Mental Health and Benefits Handbook 1st editionPart 2: Benefits Chapter 10: Disability living allowance
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Chapter 10: Disability living allowance
Note: this chapter only covers the rules about disability living allowance (DLA) for children. For information about DLA for adults, see CPAG’s Welfare Benefits and Tax Credits Handbook.
Key facts
    •Disability living allowance (DLA) is a non-means-tested benefit for children with a disability or long-term health condition.
    •You can claim DLA for a child alongside most other benefits. It does not count as income for the purposes of means-tested benefits.
    •DLA has two components. A child can qualify for one or both. The ‘care component’ reflects a child’s needs for attention or supervision during the day and/or at night, and is paid at one of three rates. The ‘mobility component’ reflects difficulties going out and getting around, including for mental health reasons, and is paid at one of two rates.
    •You can challenge decisions about a child’s eligibility for DLA.
    •Getting DLA for a child can mean that you are eligible for other kinds of financial support.
    •You can no longer make a claim for child DLA in Scotland (see Chapter 11).
1. Who can get disability living allowance
Disability living allowance (DLA) is a non-means-tested benefit for children and young people under 16 (we use the term ‘children‘ in this chapter). DLA is intended to help with the extra costs of having a disability or long-term health condition. Children with mental health symptoms, with or without a diagnosis, may be eligible for DLA.
You can get DLA for a child if the child:1ss71(6), 72 and 73 SSCBA 1992; regs 3(3), (4), (4A) and (5B) and 18 PIP(TP) Regs
    •is under 16 when you claim (they must be at least three to get the mobility component and five to get the lower rate; DLA normally ends when a child is 16); and
    •meets the residence conditions and is not a ‘person subject to immigration control’ (although there are some exceptions), see CPAG’s Welfare Benefits and Tax Credits Handbook; and
    •meets the disability conditions below; and
    •has had their needs for at least three months and is expected to have them for at least six months longer (this is called the ‘qualifying period condition’).
Note:
    •If a child meets these criteria, but lives in Scotland, see Chapter 11.
    •Special rules apply if a child is regarded as being terminally ill (see here) and in certain other situations (eg, if they are living in a care home – see Chapter 16).
 
