£51,336 awarded in Continuing Healthcare (CHC) funding case

Dated:

We were recently approached to assist a client who had been refused continuing healthcare funding and to make both an appeal against this refusal, as well as a request for a full retrospective review of eligibility. Following the refusal of funding, our client had to self fund his placement within a care home and was therefore seeking legal help to gain the appropriate funding and claim back the money that had already been paid.

Elderly Care Funding

Our client entered full time care in November 2009 and had a number of health problems, which included depression, dementia, diabetes, heart disease, atrial fibrillation, chronic anaemia, carcinoma of the prostate, recurrent urinary tract infections, diverticular disease, back pain and pressure sores. The client was under the care of a Consultant Psychiatrist for his mental health problems.

In the initial approach to the Primary Care Trust (PCT), we negotiated a deferral of the current appeal pending our request for a full review. We put forward the client’s case, outlining when, how and why he met and continued to meet the CHC eligibility criteria. The client’s case was then placed before a continuing healthcare (CHC) review panel.

The Primary Care Trust (PCT) agreed eligibility for the period of March 2010 onwards and agreed to carry out a full retrospective review for the outstanding period of 2009 onwards.

Full retrospective continuing healthcare funding was eventually granted in July 2011.

Negotiations then took place with the Primary Care Trust regarding the final settlement figure of £51,336.30.

Our Care Home Claims Specialist said: "We were not only pleased to be able to assist the client with his claim for continuing healthcare funding but were also able to provide legal advice and assistance on an application for a Deputyship Order and a related data subject access request matter. Simpson Millar take pride in being able to offer a holistic approach to the provision of legal services"




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