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Adult Disability Payment decision making guide
The decision making guidance, along with training provided to case managers, provides an official interpretation of legislation for Social Security Scotland staff to make decisions about entitlement to Adult Disability Payment.
Supporting documentsPages in this publication:
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- Daily living component activity 1 descriptor A (0 points)
- Daily living component activity 1 descriptor B (2 points)
- Daily living component activity 1 descriptor C (2 points)
- Daily living component activity 1 descriptor D (2 points)
- Daily living component activity 1 descriptor E (4 points)
- Daily living component activity 1 descriptor F (8 points)
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- Daily living component activity 2 descriptor A (0 points)
- Daily living component activity 2 descriptor B (2 points)
- Daily living component activity 2 descriptor C (2 points)
- Daily living component activity 2 descriptor D (4 points)
- Daily living component activity 2 descriptor E (6 points)
- Daily living component activity 2 descriptor F (10 points)
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- Daily living component activity 3 descriptor A (0 points)
- Daily living component activity 3 descriptor B (1 point)
- Daily living component activity 3 descriptor C (2 points)
- Daily living component activity 3 descriptor D (4 points)
- Daily living component activity 3 descriptor E (6 points)
- Daily living component activity 3 descriptor F (8 points)
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- Daily living component activity 4 descriptor A (0 points)
- Daily living component activity 4 descriptor B (2 points)
- Daily living component activity 4 descriptor C (2 points)
- Daily living component activity 4 descriptor D (2 points)
- Daily living component activity 4 descriptor E (3 points)
- Daily living component activity 4 descriptor F (4 points)
- Daily living component activity 4 descriptor G (8 points)
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- Daily living component activity 5 descriptor A (0 points)
- Daily living component activity 5 descriptor B (2 points)
- Daily living component activity 5 descriptor C (2 points)
- Daily living component activity 5 descriptor D (4 points)
- Daily living component activity 5 descriptor E (6 points)
- Daily living component activity 5 descriptor F (8 points)
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- Daily living component activity 6 descriptor A (0 points)
- Daily living component activity 6 descriptor B (2 points)
- Daily living component activity 6 descriptor C (2 points)
- Daily living component activity 6 descriptor D (2 points)
- Daily living component activity 6 descriptor E (4 points)
- Daily living component activity 6 descriptor F (8 points)
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- Mobility component activity 1 descriptor A (0 points)
- Mobility component activity 1 descriptor B (4 points)
- Mobility component activity 1 descriptor C (8 points)
- Mobility component activity 1 descriptor D (10 points)
- Mobility component activity 1 descriptor E (10 points)
- Mobility component activity 1 descriptor F (12 points)
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- Mobility component activity 2 descriptor A (0 points)
- Mobility component activity 2 descriptor B (4 points)
- Mobility component activity 2 descriptor C (8 points)
- Mobility component activity 2 descriptor D (10 points)
- Mobility component activity 2 descriptor E (12 points)
- Mobility component activity 2 descriptor F (12 points)
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- Circumstances when an application may be made
- How to make an application
- Who can make a new application
- Beginning an application
- Date the application is to be treated as made
- Acceptable and unacceptable applications
- Rejecting an application
- Change of circumstances after an application is submitted and before a decision is made
- Determination of entitlement
- Withdrawal of application
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- New applications for ADP
- Eligibility for new applications for individuals older than the relevant age to receive ADP
- Eligibility for new applications, for individuals over the relevant age after an interval, that includes the mobility component
- Eligibility for new applications for individuals under the relevant age after an interval
- Case transfer and the age criteria
- Determination of an ongoing award after the individual has reached the relevant age
- Exceptions for a new determination that includes the mobility component for those above the relevant age
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- What is our approach to award reviews?
- General approach when carrying out award reviews
- Needing more detail to establish the new level of need
- Specific review scenarios: No change in needs reported
- Specific review scenarios: A change in needs is reported (either as part of a scheduled or unscheduled review)
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- Events that prompt an unscheduled review
- Unscheduled review following change of circumstances
- Individuals tell us about a change
- Third parties telling us about a change
- Changes that require an unscheduled review
- Changes which do not require an unscheduled review
- A change that occurs before the initial determination is made
- What information is used to make the decision
- When a change of entitlement takes effect
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- When an individual in receipt of PIP moves to Scotland
- Entitlement to ADP beginning while in 'alternative accommodation'
- Differences between ADP and PIP eligibility criteria
- When case managers are required to make a determination without application
- If entitlement to ADP is based on a PIP award that later changes
- When an individual in receipt of ADP moves to another part of the UK
- When the individual notifies Social Security Scotland in advance of the move
- An individual cancels the move after they have told Social Security Scotland that they are moving
- When an individual notifies Social Security Scotland more than 13 weeks after the move
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- Change of circumstances: change in mobility or care needs
- Examples of typical changes in mobility or daily living needs
- Making an unscheduled review because of a change of circumstance
- Applying the backwards and forwards tests
- When the change in entitlement should begin if the individual meets the criteria for a higher award
- What is a good reason for not notifying within 1 month
- Setting an earlier start date for entitlement when a change in an individual’s needs leads to a higher award
- When the change in entitlement should begin if the individual meets the criteria for a lower or no award
- Setting a later start date to entitlement when a change in an individual’s condition and needs leads to a lower award or the end of the award
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- Need for Discretion
- Special Rules for Terminal Illness
- Eligibility
- Supporting information for SRTI
- Applications from a third party
- Date of Award
- Terminal Illness identified during non-SRTI Application
- Terminal illness diagnosis during non-SRTI application
- Incomplete SRTI applications
- Moving from Child Disability Payment to Adult Disability Payment
- Change of Circumstances
- Re-determinations and Appeals
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- Right to Appeal to the First-tier Tribunal
- Appealing a process decision
- How an individual can appeal to the First-tier Tribunal against a determination or re-determination
- Deadlines for appealing
- Non-disclosure of documents and information that could cause serious harm to physical or mental health
- Responding to the notice of appeal
- Who is in the First-tier Tribunal
- Hearings
- Representatives and supporters
- Evidence and submissions
- Witnesses
- Withdrawing or deciding to stop an appeal
- The First-tier Tribunal’s decision
- Applying for a written statement of reasons
- The First-tier Tribunal’s power to review and set aside its decisions
- Duty to treat a request for a review as an application for permission to appeal
- Appealing against a decision of the First-tier Tribunal
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- Death of an individual
- Verification of death
- Overpayments of ADP after the death of an individual
- Death arrears
- Establishing next of kin / representative details for someone who has died
- How does Social Security Scotland decide who to appoint or pay
- When Social Security Scotland are unable to identify an individual to act or receive any assistance that is due
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- Principles of choosing a review period
- What are review periods?
