Following an NHS England appeal of a retrospective assessment, Compass CHC has been successful in securing a refund of over two years of care fees, amounting to over £100,000.
Currently, it is possible to request a retrospective review of Continuing Healthcare Funding entitlement for any period after 1 April 2012, provided that the period being reviewed is classed as an ‘unassessed period of care’.* This means that the period under review must not have already been reviewed by the NHS Integrated Care Board.
In this case, Compass CHC requested that a retrospective review be completed by the Integrated Care Board. However following the completion of a retrospective Decision Support Tool assessment which considered the evidence for the relevant period, the NHS unfortunately refused to award funding.
Compass CHC then pursued an appeal through the Integrated Care Board’s local appeals process, but again the negative decision was upheld.
Finally, a successful challenge was made to NHS England, with the Independent Review Panel agreeing that the initial negative decision was incorrect. The matter was referred back to the Integrated Care Board, who then agreed to award funding, resulting in the reimbursement of two years of care fees which otherwise would not have been given.
Our Legal Services Director, Louis Seymour commented:
“We’re delighted to have achieved this outcome with funding rightfully being awarded for the entire retrospective period, resulting in a significant reimbursement of care fees which should have been paid for by the NHS. This successful outcome is just one example of the many positive eligibility decisions obtained by our team of experts, who are continuously helping many families recover years of care fees, often amounting to tens or hundreds of thousands of pounds.”
If you believe that you or your loved one may have been entitled to Continuing Healthcare funding, but an assessment was never completed by the NHS, please get contact us for a free, no-obligation assessment. Our Specialist Advisors will be able to guide you through the retrospective process and advise on whether a retrospective claim should be pursued.
*Please note that this time period relates only to retrospective claims pursued with NHS Integrated Care Boards in England. Retrospective claims in Wales operate differently, so please contact our Specialist Advisors if you require further advice in relation to a retrospective claim for an individual residing in Wales.
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