthcare (massage/physio/osteopath/acupuncture/chiropractor treatments, etc)
- Gardening, cleaning, online shopping delivery fees – if you cannot go to the shops because of a disability
- Taxis if public transport is inaccessible
- Internet connectivity – if needed for wellbeing, monitoring or for disability aids to connect
- Subscriptions such as personal alarm, app subscriptions
- Laundry collection and delivery/service washes.
- Ready meals vs ingredients to cook with
- Washed and chopped vegetables etc
- Specially adapted clothing/shoes.
- Laundry (extra washes due to incontinence or specialist washing powder)
- Water if metered (for toilet use/personal care). This is if someone’s condition requires an above average water level in the home, ie, more washing due to incontinence, sweating etc
- Heating – if someone’s condition requires an above average temperature maintained in the home for example.
Providing evidence is crucial. Your council or trust will request documents or receipts to prove your case for these extra costs being incurred. They may argue that a particular medical product or service is provided by the NHS for example. So you will need to put the case forward that the product you need is not available or a therapy session is only available for a limited amount of time, ideally with the backing of a doctor’s note for reference.
It is vital that your doctor or another health professional supports you with this because the local authority will most likely base their decision on this evidence. Doctors can charge for these letters but some may not – you can discuss this with your doctor if you have limited money and cannot pay.
When they request evidence, it’s important to note that there are many different forms of proof you could show including the following:
-care assessments and support plans
-Occupational Therapist plans
- Ask the council or trust for their charging policy or for information about disability-related expenses – this may already be on their website or you can request it by looking up their contact details.
- Ask the local authority or trust to put all invoices on hold until any dispute has been resolved.
- Refer to our Being Heard guide to help you explain your approach and get the message across during the financial assessment.
- Make a list of the expenses that relate to the illness or disability as opposed to regular expenses.
- Check what the council or trust’s flat rate is and put forward any disability-related expenses that exceed this. Refer to the statutory carer guidance, annex C p370 – see the guidance notes.
- Be clear in your claims – using a chart like the following example is a great way to clearly demonstrate your need and case:
|Item||Cost||Reason for expense||Evidence|
|Incontinence pads||£8.99 per month
|Incontinence pads available under the NHS do not suit service user. Expense is allowed as per statutory carer guidance – required because of disability/age/condition.||Please see attached receipts for pads and letter from GP confirming that these pads are not available under the NHS.|
1/ General daily-living equipment or services not specifically used for a disability or health condition.
2/ Any type of item or service that can be met by a grant or funder.
3/ Any product or service that can be sourced via the NHS or social care more cheaply.
Here are some ideas to help:
- Ask for a copy of the financial assessment as well as reasons for the local authority not accepting your disability-related expenses. This will help form your complaint.
- Ask your GP or another medical professional to provide a supporting letter reflecting the need for the expenses required, especially if the item is not available under the NHS, ie, certain vitamins, supplements or certain types of incontinence pads.
- The council or trust should take into consideration that, on occasion, you may not be able to provide receipts for everything. Any extenuating circumstances should be taken into account.
- Challenge the decision with the finance team in question and ask them to review it, providing additional evidence if possible. Try to remain calm and keep your emotions in check.
- If you’re unhappy, ask for a copy of their complaints procedure.
- You can escalate your case further if you’re still dissatisfied. The process will vary according to where you are based in the UK – see our making complaints guidance.
- If you are eligible for legal aid, you can get a solicitor or caseworker to look into the matter and write to the council on your behalf. You can search for a legal aid provider online.
- You can also seek advice from our Helpline: email@example.com. We, unfortunately, cannot provide casework assistance, but we can provide guidance and information.
Never underestimate the power of your voice to achieve great outcomes for you and those you care for! We have started a thread on our forum about DRE where you can see other carers’ successes and share ideas. We’d love you to share yours too. (You can view the forum any time but need to be a member to post.)
Alternatively, please drop us an email at firstname.lastname@example.org to share your successes with DRE for us to include in future guidance.