- Choosing an appropriate review period
- Relevant considerations for setting a review period
- Choosing an appropriate review period between 2 and 10 years
- Exception: Review periods under 24 months
- Exception: Indefinite awards (awards without a review date)
- Conditions that suggest a review is inappropriate (Pathway 1)
- Conditions that suggest a review may be inappropriate (Pathway 2)
- Conditions that might indicate a review is appropriate but additional factors suggest it might not (Pathway 3)
- The views of the individual
- Other necessary considerations before selecting an indefinite award
- Justifying a decision to (not) set a review date
- Individual’s responsibility to report changes
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- Eligibility
- Ordinary residence in Scotland
- Habitual residence
- Presence in the Common Travel Area
- Past presence in the Common Travel Area
- Subject to immigration control
- Members of the armed forces and civil servants
- Temporary absence
- Time spent in alternative accommodation / legal detention
- EU rules on social security coordination
- Personal scope of the EU coordination rules
- First Claims from Abroad
- Export
- Competent State
- Residence criteria for the protected cohort
- Genuine and Sufficient Link to Scotland
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- Definition of care home, hospital, hospice and residential educational establishment
- Effect on entitlement of an individual spending time in care homes, hospitals or hospices
- Calculating the length of stay
- Temporary periods of leave during a stay in a care home or hospital
- Linked periods
- Exceptions
- Applications made while residing in a care home or hospital
- Care homes, hospital or similar institutions and short- term assistance
- Impact on transferring individuals from UK benefits when entitlement to ADP begins while they are in a care home or hospital
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- The meaning of case transfer
- The case transfer process from Personal Independence Payment to Adult Disability Payment
- The Adult Disability Payment determination
- Ending the client’s Personal Independence Payment award
- Information received from Department for Work and Pensions
- Payment Cycles
- Special Rules for Terminal Illness
- Effect of legal detention on payment of the mobility component: 16 and 17 year olds
- Reported relevant change of circumstance
- Case Transfer Scheduled Review
- Appointees
- Residence
- Temporary time abroad
- Time in alternative accommodation
- Re-determinations and appeals
- When a Personal Independence Payment award that ended at the point of case transfer is retroactively changed
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- The meaning of case transfer
- The case transfer process from Disability Living Allowance to Adult Disability Payment
- The Adult Disability Payment determination
- Ending the client’s Disability Living Allowance award
- Information received from Department for Work and Pensions
- Two stage review process
- Special Rules for Terminal Illness
- Payment cycles
- Reported relevant change of circumstance
- Appointees
- Residence
- Temporary time abroad
- Time in alternative accommodation
- Re-determinations and appeals
- When a Disability Living Allowance award that ended at the point of case transfer is retroactively changed
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- Our approach to gathering supporting information
- What is supporting information?
- Confirmation from a professional
- Additional supporting information
- Lack of confirmation from a professional
- Gathering supporting information
- Requesting more additional supporting information
- Disengagement
- Supporting information when carrying out a review
- Supporting information and Special Rules for Terminal Illness
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- When payment of assistance may be suspended
- Suspension for failure to provide information
- Suspension because person unable to continue acting or individual at risk of financial abuse
- Suspension for failure to provide payment details
- Suspending Payments
- Considering the individual’s financial circumstances
- Reviewing a decision to suspend payments
- Impact of suspension on individuals with an AVE lease
- Ending a suspension
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- Right to appeal to the Upper Tribunal
- Applying to the First-tier Tribunal for permission to appeal to the Upper Tribunal
- Applying to the Upper Tribunal for permission to appeal if the First-tier Tribunal refuses permission
- Notice of appeal
- Non-disclosure of documents and information that could cause serious harm to physical or mental health
- Who is in the Upper Tribunal
- The Upper Tribunal’s case management powers
- Hearings
- Representatives
- Evidence and submissions
- Witnesses
- Withdrawing or deciding to stop an appeal
- Upper Tribunal’s decision
- The Upper Tribunal’s powers to review and set aside its decisions
- Appealing against a decision of the Upper Tribunal
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- What is a consultation
- What is a practitioner
- When a consultation can be requested by Social Security Scotland
- Client requests for a consultation
- Client refuses a request for a consultation
- Scheduling and rescheduling a consultation
- Who should carry out a consultation
- Who can participate in a consultation
- How a consultation can be carried out
- What a consultation should cover
- Unexpected findings
- Audio recording of the consultation
- Ending a consultation
- Client expenses
- After the consultation