Mental Health and Benefits Handbook 1st edition - with new materialPart 2: Benefits Chapter 12: Attendance allowance
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Chapter 12: Attendance allowance
Key facts
    •Attendance allowance (AA) is a non-means-tested benefit for people over pension age with a disability or long-term health condition.
    •You can get AA while in or out of work, and you can get it alongside most other benefits. AA does not count as income for the purposes of means-tested benefits.
    •AA is paid at one of two rates. Whether you qualify and which rate you get depends on your needs for attention or supervision during the day and at night.
    •You can challenge decisions about your eligibility for AA.
    •Getting AA can mean that you are eligible for other kinds of financial support.
    •AA usually stops being paid if you are in hospital or residential care for more than 28 days.
1. Who can get attendance allowance
Attendance allowance (AA) is a non-means-tested benefit 1A benefit that is paid regardless of the amount of someone’s income or capital such as savings. for people over pension age 2This is age 66, and will reach 67 by October 2028., intended to help with the extra costs of having a disability or long-term health condition. People with mental health symptoms, with or without a diagnosis (see here), may be eligible for AA.
You can get AA if you:1ss64, 65 and 66 SSCBA 1992; reg 2 SS(AA) Regs
    •are pension age or over (pension age is currently 66; you can check your pension age at gov.uk/state-pension-age); and
    •meet the residence conditions, and are not a person subject to immigration control 3Someone who requires leave to enter or remain in the UK but does not have it, or who has leave to remain but is prohibited from having recourse to public funds, or has leave to remain in the UK on the basis of a sponsorship agreement. (although there are some exceptions) – see CPAG’s Welfare Benefits and Tax Credits Handbook; and
    •are not entitled to personal independence payment (PIP), adult disability payment (ADP) or the care component 4Part of disability living allowance and child disability payment paid if someone needs supervision or assistance because of a disability or health condition. of disability living allowance (DLA); and
    •meet the ‘disability conditions’ below; and
    •have had your needs for at least six months (sometimes called the ‘qualifying period’ condition).
Note:
    •AA is due to be replaced in Scotland with a pension age disability payment at some point in the future.
    •If you are getting PIP, ADP or DLA and reach pension age, you can carry on getting that benefit rather than having to switch to claiming AA. Check the chapter of this Handbook about the relevant benefit for any rules that apply when you reach pension age.
    •Special rules apply if you are regarded as being terminally ill (see here) and in certain other situations – eg, if you are in hospital or living in a care home (see Chapter 18).
 
