Examples of typical changes in mobility or care needs
Changes in the level of the individual’s need that could lead to an unscheduled review include:
- an increase in care needs due to a worsening of their condition
- the individual receives medical treatment which decreases or stops the individual’s needs
This list is not exhaustive.
Once the review is complete, the case manager:
- makes a determination on the individual’s entitlement to Scottish Adult DLA, taking into account the change in circumstances and
- sends the individual the notice of this new determination
Example: An individual’s care needs change to include requiring attention during the day and at night
Hazal is 32 and has a learning disability. She is entitled to the middle rate of the care component of Scottish Adult DLA. This is because she requires continual supervision during the day. Recently, Hazal:
- has been having trouble getting settled for bed in the evening
- requires prolonged attention throughout the night when she wakes up. A specialist determines that Hazal has attention deficit hyperactivity disorder.
Hazal’s mother informs Social Security Scotland that Hazal’s needs have changed. A case manager carries out an unscheduled review of Hazal’s award of Scottish Adult DLA. They determine that Hazal is now entitled to the highest rate of the care component of Scottish Adult DLA. This is because Hazal requires frequent attention during the day and prolonged attention at night, satisfying the ‘day criterion’ and ‘night criterion’.
Example: A reported increase in needs does not result in an increase in award
Sammy is 29 and has Down’s syndrome. He is entitled to the middle rate of the care component of Scottish Adult DLA. This is because he requires attention frequently throughout the day. Sammy’s carers contact Social Security Scotland to report that they are spending more time encouraging Sammy to choose healthy activities and exercise.
Social Security Scotland must make an unscheduled review as they have become aware of a change of circumstances. This change could possibly result in an alteration to the level of Sammy’s award.
The case manager determines that Sammy’s award of Scottish Adult DLA will remain the same. This is because, while Sammy requires more frequent attention during the day, he does not require it at night. This means he only meets the day criterion. Individuals must meet the day and night criteria to be entitled to the highest rate of the care component.
Case managers can extend the review date of an individual’s award as part of their determination, if appropriate. This is true even if an individual’s needs have not changed.
A case manager should only set an award review date earlier if they receive new information that justifies doing this.
Example: An individual’s award rates do not change but the review period is changed
Gilly is 68 and has been experiencing joint pain and joint dislocations regularly since her early 60s. She requires attention throughout the day to relocate her joints when they dislocate. She frequently has days when she can’t attend her regular activities due to fatigue. She has been entitled to the middle rate of the care component and the higher rate of the mobility component for around 15 years.
Gilly’s last review period was set for 5 years because:
- medical tests were still being done
- it was unclear whether treatment would be possible.
The review is set to start on 6 Oct this year. Gilly sends an updated piece of supporting information, 7 months before the review date. The supporting information confirms that she:
- has a diagnosis of Ehlers-Danlos Syndrome
- has symptoms that are expected to worsen over time.
The case manager considers that this supporting information suggests that this information means this change in circumstances may result in a change to the rate or component that Gilly is receiving. They also consider that it may be prudent to set a shorter review period for Gilly’s next review, since her condition is likely to deteriorate over time. The case manager conducts a review of Gilly’s award.
They take part in a case discussion with a practitioner who provides more information on Ehlers-Danlos Syndrome. The case manager determines that Gilly’s award should continue at the middle rate of the care component and higher rate of the mobility component, because they now have a clearer understanding of Gilly’s prognosis. The case manager makes a determination without application, and Gilly’ award will now be reviewed in 2 years’ time.
‘Unnecessary to Review’ Change of circumstances
Some changes might have an impact on the individual’s life but do not constitute a change that could possibly affect entitlement. These changes do not require an unscheduled review. For example, a change in an individual’s contact details.
It is unnecessary to review a client’s award if:
- they report that their needs due to their condition or disability either remained the same or got worse and
- due to the structure of the benefit, their entitlement won’t change as they are already receiving the highest rate of Scottish Adult DLA possible for their needs.
Case managers should follow the Operational Guidance on “Unnecessary to Review” if the change of circumstances meets both of the above criteria.
Example: An individual’s needs increase but they already receive the highest rate of the care component and higher rate of the mobility component
Ana is 42 and is entitled to the highest rate of the care component and higher rate of the mobility component of Scottish Adult DLA. She has been awarded these rates and criteria on an indefinite award period. When Ana is 43, she informs Social Security Scotland that her care needs have increased because her condition has worsened.
The case manager is not required to review Ana’s award because there has not been a change of circumstances that would possibly result in an alteration: Ana is already on the highest possible rate of the care and mobility components. Also, Ana’s award cannot be extended. Ana is informed that Social Security Scotland will not carry out a review for this reason.