Case study: Does the DDA apply

1
Case study Does the DDA apply?

• Dr Jacques Tamin TD
• MBChB MA(HS Law) LLM FFOM MRCGP
• Consultant Occupational Physician
• Honorary Lecturer, COEH

2
Mrs X

• Aged 59
• made redundant from work Aug 2004
• work related stress
• arthritic condition knees
• proceedings under DDA

3
Instructions

• Assist the Employment Tribunal to decide whether
  at the time of her dismissal, her symptoms
  amounted to a disability for the purposes of the
  DDA
• to identify the mental or physical impairments
• to identify which one or more normal day-to-day
  activities are affected etc

4
Occupational History

• 1987-1995 Technical clerk, MOD
• 1995-2001 PA (temp)
• 2001-2002 Technical clerk, manufacturing
  organisation
• Applied for post as secretary

5
Pre-employment in 2002

• Declared anxiety/stress
• amitryptiline 1995
• arthritis diagnosed 1995
• OH nurse asked for GP report
• GP confirmed, but conditions were stable stated
  should not be problematic
• OH nurse did not document advice she gave to
  employer based on this
• no written stress risk assessment

6
What does the employer know?

• Court of Appeal decision in Hartman v South Essex
  Mental Health Community Care NHS Trust
• Diana Kloss questioned whether future Employment
  Tribunals would take the same view Ref OH at
  work 1(6)30-31

7
Knee condition

• GP records
• Bilateral knee pain 1990
• XR L knee 1996 early OA
• XR 2002 OA changes bilaterally with osteophytes,
  but no significant narrowing
• physio 2003
• uses topical ketoprofen gel
• o/e FROM, slight bilat effusion

8
Functional level

• Potters around the house and garden
• does most housework
• cant clean skirting boards
• shops in car, small amounts at a time
• lost 2 st on Xenical in last year, symptoms have
  improved
• Barcelona 2003, could not walk for 2 weeks after
• flower shows had to stop and sit

9
DID THE DDA APPLY AT THE TIME OF HER DISMISSAL?
10
Psychiatric condition

• GP records
• 1983 depressed, obsessional Prothiaden
• further episodes 1986, 1988, 1990
• 1992 loss of memory
• on antidepressants continuously from 92
• 1999 gets agitated at work, does not cope in work
  situation very well
• 2004 unhappy at work, stress at work

11
Mental state Functional status

• Currently NAD
• pleasant, co-operative, did not appear to
  exaggerate
• stated memory and ability to concentrate markedly
  affected e.g. in 2004
• never to the point where e.g. needed help to
  write a cheque

12
DID THE DDA APPLY AT THE TIME OF HER DISMISSAL?
13
Psychiatric assessment

• Diagnoses
• Depressive episode with psychotic symptoms of
  moderate severity
• Anankastic personality disorder
• ?Paranoid personality disorder
• persecutory delusional beliefs
• no disability of memory, concentration or any
  capacity issues

14
DID THE DDA APPLY AT THE TIME OF HER DISMISSAL?
15
What about

• memory or ability to concentrate, learn or
  understand
• understand what is real and not psychosis?
• Mobility??

16
Any further questions?

• Thank you for your attention