An individual to whom a relevant EU Regulation applies is not entitled to the daily living component for a period unless during that period the United Kingdom is competent for payment of sickness benefits in cash to the individual for the purposes of the relevant EU Regulation in question.

Refugees

Adjustment of payment where medical expenses are paid from public funds under war pensions instrument

34A

(1) Except where paragraph (2) applies, where

(a) an individual is provided with relevant accommodation, and

(b) there are payable in respect of that individual both—

(i) a payment under article 21 (medical expenses) of the Naval, Military and Air Forces etc. (Disablement and Death) Service Pensions Order 2006, and

(ii) the daily living component of Adult Disability Payment,

the amount of the daily living component of Adult Disability Payment is reduced by the amount of the payment mentioned in sub-paragraph (b)(i).

(2) Paragraph (1) does not apply to an individual in respect of the first 28 days of any period during which the amount of the daily living component of Adult Disability Payment would otherwise be adjusted by virtue of paragraph (1).

(3) The 28 days referred to in paragraph (2)—

(a) may comprise two or more separate periods, provided that there is no more than 28 days between each period, and

(b) is reduced by the number of relevant days.

(4) In this regulation—

“relevant accommodation” means accommodation provided as a necessary ancillary to nursing care where the medical expenses involved are wholly borne by the Secretary of State pursuant to article 21 of the Naval, Military and Air Forces etc. (Disablement and Death) Service Pensions Order 2006,

“relevant day” means a day that falls not earlier than 28 days before the first day on which the individual was provided with relevant accommodation, and either—is a day when the individual was undergoing medical treatment in a hospital or similar institution in the circumstances mentioned in regulation 28(1)(b) (effect of admission to hospital on ongoing entitlement to Adult Disability Payment), oris a day when the individual was prevented from receiving the daily living component of Adult Disability Payment by virtue of regulation 27(2) (effect of admission to a care home on ongoing entitlement to daily living component).

When an application is to be treated as made and beginning of entitlement to assistance

Time of Payment

Continuing Eligibility

Circumstances in which assistance may be suspended

Having regard to financial circumstances

Information to be given following suspension

Right to review suspension

Ending a suspension

Effect of suspension ending

Form of payment – giving Adult Disability Payment by way of deduction

When an increase in level of entitlement takes effect

When a decrease in level or cessation of entitlement takes effect

PART16A — Applications for Adult Disability Payment by individuals entitled to Scottish Adult Disability Living Allowance

Applications by individuals entitled to Scottish Adult Disability Living Allowance

60A

Part 3A of schedule 2 makes provision about applications for Adult Disability Payment by individuals who are entitled to Scottish Adult Disability Living Allowance.

PART 3A — Applications for Adult Disability Payment by individuals entitled to Scottish Adult Disability Living Allowance

Determination of entitlement to Adult Disability Payment – interim determination

15A

(1) This regulation applies when an application for Adult Disability Payment is received in respect of an individual who—

(a) was under 65 years old on 8 April 2013, and

(b) on the day on which the application is received, is entitled to Scottish Adult Disability Living Allowance.

(2) Entitlement to Adult Disability Payment under the determination of an application referred to under sub-paragraph (1) (the “interim determination”) begins on the date specified in the notice of determination given to the individual in accordance with section 40 (notice of determination) of the 2018 Act.

(3) Subject to sub-paragraph (5) and (6), the interim determination is to be made on the basis of—

(a) such information as the Scottish Ministers have in respect of the individual’s entitlement to Scottish Adult Disability Living Allowance, and

(b) any other information available to the Scottish Ministers that appears to them to be relevant.

(4) Subject to paragraph 15E (special rules for terminal illness – exceptions to 15A(4)), an interim determination must be made in accordance with paragraph 15B (entitlement to Adult Disability Payment under an interim determination).

(5) The interim determination does not need to be made on the basis of the information mentioned in sub-paragraph (3)(b) where—

(a) the individual—

(i) before making the application for Adult Disability Payment reported a change of circumstances to the Scottish Ministers which has not been taken into account for the individual’s entitlement to Scottish Adult Disability Living Allowance, or

(ii) has, since making the application for Adult Disability Payment, notified a change of circumstances to the Scottish Ministers, and

(b) following the interim determination, the change of circumstances is to be taken into account in a review determination under regulation 15F (review determination of entitlement to Adult Disability Payment).

