Case studies & success stories
Retrospective Claim Success Story
We helped with
Retrospective Review
This week’s success story concerns a retrospective claim for a gentleman who was receiving care at home.
When the family approached Farley Dwek for advice, the Integrated Care Board (ICB) had already completed their Decision Support Tool (DST), recommending eligibility for NHS Continuing Healthcare Funding for a period of months towards the end of the patient’s life. We reviewed the DST and available evidence, and recommended an appeal be submitted for an additional 18-months of funding.
Our expert team prepared a Written Submission using the evidence provided by the family. The case was more challenging than some, in so far as there were no formal care records, as would be the case for someone residing in a residential care or nursing home. Nevertheless, with statements from the carers and our client’s detailed diaries, we were able to present a cogent case for eligibility for CHC Funding.
Upon receipt of our Written Submission, the ICB arranged a Local Resolution Meeting which we attended with our client. A deciding factor was our client’s ability to provide detailed information to the Local Review Panel, in addition to the written evidence.
After a short wait, the ICB wrote to confirm it had awarded CHC funding for the full period under appeal. A great outcome for the family!