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I work as a Welfare Rights Officer for North Lanarkshire Council and would appreciate advice/information concerning how mobile someone needs to be for the formation of callouses on the feet. Examining Doctor's are stating that "callus present on soles of feet", this is then used as a justification for stating that the person is more mobile than they claim, especially in cases where people have Fybromyalgia or Chronic Fatigue Syndrome and are claiming the Mobility Component of Disability Living Allowance.

I beleive the inference is that if their feet are calloused then they are doing a lot of walking and would appreciate some guidance on this. Thanks.

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Dear D Nelson,

This is a very interesting question and is one my colleagues and i regularly see when a pt says they are housebound so never go out.

So why the level of callosity if pt is basically chair or bed bound for all or most of the day.

Simple answer is probably to attach a pedometer. This measures the no of steps taken by a pt.

This was recently used as a part of the get walking health education that took place this year.

10,000 steps per day being the objective for a reasonably fit and mobile person.

WE have many who claim to be housebound but who still :

STRUGGLE TO GO TO SPAIN ON HOLIDAY WITH FAMILY once or twice a year.

WE even have people who go to GP surgery for a letter to state that they are housebound.

Best one i came across was a private pt who was referred to me by BLESSMA.

This is a War veterans charity who provide health care for War Injury victims.

I was asked to see this guy and asked him to attend my clinic.

He said he was housebound and so needed a home visit. This home visit every 4 weeks for a nail clipping naturally entailed greater expense for the charity than a clinic visit.

GP signed him off as house bound so out i went 28 mile round trip at £0.50 per mile and my fee.

LOVERLY NEW SHINY CAR IN DRIVE . VISIBLE DISABLED STICKER WITH PT NAME ON IT.

Yep GP signed him up for Mobility Car.

Guys injury was a below elbow amputation due to shrapnel injury.

THis guy was successfully DEFRAUDING THE TAX PAYER , THE NHS, THE CHARITY ETC ETC.

He used to moan if i was bit late for his appt as he had to go to the British Ex Servicemans Club for lunch and card game.

I informed the charity of the above so as not to be in collusion with this fraud.

They said not to worry as this was a normal occurrence.

Not good politically to challenge the fraudster.

WAR Veteran denied essential health care by horrible charity.

So fraud is acceptable for certain groups in this country.

Trouble is it means that those who genuinely need the help do not get it as the resources have been defrauded by someone else.

So good luck.

BUt i would say in answer to your question:

If there is marked physical disability and impairment of the way he walks then Callus formation on limited walking may occur.

But generally the more you walk the greater the degree and severity of callus formation.

If there is a physical abnormality of the foot and or leg then suitable insoles and protective footwear may be needed.

Also obesity will adversely impact on the above.

So good luck.

It may turn out to be easier to allow the suspected fraud, than to get embroiled in a Disciplinary claim against you for your uncaring attitude. THis tactic works in the NHS for pts to get care they have no need of but want.

regards David

I would be inlcined to agree - highly unikely to get calluses without being mobile.

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Craig Payne
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