"13………there was tenderness of the upper fibres of both the trapezius muscles, upper limb tension signs were positive on the right side, movements of the neck were all painful but were not limited by pain. There was diffuse tenderness at various points in the upper limbs and the first web muscles in the left hand. There was coldness of the fingers of both hands and capillary return was slow."
" undoubtedly suffering genuine pain and disability over her severe complaints and disability however her severe complaints are not accompanied by any objective evidence or visual disease. Certain descriptors including prescribed disease A4 (cramp of the hands) have been applied to such diffuse complaints but I emphasise that those descriptors are no more than that and do not constitute a physical diagnosis in the ordinary medical understanding of the disease. On the basis of the above, I do not find any evidence of physical disorder for example Tenosynovitis which can be related to any occupation."
"With regard to her ability to carry out day-to-day activities, Ms Gibbs told us that she had difficulty in holding small objects for any length of time and found it difficult to chop and peel vegetables. She had difficulty in lifting cooking pans and kettles which were full. She had difficulty with small buttons and therefore adjusted her wardrobe accordingly. She had difficulty sitting or standing for any length of time. She could carry a supermarket basket with a few items but could not carry a full basket."
"….. 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."
"An impairment is to be taken to affect the ability of the person concerned to carry out normal day-to-day activities only if it affects one of the following -" and one of the following is: "(b) manual dexterity" another is: "(e) ability to lift, carry or otherwise move everyday objects."
"A7 Account should be taken of how far a person can reasonably be expected to modify behaviour to prevent or reduce the effects of an impairment on normal day-to-day activities. If a person can behave in such a way that the impairment ceases to have a substantial effect on his or her ability to carry out normal day-to-day activities the person would no longer meet the definition of disability. A8 In some cases people have such "coping" strategies which cease to work if certain circumstances ……….If it is possible that a person's ability to manage the effects of an impairment will break down so that effects will sometimes still occur, this possibility must be taken into account when assessing the effects of the impairment. A9 If a disabled person is advised by a medical practitioner to behave in a certain way in order to reduce the impact of the disability, that might count as treatment to be disregarded."
"C2 The term "normal day-to-day activities" is not intended to include activities which are normal only for a particular person or group of people. Therefore in deciding whether an activity is a "normal day-to-day activity" account should be taken of how far it is normal for most people and carried out by most people on a daily or frequent and fairly regular basis. C3 The term "normal day-to-day activities" does not, for example, include work of any particular form, because no particular form of work is "normal" for most people."
"C15 This covers the ability to use hands and fingers with precision. Account should be taken of the extent to which a person can manipulate the fingers on each hand or co-ordinate the use of both hands together to do a task. This includes the ability to do things like pick up or manipulate small objects, operate a range of equipment manually, or communicate through writing or typing on standard machinery. Loss of function in the dominant hand would be expected to have a greater effect than equivalent loss in the non-dominant hand. It would be reasonable to regard as having a substantial adverse effect - loss of function in one or both hands such that the person cannot use the hand or hands; inability to handle a knife and fork at the same time; ability to press the buttons on keyboards or keypads but only much more slowly than is normal for most people. It would not be reasonable to regard as having a substantial adverse effect - inability to undertake activities requiring delicate hand movements, such as threading a small needle; inability to reach typing speeds standardised for secretarial work; inability to pick up a single small item, such as a pin."
"…….The focus of attention required by the Act is on the things that the applicant either cannot do or can only do with difficulty, rather than on the things that the person can do. The Act is looking to see whether the capacities listed in para.4(1) have been affected. These capacities are those which will be required, to a greater or lesser extent, to carry out normal day-to-day activities, whether at home or at work."
"On the assumption that the impairment and adverse effect conditions have been fulfilled, the tribunal must consider whether the adverse effect is substantial. This is a word which is potentially ambiguous. 'Substantial' might mean 'very large' or it might mean 'more than minor or trivial'. Reference to the Guide shows that the word has been used in the latter sense: see paragraph A1."
"Whilst it is essential that a tribunal considers matters in the round and makes an overall assessment of whether the adverse effect of an impairment on an activity or a capacity is substantial, it has to bear in mind that it must concentrate on what the applicant cannot do or can only do with difficulty rather than on the things that they can do. This focus of the Act avoids the danger of a tribunal concluding that as there are still many things that an applicant can do the adverse effect cannot be substantial."