DLA & terminal illness

The legislation on terminal illness under s66(2) of the SSCBA 1992 states that a person is ‘terminally ill’ if they suffer from a progressive disease and their death as a consequence of that disease can be reasonably expected within 6 months.

The CPAG handbook states that “This does not mean that it must be more likely than not that you will die within this period. It simply means that death within six months would not be unexpected.” (p157)

There isn’t a reference for this interpretation - only to the definition at s66(2). Does anyone know of any caselaw to back the interpretation up? Or more generally, how specific is the general guidance given to doctors who issue the DS1500 regarding the legislative definition of ‘terminally ill’ (and its interpretation) for benefits purposes?

Thanks - that’s the conclusion I had a come to. We’ve just come across a couple of clients who seem that they ought to have a DS1500 under this definition but don’t and were looking at the quickest way for them to get one (if they want to and it would benefit them!) and came across this. I was curious really as to whether the consultants issuing the DS1500 forms have this definition in mind or whether they are working to a stricter guidance…

Not sure if this helps.  I found it by using Google and searching - “DS1500 guidance to doctors”.  This extract came from “GP Notebook”

“A form DS 1500 should be issued if requested by a patient (or their representative) if you consider that the patient may be suffering from a potentially terminal illness. The DS 1500 should be handed to the patient or their representative and not sent directly to the DWP. A fee is payable by the DWP for the completion of this form, which is supplied in booklets by the Department on written application. The DS 1500 asks for factual information and does not require you to give a prognosis.

the DS 1500 report should contain details of:
diagnosis - also whether the patient is aware of their condition and if unaware, the name and address of the patient’s representative requesting the DS1500
current and proposed treatment
brief details of clinical findings
Notes:

terminal illness is defined in Social Security legislation as: ‘a progressive disease where death as a consequence of that disease can reasonably be expected within 6 months’. If a patient is suffering from such an illness can claim Disability Living Allowance (DLA), Attendance Allowance (AA) or Incapacity Benefit (IB) under what are called ‘special rules’.
to be eligible for DLA or AA for help with personal care, a person usually has to show that they need help to look after themselves. Under ‘special rules’ someone who is terminally ill can get:
DLA or AA without having to satisfy a qualifying period
DLA or AA paid at the highest rate of care even if they do not need help looking after themselves
if a patient is claiming IB then a person who is terminally ill and incapable of work can get the highest rate of benefit after 28 weeks instead of 52 weeks sickness

Reference:

Department of Work and Pensions (UK). IB204 (August 2004).”

That’s great, thanks!

When advising medical professionals (and clients) of the criteria, I have always said that even if there is only a 15 - 20% chance that a person might die within 6 months, if they then did die one would not say that that was unexpected. So that it would be appropriate to sign the DS1500 in such circumstances. Never had the DWP argue with this (i.e. even where I’ve included the covering letter to the GP/consultant setting this out in the claim form).