Disability Living Allowance (DLA)
awarded under the Special Rules (Review)

The Disability and Careers Service (DCS) is undertaking a review of “special rules” Disability Living Allowance cases awarded more than 3 years ago. This follows a legal review, a consultation with relevant care groups and a pilot survey of a small number of awards made more than seven years ago.

Why Are They Carrying Out The Review?

A number of people with HIV were awarded the highest rate of the care and/or mobility components of DLA on the grounds, accurate at the time; that they were reasonably expected to die within six months. However the introduction and development of combination therapy has led to life expectancy of people with HIV improving a lot over the past decade thereby leading to a change in people’s care and mobility needs.

The Review Process

An initial form is sent to a current recipient affected by the review. This asks the person for a list of their medical conditions and treatments. It also asks for the names of the claimant’s consultant, GP, and any other professionals involved in their care. The DCS asks the claimant who is the best person to be contacted to confirm their conditions. The deadline for the return of this form is indicated on it. If you don’t give consent for your doctors to be contacted, the DCS will send their own doctor to examine you.

Upon receipt of the above form, the DCS will send you an acknowledgement letter, in it advising who they are going to write to for an updated report on your condition. The DCS will generally contact your hospital consultant or GP.
So if your consultant or GP is not the best person to provide medical evidence on your condition you need to specify the person you would like them to contact instead very clearly on the form.

Once the medical update is received from your doctor it is passed to their Medical Services section who decides if you are terminally ill or not from the evidence obtained. The definition for “terminally ill” in this situation is where death could reasonably be expected within 6 months. If the DCS decide that you are terminally ill you will receive a letter confirming your DLA award.

However if they decide that you are not terminally ill then they will send a DLA review form so that you have an opportunity to provide them with full details of your care and mobility needs. When this DLA form is received the DCS looks at all the information in your claim and the doctor’s report to make a decision on your entitlement.

You may have your DLA award reduced, stopped or confirmed. If your award is confirmed but not done under Special Rules it may be for an indefinite period or more likely for a set period of time.

You have the right to revise and later appeal any decision made on your DLA entitlement.

The DCS will not seek to reclaim any money from people who are not found to be eligible for the higher rates.

What should you do if you get a letter from the DCS?

• Please do not ignore the letter because a decision may be made about your benefit in the absence of the most up to date medical information.
• If you live in or attend an HIV Clinic in the City of London or in the London boroughs of: Barking and Dagenham, Hackney, Havering, Newham, Redbridge, Tower Hamlets and Waltham Forest, please contact our advice line on 020 7791 2855 if you would like to speak to someone about the forms.
• Let your hospital consultant, GP or specialist named on your initial form know that they will be getting a letter asking for information about your DLA claim.
• Discuss your medical condition with your doctor or consultant so that they are in a position to provide up to date and accurate information about your condition.
• Ask for a copy of the doctor’s report from your doctor or DCS, as you will not automatically be sent a copy.
• If as a result of this review your award changes and you are unhappy about this, contact our Welfare Rights team who may be able to advise you accordingly.

Note: A significant number of people accessing our services appear to be affected by the review. As a result we are currently experiencing increased demand for review related appointments. The current waiting period for DLA related appointments is over one month. If you receive a DLA review form and require our help in completing it, we may ask you to call the DCS to request an extension of time for returning the form if we cannot offer you an appointment within the current set date.

We are trying our best to deal with the situation considering resource limitations so please bear this in mind as we help you go through the process.

Dated: February 2008