Change of Circumstances

The individual must notify Social Security Scotland of any change in circumstances that could possibly result in a change in the level of the individual’s entitlement or appropriate value of payment. This includes but is not limited to:

• if the individual is living in alternative accommodation
• a change of health condition or care needs
• a change in diagnosis meaning the individual is no longer considered to be terminally ill

If an individual is terminally ill, changes to the appropriate value of payment where the individual is in alternative accommodation follow the standard Scottish Adult DLA rules for alternative accommodation.

Payment continues after 28 days when the individual is in a hospice, is terminally ill and Social Security Scotland have been informed that the individual is terminally ill (Scottish Adult DLA regs, reg. 24(1)).

A hospice is a palliative care institution that isn’t publicly funded and whose main function is to provide palliative care for people suffering from a progressive disease in the final stages (Scottish Adult DLA regs, reg. 24(2))

A hospice is a separate organisation to a hospital.

If, however, an individual is receiving palliative care within a specialised ward or facility in a hospital or care home, the individual is considered to be in a publicly funded hospital or care home. Their award will be £0 rated on the 29th day.

Changes when an individual already entitled to Scottish Adult DLA becomes terminally ill

If an individual already in receipt of Scottish Adult DLA becomes terminally ill, a case manager should make a determination without application setting out the individual’s new level of entitlement.

This could happen in two ways:

• the individual informs Social Security Scotland that they have become terminally ill.
• a clinical judgement is received by Social Security Scotland for an individual currently in receipt of Scottish Adult DLA.

On receipt of a clinical judgement, the individual’s award becomes subject to the special rules for terminal illness. Social Security Scotland will make a determination without application so that the individual receives the appropriate award. There is no review date.

The new level of entitlement begins no earlier than 21 March 2025 which is the date the Scottish Adult DLA Regulations commenced and from the earlier of:

• the date that the RMP/RN made the clinical judgement that the individual met the terminal illness definition. The clinical judgement may be provided on the phone, via a letter or on the BASRiS (or equivalent) form.
• the date Social Security Scotland were notified by the individual or otherwise about their terminal illness (Scottish Adult DLA regs, reg. 20(7)). Where the BASRiS (or equivalent) date is earlier than the individual’s reported terminal illness and within 26 weeks of the reported date, the award will commence from the clinical judgement date on the BASRiS. If the clinical judgement date is more than 26 weeks earlier than the reported terminal illness, the RMP/RN must confirm that the individual’s terminal illness diagnosis is still accurate. If this confirmation is received, the date the award will commence is still only backdated to a maximum of 26 weeks.

Changes in award due to new information received

Social Security Scotland can make a determination without application if it becomes aware of a change of circumstances which would possibly result in an alteration to the components/rates of Scottish Adult DLA payable, or cause entitlement to Scottish Adult DLA to end.

This can affect one or more of the following:

• whether payment of assistance can continue
• the rate/components of assistance which the individual receives.

Case managers might need to ask for further information to make the decision.

Examples of relevant changes in circumstances include:

• a change in prognosis
• admission to publicly funded residential care or to legal detention
• change to immigration status
• official error
• moving from Scotland to another part of the UK.

For example, a terminally ill individual admitted to a publicly funded care home or hospital (not a hospice) would:

• if entitled, still be paid Scottish Adult DLA for the first 28 days only.
• stop being paid both components of Scottish Adult DLA on the 29th day of their stay in a publicly funded care home or hospital (not including a hospice).

A terminally ill individual admitted to a hospice, as defined above, will continue to receive Scottish Adult DLA payments after 28 days.

A terminally ill individual paying for their own care will continue to receive Scottish Adult DLA payments after 28 days.

Where an individual reports that they are no longer terminally ill due to a change in prognosis, a case manager makes a determination without application, setting out the individual’s new rate of entitlement by applying the normal rules.