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Publication - Publication

Adult Disability Payment decision making guide

Published
7 Aug 2025
Topic
Adult Disability Payment
Determinations and Awards - Overview chapter

What a determination of entitlement is

Case managers are responsible for determining whether an individual is entitled to ADP.

ADP has two components. Each component is payable at different rates.

The components and rates of ADP are:

  • the daily living component (standard or enhanced rate)
  • the mobility component (standard or enhanced rate)

Case managers must determine whether an individual meets the eligibility criteria for entitlement to ADP. The eligibility criteria refer to:

Individuals entitled to any of the following benefits are not entitled to ADP (ADP regs, reg 4)

  • Disability Living Allowance
  • Personal Independence Payment
  • Attendance Allowance
  • Pension Age Disability Payment
  • Child Disability Payment
  • Armed Forces Independence Payment.

Individuals must meet the residence and presence conditions and the age criteria to be entitled to ADP.

The daily living component scoring criteria only apply to entitlement to the daily living component of ADP. The mobility component scoring criteria only apply to entitlement to the mobility component of ADP. This means that individuals do not need to meet the daily living component criteria to be entitled to the mobility component and vice versa.

An individual with a terminal illness should be considered to satisfy the conditions for the enhanced rate of the daily living component and the enhanced rate of the mobility component of ADP (ADP regs, reg. 26)

A determination of entitlement to ADP consists of: 

  • a decision about whether or not the individual is entitled to either or both the daily living and mobility components of ADP
  • if the individual is entitled to ADP, a decision about:
    • the weekly rate of both the daily living component and the mobility component of ADP they are entitled to
    • when they will become entitled to ADP
    • reducing the payment of the weekly rate of components to zero in certain circumstances. For example, when the individual is resident in alternative accommodation for more than 28 days.
    • Reducing the payment of the weekly rate because of entitlement to other benefits such as Constant Attentandance Allowance.

This chapter provides an overview of how and when case managers make determinations of entitlement to ADP. More detailed information on the specific aspects of making determinations are provided in linked chapters.

Case managers are required to make determinations of entitlement when they:

  • receive an application for ADP
  • are required to make a determination without application as part of a scheduled or unscheduled review
  • an individual requests a re-determination 

The rules also require a court or tribunal to make determinations of entitlement if an individual makes an appeal regarding a determination of entitlement (SS Act 2018, s25). This chapter will focus on determinations of entitlement made by case managers.

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