Change of circumstances before an initial determination has been made
This section applies in circumstances where an individual provides additional information:
- after having submitted their application
- before an initial determination has been made.
Case managers should take any new information they receive into account when making a determination. 56.A further application is not necessary when an individual reports a change of circumstances before the initial determination is made.
Case managers will need to make two determinations if the individual’s needs have changed since their application was initially submitted, where the change reported affects the initial rate of award.
This includes the possibility of an individual not being entitled to PADP for the period before or after the change of circumstances.
The first determination takes into account the needs of the individual based on the original information provided in the application.
The second determination takes into account the needs of the individual based on the change reported, or new information provided.
This could result in two different rates of award, which is known as a split award. See operational guidance on split awards.
The second award is effective for payment once the individual meets the backwards test for the new information provided.
Where an individual has reported a change of circumstances for an award that is already in payment, case managers should refer to the ‘Change of Circumstances’ chapter.
Example: a change of circumstances is reported in advance of a determination
Francis is 78 and has arthritis and a heart condition. He applies for PADP on 6 April, stating that his needs have existed for 2 years prior to applying. This means that he satisfies the backwards test at the time of application. The information within the application form suggests that Francis is likely to be entitled to the lower rate of PADP from the date of application in relation to his daytime needs.
Before the case manager has made their determination, Francis’ spouse contacts Social Security Scotland on 27 May to say that Francis had a stroke on 21 May and now has increased needs. After considering the additional information the case manager decides that Francis will be entitled to the higher rate of PADP, as he has developed night-time needs.
As Francis’ increased needs began on 21 May, the date that he had a stroke, he does not yet satisfy the backwards test for an award of the higher rate of PADP. This will be satisfied on 19 November. Therefore, Francis will be entitled to the lower rate of PADP from 6 April, and the earliest date that he can be paid the higher rate will be 19 November.
Two separate determinations of entitlement set out both of these awards.
Example: a change of circumstances is reported in advance of a determination
Rana is 75 and applied for PADP on 4 June due to having depression and anxiety. Her application form states that her needs have existed for more than 6 months prior to applying. Therefore, Rana has satisfied the backwards test. The information provided in the initial application suggests that Rana will be entitled to the lower rate of PADP as she needs someone to watch over her during the night.
Before the case manager makes their determination, Rana writes to Social Security Scotland to say that she was involved in a road traffic accident on 23 July.
She received severe injuries to her right leg, requiring emergency surgery and intensive follow up physiotherapy. Supporting information from an orthopaedic surgeon confirms Rana’s injuries and sets out the long-term nature of Rana’s condition. The case manager decides an award of the higher rate of PADP is appropriate, as Rana now requires attention throughout the day.
As Rana’s increased needs began on 23 July, the backwards test will be satisfied on 21 January. This is the earliest date that the higher rate of PADP can be paid from
Therefore, the case manager will make an initial determination that Rana is entitled to the lower rate of PADP from 4 June to 21 January, and a second determination that she is entitled to the higher rate of PADP from 21 January onwards. A review is scheduled for 3 years from the date the determination was made, to check whether Rana’s needs have changed.