1     ss71(6), 72 and 73 SSCBA 1992; regs 3(3), (4), (4A) and (5B) and 18 PIP(TP) Regs  »
The disability conditions
The health-related eligibility criteria for DLA are known as the ‘disability conditions’. This does not mean that a child must be considered to have a disability in order to qualify. Throughout this section we also use the expression ‘so severely disabled, physically or mentally’. This is the phrase used in law but, in practice, it just means that a child’s difficulties must be the result of a mental or physical health condition or disability.
Disability conditions for the care component
Entitlement to the care component of DLA is about a child’s need for attention and/or supervision. Broadly speaking, ‘attention’ is active care and ‘supervision’ is passive care which might never involve intervention.1R(A) 3/74; R(A) 2/75 The two categories can overlap. When you complete a DLA form, it is important to emphasise the full extent of a child’s needs without trying to fit them neatly into either category at the expense of leaving things out.
‘Attention’ and mental health
Attention means ‘a service of a close and intimate nature… involving personal contact carried out in the presence of the disabled person’ and does not need to be physical. 2Reg 10C SS(DLA) Regs; R v National Insurance Commissioner ex parte Secretary of State for Social Services [1981] 1 WLR 1017 (CA), also reported as R(A) 2/80; R(A) 1/06 Encouragement, stimulation, reassurance or giving verbal instructions may be attention.3Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94; CA/177/1988; CDLA/14696/1996; R(DLA) 1/07, tribunal of commissioners
Attention must be in connection with ‘bodily functions’.4Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94 These include things like eating, washing, dressing and undressing, taking medication, reading, communicating, cognition and sleeping. So, for example, if you need to encourage a child to change their clothes, wash, and take medication, this may be classed as attention.
Attention must be needed to allow a child ‘as far as reasonably possible to live a normal life’.5R(DLA) 2/02 Having a social life, recreation and cultural activities are part of normal life. A child’s age and interests should be taken into account when deciding what help they reasonably need.6Secretary of State for Social Security v Fairey (aka Halliday), 21 May 1997 (HL), reported as R(A) 2/98
‘Supervision’ and mental health
To show that a child needs supervision (eg, to prevent them from self-harming), you do not need to show that supervision would completely remove all risk of harm; the test is whether it would result in ‘a real reduction in the risk of harm’.7R(A) 3/92
In considering a need for supervision, the decision maker weighs the likelihood of a risk and the seriousness of the potential consequences.8RJ, GMcL and CS v SSWP (PIP) [2017] UKUT 105 (AAC), reported as [2017] AACR 32. Although this case relates to PIP, the same arguments about the likelihood of harm occurring and the need for supervision to prevent it also apply to DLA. For example, the consequences of an unsupervised child acting on suicidal thoughts could be dire, even though the likelihood of this happening might be reasonably low. In this situation it can be argued that the child reasonably requires continual supervision.9CA/15/1979, approved in R(A) 1/83; R(A) 2/89 In assessing the likelihood of danger, the DWP must look at what has happened in the past as well as what may happen in the future.10CA/33/1984
Lowest rate care component
A child can get the lowest rate care component if they are so severely disabled, physically or mentally, that they require attention from another person for a significant portion of the day (whether during a single period or a number of periods) in connection with their bodily functions.11ss71(6) and 72 SSCBA 1992
‘A significant portion of the day’ is often taken to mean about an hour.12CDLA/58/1993 However, spending less time than that in total but needing to give attention for a number of short periods might qualify. Factors like the amount, importance or effect of the attention may be taken into account.13CSDLA/29/1994; Ramsden v SSWP, 31 January 2003 (CA), reported as R(DLA) 2/03; SO v SSWP (DLA) [2019] UKUT 272 (AAC) Help at night does not count.14R(DLA) 8/02
Middle rate care component
A child can get the middle rate care component if:15s72(4)(b) SSCBA 1992; reg 7 SS(DLA) Regs
    •they satisfy one of the daytime disability conditions or one of the night-time disability conditions (see here); or
    •they undergo renal dialysis, in certain circumstances.
Highest rate care component
A child can get the highest rate care component if:16s72(4)(a) and (5) SSCBA 1992
    •they satisfy one of the daytime disability conditions and one of the night-time disability conditions (see here); or
    •they are regarded as being terminally ill (see here).
The daytime disability conditions
The daytime disability conditions are that a child is so severely disabled, physically or mentally, that their needs satisfy at least one of the following two requirements.17s72(1)(b) SSCBA 1992
– They require frequent attention from another person throughout the day in connection with their bodily functions. Frequency refers to the number and pattern of times attention is needed over a period of time, and should be considered as a whole.18R(DLA) 5/05 A child may still qualify even if the times when attention is needed are not spread evenly throughout the day.19CA/140/1985 The aggregate amount of time taken up is not relevant.
– They require continual supervision throughout the day in order to avoid substantial danger to themself or others. ‘Continual’ does not mean constant, but supervision which is required only occasionally or intermittently is insufficient.20R(A) 1/73 The fact that a child may need less supervision in a safe, structured environment, such as school, does not mean that continual supervision is not needed.21CP v SSWP (DLA) [2013] UKUT 230 (AAC) If it is unavoidable that a child is left alone for a period, they can still qualify if you can show that they are at risk during this time.
The night-time disability conditions
‘Night’ means ‘that period of inactivity’ which begins when ‘the household… closes down for the night’. This is usually assumed to start at around 11pm and end at around 7am.22R v National Insurance Commissioner ex parte Secretary of State for Social Services [1974] 1 WLR 1290 (DC), also reported as R(A) 4/74; R(A) 1/04; CDLA/2852/2002; CDLA/997/2003; LB v SSWP (DLA) [2018] UKUT 445 (AAC); R(A) 1/78 So if, for example, a child can be understood as having night needs if care is needed at 11pm, even if they do not go to bed until later.
The night-time disability conditions are that a child is so severely disabled, physically or mentally, that their needs satisfy at least one of the following two requirements.23s72(1)(c) SSCBA 1992
– They require prolonged or repeated attention from another person at night in connection with their bodily functions. Sleeping is a ’bodily function’, so help needed for a child to get (back) to sleep is attention.24R(A) 3/78 There is no clear definition of ‘prolonged’ but it could mean around 20 minutes.25R(DLA) 5/05 ‘Repeated’ means twice or more.26R(DLA) 5/05 There is no requirement that attention should be needed ’most of the time’ – eg, on more than half the nights in a week. A broad overall judgement of a child’s needs should be made.27AD v SSWP (DLA) [2017] UKUT 29 (AAC)
– They require another person to be awake at night for a prolonged period or at frequent intervals to watch over them in order to avoid substantial danger to themself or others. A ‘prolonged period’ may mean about 20 minutes or more.28Vol 10 Ch 61, para 61164 DMG ‘At frequent intervals’ is more than twice. The frequent intervals need not be spread throughout the night, but can be concentrated in one part of it.29Vol 10 Ch 61, para 61164 DMG
What else you need to know about the care component
    •To get the care component of DLA, a child’s need for attention or supervision must be ‘substantially in excess of the normal requirements’ of a child of the same age.30s72(1A)(b) SSCBA 1992; R(DLA) 1/05; BM v SSWP (DLA) [2015] UKUT 18 (AAC), reported as [2015] AACR 29
    •The attention or supervision they ‘require’ is what is reasonably required rather than what is medically required.31R(A) 3/86; Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94
    •A child with a mental health problem does not need to have a diagnosis to get the care component. What is important is that they have care needs because of their mental health symptoms.32R(DLA) 3/06, tribunal of commissioners However, medical evidence is usually still important to establish that they have mental health symptoms and what their needs are.33CDLA/4475/04 Problems can sometimes arise if a child has, for example, behavioural issues that are not clearly linked to a particular mental health condition. In these cases, decision makers will consider whether a child has the physical or mental power to control their behaviour.34R(DLA) 3/06, tribunal of commissioners
    •Refusing medical treatment for a child may affect whether or not they can get the care component. If treatment offered by their doctor would remove the need for help, the attention or supervision a child gets may not be reasonably required. However, it may not be ‘reasonably appropriate’ for you to agree to the treatment – eg, because of the risks or side effects.35CDLA/3925/1997; HJ v SSWP (DLA) [2010] UKUT 307 (AAC); R(DLA) 10/02
Examples
Khadija (12) has anorexia. Anorexia affects different people in different ways but for Khadija its means that she restricts the amount of food she eats, exercises excessively, and has compulsive weighing and appearance-checking behaviour. Due to her illness, Khadija struggles with her emotions and thoughts. She can be withdrawn around other people and finds it difficult to concentrate.
Khadija’s parents need to give Khadija more attention than a child her age without the same condition. She needs lots of reassurance and persuasion to eat meals. She needs help getting dressed, and this takes a long time, due to appearance-checking behaviours. She needs somebody to support her in social activities. At school she needs attention at lunch time and extra support to engage with others and focus in lessons. She also needs a lot of encouragement to communicate in counselling sessions.
Khadija is awarded the middle rate of the care component of DLA because it is decided that she needs frequent attention from another person throughout the day in connection with bodily functions such as eating, dressing, reading and communicating.
Ania (8) has social anxiety and selective mutism. She experiences significant anxiety when she is at school and does not speak to her teachers or classmates. The same applies in out-of-school activities and larger family gatherings. A decision maker awards her the lower rate of the care component of DLA on the basis that she needs another person’s help to communicate for a ‘significant portion’ of the day. Ania’s grandmother, who is her appointee, challenges this decision arguing that the middle rate should be awarded because Ania actually needs frequent attention throughout the day. Ania’s grandmother also explains that Ania not only needs help with communicating but, because of her anxiety, with activities like eating her school dinner and changing clothes for PE.
 