(6) The interim determination does not need to be made on the basis of any information which the Scottish Ministers receive within the application for Adult Disability Payment referred to under sub-paragraph (1).

(7) An interim determination—

(a) is to be made on the assumption that the individual meets the conditions relating to residence and presence set out in regulations 15 to 21, and

(b) may be made on the assumption that whatever can be discerned about the individual’s circumstances from the information mentioned in sub-paragraph (3) remains accurate on the date on which the determination is made.

(8) In this Part “interim determination” has the meaning given in sub-paragraph (2).

Entitlement to Adult Disability Payment under an interim determination

15B

(1) For the purposes of an interim determination made in accordance with paragraph 15A, an individual may be awarded the daily living component of Adult Disability Payment at the transitional rate specified in paragraph 15C(1) instead of being awarded that component at the standard or the enhanced rate in accordance with regulation 5(2) or (3).

(2) An interim determination is to be made on the basis that an individual who had been entitled to the—

(a) lowest rate of the care component of Scottish Adult Disability Living Allowance immediately prior to the interim determination is entitled to the transitional rate of the daily living component of Adult Disability Payment,

(b) middle rate of the care component of Scottish Adult Disability Living Allowance immediately prior to the interim determination is entitled to the standard rate of the daily living component of Adult Disability Payment,

(c) highest rate of the care component of Scottish Adult Disability Living Allowance immediately prior to the interim determination is entitled to the enhanced rate of the daily living component of Adult Disability Payment,

(d) lower rate of the mobility component of Scottish Adult Disability Living Allowance immediately prior to the interim determination is entitled to the standard rate of the mobility component of Adult Disability Payment,

(e) higher rate of the mobility component of Scottish Adult Disability Living Allowance immediately prior to the interim determination is entitled to the enhanced rate of the mobility component of Adult Disability Payment.

(3) An individual to whom sub-paragraph (2)(e) applies is to be treated as though they have obtained the maximum points for each activity listed in column 1 of the table in Part 3 of schedule 1.

Amount and form and time of payment of Adult Disability Payment

15C

(1) The weekly rate of payment of the daily living component of Adult Disability Payment is, where the individual is entitled to the transitional rate, £28.70.

(2) Where an award of Adult Disability Payment is made to an individual under this Part, the Scottish Ministers are to make—

(a) the first payment of assistance on a date specified in the notice of determination, and

(b) any subsequent payment—

(i) 4 weekly in arrears,

(ii) weekly in advance, or

(iii) where the Scottish Ministers consider that it would be unjust not to do so, at such intervals as may be specified in the notice of determination.

Effect of interim determination on entitlement to Scottish Adult Disability Living Allowance

15D

Where an interim determination is made that an individual is entitled to Adult Disability Payment, the individual’s award of Scottish Adult Disability Living Allowance will cease on—

(a) the date their entitlement to Adult Disability Payment begins, or

(b) where paragraph 15E (special rules for terminal illness – exceptions to 15A(4) applies, the date their entitlement to Adult Disability Payment would have begun had paragraph 15E(2) not applied to set an earlier date of entitlement.

Special rules for terminal illness – exceptions to 15A(4)

15E

(1) Sub-paragraph (2) apples where the Scottish Ministers become aware before they have made an interim determination that the individual has a terminal illness in terms of regulation 26(7).

(2) The interim determination must be made on the basis that the individual satisfies the conditions for the enhanced rate of the daily living component of Adult Disability Payment and—

(a) if the individual became terminally ill before reaching the relevant age, that the individual satisfies the conditions for the enhanced rate for the mobility component of Adult Disability Payment,

(b) if the individual had reached the relevant age when they became terminally ill and made the application for Adult Disability Payment mentioned in paragraph 15A(1) on or before 31 December 2027, that the individual satisfies the conditions for the enhanced rate for the mobility component of Adult Disability Payment,

(c) if the individual had reached the relevant age when they became terminally ill and did not make the application for Adult Disability Payment mentioned in paragraph 15A(1) on or before 31 December 2027, that the individual satisfies the conditions for—

(i) the standard rate of the mobility component of Adult Disability Payment if the individual was entitled to the lower rate of the mobility component of Scottish Adult Disability Living Allowance immediately prior to making the application for Adult Disability Payment,

(ii) the enhanced rate of the mobility component of Adult Disability Payment if the individual was entitled to the higher rate of the mobility component of Scottish Adult Disability Living Allowance immediately prior to making the application for Adult Disability Payment, and

(iii) no mobility component of Adult Disability Payment if the individual was not entitled to the mobility component of Scottish Adult Disability Living Allowance immediately prior to making the application for Adult Disability Payment.

