| Activity1 | Descriptors 2 | Points |
|---|
| 1. Mobilising unaided by another person with or without a walking stick, manual wheelchair or other aid if such aid is normally or could reasonably be worn or used. | 1(a) | Cannot, unaided by another person, either: | 15 |
| (i) | mobilise more than 50 metres on level ground without stopping in order to avoid significant discomfort or exhaustion, or | |
| | (ii) | repeatedly mobilise 50 metres within a reasonable timescale because of significant discomfort or exhaustion. | |
| (b) | Cannot, unaided by another person, mount or descend 2 steps even with the support of a handrail. | 9 |
| (c) | Cannot, unaided by another person, either— | 9 |
| | (i) | mobilise more than 100 metres on level ground without stopping in order to avoid significant discomfort or exhaustion, or | |
| | (ii) | repeatedly mobilise 100 metres within a reasonable timescale because of significant discomfort or exhaustion. | |
| (d) | Cannot, unaided by another person, either— | 6 |
| | (i) | mobilise more than 200 metres on level ground without stopping in order to avoid significant discomfort or exhaustion, or | |
| | (ii) | repeatedly mobilise 200 metres within a reasonable timescale because of significant discomfort or exhaustion. | |
| (e) | None of the above applies. | 0 |
| 2. Standing and sitting. | 2(a) | Cannot move between one seated position and another seated position which are located next to one another without receiving physical assistance from another person. | 15 |
| (b) | Cannot, for the majority of the time, remain at a work station: | 9 |
| | (i) | standing unassisted by another person (even if free to move around), | |
| | (ii) | sitting (even in an adjustable chair); or | |
| | (iii) | a combination of paragraphs (i) and (ii), | |
| | for more than 30 minutes, before needing to move away in order to avoid significant discomfort or exhaustion. | |
| (c) | Cannot, for the majority of the time, remain at a work station— | 6 |
| | (i) | standing unassisted by another person (even if free to move around), | |
| | (ii) | sitting (even in an adjustable chair); or | |
| | (iii) | a combination of paragraphs (i) and (ii), | |
| | for more than an hour before needing to move away in order to avoid significant discomfort or exhaustion. | |
| (d) | None of the above applies. | 0 |
| 3. Reaching. | 3(a) | Cannot raise either arm as if to put something in the top pocket of a coat or jacket. | 15 |
| (b) | Cannot raise either arm to top of head as if to put on a hat. | 9 |
| (c) | Cannot raise either arm above head height as if to reach for something. | 6 |
| (d) | None of the above applies. | 0 |
| 4. Picking up and moving or transferring by the use of the upper body and arms. | 4(a) | Cannot pick up and move a 0.5 litre carton full of liquid. | 15 |
| (b) | Cannot pick up and move a one litre carton full of liquid. | 9 |
| (c) | Cannot transfer a light but bulky object such as an empty cardboard box. | 6 |
| (d) | None of the above applies. | 0 |
| 5. Manual dexterity. | 5(a) | Cannot press a button (such as a telephone keypad) with either hand or cannot turn the pages of a book with either hand. | 15 |
| (b) | Cannot pick up a £1 coin or equivalent with either hand. | 15 |
| (c) | Cannot use a pen or pencil to make a meaningful mark with either hand. | 9 |
| (d) | Cannot single-handedly use a suitable keyboard or mouse. | 9 |
| (e) | None of the above applies. | 0 |
| 6. Making self understood through speaking, writing, typing, or other means which are normally or could reasonably be used, unaided by another person. | 6(a) | Cannot convey a simple message, such as the presence of a hazard. | 15 |
| (b) | Has significant difficulty conveying a simple message to strangers. | 15 |
| (c) | Has some difficulty conveying a simple message to strangers. | 6 |
| (d) | None of the above applies. | 0 |
| 7. Understanding communication by: | 7(a) | Cannot understand a simple message, such as the location of a fire escape, due to sensory impairment. | 15 |
| (i) | verbal means (such as hearing or lip reading) alone, | (b) | Has significant difficulty understanding a simple message from a stranger due to sensory impairment. | 15 |
| (ii) | non-verbal means (such as reading 16 point print or Braille) alone, or | (c) | Has some difficulty understanding a simple message from a stranger due to sensory impairment. | 6 |
| (iii) | a combination of sub-paragraphs (i) and (ii), | (d) | None of the above applies | 0 |
| using any aid that is normally or could reasonably be used, unaided by another person. | | |
| 8. Navigation and maintaining safety using a guide dog or other aid if either or both are normally used or could reasonably be used. | 8(a) | Unable to navigate around familiar surroundings, without being accompanied by another person, due to sensory impairment. | 15 |
| (b) | Cannot safely complete a potentially hazardous task such as crossing the road, without being accompanied by another person, due to sensory impairment. | 15 |
| (c) | Unable to navigate around unfamiliar surroundings, without being accompanied by another person, due to sensory impairment. | 9 |
| (d) | None of the above applies. | 0 |
| 9. Absence or loss of control whilst conscious leading to extensive evacuation of the bowel and/or bladder, other than enuresis (bed-wetting), despite the wearing or use of any aids or adaptations which are normally or could reasonably be worn or used. | 9(a) | At least once a month experiences: | 15 |
| (i) | loss of control leading to extensive evacuation to the bowel and/or voiding of the bladder, or | |
| (ii) | substantial leakage of the contents of a collecting device, | |
| sufficient to require cleaning and a change in clothing. | |
| (b) | The majority of the time is at risk of loss of control leading to extensive evacuation of the bowel and/or voiding of the bladder, sufficient to require cleaning and a change in clothing, if not able to reach a toilet quickly. | 6 |
| (c) | Neither of the above applies. | 0 |
| 10. Consciousness during waking moments. | 10(a) | At least once a week, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. | 15 |
| (b) | At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration. | 6 |
| (c) | Neither of the above applies. | 0 |
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