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Pension Age 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 Pension Age Disability Payment.
Supporting documentsPages in this publication:
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- Circumstances when an application may be made
- How to make a new application
- Who can make an application
- Beginning an application
- Date the application is to be treated as made
- Date of entitlement
- Acceptable and unacceptable applications
- Rejecting an application
- Making an application before the qualifying age
- Making an application before residence and presence requirements are met
- Change of circumstances before an initial determination has been made
- Determination of entitlement
- Withdrawal of an application
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- What scheduled reviews are
- When new determinations take effect
- If there has been no change in level of entitlement
- If there has been an increase in level of entitlement
- Setting an earlier start date if it would be unjust not to do so
- If there has been a decrease in level of entitlement
- If the decrease should have been reported sooner
- Setting a later start date if it would be unjust not to do so
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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
- A change that occurs during an ongoing award review
- 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 AA moves to Scotland
- Entitlement to PADP beginning while in ‘alternative accommodation'
- Differences between PADP and AA eligibility criteria
- When case managers are required to make a determination without application
- If entitlement to PADP is based on an AA award that later changes
- When an individual in receipt of PADP 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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- Examples of typical changes in care needs
- Making an unscheduled review because of a change of circumstance
- Applying the backwards test
- 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 one 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 – harmful information
- Special Rules Requirements
- Rates of Payment
- Notification of changes in circumstances
- Eligibility
- Supporting information for SRTI
- Applications from a third party
- Incomplete applications
- Date of Award
- Application not made under SRTI –individuals who may be terminally ill
- Terminal illness diagnosis during non-SRTI application
- 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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- Verification of death
- Unscheduled review following an individual’s death being verified
- Overpayments of Pension Age Disability Payment after the death of an individual
- Arrears of Pension Age Disability Payment due to the individual after death
- How will Social Security Scotland be able to tell if there is an Executor?
- How does Social Security Scotland decide who the most appropriate person is?
- When Social Security Scotland are unable to identify an individual to act or receive any Pension Age Disability Payment that is due
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- Principles of choosing a review period
- Relevant considerations for giving an indefinite award or setting a review period
- Age
- Level of award
- Single or multiple conditions
- Length of time the individual has had the condition
- Ongoing, current or planned treatment or surgery
- Condition
- Relevant life events
- Choosing an appropriate review period between 2 and 10 years
- Shorter review periods (2 to 5 years)
- Longer review periods (5 to 10 years)
- Exception: Review periods under 2 years
- Indefinite awards (awards without a review date)
- Indefinite awards for individuals on higher rate PADP awards
- Indefinite awards for individuals on lower rate PADP awards
- The views of the individual
- Justifying a decision to set a review date or choose an Indefinite Award
- Individual’s responsibility to report changes
- Example section for Indefinite Awards
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- Eligibility
- Ordinary residence in Scotland
- Habitual residence in the Common Travel Area
- 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
- Mariners, aircraft workers and continental shelf workers
- Temporary absence from the Common Travel Area
- Time spent in alternative accommodation / legal detention
- EU rules on social security coordination
- Personal scope of the EU coordination rules
- Residence criteria for the protected cohort
- Other international agreements
- First applications from abroad
- Export
- Competent state
- Genuine and sufficient link to Scotland
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- Definition of care home, hospital and hospice
- Effect on entitlement of an individual already in receipt of Pension Age Disability Payment 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, hospitals, or similar institutions and Short-term Assistance
- Impact on transferring individuals from Attendance Allowance when entitlement to PADP begins while they are in a care home or hospital
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- What is an error?
- Correcting an error that leads to an overpayment
- When change in entitlement begins
- Official error leading to an underpayment
- Correcting an official error that causes an underpayment
- When change in entitlement begins
- What is ignorance of a material fact?
- Correcting a determination made in ignorance of a material fact
- When increase in entitlement begins
- Liability to repay an overpayment
- Split liability to repay an overpayment
- Calculating the value of an overpayment
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- The meaning of case transfer
- The case transfer process from Attendance Allowance to Pension Age Disability Payment (PADP)
- The PADP determination
- Information received from the Department for Work and Pensions (DWP)
- The end of the Attendance Allowance award
- Special Rules for Terminal Illness
- Backdating - SRTI
- Backdating – Scheduled Review after Transfer
- Payment cycles
- Alternative Accommodation
- Legal Detention
- Temporary absence abroad
- Appointees
- Residence
- People who live in certain countries (exported benefits)
- Re-determinations and appeals
- When an Attendance Allowance award that ended at the point of case transfer is retroactively changed
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- Our approach to information about an individual’s needs
- Can I make a robust decision with the information available?
- What is supporting information?
- Confirmation from a professional
- Lack of confirmation from a professional and good cause
- Requirements of the professional
- Confirmation from a professional that has gaps and inconsistencies
- Additional supporting information
- Gathering supporting information
- Requesting more supporting information
- Denying an application due to lack of supporting information
- 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
- Response to the notice of appeal
- 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