Claiming a benefit under the special rules
There are some main benefits for people living with a terminal illness that are covered by the special rules. These are:
- Personal Independence Payment
- Disability Living Allowance*
- Attendance Allowance
- Employment and Support Allowance
Universal credit has different rules for people who are terminally ill.
*It is no longer possible to make a new claim for Disability Living Allowance if you are aged 16 or over.
If you’re living with a terminal illness and your death ‘can reasonably be expected’ within the next six months, your claim for certain benefits can be fast-tracked and paid at the highest rate.
If this applies to you, it means you don’t have to wait for the three month qualifying period to get Disability Living Allowance or Personal Independence Payment. And you don't have to wait for the six month qualifying period to get Attendance Allowance.
Depending on which benefit you claim, you’ll automatically qualify for the:
- highest rate of the Disability Living Allowance care component
- enhanced rate of the Personal Independence Payment daily living component
- higher rate of Attendance Allowance
In each case this is £83.10 a week.
If you have a terminal illness but your death can’t reasonably be expected within the next six months, you won’t qualify under the special rules.
What about the mobility component?
Both Personal Independence Payment and Disability Living Allowance include a mobility component. You won’t automatically get this under the special rules. The normal rules of assessment still apply, but not the three month qualifying period.
Personal Independence Payment mobility component
If you’re claiming Personal Independence Payment under the special rules, you’ll be asked questions about your mobility when you start the claim. This should speed up the decision on the mobility component and ensure you don’t have to complete another claim form.
Disability Living Allowance mobility component
It’s no longer possible to make a new claim for Disability Living Allowance if you're aged 16 or over.
You can carry on qualifying under the special rules if you live longer than expected. If you’re told that your death could reasonably be expected at any time in the next five to 10 months, you can claim under the special rules. If you live longer than this, you can carry on claiming under the special rules.
If you don’t meet the official definition above, you’ll need to follow the standard claim process for each benefit you want to apply for.
The claim procedure is outlined on the separate pages for Personal Independence Payment, Disability Living Allowance and Attendance Allowance. If you’re claiming under the special rules you’re usually asked to send a factual statement (called a DS 1500 report) from your doctor or consultant to the Department of Work and Pensions (DWP) or the Disability and Carers Service (DCS) in Northern Ireland when you make the claim. Your doctor should have copies of these forms.
The DWP and DCS normally process Disability Living Allowance and Attendance Allowance claims under the special rules within eight working days. Personal Independence Payment claims under the special rules currently take longer to process.
If you’re already getting a health and disability benefit and become terminally ill
Personal Independence Payment and Attendance Allowance
If you’re already getting one of these two benefits and your illness becomes terminal, you don’t have to make another claim under the special rules.
Contact the department that deals with that benefit (see the individual benefit pages for more details) or write to the address on your award letter and ask for the award to be changed because of a terminal illness.
If you’re successful, the new top rate of benefit can be backdated to the date you became terminally ill. You’ll need to tell the DWP or DCS within one month to have your claim backdated. If it has been longer than one month, the top rate can still be fully backdated if you had good reason for the delay.
Disability Living Allowance
The process for Disability Living Allowance is different to the process for Personal Independence Paymentand Attendance Allowance. If you’re already getting Disability Living Allowance and become terminally ill, it counts as a change in circumstances.
This means you’ll need to make a claim for Personal Independence Payment under the special rules. It’s a good idea to make a claim as soon as possible because new claims cannot be backdated.
If you're staying on DLA because you were aged 65 or over on 8 April 2013 (or 20 June 2016 in Northern Ireland), you still need to tell the DWP or DCS.
Employment and Support Allowance
If you’re living with a terminal illness, your claim for Employment and Support Allowance (ESA) can be processed under the special rules and fast-tracked.
If you claim under the special rules, the DWP or DoC will normally contact your GP, consultant or specialist nurse to confirm that you have a terminal illness.
Once it receives confirmation, you’ll be put in the ‘support group’ of claimants (which means you will be paid a higher rate of ESA and will not have to meet work-related responsibilities to keep getting the benefit in full). You can be paid from the date of your claim (without having to go unpaid during the first seven days, known as waiting days).
Universal Credit cannot normally be paid for the first seven days of your claim: the ‘waiting period’. If you’re living with a terminal illness and your death ‘can reasonably be expected’ within the next six months, this waiting period will not apply. Furthermore, you will not have to meet work-related requirements (such as attending work-focused interviews) to keep getting Universal Credit in full. Your Universal Credit will be paid at a higher rate, as a ‘work capability amount’ will be included in your award.
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