1     R(A) 3/74; R(A) 2/75 »
2     Reg 10C SS(DLA) Regs; R v National Insurance Commissioner ex parte Secretary of State for Social Services [1981] 1 WLR 1017 (CA), also reported as R(A) 2/80; R(A) 1/06 »
3     Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94; CA/177/1988; CDLA/14696/1996; R(DLA) 1/07, tribunal of commissioners »
4     Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94 »
5     R(DLA) 2/02 »
6     Secretary of State for Social Security v Fairey (aka Halliday), 21 May 1997 (HL), reported as R(A) 2/98 »
7     R(A) 3/92 »
8     RJ, GMcL and CS v SSWP (PIP) [2017] UKUT 105 (AAC), reported as [2017] AACR 32. Although this case relates to PIP, the same arguments about the likelihood of harm occurring and the need for supervision to prevent it also apply to DLA. »
9     CA/15/1979, approved in R(A) 1/83; R(A) 2/89 »
10     CA/33/1984 »
11     ss71(6) and 72 SSCBA 1992 »
12     CDLA/58/1993 »
13     CSDLA/29/1994; Ramsden v SSWP, 31 January 2003 (CA), reported as R(DLA) 2/03; SO v SSWP (DLA) [2019] UKUT 272 (AAC) »
14     R(DLA) 8/02 »
15     s72(4)(b) SSCBA 1992; reg 7 SS(DLA) Regs  »
16     s72(4)(a) and (5) SSCBA 1992 »
17     s72(1)(b) SSCBA 1992 »
18     R(DLA) 5/05 »
19     CA/140/1985 »
20     R(A) 1/73 »
21     CP v SSWP (DLA) [2013] UKUT 230 (AAC) »
22     R v National Insurance Commissioner ex parte Secretary of State for Social Services [1974] 1 WLR 1290 (DC), also reported as R(A) 4/74; R(A) 1/04; CDLA/2852/2002; CDLA/997/2003; LB v SSWP (DLA) [2018] UKUT 445 (AAC); R(A) 1/78 »
23     s72(1)(c) SSCBA 1992 »
24     R(A) 3/78 »
25     R(DLA) 5/05 »
26     R(DLA) 5/05 »
27     AD v SSWP (DLA) [2017] UKUT 29 (AAC) »
28     Vol 10 Ch 61, para 61164 DMG »
29     Vol 10 Ch 61, para 61164 DMG »
30     s72(1A)(b) SSCBA 1992; R(DLA) 1/05; BM v SSWP (DLA) [2015] UKUT 18 (AAC), reported as [2015] AACR 29 »
31     R(A) 3/86; Mallinson v Secretary of State for Social Security, 21 April 1994 (HL), reported as R(A) 3/94 »
32     R(DLA) 3/06, tribunal of commissioners »
33     CDLA/4475/04 »
34     R(DLA) 3/06, tribunal of commissioners »
35     CDLA/3925/1997; HJ v SSWP (DLA) [2010] UKUT 307 (AAC); R(DLA) 10/02 »
Disability conditions for the mobility component
Lower rate mobility component
A child aged five or over can get the lower rate mobility component of DLA if they are ‘so severely disabled physically or mentally’ that they cannot use unfamiliar routes outdoors ‘without guidance or supervision from another person most of the time’.1s73(1)(d) SSCBA 1992; R(DLA) 6/03 The need for guidance or supervision must be substantially more than the usual needs of a child of the same age.2s73(4A) SSCBA 1992
‘Guidance’ and ‘supervision’ can overlap. It is important to emphasise the full extent of a child’s needs without trying to fit them neatly into either category.
‘Guidance’ can mean physically leading or directing a child, or verbally giving instructions or encouragement. It can include helping to avoid obstacles or places that upset them, or leading or persuading a child when they become disorientated or are anxious.
‘Supervision’ can be precautionary. For example, it can be monitoring a child’s mental or emotional state in case they need more assistance to continue walking, or monitoring the route ahead for places or situations which might upset them. Supervision can also be active, such as encouraging or cajoling a child, or distracting them from fears3R(DLA) 3/04 or possibly alarming situations.4CDLA/42/1994 Unlike the ‘continual supervision’ condition for the DLA care component (see here), the child does not need to require supervision to prevent ‘substantial danger’.5CDLA/42/1994 If they get the care component because they require continual supervision, they may also get the lower rate mobility component, but this is not automatic.6CDLA/42/1994; CDLA/3360/1995; CSDLA/591/1997; CDLA/2643/1998; R(DLA) 4/01
It is enough that supervision helps, even if it does not remove risks completely or if a child may not always respond well to the person providing it.7IN v SSWP (DLA) [2013] UKUT 249 (AAC); R(DLA) 4/01; R(DLA) 6/05
If a child’s mental health problem means that they need somebody to come with them to overcome a fear of going outside, they are likely to satisfy the ‘guidance or supervision’ requirement.8CDLA/42/1994; R(DLA) 3/04 If they can just manage a walk into their garden, this could be enough to qualify.9CDLA/2142/2005 If no amount of reassurance can persuade them to go outside, it is possible that they may not qualify.10CDLA/2364/1995; KH v SSWP (DLA) [2015] UKUT 8 (AAC), but see CDLA/42/1994
Higher rate mobility component
A child aged three or over can get the higher rate mobility component if:11s73 SSCBA 1992; reg 12(1)(b) SS(DLA) Regs
    •they have a disability from a physical cause that means they are unable, or virtually unable, to walk; or
    •they are both blind and deaf; or
    •they are blind or severely visually impaired; or
    •they were born without feet or are a double amputee; or
    •they have a ‘severe mental impairment’ (ie, arrested or incomplete development of the brain which results in severe impairment of intelligence and social functioning), have ‘severe behavioural problems’ and qualify for the highest rate of DLA care component.12JH v SSWP (DLA) [2010] UKUT 456 (AAC); AH v SSWP (DLA) [2012] UKUT 387 (AAC); SSWP v MG (DLA) [2012] UKUT 429 (AAC) This definition is unlikely to apply to children whose only disability or health condition is a mental health problem, but can apply to children with mental health symptoms who also have a developmental condition or autism.
’Unable or virtually unable to walk’
To get the higher rate mobility component on the basis of walking difficulties, those difficulties must have a physical cause.13Reg 12(1)(a) SS(DLA) Regs; KS v SSWP (DLA) [2013] UKUT 390 (AAC) This does not mean that this category is always irrelevant for children with mental health problems. For example, if a child’s walking is impaired by physical weakness due to anorexia , the cause is physical and they can meet this criterion.14CDLA/1525/2008
‘Benefit from enhanced facilities for locomotion’.
On top of the criteria above, to get the DLA mobility component, a child must be able to ‘benefit from enhanced facilities for locomotion’. That means they must be able to make outdoor journeys from time to time.15CM/5/1986; BP v SSWP [2009] UKUT 90 (AAC) It is not essential that they are interested in or enjoy going out, provided that it would be beneficial for them to do so.
Example
George (15) has severe depression. For George, this means that he does not enjoy the things he used to and feels very low most of the time. He has no energy or enthusiasm for day-to-day activities, does not have much appetite, and sleeps poorly. For the last three months, George has been unable to go to school because of his condition. George self-harms and has recently been telling his mother that he is having suicidal thoughts.
George needs substantially more help than another 15-year-old without his condition. The attention he needs in the daytime includes encouragement to wash, change clothes, eat, take medication, and communicate with professionals. He also needs continual supervision throughout the day to minimise the risk of him self-harming or acting on suicidal thoughts. George’s needs are likely to satisfy one or both of the daytime care conditions (he only ‘needs’ to satisfy one).
George is often awake until 1 or 2am because he struggles to get to sleep and this is a time when he has particularly difficult thoughts and feelings. His mother regularly spends two hours or more after 11pm comforting and reassuring George to help him to get to sleep. During this time she is also watching over him to minimise the risk that he might harm himself. George’s needs are likely to satisfy one or both of the night-time care conditions (he only ‘needs’ to satisfy one).
Based on his daytime and night-time needs, George should be awarded the highest rate of the care component of DLA.
George’s needs are also likely to satisfy the requirements for the lower rate of the mobility component of DLA. He rarely leaves the house, except to go to medical appointments with his mother. It is unlikely that he could go out without guidance or supervision from another person because of his need for verbal reassurance, encouragement and comforting, as well as the need for supervision to minimise the risk that he will hurt himself or act on suicidal thoughts.
George will not be awarded the higher rate of the mobility component of DLA because he does not have any difficulty with the physical act of walking or with his sight, has both feet, and does not have, for example, a developmental condition or autism.
 