(3) Where sub-paragraph (1) applies—

(a) paragraphs (4) to (6) of regulation 26 (entitlement under special rules for terminal illness) do not apply, and

(b) the individual’s entitlement to Adult Disability Payment will commence on whichever is the later of—

(i) the date the individual’s application for Adult Disability Payment was made, where the application included information about the individual’s terminal illness,

(ii) the date the Scottish Ministers become aware of the individual’s terminal illness (whether as a result of the individual notifying a change in circumstances or otherwise),

(iii) the date that the clinical judgement was made in accordance with regulation 26(7).

Review determination of entitlement to Adult Disability Payment

15F

(1) The Scottish Ministers are to make a determination of the individual’s entitlement to Adult Disability Payment (a “review determination”) as soon as reasonably practicable after making an interim determination in respect of that individual.

(2) Sub-paragraph (1) does not apply—

(a) to individuals to whom paragraph 15E (special rules for terminal illness – exceptions to 15A(4)) applies, or

(b) where an individual has requested a re-determination under section 41 (right to request re-determination) of the 2018 Act, or made an appeal under section 46 (right to appeal to First-tier Tribunal against determination) of the 2018 Act, in relation to the interim determination.

(3) Subject to paragraphs 15H (when an increase in level of entitlement takes effect) and 15I (when a decrease in level or cessation of entitlement takes effect), entitlement to Adult Disability Payment under a review determination under sub-paragraph (1) begins on the date specified in the notice of determination given to the individual in accordance with section 40 of the 2018 Act.

(4) The review determination under sub-paragraph (1) is to be made on the basis of any information that—

(a) the Scottish Ministers have received in respect of the individual’s entitlement to Scottish Adult Disability Living Allowance,

(b) was provided in the individual’s application for Adult Disability Payment,

(d) is available to the Scottish Ministers that appears to them to be relevant.

(5) The restrictions in sub-paragraph (6) apply to a review determination under sub-paragraph (1) where—

(a) an individual did not make the application for Adult Disability Payment mentioned in paragraph 15A(1) on or before 31 December 2027,

(b) the individual has reached the relevant age, and

(i) a change of circumstances which occurred after the person reached the relevant age, or

(ii) a material fact which the Scottish Ministers were not previously aware of which relates to circumstances which began after the individual reached the relevant age.

(6) The restrictions referred to in sub-paragraph (5) are—

(a) where the mobility component award under the interim determination is for the standard rate then, regardless of whether the award would otherwise have been for the enhanced rate, the Scottish Ministers—

(i) may only make an award for the standard rate of that component, and

(ii) may only make such an award where entitlement results from substantially the same condition or conditions in respect of which the mobility component in the original award was given,

(b) where the mobility component award under the interim determination is for the enhanced rate, the Scottish Ministers may only award that rate of that component where entitlement results from substantially the same condition or conditions in respect of which the mobility component in the original award was given,

(c) where the award under the interim determination did not include an award of the mobility component, the Scottish Ministers may not award that component at either the standard or enhanced rate.

Time of payment

15G

Where an award of Adult Disability Payment is made under a review determination, the Scottish Ministers are to make—

(a) the first payment of assistance on a date specified in the notice of determination, and

(b) any subsequent payment—

(i) 4 weekly in arrears,

(ii) weekly in advance, or

(iii) where the Scottish Ministers consider that it would be unjust not to do so, at such intervals as they specify in the notice of determination.

When an increase in level of entitlement takes effect

15H

(1) Where, as a result of a review determination, the amount of Adult Disability Payment payable in respect of an individual is increased, or their entitlement to a component is awarded, the change takes effect on the date that the individual’s entitlement to Adult Disability Payment would have begun if paragraph 15A(2) did not apply to the individual, in terms of regulation 35(4) to (6).

(2) Where an individual has previously received Adult Disability Payment for a period under an interim determination and a review determination has subsequently been made that the same individual is entitled to Adult Disability Payment at a higher rate for that period, the individual is entitled to be paid the difference between the value of entitlement to Adult Disability Payment under the review determination and—

(a) the value of Adult Disability Payment to which that individual was previously entitled under the interim determination, and

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