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Forum Home  →  Discussion  →  Disability benefits  →  Thread

Terminal illness, benefits and DS1500

Ianb
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Macmillan benefits team, Citizens Advice Bristol

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Total Posts: 958

Joined: 24 November 2017

UC Regulations 2013 Schedule 9 provides that
“Circumstances in which a claimant is to be treated as having limited capability for work and work-related activity
Terminal illness
1.  The claimant is terminally ill.”
Regulation 2 states that “terminally ill” means “suffering from a progressive disease where death in consequence of that disease can reasonably be expected within 6 months”.

This is reflected in Advice to Decision makers
G3007 “Terminally ill” is defined as a claimant who is suffering from a progressive disease and death in consequence of that disease can be reasonably expected within six months. This is known as “special rules”.

Welfare Reform Act 2012 Regulation 82 has a similar definition for terminal illness in respect of PIP.

I assume Attendance Allowance is also the same although I haven’t tracked down the relevant regulation.

However this definition is not consistent with the recent guidance to medical staff about when a DS1500 can be issued
https://www.gov.uk/government/publications/dwp-factual-medical-reports-guidance-for-healthcare-professionals/dwp-medical-factual-reports-a-guide-to-completion

“2.7 DS1500 report form
2.7.1 Background
The purpose of the DS1500 is to tell DWP about a patient who meets the special rules criteria. …
You should complete the form promptly if you believe that your patient meets the special rules criteria, namely:
  • they have a progressive disease and, as a consequence of that disease
  • you would not be surprised if your patient were to die within 6 months”

As has been discussed in other threads previously, this recent DS1500 guidance of “would not be surprised if” appears to widen the number of people covered beyond those “where death can reasonably be expected within 6 months”.

In theory this therefore raises the increased possibility of DWP declining a Special Rules claim on the grounds that, although a DS1500 has been issued in order “to tell DWP about a patient who meets the special rules criteria”, the claimant doesn’t meet the definition of terminal illness in the legislation.

Is anyone aware of any other DWP guidance on this which reflects the DS1500 guidance?

[ Edited: 1 Nov 2019 at 07:22 am by Ianb ]
Mr Finch
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Benefits adviser - Isle of Wight CAB

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Joined: 4 March 2011

I’ve always thought there was an ambiguity to ‘expected’, with both of these meanings being possible interpretations. So the DWP embracing the wider one doesn’t seem too bad.