“… the pain is deep and he can experience shooting pain into the left arm and forearm. He denies any paraesthesia or weakness in the arm or signs of instability within shoulder joint. He tells me that the shoulder does click occasionally with left side lying. He tells me that the pain is there most of the time and rates it as 7/10 on the NPRS. His aggravating activities are driving, shoulder abduction, left side lying. He currently uses Ibuprofen to manage the pain. I note findings of an ultra sound scan which concludes subacromial impingement and left supraspinatus tendinopathy. …”
“… has ongoing problems with L shoulder. Had USS guided injection approx 6/52 ago but didn’t have follow-up Physio because pain was better. Pain has now returned so needs re-referral to Physio.”
“Cannot use a telephone with left arm; Painful to drive; Inability to mow the law or cut hedges; Difficulty wearing upper garments - need assistance; Unable to go swimming with children; Cannot hang washing on drying line or fold laundry; Painful to push a supermarket trolley or carry shopping basket/bag with left hand; Painful to use a vacuum cleaner with left hand; Avoid using public transport during rush hour; Severely [interrupted] sleep due to constant pain.”
“Mr Mefful attended for a review. As you know he developed sudden sensorineural hearing loss in a right ear back in April. At that time his audiogram showed normal hearing in the left ear but a sensorineural loss of about 90dB on the right. Subsequent to that Mr Mefful feels that there has been some improvement in his hearing. Pure tone audiometry today shows that his hearing is now ranging between 25 and 55 dB. I have explained to him that this represents a substantial improvement and since his hearing has improved so much, there is an excellent chance it will continue to improve in the coming months. However there is no specific treatment at this stage which will affect that and we just need to wait spontaneous improvement. His hearing has now improved to the point where he would benefit from a hearing aid, so I am arranging for this to be provided. I have however cautioned him that if his hearing improves further then the aid may become too loud and he will need to contact the hearing aid department to have it adjusted, if necessary. I am due to see him again in about 6 months time to re-check his hearing.”
“… his left sensorineural thresholds are starting to drop. On the right his initial dead ear improved but the low frequency hearing loss is increasing now. …”
“Initially Mr Mefful had one sided hearing loss and at that point I would expect him to have minimal disability from his condition. However, it now appears that both ears are becoming affected and I think this will significantly increase the symptoms he suffers as a result.”
“5. Are SHL and tinnitus curable medical treatment? 6. In your expert opinion, is SHL considered to be a condition that could likely last for at least 12 months or the rest of a person’s life? 7. Similarly, is tinnitus considered to be a condition that could likely last for at least 12 months or the rest of a person’s life?”
“5. The hearing loss and tinnitus are treatable but not always curable. 6. Sensorineural hearing loss can easily last for 12 months or longer including for the duration of a person’s life. 7. Tinnitus can easily last for 12 months or longer including for the duration of a person’s life.”
“In your letter of08 August 2012 you said Mr Mefful’s hearing ranges between 25db and 55db. As this will certainly prove challenging for the Tribunal to understand and conceptualise, perhaps you could explain what this [means] using normal day to day examples.”
“Mr Mefful’s hearing in the left ear probably sounds like his ear is blocked in keeping with a cold. On the right I suspect he has little meaningful hearing. This description is an over simplification, as it is likely he has lost some fidelity of hearing as well as just hearing sounds more quietly.”
“On the evidence, we concluded that at the time of matters complained [of] by the Claimant, the Claimant’s left shoulder condition did not have a substantial and adverse effect on his day to day activities.” (paragraph 30) The ET went on: “Accordingly, it was the unanimous judgment of the Tribunal that the Claimant was not a disabled person, by reason of his shoulder condition or by the cumulative effect of his hearing and shoulder conditions at the time of the matters complained of …”
“A person (P) has a disability if— (a) P has a physical or mental impairment, and (b) the impairment has a substantial and long-term adverse effect on P’s ability to carry out normal day-to-day activities.”
“Long-term effects (1) The effect of an impairment is long-term if – (a) it has lasted for at least 12 months, (b) it is likely to last for at least 12 months, or (c) it is likely to last for the rest of the life of the person affected.”
“B9: Account should also be taken of where a person avoids doing things which, for example, cause pain, fatigue or substantial social embarrassment, or avoids doing things because of a loss of energy and motivation. It would not be reasonable to conclude that a person who employed an avoidance strategy was not a disabled person. In determining a question as to whether a person meets the definition of disability it is important to consider the things that a person cannot do, or can only do with difficulty . … C7. It is not necessary for the effect to be the same throughout the period which is being considered in relation to determining whether the ‘long-term’ element of the definition is met. A person may still satisfy the long-term element of the definition even if the effect is not the same throughout the period. It may change: for example activities which are initially very difficult may become possible to a much greater extent. The effect might even disappear temporarily. Or other effects on the ability to carry out normal day-to-day activities may develop and the initial effect may disappear altogether. A person has Menières Disease. This results in his experiencing mild tinnitus at times, which does not adversely affect his ability to carry out normal day-to-day activities. However, it also causes temporary periods of significant hearing loss every few months. The hearing loss substantially and adversely affects his ability to conduct conversations or listen to the radio or television. Although his condition does not continually have this adverse effect, it satisfies the long-term requirement because it has substantial adverse effects that are likely to recur beyond 12 months after he developed the impairment. … D22 An impairment may not directly prevent someone from carrying out one or more normal day-to-day activities, but it may still have a substantial adverse effect on how the person carries out those activities. For example: • pain or fatigue: where an impairment causes pain or fatigue, the person may have the ability to carry out a normal day-to-day activity, but may be restricted in the way that it is carried out because of experiencing pain in doing so. Or the impairment might make the activity more than usually fatiguing so that the person might not be able to repeat the task over a sustained period of time. ( See also paragraphs B7 to B10 (effects of behaviour) ).”