PART 1SELIGIBILITY
CHAPTER 1SELIGIBILITY IS TO DEPEND ON HAVING, OR HAVING HAD, A DISABILITY
1(1)The regulations must be framed so that (subject to any provision of the kind described in paragraph 2) an individual's eligibility in respect of a given period depends on the individual having, during that period—S
(a)a physical or mental impairment that―
(i)has a significant and not short-term adverse effect on the individual's ability to carry out normal day-to-day activities, or
(ii)otherwise gives rise to a significant and not short-term need, or
(b)a terminal illness.
(2)The regulations must provide that an individual is to be regarded as having a terminal illness for the purpose of determining entitlement to disability assistance if, having had regard to the guidance mentioned in sub-paragraph (3), it is the clinical judgement of [F1an appropriate healthcare professional] that the individual has a progressive disease that can reasonably be expected to cause the individual's death.
[F2(2A)The regulations may provide that, in the situation mentioned in sub-paragraph (2B), an individual who is not resident in the United Kingdom is to be regarded as having a terminal illness despite the clinical judgement described in sub-paragraph (2) not having been formed with regard to the guidance mentioned in sub-paragraph (3).
(2B)The situation referred to in sub-paragraph (2A) is that it would not be reasonable in the circumstances to insist on a clinical judgement being provided that has been formed with regard to the guidance.
(2C)The regulations are to define “appropriate healthcare professional” for the purpose of determining entitlement to disability assistance on the basis of an individual having a terminal illness.
(2D)In defining “appropriate healthcare professional” the regulations—
(a)must provide that being a registered medical practitioner or registered nurse is a requirement for being an appropriate healthcare professional,
(b)may provide that being a registered member of a healthcare profession otherwise than as mentioned in paragraph (a) is a requirement for being an appropriate healthcare professional,
(c)may include additional requirements that a person must satisfy in order to be an appropriate healthcare professional, including by reference to a person's—
(i)skills, training, qualifications and experience,
(ii)professional relationship to the individual in question,
(iii)being authorised to act as an appropriate healthcare professional in relation to the individual in question by—
(A)a Health Board constituted under section 2(1)(a) of the National Health Service (Scotland) Act 1978,
(B)a Special Health Board constituted under section 2(1)(b) of that Act,
(C)the Scottish Ministers.
(d)may make different provision about the requirements for being an appropriate healthcare professional for the purposes of determining the entitlement to disability assistance of individuals who are resident in the United Kingdom and those who are not.]
[F3(3)The Chief Medical Officer of the Scottish Administration is—
(a)to prepare and from time to time revise, and
(b)to make publicly available by such means as the Chief Medical Officer considers appropriate,
guidance that sets out when a progressive disease can reasonably be expected to cause an individual's death for the purpose of determining entitlement to disability assistance.
(4)Before preparing or revising guidance under sub-paragraph (3), the Chief Medical Officer must consult appropriate healthcare professionals (as defined in sub-paragraph (2C)) who are registered in the United Kingdom as members of a healthcare profession.]
Textual Amendments
F1Words in sch. 5 para. 1(2) substituted (26.7.2021) by Social Security Administration and Tribunal Membership (Scotland) Act 2020 (asp 18), ss. 11(2)(a)(i), 18(2)(3); S.S.I. 2021/232, reg. 2(e)
F2Sch. 5 para. 1(2A)-(2D) inserted (26.7.2021) by Social Security Administration and Tribunal Membership (Scotland) Act 2020 (asp 18), ss. 11(2)(a)(ii), 18(2)(3); S.S.I. 2021/232, reg. 2(e)
F3Sch. 5 para. 1(3)(4) substituted for sch. 5 para. 1(3) (26.7.2021) by Social Security Administration and Tribunal Membership (Scotland) Act 2020 (asp 18), ss. 11(2)(a)(iii), 18(2)(3); S.S.I. 2021/232, reg. 2(e)
Commencement Information
I1Sch. 5 para. 1 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
2(1)The regulations may be framed so that, despite the criterion described in paragraph 1(1) not being fulfilled in respect of a given period, an individual may nevertheless be eligible in respect of that period.S
(2)Where the regulations allow an individual to be eligible in respect of a period in relation to which the criterion described in paragraph 1(1) is not fulfilled, they must be framed so that the individual's eligibility depends on the individual having had, during some other period, a physical or mental impairment of the kind described in paragraph 1(1)(a).
Commencement Information
I2Sch. 5 para. 2 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
CHAPTER 2SFURTHER CRITERIA
Nature and extent of disability and needsS
3SThe regulations may make an individual's eligibility depend on the nature and extent of—
(a)the individual's impairment,
(b)the needs of the individual in consequence of the impairment.
Commencement Information
I3Sch. 5 para. 3 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Residence and presenceS
4SThe regulations may make an individual's eligibility depend on the individual being resident and present in a particular place.
Commencement Information
I4Sch. 5 para. 4 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
AgeS
5SThe regulations may make an individual's eligibility depend on the individual's age.
Commencement Information
I5Sch. 5 para. 5 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Financial circumstancesS
6SSubject to paragraph 7, the regulations may not make an individual's eligibility depend on the financial circumstances of either or both—
(a)the individual, and
(b)anyone who lives with the individual.
Commencement Information
I6Sch. 5 para. 6 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Receipt of, or eligibility for, other types of State assistanceS
7SThe regulations may make an individual's eligibility depend on the individual—
(a)being, or not being, in receipt of another type of assistance (whether under this Act or another enactment),
(b)being, or not being, eligible or entitled to receive such assistance.
Commencement Information
I7Sch. 5 para. 7 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Application within specified periodS
8SThe regulations may provide that an individual ceases to be eligible in respect of a given period unless, by a deadline specified in the regulations—
(a)the individual has applied for disability assistance in respect of the period, or
(b)the Scottish Ministers have become required to make a determination of the individual's entitlement to disability assistance in respect of the period by regulations under section 52.
Commencement Information
I8Sch. 5 para. 8 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
CHAPTER 3SSPECIAL RULES FOR TERMINAL ILLNESS CASES
No minimum periodS
9SThe regulations may not make the eligibility of an individual who has a terminal illness depend on the individual having had the illness for any length of time.
Commencement Information
I9Sch. 5 para. 9 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
No requirement for assessmentS
10SThe regulations may not make the eligibility of an individual who has a terminal illness depend on the individual producing any evidence of that fact beyond a diagnosis by [F4an appropriate healthcare professional (see paragraph 1(2C))].
Textual Amendments
F4Words in sch. 5 para. 10 substituted (26.7.2021) by Social Security Administration and Tribunal Membership (Scotland) Act 2020 (asp 18), ss. 11(2)(b), 18(2)(3); S.S.I. 2021/232, reg. 2(e)
Commencement Information
I10Sch. 5 para. 10 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Eligibility from date of applicationS
11SThe regulations must be framed so that an individual who applies for disability assistance on the basis of having a terminal illness, and does have a terminal illness, is eligible, at the latest, from the day the application is made.
Commencement Information
I11Sch. 5 para. 11 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)
Entitlement to maximum amountS
12SThe regulations must be framed so that an individual who is eligible by reason of having a terminal illness is entitled to the maximum amount of the assistance that the individual is eligible for.
Commencement Information
I12Sch. 5 para. 12 in force at 8.10.2020 by S.S.I. 2020/295, reg. 2(c)