Unscheduled reviews for Adult Disability Payment

This chapter is relevant to individuals who have an Adult Disability Payment (ADP) award when new information emerges that could change their entitlement. 

This could affect either:

• entitlement to ADP overall, 
• the rate of the daily living or the mobility component or both the individual receives

The rates of payment that individuals receive can increase or decrease. 

Entitlement to either or both the daily living and mobility components can stop.

Unscheduled reviews are different from scheduled reviews. Individuals are informed in their notice of determination that they will have a scheduled review after a certain date. This is to ensure that they still meet the eligibility criteria and continue to receive the appropriate components and rate.

New information becoming available may prompt an unscheduled review of the individual’s case.

Common examples include:

• a new health condition that impacts on the individual’s ability to carry out the daily living and/or mobility activities
• a deterioration or improvement in a condition that impacts on the individual’s
• ability to carry out the daily living and /or mobility activities
• moving away from Scotland
• discovery that an error was made with the previous determination
• the individual going into a care home, residential educational establishment, a hospital or similar institution, or legal detention. 

The individual does not need to fill in a new application form in these situations. However they must report the change to Social Security Scotland. They can do this by filling in a form online or on paper or by calling Social Security Scotland.

An unscheduled review can occur both when:

• a change has happened after the original entitlement decision has started
• later determinations have happened. 

These later determinations could be as a result of a scheduled or unscheduled review.

Making an unscheduled review involves making a determination without application. A determination without application is the decision whether an individual is still entitled to ADP, and if so, at what rate. The case manager must tell the individual when a determination without application is made. The individual can ask for a re-determination and an appeal if they disagree with this new determination.

If the unscheduled review results in no change to entitlement, a new determination will still be sent to the individual. This is because any decision on entitlement must be done by a determination even if it results in no change to the components or rates. The notice of determination will explain that the outcome of the unscheduled review is no change to the entitlement. This will allow the individual to request a re-determination and appeal.

The individual will also receive a letter if they report a matter that does not prompt an unscheduled review. An example of such a matter is if the individual moves house, but is still residing in Scotland and is not residing in a care home or a residential educational establishment. The letter the individual receives may explain that Social Security Scotland has updated its record of the individual’s personal information.