1     ss64, 65 and 66 SSCBA 1992; reg 2 SS(AA) Regs »
The disability conditions
The health-related eligibility criteria for AA are known as the ‘disability conditions’. This does not mean that you cannot qualify if you do not consider yourself to have a disability. Throughout this section we avoid using the expression ‘so severely disabled, physically or mentally’. This is the phrase used in law but, in practice, it just means that your difficulties must be the result of a mental or physical health condition or disability.
What advisers say: not just for severe disability
‘Please do not be put off by the legal jargon. The conditions apply across a wider range of difficulties than you might first think when considering the legal wording. AA is not just for people who see themselves as “severely disabled” - awards are made to people living with perhaps less severe sounding, but still really limiting, conditions like anxiety and depression.’
AA is paid at one of two rates.
You get the lower rate of AA if you satisfy one of the daytime disability conditions or one of the night-time disability conditions.1s65(3) SSCBA 1992 You may also get the lower rate of AA if you undergo renal dialysis.2s65(2) SSCBA 1992; reg 5 SS(AA) Regs
You get the higher rate of AA if you satisfy one of the daytime disability conditions and one of the night-time disability conditions.3s65(3) SSCBA 1992 You also get the higher rate of AA if you are regarded as terminally ill (see here).
The daytime and night-time disability conditions
The daytime disability conditions are that, as a result of your mental or physical health condition or disability, throughout the day you need:4s64(2) SSCBA 1992
– frequent attention from another person in connection with your bodily functions; or
– continual supervision in order to avoid substantial danger to yourself or others.
The night-time disability conditions are that, as a result of your mental or physical health condition or disability, at night you need:5s64(3) SSCBA 1992
– prolonged or repeated attention from another person in connection with your bodily functions; or
– another person to be awake for a prolonged period or at frequent intervals to watch over you in order to avoid substantial danger to yourself or others.
The daytime and night-time disability conditions are the same as those for DLA (see here). You can argue that DLA caselaw about the meaning of these conditions, including about the meanings of ‘bodily functions’ (here), ‘attention’ (here) and ‘supervision’ (here), ought to be followed in your AA case.
Examples
Keiko (68) has depression and struggles with daytime activities like changing clothes, washing, taking medication and eating enough. She is also the main carer for her son Robert who has a physical disability. Keiko has always thought of herself as a carer, not as a person needing care, and does not believe that she can qualify for AA. However, her adviser points out that what matters is the help she reasonably needs, not the help she actually gets (see here and here). If Keiko reasonably needs frequent attention from another person in the daytime in connection with her bodily functions, she can qualify for the lower rate of AA.
John (77) experiences hallucinations, delusions and disordered thinking. He needs frequent attention in the daytime and prolonged attention at night in connection with bodily functions like cognition, communicating, taking medication and getting to sleep. This means that he should qualify for the higher rate of AA. When completing his AA claim form (see here), John’s daughter and appointee Leah includes a diary of the symptoms John has experienced over the last month, including the help he has needed from family members each day, and what has happened when that help was not available.
Note: in both examples, getting an award of AA might also mean becoming entitled to pension credit, or getting a greater amount. See Chapter 6.
 
1     s65(3) SSCBA 1992 »
2     s65(2) SSCBA 1992; reg 5 SS(AA) Regs »
3     s65(3) SSCBA 1992 »
4     s64(2) SSCBA 1992 »
5     s64(3) SSCBA 1992 »
2. The amount of benefit
Attendance allowance is paid at one of two weekly rates:1Sch 4 Part III SSCBA 1992
    •the lower rate is £68.10;
    •the higher rate is £101.75.
 
1     Sch 4 Part III SSCBA 1992 »
3. Making a claim
How to claim
A claim for attendance allowance (AA) must be in writing. You should claim by completing the approved claim form (AA1). It is best to request a claim form by telephone from the AA helpline (0800 731 0122, textphone: 0800 731 0317, Relay UK and British Sign Language (BSL) video relay 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.1Reg 6(8), (8A) and (9) SS(C&P) Regs The DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. can extend the six-week deadline if it considers that this is reasonable, so if you return the form late, explain why.2Reg 6(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 AA 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 AA1 form from the internet.
The claim form asks a lot of questions about your needs. There are tips for completing it on here.
What advisers say: getting a paper form
‘When you call the AA helpline, the recorded message tells you to go online and download a claim form instead of waiting on hold. You do not have to do this – even if you are very computer literate. Getting through to a telephonist and getting a form posted out to you is best. It means your claim starts from the date of the phone call (so long as you get the form back in time).’
 
1     Reg 6(8), (8A) and (9) SS(C&P) Regs »
2     Reg 6(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 AA claims »
Claiming in advance and backdating
A claim for AA can be made in advance, before you meet the qualifying conditions on here, provided you claim no more than six months before you will actually qualify.1s65(6) SSCBA 1992
A claim for AA cannot be backdated 1When you can get a benefit from a date before the date on which you actually claimed it. Not to be confused with getting arrears of benefit – eg, after winning an appeal..2s65(4) SSCBA 1992 If you might have qualified for AA 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     s65(6) SSCBA 1992 »
2     s65(4) SSCBA 1992 »
Additional support and appointees
If you have (or will have) difficulty with the claims process and need additional support, see Chapter 20. If you cannot manage the claims process at all, you may need an appointee 1Someone authorised to claim and receive your benefit on your behalf, when you are unable to manage it yourself. (see here).
Terminal illness
The AA claims process is different if you are terminally ill. You are regarded as ‘terminally ill’ if you have a progressive illness and it would not be a surprise to your doctors were you to die from it within the next 12 months. This can apply even if there are also realistic hopes that you may live much longer than that.1s66(2)(a) SSCBA 1992 You should explain that the claim is on the grounds of terminal illness when making it (claims from terminally ill people are widely referred to as ‘special rules’ claims).2Regs 3(9)(b) and 6(6)(c) SS&CS(DA) Regs Your GP, consultant or specialist nurse should complete Form SR1 or DS1500, giving details of your condition and prognosis.
If you are regarded as terminally ill, you are automatically entitled to the higher rate of AA.3s66(1) SSCBA 1992
 