1     s73(1)(d) SSCBA 1992; R(DLA) 6/03 »
2     s73(4A) SSCBA 1992 »
3     R(DLA) 3/04 »
4     CDLA/42/1994 »
5     CDLA/42/1994 »
6     CDLA/42/1994; CDLA/3360/1995; CSDLA/591/1997; CDLA/2643/1998; R(DLA) 4/01 »
7     IN v SSWP (DLA) [2013] UKUT 249 (AAC); R(DLA) 4/01; R(DLA) 6/05 »
8     CDLA/42/1994; R(DLA) 3/04 »
9     CDLA/2142/2005 »
10     CDLA/2364/1995; KH v SSWP (DLA) [2015] UKUT 8 (AAC), but see CDLA/42/1994 »
11     s73 SSCBA 1992; reg 12(1)(b) SS(DLA) Regs »
12     JH v SSWP (DLA) [2010] UKUT 456 (AAC); AH v SSWP (DLA) [2012] UKUT 387 (AAC); SSWP v MG (DLA) [2012] UKUT 429 (AAC) »
13     Reg 12(1)(a) SS(DLA) Regs; KS v SSWP (DLA) [2013] UKUT 390 (AAC) »
14     CDLA/1525/2008 »
15     CM/5/1986; BP v SSWP [2009] UKUT 90 (AAC) »
2. The amount of benefit
Disability living allowance (DLA) care component is paid at one of three weekly rates:1Reg 4(2) SS(DLA) Regs
    •the lowest rate is £26.90;
    •the middle rate is £68.10;
    •the highest rate is £101.75.
DLA mobility component is paid at one of two weekly rates:2Reg 4(1) SS(DLA) Regs
    •the lower rate is £26.90;
    •the higher rate is £71.00.
 
