Indefinite awards (awards without a review date)
Indefinite awards are awards without a review date (PADP regs, reg 29(3)(a))
Indefinite awards should be given where setting a review date would not be appropriate. This is the case where the available information suggests the individual’s level of need related to their conditions or disability is either:
- highly unlikely to change in the long term (for lower and higher rate PADP awards);
- only likely to increase (for higher rate PADP awards).
Whether the needs of an individual with a lifelong condition are highly unlikely to change depends on a range of factors, rather than just on the individual’s condition. These factors are outlined in this chapter in the relevant considerations for setting a review period section. The nature of the individual’s condition is only one of many indications.
It is essential that you consider all relevant factors to build up a holistic picture of the individual’s circumstances and the likelihood of their needs changing over time.
You should also consider the age an individual would be at their next review. If an individual will be of an advanced age, it might be more appropriate to give them an indefinite award. See the Age section for more information.
Generally, individuals do not have to have severe conditions to be eligible for an indefinite award. Rather than focusing on the severity of their conditions, when deciding whether an indefinite award is appropriate, you must consider whether or not an indefinite award would be appropriate, based on the likelihood of the individual’s needs changing as detailed above. For example, if it is unlikely that the individual on a lower rate award would report a change of circumstances if their needs increased, an indefinite award might not be right for them.
It is important that before deciding not to set a review date, you have enough information to make this decision. If you incorrectly choose not to set a review date, this may mean an individual continues to be paid the wrong rate of assistance after their needs have changed, if they do not report the change in circumstances.
There is no requirement for the individual to have a terminal illness in choosing not to set a review date. Individuals who have a terminal illness will not have a scheduled review of their entitlement. Special rules for terminal illness awards are ongoing without review. There will be no review period and an individual remains eligible unless they have informed Social Security Scotland that their circumstances have changed. For more information on making a determination on a terminal illness case please refer to the SRTI chapter.
Example: An individual’s significant needs are highly unlikely to change
Wilson is 73 years old and has a history of alcohol addiction spanning several decades. In his application form, his support worker explains that Wilson’s excessive alcohol consumption has led to the development of severe peripheral neuropathy causing numbness, tingling and weakness in feet and hands. Additionally, Wilson is experiencing symptoms of confusion, suggestive of Korsakoff’s syndrome, a neurological disorder often associated with chronic alcohol abuse.
His peripheral neuropathy causes difficulty walking, loss of balance and chronic pain in his limbs. Wilson also demonstrates signs of cognitive impairment such as disorientation and memory loss. His alcohol addiction is identified as a significant contributor to his current medical and neurological issues.
With the help of his support worker, Wilson has uploaded a photo of a letter from a medical specialist as confirmation from a professional. The letter states that, due to
- the complex nature of his condition
- the length of time he has had an issue with alcohol; and
- Wilson’s age,
the damage is irreversible and Wilson is being considered for supported accommodation to offer assistance with his care needs, medication and access to healthcare services.
After case familiarisation, the case manager requests a case discussion because they are unsure what review period might be appropriate for Wilson. They are wondering whether Wilson could potentially experience a decrease in needs after a phase of adapting to his supported accommodation and whether therefore a short review period might be best.
However, the practitioner explains that, although Wilson may abstain from alcohol, the damage is irreversible and his needs are highly likely to increase over time due to his degenerative condition, even if he moves into supported accommodation. The case manager decides to award Wilson an indefinite award.
Wilson’s determination letter sets out the reasons why we would not be reviewing his award in future. As no review date was set, the case manager did not need to set out any updates Wilson may need to provide at his next review.
Example: an indefinite award is made at scheduled review now that the individuals needs are highly unlikely to change
Martin is 70 years old and had developed sepsis following an operation, resulting in the amputation of both his legs. On his PADP application Martin detailed that he required help with his daytime and night time needs. Martin applied for PADP 6 months after legs had been amputated and satisfied the backwards test.
Martin explained that he was still coming to terms with losing his limbs and this was affecting his ability to care for himself during the day. His wife now helped him to get washed, dressed and go to the toilet. She also needed to encourage him to eat, as he had been feeling very low since the operation. He had been given a wheelchair when he was discharged from hospital but he was still getting used to it. He said that due to his age he had to visit the toilet several times a night and his wife now had to help him.
The case manager awarded Martin the higher rate of PADP as he satisfied both the daytime and night-time criteria.
When setting the initial review period, the case manager noted that Martin’s consultant said that he was expected to receive prosthetic limbs within the next year. Based on advice from medical guidance about adjusting to prosthetics, an initial three year review period was set. Martin was advised that this would allow time for any changes in his needs to stabilise after receiving the prosthetics. Martin was asked to provide an update on his ability to manage his daytime and night time needs.
At his scheduled review, Martin shared that he has no improvement in his care needs. He found the prosthetics painful and difficult to use due to nerve damage and rarely used them, so his care needs hadn’t changed. His wife is still required to help him during the day and night.
A case discussion with a practitioner provided the case manager with a clearer understanding of adjusting to using prosthetics and the impact of muscle loss and pain relating to nerve damage following amputation. The practitioner explained that, as Martin was unable to use prosthetics, he was likely to continue to require support with bodily functions during the day and night.
As the prosthetics had not improved Martin’s condition and his needs remained unchanged, the case manager awarded him an indefinite award of PADP at the higher rate.
As Martin had been given an indefinite award his determination letter advised him that his award would not be reviewed. As no review date was set, the case manager was not required to outline any updates Martin would need to provide for the next review.