Eligibility for new applications for individuals under the relevant age after an interval
Where an individual under the relevant age makes a new application for Adult Disability Payment (ADP) and they do not meet the backwards test, they may still be eligible to have their ADP award backdated to their application date if they have a previous award which ended within 12 months of making the new application. (ADP regs. reg 23 (1b) (i) (ii))
Provided entitlement under the new application results from the same physical/mental condition(s), for which the previous award was made (ADP regs. reg 23 (1c)) , or a new physical/mental condition(s) which developed because of the condition(s) for which the previous award was made.(ADP regs. reg 23 (1d) (i) (ii))
This means the required 3 months backwards test will be considered to have been satisfied by the end date of the previous award, it does not need to be re satisfied for the new application. (ADP regs. reg 23 (3)) The 9 months forwards test will be considered from the date of the new application.
Example: an individual under the relevant age who was previously awarded ADP applies again within 12 months as his condition has returned.
Application form
Mark has depression and has been receiving the standard rate of both the daily living and mobility components of ADP. During a scheduled review Mark is found to no longer have the same level of needs and is no longer eligible for ADP.
Nine months later Mark makes a new application to ADP, as his depression has returned. The case manager decides Mark is entitled to the same level of daily living and mobility components as previously awarded.
Case manager’s decision
As the new application is within 12 months and Mark is under the relevant age, he is entitled to ADP from the date of application, and the backwards test is deemed to be satisfied immediately.
Example: an individual under the relevant age, who was previously awarded ADP, applies again within 12 months, with the same condition and her needs are now greater.
Application form
Jane has anxiety and depression and has been receiving the standard rate of ADP. Jane is prescribed antidepressants and has a course of cognitive behavioural therapy. As a result of this Jane’s conditions improve.
She submits a change of circumstances that triggers an unscheduled review. The case manager decides that she is no longer eligible for ADP. Ten months later Jane makes a new application to ADP, as her anxiety and depression has returned.
Case manager’s decision
The application is within 12 months and Jane is under relevant age. However, the case manager decides Jane is now entitled to the enhanced rate of both the daily living and mobility components of ADP. This means Jane will be required to satisfy both the backwards and forwards test from the date of her new application, as her needs have significantly increased.
Example: An individual under relevant age, who was previously awarded ADP, applies after 12 months with same condition.
Application form
Robert has arthritis in his knee, and has been receiving the standard rate of both the daily living and mobility component of ADP. Robert receives physiotherapy, and loses a significant amount of weight, his condition significantly improves.
He submits a change of circumstances that triggers an unscheduled review. The case manager decides Robert is no longer eligible for ADP.
Thirteen months later Robert makes a new application to ADP as his arthritis has flared up again. The case manager decides Robert is again, entitled to both the standard rate of the daily living and mobility components of ADP.
Case manager’s decision
However, as the new application is more than 12 months after the end of the previous award, Robert is required to satisfy both the backwards and forwards test from the date of the new application.
Example: an individual under the relevant age who was previously awarded ADP applies within 12 months, with a new condition.
Application form
James has arthritis in one of his hips and is receiving the enhanced rate for both the daily living and mobility components of ADP.
James has a hip replacement and his condition significantly improves. He submits a change of circumstance and the case manager decides he is no longer eligible for ADP.
Eleven months later James is diagnosed with Crohn’s disease, he makes a new application for ADP. James is under the relevant age and the application is made within 12 months.
Case manager’s decision
However, as this new application is in relation to a different condition, James will be required to satisfy both the backwards and forwards test from the date of the new application.
Example: an individual under the relevant age who was previously awarded ADP applies again within 12 months for a condition that has arisen as a result of an earlier condition.
Application form
John has thyroid cancer and is receiving the enhanced rate for both the daily living and mobility components of ADP. John’s treatment is successful and he fully recovers. He submits a change of circumstances that triggers an unscheduled review and the case manager decides he is no longer eligible for ADP.
Eight months later John is diagnosed with post-traumatic stress disorder as a result of his previous cancer diagnosis and he makes a new application to ADP. The case manager decides John is entitled to the same level of daily living and mobility components as previously awarded.
Case manager’s decision
As the new application is within 12 months, and John is under the relevant age, he is entitled to ADP from the date of application, and the backwards test is deemed to be satisfied immediately.