1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid can reasonably be used. | 1 | (a) | Cannot either:
(i) mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion.
| 15 |
(b) | Cannot mount or descend two steps unaided by another person even with the support of a handrail. | 9 |
(c) | Cannot either:
(i) mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion.
| 9 |
(d) | Cannot either:
(i) mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion;
or
(ii) repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion.
| 6 |
(e) | None of the above apply. | 0 |
2. Standing and sitting. | 2 | (a) | Cannot move between one seated position and another seated position located next to one another without receiving physical assistance from another person. | 15 |
(b) | Cannot, for the majority of the time, remain at a work station, either:
(i) standing unassisted by another person (even if free to move around); or
(ii) sitting (even in an adjustable chair)
for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion.
| 9 |
(c) | Cannot, for the majority of the time, remain at a work station, either:
(i) standing unassisted by another person (even if free to move around); or
(ii) sitting (even in an adjustable chair)
for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion.
| 6 |
(d) | None of the above apply | 0 |
3. Reaching. | 3 | (a) | Cannot raise either arm as if to put something in the top pocket of a coat or jacket. | 15 |
(b) | Cannot raise either arm to top of head as if to put on a hat. | 9 |
(c) | Cannot raise either arm above head height as if to reach for something. | 6 |
(d) | None of the above apply. | 0 |
4. Picking up and moving or transferring by the use of the upper body and arms. | | (a) | Cannot pick up and move a 0.5 litre carton full of liquid. | 15 |
(b) | Cannot pick up and move a one litre carton full of liquid. | 9 |
(c) | Cannot transfer a light but bulky object such as an empty cardboard box. | 6 |
(d) | None of the above apply. | 0 |
5. Manual dexterity. | 5 | (a) | Cannot either:
(i) press a button, such as a telephone keypad; or
(ii) turn the pages of a book
with either hand.
| 15 |
(b) | Cannot pick up a £1 coin or equivalent with either hand. | 15 |
(c) | Cannot use a pen or pencil to make a meaningful mark. | 9 |
(d) | Cannot use a suitable keyboard or mouse. | 9 |
(e) | None of the above apply. | 0 |
6. Making self understood through speaking, writing, typing, or other means normally used, unaided by another person. | 6 | (a) | Cannot convey a simple message, such as the presence of a hazard. | 15 |
(b) | Has significant difficulty conveying a simple message to strangers. | 15 |
(c) | Has some difficulty conveying a simple message to strangers. | 6 |
(d) | None of the above apply. | 0 |
7. Understanding communication by both verbal means (such as hearing or lip reading) and non-verbal means (such as reading 16 point print) using any aid it is reasonable to expect them to use, unaided by another person. | 7 | (a) | Cannot understand a simple message due to sensory impairment, such as the location of a fire escape. | 15 |
(b) | Has significant difficulty understanding a simple message from a stranger due to sensory impairment. | 15 |
(c) | Has some difficulty understanding a simple message from a stranger due to sensory impairment. | 6 |
(d) | None of the above apply. | 0 |
8. Navigation and maintaining safety, using a guide dog or other aid if normally used. | 8 | (a) | Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment. | 15 |
(b) | Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment. | 15 |
(c) | Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment. | 9 |
(d) | None of the above apply. | 0 |
9. Absence or loss of control leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting) despite the presence of any aids or adaptations normally used. | 9 | (a) | At least once a month experiences:
(i) loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder; or
(ii) substantial leakage of the contents of a collecting device
sufficient to require cleaning and a change in clothing.
| 15 |
(b) | At risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly. | 6 |
(c) | None of the above apply. | 0 |
10. Consciousness during waking moments. | 10 | (a) | At least once a week, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. | 15 |
(b) | At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. | 6 |
(c) | None of the above apply. | 0. |