61491
People are considered to be terminally ill if they have a progressive disease from which death may reasonably be expected within six months.
61492
If death is reasonably expected beyond six months, the person is not considered to be terminally ill within the meaning of the Act. The DM should consider the reasonable expectation at:
It is irrelevant that, by the date of the DM's decision, the person has lived for six months since the diagnosis was made.
61493
The special rules apply if a person submits evidence that they have been diagnosed as terminally ill
61494
If, before the DM's decision is made, the claimant indicates in writing that it was intended to make a claim under the special rules, see DMG 61497 below.
61495
The form used by the person's doctor makes no specific reference to terminally ill. The form asks for details of the claimants condition and any treatment which is being given.
61496
The DM refers all claims made under the special rules direct to Medical Services for advice before a decision is made. Medical advice is always available for the DM to decide whether the person is terminally ill.
61497
A claim can only be considered under the special rules if it is made expressly because the person is terminally ill.
61498
There must be evidence that the claim is being made specifically because the disabled person is terminally ill.
61499
Where a claim has not been made under the special rules but written evidence of a terminal illness is received from the claimant or from another person on their behalf before the claim has been determined, the claim can be amended into a claim made expressly because the person is terminally ill.
61500
The fact that a person is terminally ill is not sufficient for accepting the claim under the special rules. The DM should decide cases under the special rules only when the person making the claim has:
If the person has failed to do this, and still wishes to claim under the special rules, the claim must be amended in writing before it is decided.
Qualifying period
AA and DLA care component.
61501
There is no qualifying period if AA or the care component of DLA is claimed expressly because the person is terminally ill, and the illness is confirmed by Medical Services. The conditions of entitlement for
are treated as satisfied from the date of claim or, the first date that the person is terminally ill, whichever is later.
Period of award
61502
From January 2000 DMs have not been required to make awards for life for terminally ill people under the special rules but have the option of making indefinite or fixed period awards.
61503
Special Rules awards of AA and DLA care component should normally be made for an appropriate fixed period. Disability Living Allowance Advisory Board have recommended that three years would normally be an appropriate fixed period. This will enable entitlement to be considered afresh at the end of an award where a person’s life expectancy is exceeded.
61504
Legislation provides that an award of a care component and a mobility component cannot be made for different fixed periods. Where a DM finds that a person has claimed DLA under the special rules and also satisfies the entitlement conditions for a mobility component the DM must consider whether it is appropriate
61505,
A special rules care component award will not disturb an existing mobility component award because acquiring the status of a terminally ill person for the purposes of the special rules is not a relevant change of circumstances which gives grounds for reconsidering entitlement to the mobility component. Entitlement to the mobility component may only be reconsidered if there is evidence on the special rules claim form that the claimant’s walking difficulties have changed.
61506,
However where the existing mobility component award is for a fixed period the prohibition of the mobility component and care component awards for different fixed periods means that there may be cases in which the period of special rules care component award will need to be adjusted to more or less than three years to fit the period of the mobility award.
Example 1,
A woman has been diagnosed with a terminal illness and submits a claim under the special rules. Her walking ability is unaffected so the DM awards the highest rate of care component for a fixed period of three years. This will enable the claimant’s entitlement to be considered afresh at the end of an award where a person’s life expectancy is exceeded.
Example 2,
A man suffering from a terminal illness submits a claim under the special rules. His walking ability is severely affected by the progressive disease and he is virtually unable to walk. The DM awards the highest rate of care component and the higher rate of mobility component for an aligned fixed period of three years. Again, this will allow entitlement to be considered afresh when the award expires.
Example 3,
A man suffering from a terminal illness submits a claim under the special rules. He is already in receipt of a fixed period award of mobility component that is unconnected to his progressive disease. The mobility component still has two years to run before expiry. In order to align the two fixed period awards, the DM awards the highest rate of care component for two years only.
Example 4,
A man suffering from a terminal illness submits a claim under the special rules. He is already in receipt of a five year fixed period award of mobility component that is unconnected to the progressive disease. The mobility component has four years to run before expiry. In order to align two fixed period awards, the DM awards the highest rate of care component for four years.
Example 5,
A terminally ill woman submits a claim under the special rules. She is already entitled to an indefinite award of mobility component for reasons unconnected to her progressive disease. The DM awards the highest rate of care component for a fixed period of three years.
Mobility component
61510
There is no qualifying period if people
The period for which they are likely to continue to satisfy the conditions may be reduced from six months if they are not expected to live that long (see DMG 61466 2.2)1. Benefit is payable immediately at the appropriate rate provided they are likely to continue to satisfy the conditions for the remainder of their life.
Claim on behalf of a terminally ill person made by a third party
61511
If somebody makes a claim on behalf of a person who is terminally ill, the terminally ill person is treated as having made the claim. The claim can be made without the terminally ill person's knowledge or authority.