1     Reg 4(2) SS(DLA) Regs »
2     Reg 4(1) SS(DLA) Regs »
3. Making a claim
How to claim
A claim for disability living allowance (DLA) is made by an ‘appointee’ on a child’s behalf. This person must usually live with the child and is often the child’s parent or guardian.1Reg 43 SS(C&P) Regs
A claim for DLA must be in writing. You should claim by completing the approved claim form (DLA1 Child). It is best to request a claim form by telephone from the DLA helpline (0800 121 4600, textphone: 0800 121 4523, Relay UK and BSL video services available). A form you request by phone should arrive date stamped, and if you return it within six weeks, the date you called to request it will be treated as your date of claim. The DWP can extend the six-week deadline if it considers that this is reasonable, so if you return the form late, explain why.2Regs 4(1) and 6(8), (8A) and (9) SS(C&P) Regs; SNN v SSWP (PIP) [2018] UKUT 210 (AAC) - although decided on similar rules for PIP, this case considers circumstances that may be reasonable and the discussion is relevant for DLA claims
If you do not get a date-stamped form, or if you return a date-stamped form too late, your date of claim will be the date that the DWP receives your completed form. This applies, for example, if you print an DLA1 Child form from the internet.
The claim form asks a lot of questions about the child’s needs. See here for tips on completing the form.
 