1     s66(2)(a) SSCBA 1992 »
2     Regs 3(9)(b) and 6(6)(c) SS&CS(DA) Regs »
3     s66(1) SSCBA 1992 »
4. How you are assessed
Note: this assessment process does not apply if you are regarded as terminally ill (see here).
To get attendance allowance (AA), you need to meet its ‘disability conditions’, set out on here. The DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. uses a standard assessment process to decide whether you meet those conditions.
The claim form
The assessment process starts with the AA claim form, which asks about different aspects of your 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 20 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 your 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, night-time) as well as one sheet to summarise your main symptoms and treatment history.
To give a full picture of your needs, it might be useful for you to keep a diary for a week or a month to record your symptoms and the help you need. Attach a copy to the form and refer to it in your answers.
Remember to explain:
– what help you need, even if you do not actually get it;
– 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 you do not get the help you need;
– how many days (and nights) a week help is needed. You may still get AA even if you 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) - although about DLA, the discussion is also relevant for AA Explain fully the help you need on ‘bad’ days, but include the help needed on ‘good’ days for an overall picture.
Ideally, get somebody who knows you well to check your answers.
Keep a copy of your completed form and ask the Post Office for free proof of posting.
What advisers say: completing the AA claim form
‘Think outside the boxes. Do not be contained by the examples or to the types of difficulties as listed on the form.’
‘Take it slowly and be kind to yourself. For every page, take time to congratulate yourself on what you do manage, but do think about how any help from someone else could make a difference. It can be very upsetting describing all these difficulties and limitations to get a full picture over on the form. Take breaks, do it over several sessions, get help and plan something cheerful for afterwards.’
‘There is some flexibility about how long you have to return the form, no matter what date might be stamped on it (see here).’
 
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) - although about DLA, the discussion is also relevant for AA »
Gathering further information
When you return the AA form, it is a good idea to enclose supporting evidence – eg, reports from your doctor or other professionals, a letter from somebody who knows you well and/or a diary of symptoms. Chapter 15 has more information about supporting evidence.
AA 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, your GP 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 a medical examination by a healthcare professional 1A doctor, nurse, paramedic, physiotherapist or occupational therapist who carries out assessments.. For AA, this is very unusual in practice. If you 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 decisions about attendance allowance (AA) by letter. You may get a decision about your eligibility for AA about eight weeks after returning the claim form.
If you disagree with a decision about AA, you can usually challenge it by making a mandatory reconsideration 1The requirement to have a decision looked at again by the DWP before you can make an appeal. request and then pursuing an appeal if necessary (see Chapter 19). Note that there are deadlines for challenging decisions.
If you challenge a decision, the DWP 2The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. (or tribunal) can look at all the AA disability conditions again, not just the ones that you ask it to reconsider. This means that following a mandatory reconsideration or appeal, the award could decrease, instead of increasing. It is usually best to get advice before challenging a decision.
If you have been awarded the lower rate of AA and challenge this decision, you can continue to get the lower rate while a request for mandatory reconsideration is being considered and while an appeal is pending. However, if you have not been given any award of AA, you will not get any interim payments while waiting for a decision on a mandatory reconsideration or appeal. See here for more information.
Length of awards
AA can be awarded for a fixed period or indefinitely.1s65(1)(a) SSCBA 1992 The length of award should be based on how soon, if at all, your 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 will be invited to make a renewal claim up to six months before the award runs out (see here).
 
