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Introduction

You can get Severe Disablement Allowance (SDA) only if you were getting it on 5 April 2001 or the linking rules (see under the heading ‘Linking’ in this section) apply if you make another claim.

SDA was designed to help people who had never been able to work, or who had not been able to work for at least 28 weeks, because of physical or mental illness or disability. Once it has been awarded there is no upper age limit. [Legislation (36)]

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New claims for people aged 16–25

If you are aged 16 or over and under 20 (or under 25 if you have been in education or training) and you have been sick or disabled for 28 weeks, you may be able to get Incapacity Benefit even if you have not paid enough National Insurance contributions to get it under the normal rules. See leaflet IB1JP A guide to Incapacity Benefit - Information for new customers.

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Linking

You may get SDA as soon as you become incapable of work. The following rules explain when this is allowed, but they are quite complicated. If you think they might apply to your case, ask your Jobcentre Plus office. Claims which are based on these rules are said to link with the earlier period of entitlement to SDA, Non-contributory Invalidity Pension (NCIP) or Housewives’ Non-contributory Invalidity Pension (HNCIP). You may get SDA without having to wait 28 weeks if: [Legislation (37)]

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Incapacity for work

You are regarded as incapable of work when you are not working because you are either physically or mentally disabled or suffering from a specific disease or condition, which includes mental illness and/or a learning disability. There are procedures for assessing incapacity for work. [Legislation (38)]

SDA customers in receipt of the benefit on 12 April 1995 are exempt from the current test of incapacity unless there is good reason to doubt incapacity.

The procedures apply to all SDA claims made on or after 13 April 1995. There are 2 tests:

Where both incapacity and disability need to be tested you will normally be asked to attend only one. For more information see guide IB1JP A guide to Incapacity Benefit – Information for new customers. You can get it from your Jobcentre Plus office.

Usually for the first 28 weeks of incapacity for work we will assess your ability to carry out your own job. This is called an ‘own occupation’ test and is based on medical certificates provided by your doctor.

After 28 weeks of incapacity for work, you will be assessed under the personal capability assessment (PCA) to establish whether you meet the threshold of incapacity for benefit. It can apply from the start of your illness or from the 28th week of your illness, depending on whether you were working, and for how long, before you claimed. The PCA assesses the extent to which you are capable of carrying out certain every-day activities. The activities cover physical, sensory and mental functions. The assessment measures the disabling effects of your medical condition.

You may be asked to complete a questionnaire about your illness or disability and to get a form MED 4 from your doctor. The MED 4 will be used by your doctor to give us further information about your medical condition. You may also be examined by one of our own doctors.

There are special arrangements for people who have mental health problems.

A decision maker in Jobcentre Plus will decide if you meet the threshold of incapacity under the PCA.

Some people with certain illnesses or disabilities are treated as meeting the threshold of incapacity without being assessed [Legislation (39)].

There are a minority of cases where exceptional circumstances may apply and someone is treated as meeting the threshold of incapacity [Legislation (39)].

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Permitted work

There are more flexible rules for people getting SDA who want to try some paid work. These replaced the former therapeutic work rules. The work you can do is now called permitted work.

There are 3 situations where you can get SDA and do some permitted work:

If you want to do permitted work you do not need to get a doctor’s approval to do the work, but you must tell the office that deals with your benefit in writing.

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Permitted work notification procedures

You should tell the office that deals with your benefit about permitted work you want to do before you start it. This should ensure that your benefit records are kept up to date, and that we should not need to ask you extra questions about your change in circumstances.

If, however, you are not able to tell the office that deals with your benefit before you start work, you must write to them about the work within the following time limit:

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Voluntary work

You may be able to get SDA if you do voluntary work. The work must be for someone other than a member of your family and you must not get any payment for it, other than reasonable expenses.

You may also be able to carry on getting SDA if you are a member of the Disability Living Allowance Advisory Board or a panel member with a disability qualification of a Social Security Appeal Tribunal and you do not carry out your duties as a Board or Tribunal member on more than one day a week.

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80% disablement

If your incapacity began after age 20, you must continue to be at least 80% disabled to get SDA.

You do not have to be 80% disabled to get SDA under the linking rules if you once had NCIP or HNCIP or if you have had SDA on the basis of incapacity starting on or before your 20th birthday.

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Who is accepted as 80% disabled?

You may be accepted as passing the 80% disablement test without having to provide any further medical evidence if you:

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How disablement is assessed

Any type of mental or physical illness or disability can count towards 80% disablement for the purposes of SDA, and two or more illnesses or disabilities can be added together to count as 80% disablement. When the assessment is being made, all your disabling conditions are taken into account. They will be rounded up to the nearest 10%. [Legislation (41)]

In general, if your overall condition is such that, because of mental or physical illness or disability, you are severely restricted in the things you can do, or you cannot lead a normal life, you may be 80% disabled.

Because every case is assessed individually and the facts of each case vary so much, it is difficult to give hard and fast examples for all types of illness or disability.

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Listed physical disabilities

Some types of disability have a fixed percentage. These are listed in the Schedule of prescribed degrees of disablement. There is a copy of this list on the prescribed degrees of disablement page.

The schedule shows, for example, that someone who is profoundly deaf or who has lost both hands is 100% disabled. Someone who has lost a leg just below the hip will be 80% disabled, however well they manage with an artificial limb. Loss of a thumb counts as a 30% disablement. The assessment may be higher than the percentage listed in the schedule if, for example, you have a lot of pain or there are other complications in your case.

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Unlisted disabilities

If you have an illness or disability which is not listed in the schedule, it will be assessed in two ways – by comparing the effects of the illness or disability with the effects of those listed and by comparing your mental and physical condition with that of a non-disabled person of the same sex and age. So, for example, if you have such bad arthritis in your hand that you cannot use it at all, you may be assessed as if you had actually lost your hand (60% disablement). If you have pain, the assessment may be higher still.

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Mental disabilities

With cases of learning disability or mental illness, decision makers will try to build up a complete picture of the disablement. This will be based on statements provided by the disabled person and those caring for him or her, and, where appropriate, doctors’ reports, hospital case notes, and information obtained from sources like special schools and social service work departments. The assessment will take into account things like:

A disabled person who is capable of carrying out all the functions of everyday living unaided but can do so only when instructed and does not have the initiative to perform them without prompting may well be assessed as 100% disabled. In many cases, of course, the person with a learning disability will have had this condition since birth and will not have to satisfy the 80% condition.

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Occasional disabilities

Some disabilities like epilepsy or multiple sclerosis only occur from time to time, or are worse at some times than others. When doctors are assessing cases like this, they will want to know the history of the illness, and how much it varies. They will also use their medical judgement, and specialist reports if necessary, to consider what is likely to happen in the future. For example they will consider whether the disability is likely to get better or worse.

Then they will work out a percentage which is based on your average condition over a period of time and provides an opinion for the decision maker. If you are in doubt about whether or not you will satisfy the 80% disablement test, you should claim anyway.

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