1     Reg 43 SS(C&P) Regs »
2     Regs 4(1) and 6(8), (8A) and (9) SS(C&P) Regs; SNN v SSWP (PIP) [2018] UKUT 210 (AAC) - although decided on similar rules for PIP, this case considers circumstances that may be reasonable and the discussion is relevant for DLA claims »
Claiming in advance and backdating
A claim for DLA can be made in advance, before a child meets the qualifying conditions on here, provided you claim no more than three months before the child will actually qualify.1Reg 13A(1) SS(C&P) Regs
A claim for DLA cannot be backdated.2s76(1) SSCBA 1992 If a child might have qualified for DLA earlier but you did not claim because you were given the wrong information or were misled by the DWP, you could make a complaint and ask for compensation (see here).
Note: the term ‘backdating’ is often informally used to mean getting arrears of your benefit going back to a claim or decision date – eg, after winning an appeal. However, in this Handbook, we use backdating to mean getting paid benefit for a period before the date you claimed.
 
1     Reg 13A(1) SS(C&P) Regs »
2     s76(1) SSCBA 1992 »
Additional support
If you have (or will have) difficulty with the claims process and need additional support, see Chapter 18.
Terminal illness
The DLA claims process is different if a child is terminally ill. They are regarded as ‘terminally ill’ if they have a progressive disease from which their death can reasonably be expected within 12 months. 1ss66(2), 72(5) and 73(9) and (12) SSCBA 1992; regs 3(9)(b) and 6(6)(c) SS&CS(DA) Regs
If you are claiming on the basis of a child’s terminal illness, you must tick the box on the claim form to say you are claiming under the ‘special rules’. The claim will then be fast-tracked. In addition to the claim form, you must provide Form DS1500, completed by the child’s GP, consultant or specialist nurse.
If a child is regarded as being terminally ill, they are automatically treated as satisfying the conditions for the highest rate of the DLA care component, so you do not need to complete the parts of the claim form that relate to their care needs. They do not automatically get DLA mobility component, so if you think they will qualify for this, you must complete the sections of the form that are about mobility. They must satisfy the usual mobility conditions (except the three-month qualifying period).
 
1     ss66(2), 72(5) and 73(9) and (12) SSCBA 1992; regs 3(9)(b) and 6(6)(c) SS&CS(DA) Regs »
4. How a child is assessed
Note: this assessment process does not apply if a child is regarded as terminally ill (see here).
To get disability living allowance (DLA), a child must meet the ‘disability conditions’, set out on here. The DWP uses a standard assessment process to decide whether a child meets those conditions.
The claim form
The assessment process starts with the DLA claim form, which asks about different aspects of a child’s needs. If you find it difficult to complete the form, most advice agencies can help, and the DWP can in some circumstances send a visiting officer to help you complete the form at your home. See Chapter 18 for more information.
Completing the claim form
Look at the rules on here to understand what the decision maker needs to know.
Consider all of the mental health symptoms listed on here.
Give as much detail as you can. The form does not have a lot of space for you to explain a child’s difficulties so it is usually a good idea to include more information on extra sheets of paper. You might choose to use one sheet for each different activity (eg, eating, communicating, going out) as well as one sheet to summarise your child’s main symptoms and treatment history.
To give a full picture of a child’s needs, it might be useful for you to keep a diary for a week or a month, to record their symptoms and the help they need. Attach a copy to the form and refer to it in your answers.
Remember to explain:
– how often help is needed each day (and night);
– how long help is needed for each time;
- what has happened or is likely to happen if the child does not get the help they need; and
– how many days (and nights ) a week help is needed. The child may still get DLA even if they need help on fewer than half of the days in a week. It is not about simply comparing the number of ‘good’ versus ‘bad’ days.1R(A) 2/74; see also Moyna v SSWP, 31 July 2003 (HL), reported as R(DLA) 7/03; DJ v SSWP (DLA) [2016] UKUT 169 (AAC) Explain fully the help needed on ‘bad’ days, and include the help needed on ‘good’ days for an overall picture.
Ideally, get somebody who knows the child well to check your answers.
Keep a copy of the completed form and ask the Post Office for free proof of posting.
 
