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Scottish Adult Disability Living Allowance 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 Scottish Adult Disability Living Allowance.
Supporting documentsPages in this publication:
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- How to process an Adult Disability Payment application from someone getting Scottish Adult Disability Living Allowance
- Ending the client’s Scottish Adult Disability Living Allowance award
- Two stage process
- Backdating
- Special Rules for Terminal Illness
- Appointees
- Re-determinations and appeals
- Withdrawal of application
- Rejecting an application
- When a Scottish Adult Disability Living Allowance award that was ended by an interim Adult Disability Payment determination is retroactively changed
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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 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 DLA moves to Scotland
- Entitlement to Scottish Adult DLA beginning while in ‘alternative accommodation’
- Differences between Scottish Adult DLA and DLA eligibility criteria
- When case managers are required to make a determination without application
- If entitlement to Scottish Adult DLA is based on an DLA award that later changes
- When an individual in receipt of Scottish Adult DLA 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 mobility or care needs
- Making an unscheduled review because of a change of circumstance
- Applying the backwards and forwards tests
- 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 1 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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- Mobility Component and the ‘relevant age’
- Lower Rate Mobility Component
- Guidance or Supervision
- The effects of fear or anxiety on moving around outdoors
- The higher rate mobility component - Eligibility criteria
- Unable or virtually unable to walk
- Does the individual use an aid or appliance to walk?
- Use of both legs and feet to walk
- What type of walking surfaces are relevant?
- Does the individual’s ability to walk vary or fluctuate?
- Can the individual be described as virtually unable to walk?
- Does walking cause exertion leading to danger to life or deterioration in health?
- Individuals with no legs or no feet
- Severe visual Impairment
- Individuals who are deaf and blind
- Eligibility for Accessible Vehicles and Equipment Scheme
- Exceptions to entitlement to the mobility component
- Severe Mental Impairment and Severe Behavioural Difficulties Test
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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 Scottish Adult DLA after the death of an individual
- Arrears of Scottish Adult DLA 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 Scottish Adult DLA 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
- Condition
- Length of time the individual has had the condition
- Ongoing, current or planned treatment or surgery
- 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 maximum rate Scottish Adult DLA 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
- 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
- EU rules on social security coordination
- Personal scope of the EU coordination rules
- Residence criteria for the protected cohort
- Other international agreements
- Export
- Competent state
- Genuine and sufficient link to Scotland
- Temporary absence from the Common Travel Area
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- Definition of care home, hospital and hospice
- Meaning of legal detention
- Legal detention locations
- Being legally detained abroad
- Effect on entitlement of an individual in receipt of Scottish Adult DLA spending time in alternative accommodation
- Calculating the length of stay
- Temporary periods of leave during a stay in alternative accommodation
- Linked Periods in care homes and hospitals
- Linked periods in legal detention
- Self-funding placements in a hospital
- Self-funding placements in a care home
- Entitlement begins by case transfer whilst residing in a care home or hospital
- Entitlement begins by case transfer whilst in legal detention
- Entitlement begins because of reinstatement or cross-border move, whilst in alternative accommodation
- Resident in hospital since 31 July 1995 or earlier
- Custodial sentences
- Leaving legal detention
- Alternative Accommodation and Short-term Assistance
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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 the 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- generally
- 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 Disability Living Allowance to Scottish Adult Disability Living Allowance
- The Scottish Adult Disability Living Allowance determination
- Ending the client’s Disability Living Allowance award
- Information received from Department for Work and Pensions
- Payment Cycles
- Special Rules for Terminal Illness
- Reported relevant change of circumstance
- Scheduled Review
- Appointees
- Residence
- Temporary absence abroad
- Re-determinations and appeals
- When a Disability Living Allowance award that ended at the point of case transfer is retroactively changed
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- What is supporting information?
- Confirmation from a professional
- Additional supporting information
- Gathering supporting information
- Requesting more supporting information
- Not making changes to the level of entitlement due to lack of supporting information
- 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
- Non-disclosure of documents and information that could cause serious harm to physical or mental health
- 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