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Terminal illness diagnosis during non-SRTI application
An individual applying under the normal rules may submit Part 1 of a non SRTI PADP application, then receive a terminal illness diagnosis resulting in Social Security Scotland being provided with a clinical judgement and subsequent BASRiS form.
The case manager should prioritise and make a first determination under the special rules using the date of clinical judgement. This will ensure the individual begins receiving higher rate disability assistance as soon as possible. For the SRTI award period, there is no requirement for the individual to submit a normal rules Part 2 application form. No supporting information in addition to the clinical judgement is required for this period. The SRTI award period is the period from the date of the clinical judgement.
A second determination, under non-SRTI rules, may be appropriate for the period between receipt of the non-SRTI Part 1 and the subsequent clinical judgement date. The individual may have been entitled to disability assistance under the normal rules for a period before becoming terminally ill.
For the second determination, the case manager will need to make use of a Part 2 application (if submitted) and/or any supporting information. Where the client is now terminally ill, the seeking of Part 2 and/or any supporting information should be proportionate and carried out sensitively. If a determination can be made without the individual themselves being asked to complete a Part 2, this should happen.
If the second determination finds that the client was entitled to PADP between the initial date of application and the date of clinical judgement (of terminal illness), they will receive the value of that benefit in retrospect.
If there is a suggestion of the individual being terminally ill at the time of the initial application and prior to the date of clinical judgement, this must be investigated by a practitioner by making contact with the relevant RMP/RN. Contact should be directed to the RMP/RN and not the individual as there is a possibility that harmful information has been withheld from them.
If the case manager determines that the individual was terminally ill at the time of the initial application, payments can be backdated to that date. Awards can be backdated a maximum of 26 weeks and to no earlier than 21 October 2024.
Example: normal rules Part 1 and Part 2 application followed by terminal illness diagnosis before a determination has been made
Julie has arthritis and submits a Part 1 and Part 2 normal rules application on 19 February. A BASRiS form is later received which advises that Julie has been diagnosed with stage 4 lung cancer and is now eligible under SRTI. The BASRiS gives a clinical judgement date of 1 March. Two determinations will require to be made. A first determination is prioritised using the 1 March date of clinical judgement to ensure that Julie begins to receive the higher rate of Pension Age Disability Payment as soon as possible. A second determination is then made for the normal rules period between the date of the initial application on 19 February and the clinical judgement date of 1 March. The Case Manager uses the information provided on Part 2 of the application and other available supporting information to make their normal rules determination.
Example: normal rules application with Part 1 only followed by terminal illness diagnosis before a determination has been made.
Donna has anxiety and submits Part 1 of a normal rules application on 1 May. A BASRiS form is later received which advises that Donna has been diagnosed with stage 4 breast cancer and is now eligible under SRTI. The BASRiS gives a clinical judgement date of 27 May. A Practitioner investigates the clinical judgement date with Diane’s GP as she may have been terminally ill when she submitted her Part 1 application. Diane’s GP confirms the 27 May clinical judgement date. Two determinations will require to be made. A first determination is prioritised under SRTI using the 27 May date of clinical judgement to ensure that Donna begins to receive the higher rate of Pension Age Disability Payment as soon as possible. For the SRTI award period there is no requirement to submit a normal rules Part 2 application form. No supporting information in addition to the clinical judgement is required for this period. A second determination is then required to be made for the normal rules period between the dates of the initial application on 1 May and the clinical judgement date of 27 May. As Donna is now terminally ill, the seeking of supporting information for the normal rules period needs to be carried out sensitively. Local Delivery are contacted and visit Donna to assist with completing Part 2 of the application. It is determined that Donna is entitled to normal rules PADP between the date of the Part 1 application and the date of clinical judgement of terminal illness, and Donna receives the value of that benefit in retrospect.