1     R(A) 2/74; see also Moyna v SSWP, 31 July 2003 (HL), reported as R(DLA) 7/03; DJ v SSWP (DLA) [2016] UKUT 169 (AAC) »
Gathering further information
When you return the DLA form, it is a good idea to enclose supporting evidence – eg, reports from a child’s doctor or other professionals, a letter from their teacher or somebody else who knows them well, and/or a diary of symptoms. Chapter 13 has more information about supporting evidence.
DLA can be awarded on the basis of the claim form (and supporting evidence) alone, but the DWP may decide that it needs more details to make a decision and may contact you, the child’s medical professionals, their school, or someone else you named on the form for more information.
Note: it is generally better to provide information from these people or organisations when you make the claim than to rely on the DWP to contact them for information.
The DWP can also arrange for the child to be given a medical examination by a healthcare professional. This is fairly unusual. If you (or an older child) refuse a medical examination ‘without good cause’, the claim is likely to be refused.1s19(3) SSA 1998
 
1     s19(3) SSA 1998 »
5. Decisions
Getting a decision
You will get decisions about disability living allowance (DLA) by letter. You may get a decision about a child’s eligibility for DLA about eight weeks after returning a claim form.
If you disagree with a decision about DLA, you can usually challenge it by making a mandatory reconsideration request and then pursuing an appeal if necessary. See Chapter 17. Note that there are deadlines for challenging decisions.
If you challenge a decision, the DWP (or tribunal) can look at all the DLA disability conditions again, not just the ones that you ask it to reconsider. This means that following a mandatory reconsideration or appeal an award could decrease, instead of increasing. It is usually best to get advice before challenging a decision.
If a child has been awarded some DLA, you can continue to get it while a request for a mandatory reconsideration is being considered and while an appeal is pending (see here). However, if a child has not been given any award of DLA, you will not get any interim payments while waiting for a decision on a mandatory reconsideration or appeal.
Length of awards
DLA can be awarded for a fixed period or indefinitely.1s71(3) SSCBA 1992; R(DLA) 11/02 The length of award should be based on how soon, if at all, the child’s needs are likely to change.
Regardless of the stated length of an award, the DWP can reduce or stop the award earlier if it has grounds to revise or supersede it (see here).
If an award is for a fixed term, you are invited to make a renewal claim up to six months before the award runs out (see here ).
 
1     s71(3) SSCBA 1992; R(DLA) 11/02 »
6. Getting paid
Disability living allowance (DLA) is paid to an adult ‘appointee’.
DLA is normally paid every four weeks in arrears, on a Wednesday.1Regs 22 and 25 and Sch 6 SS(C&P) Regs However, DLA can be paid at shorter intervals in individual cases and DLA under the special rules for terminal illness can be paid weekly.
 
1     Regs 22 and 25 and Sch 6 SS(C&P) Regs »
7. Reviews and reassessments
Making a renewal claim
If disability living allowance (DLA) is awarded for a fixed period, you can make a renewal claim up to six months before the fixed term ends. You will be sent a renewal claim form (DLA1A). It is important that you send back your completed form well before the existing award ends, as no backdating is possible.
The DWP normally treats a renewal claim as a new claim beginning on the day after an award ends.1Reg 13C SS(C&P) Regs However, the information you give in the renewal claim may be used to revise or supersede the child’s existing award, in which case their entitlement may be changed earlier.2CDLA/14895/1996
 