1     s65(1)(a) SSCBA 1992 »
6. Getting paid
When are you paid
Attendance allowance (AA) is normally paid every four weeks in arrears, on a Monday. Alternatively, it can be paid at shorter or longer intervals in arrears, or weekly in advance.1Reg 22 and Sch 6 SS(C&P) Regs
If you leave a care home and expect to return there within 28 days, AA can be paid at a daily rate for days at home.2Reg 25 SS(C&P) Regs
Note: it is possible for payment of AA to be suspended (see here).
 
1     Reg 22 and Sch 6 SS(C&P) Regs »
2     Reg 25 SS(C&P) Regs »
Where your payment goes
AA is usually paid into your bank account. Some or all of your AA can be paid to somebody else on your behalf if this is in your interests.1Reg 34(1) and (2) SS(C&P) Regs This might be useful if, for example, you want a trusted family member to look after your AA income because your mental health problem makes it difficult for you to manage money.
 
1     Reg 34(1) and (2) SS(C&P) Regs »
7. Reviews and reassessments
Making a renewal claim
If attendance allowance (AA) is awarded for a fixed period, you can make a renewal claim up to six months before this period ends. You will be sent a new claim form. It is important that you send back your completed form well before the existing award ends, as no backdating is possible.
The DWP 1The Department for Work and Pensions. A central government department that pays many benefits in Great Britain. 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 your existing award, in which case your entitlement may be changed earlier.2CDLA/14895/1996
Advice from advisers: renewal claims
‘Give as much information on the renewal form as you gave on the first claim form. Don’t assume that “the DWP knows that already about me”.’
 
1     Reg 13C SS(C&P) Regs »
2     CDLA/14895/1996 »
Change of circumstances
You should usually report all changes in your circumstances to the AA section of the DWP as soon as possible. You can report a change by calling the AA helpline, or in writing by sending a letter to the address on the AA 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 your health that you think might affect your entitlement to AA.
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 then make a new decision, usually by supersession 1A method of changing a benefit decision some time after it was made, often because of a change in circumstances. (see here).
 
1     Reg 32(1B) SS(C&P) Regs »
Ongoing evidence requirements
Once you are getting AA, you may be asked to provide information at any time. If you fail to do so, your AA could be suspended or even terminated.1Reg 32(1) SS(C&P) Regs
 
1     Reg 32(1) SS(C&P) Regs »
8. Attendance allowance and other benefits
Means-tested benefits and tax credits
Attendance allowance (AA) can be paid alongside means-tested benefits and tax credits. It is not taken into account as income for their means tests.
If you are entitled to AA, you may qualify for additional premiums or amounts in your means-tested benefits and may be exempt from non-dependant 1An adult, other than a partner, who lives with the person claiming benefit – eg, a grown-up daughter or son. There are some special rules about who is included. 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
AA can be paid in addition to many other non-means-tested benefits 1Benefits paid regardless of the amount of someone’s income or capital such as savings.. However, you cannot claim AA if you are entitled to personal independence payment, adult disability payment or the care component 2Part of disability living allowance and child disability payment paid if someone needs supervision or assistance because of a disability or health condition. of disability living allowance.1s64(1) and (1A) SSCBA 1992 AA also ‘overlaps’ with (ie, cannot be paid at the same time as) armed forces independence payment and constant attendance allowance under the industrial injuries scheme or war pensions scheme.2Sch 1 paras 5 and 5a SS(OB) Regs
 
1     s64(1) and (1A) SSCBA 1992 »
2     Sch 1 paras 5 and 5a SS(OB) Regs »
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 if you are entitled to AA, even if it is not paid because you are in hospital or a care home. If you are not entitled to AA, the benefit cap does not apply anyway if you are over pension age 1This is age 66, and will reach 67 by October 2028. and single (or if you have a partner and you are both over pension age).
Other sources of financial help
If you have a low income, you may be eligible for free dental treatment, council tax reduction and other financial help. See Chapter 14 for more information.