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Making an unscheduled review because of a change of circumstance
Making an unscheduled review means reviewing the individual’s entitlement to Scottish Adult DLA, taking account of the change(s) in circumstances since the last determination.
This involves:
- considering how their needs affect their entitlement to mobility and care component
- applying the backwards and forwards test (The chapter on Qualifying Periods explains the tests in more detail)
- working out when the change in entitlement should begin.
The ‘relevant age’ for Scottish Adult DLA
‘Relevant age’ for Scottish Adult DLA means pensionable age or aged 65 if this is higher than an individual’s state pension age (SPA).
An individual’s pension age depends on when they were born:
- for individuals born before 6 October 1954 their SPA is 65
- for individuals born between 6 October 1954 and 5 March 1961 their SPA is 66
- for all individuals born after 5 March 1961 their state pension age is 67. (State Pension age timetable - GOV.UK (www.gov.uk))
The backwards and forwards tests – under the ‘relevant age'
An individual under the ‘relevant age’ must have met or be deemed likely to meet one of the criteria of entitlement for a particular component, or rate of a component, for 13 weeks immediately preceding the date of entitlement. This is the backwards test (Scottish Adult DLA regs, reg. 6(2))(a), 7(4)(a) and 8(10)(a))
The individual must be likely to meet one of the criteria of entitlement for a particular component, or rate of a component, for 26 weeks from the date of entitlement. This is the forwards test (Scottish Adult DLA regs, reg. 6(2)(b), 7(4)(b) and 8(10)(b)).
The backwards and forwards tests – over the ‘relevant age’
Mobility component
An individual over the ‘relevant age’ must have met or be deemed likely to meet one of the criteria of entitlement for a particular component, or rate of a component, for 13 weeks immediately preceding the date of entitlement. This is the backwards test (Scottish Adult DLA regs, reg. 6(2)(a), 7(4)(a) and 8(10)(a))
The individual must be likely to meet one of the criteria of entitlement for a particular component, or rate of a component, for 26 weeks from the date of entitlement. This is the forwards test (Scottish Adult DLA regs, reg. 6(2)(b), 7(4)(b) and 8(10)(b) 20).
There is an additional test for eligibility for the mobility component of Scottish Adult DLA for those over the ‘relevant age’. In addition to fulfilling the ‘backwards and forwards tests’, an individual must have continually been in receipt of the relevant rate of the mobility component that they qualify for since before reaching the ‘relevant age’ (Scottish Adult DLA regs, reg 7(4)(c) and reg 8(10)(c)).
This means that over the ‘relevant age’ an individual can only maintain the rate of the mobility component that they receive. They cannot move from the lower to the higher rate, the higher to the lower rate, nor from no award of the mobility component to the lower or higher rate. This is covered in more detail in the Mobility Component chapter.
Care component
The individual must have met or be deemed likely to meet one of the criteria of entitlement for a particular component, or rate of a component, for 26 weeks immediately preceding the date of entitlement. This is the backwards test (Scottish Adult DLA regs, reg. 6(3)).
There is no forwards test for the care component for individuals over the ‘relevant age’ on Scottish Adult DLA (Scottish Adult DLA regs, reg. 6(3)).
Further, individuals cannot newly qualify for the lowest rate of the care component if they are over the ‘relevant age' (Scottish Adult DLA regs, reg 6(5) , even if they meet the backwards and forwards tests. Lowest rate awards of the care component can be maintained for those over the ‘relevant age’. This is covered in more detail in the Care Component chapter.
Example: an individual over the relevant age is in receipt of the lower rate of the mobility component, and meets the criteria for the higher rate
Graine was diagnosed with Parkinson’s when she was 62. At the time she was diagnosed, Graine was experiencing difficulty with her balance and coordination, resulting in her being admitted to hospital following a fall three times in a period of 6 months. The case manager awarded the lower rate of the mobility component, as she needed her husband to accompany her when she left the house to supervise her and help her in case she lost balance.
Graine is now 70, and her husband (who is her appointee) reports that for the last 3 months, Graine has been virtually unable to walk. He reports that it takes 3 times as long for her to walk a distance of 50m as it does for him, and that she becomes breathless easily.
The case manager determines that whilst Graine meets the criteria for the higher rate of the mobility component, as the change occurred after she had reached the relevant age, the higher rate cannot be awarded. Graine continues to require supervision when out of the house, so the case manager continues her award of the lower rate.
Example: an individual over the relevant age is not in receipt of either rate of the mobility component, and reports a change of circumstances which occurred before she reached the relevant age
Lesley is aged 65 and 10 months and has been experiencing issues with arthritis, affecting her manual dexterity since she was 64 years old. She receives the lower rate of the care component of Scottish Adult DLA.
Lesley’s sister, whom she lives with and who acts as Lesley’s appointee, reports that over the last 12 months, Lesley has required guidance and supervision when she goes out as she cannot navigate unfamiliar routes, and finds it difficult to perceive hazards such as traffic on the roads. Lesley’s sister reports that they have been referred to neurology for assessment, however no diagnosis has yet been made.
The case manager calculates that the reported change occurred when Lesley was aged 64 and 10 months and decides there was good reason for not reporting the change sooner. They therefore make the decision to award the lower rate of the mobility component, as the change occurred before Lesley reached the relevant age.