1     Reg 13C SS(C&P) Regs »
2     CDLA/14895/1996 »
Change of circumstances
You should usually report all changes in a child’s circumstances to the DLA section of the DWP as soon as possible. You can report a change by calling the DLA helpline (see here), or in writing, by sending a letter to the address on the DLA award letter.1Reg 32(1B) SS(C&P) Regs It can be preferable to report a change in writing so that there is a clear record of what you have said and when.
It is usually best to get independent advice before reporting a change in a child’s health that you think might affect their entitlement to DLA.
If there has been a relevant change of circumstances, a decision maker looks at the award again. You might be asked to go through the assessment process again (see here). The decision maker will make a new decision, usually by ‘supersession’ (see here).
Note:
    •A change of circumstances can include that a child’s needs are now expected to last beyond the end date of a fixed-term award, even if the level of their needs is still the same.2PH v SSWP (DLA) [2013] UKUT 268 (AAC)
    •If a child gets DLA and is moving to Scotland, you should notify Social Security Scotland. They will be transferred to child disability payment (CDP – see Chapter 11) automatically without having to make a claim.
 
1     Reg 32(1B) SS(C&P) Regs »
2     PH v SSWP (DLA) [2013] UKUT 268 (AAC) »
Reaching the age of 16
When a child who is getting DLA reaches 16, they are normally invited to claim personal independence payment (PIP). See Chapter 8.
Advice from an adviser
‘When a young person is assessed for PIP at 16, the first thing DWP will want to know is whether they are capable of handling their own claim or whether someone will still need to be their appointee. You may get a visit or phone call from the DWP and they may want to speak to the 16-year-old to assess that situation. If the young person is not able or willing to communicate, you will have to explain that to the DWP as being part of the reason why a PIP claim is being made.’
‘PIP is a different benefit, with different criteria, so just because a child got a certain rate of DLA it doesn’t mean they’ll get the equivalent rate of PIP – it may be the same, more, or less.’
Ongoing evidence requirements
You may be asked to provide information at any time after DLA is awarded. If you fail to do so, the child’s DLA could be suspended or even terminated.1Reg 32(1) SS(C&P) Regs
 
1     Reg 32(1) SS(C&P) Regs »
8. Disability living allowance and other benefits
Means-tested benefits and tax credits
Disability living allowance (DLA) can be paid alongside means-tested benefits and tax credits and is not taken into account as income for their means tests.
If your dependent child is entitled to DLA, you may qualify for additional premiums or amounts in your means-tested benefits, and may be exempt from ‘non-dependant deductions’. The same rules could mean that you become entitled to a means-tested benefit for the first time. See the chapter of this Handbook about the relevant means-tested benefit.
Non-means-tested benefits
DLA can be paid in addition to any other non-means-tested benefits, except that a child cannot get DLA at the same time as personal independence payment or child disability payment.1s71(7) SSCBA 1992
A child in Scotland who gets the DLA highest rate care component is eligible for a child winter heating assistance payment.2Reg 10 WHACYP(S) Regs
 
1     s71(7) SSCBA 1992 »
2     Reg 10 WHACYP(S) Regs »
Carers’ benefits
If a child gets the middle or highest rate of the DLA care component, you or someone else who regularly looks after them may be entitled to:
    •carer’s allowance; and/or
    •the carer element of universal credit; and/or
    •a carer premium in income support, income-based jobseeker’s allowance, income-related employment and support allowance or housing benefit; and/or
    •a carer addition in the guarantee credit of pension credit; and/or
    •(in Scotland) a young carer grant.
The benefit cap
In some cases, there is a limit on the total amount of specified benefits you can receive (the ‘benefit cap’). The benefit cap does not apply to you if your child is entitled to DLA, even it is not paid because they are in hospital or a care home.
Passports and other sources of help
If you get DLA for a child, you may be entitled to a blue badge parking concession or a concessionary travel card. Contact your local authority for more information.
If a child gets the DLA mobility component and her/his carer has a car used only for the child, the carer’s road tax may be reduced. There are details at gov.uk/financial-help-disabled/vehicles-and-transport.
If you have a low income, you may be eligible for free prescriptions, council tax reduction, and other financial help. See CPAG’s Welfare Benefits and Tax Credits Handbook.
Motability
Motability is a charity that runs a scheme to help you lease or buy a car, scooter or powered wheelchair. You are eligible if a child gets the enhanced rate of the DLA mobility component and there is 12 months or more left to run on their award. If you use the scheme, the child’s DLA mobility component is paid direct to Motability.1Regs 44, 45 and 46 SS(C&P) Regs You may also have to make extra payments.
 
 
1     Regs 44, 45 and 46 SS(C&P) Regs »