The Personal Independence Payment Regulations (Northern Ireland) 2016

PART 1General

Citation and commencement

1.  These Regulations may be cited as the Personal Independence Payment Regulations (Northern Ireland) 2016 and come into operation on 20th June 2016.

Interpretation

2.—(1) In these Regulations—

“the 1998 Order” means the Social Security (Northern Ireland) Order 1998(1);

[F1“adult disability payment has the meaning given in regulation 2 of the Disability Assistance for Working Age People (Scotland) Regulations 2022;]

“aid or appliance”—

(a)

means any device which improves, provides or replaces C’s impaired physical or mental function; and

(b)

includes a prosthesis;

“assessment” means the assessment referred to in regulation 4;

“C” means a person who has made a claim for or, as the case may be, is entitled to personal independence payment;

[F2“child disability payment” has the meaning given in regulation 2 of the Disability Assistance for Children and Young People (Scotland) Regulations 2021;]

“component” means the daily living component or, as the case may be, the mobility component of personal independence payment;

“descriptor” means a descriptor in column 2 of the tables in Parts 2 and 3 of Schedule 1;

“disability living allowance” means disability living allowance under section 71 of the Contributions and Benefits Act(2);

“medical treatment” means medical, surgical or rehabilitative treatment (including any course or diet or other regimen)F3...;

“prescribed date” means the date prescribed by regulation 14 or 15 [F4or 15A];

“previous award” means an award of either or both components to which C has ceased to be entitled;

“revised” means revised under Article 10 of the 1998 Order and “revision” is to be construed accordingly; and

“superseded” means superseded under Article 11 of the 1998 Order(3) and “supersession” is to be construed accordingly.

(2) Unless the context otherwise requires, any reference in these Regulations to a numbered Article is to the Article of the Welfare Reform (Northern Ireland) Order 2015 bearing that number.

(3) For the purposes of these Regulations and notwithstanding section 39(2) of the Interpretation Act (Northern Ireland) 1954(4), where a period of time is expressed to begin on, or to be reckoned from, a particular day, that day shall be included in the period.

Textual Amendments

PART 2Personal independence payment assessment

Daily living activities and mobility activities

3.—(1) For the purposes of Article 83(4) and these Regulations, daily living activities are the activities set out in column 1 of the table in Part 2 of Schedule 1.

(2) For the purposes of Article 84(4) and these Regulations, mobility activities are the activities set out in column 1 of the table in Part 3 of Schedule 1.

Assessment of ability to carry out activities

4.—(1) For the purposes of Article 82(2) and Article 83 or, as the case may be, 84 whether C has limited or severely limited ability to carry out daily living or mobility activities, as a result of C’s physical or mental condition, is to be determined on the basis of an assessment taking account of relevant medical evidence.

(2) C’s ability to carry out an activity is to be assessed—

(a)on the basis of C’s ability whilst wearing or using any aid or appliance which C normally wears or uses; or

(b)as if C were wearing or using any aid or appliance which C could reasonably be expected to wear or use.

(3) Where C’s ability to carry out an activity is assessed, C is to be assessed as satisfying a descriptor only if C can do so—

(a)safely;

(b)to an acceptable standard;

(c)repeatedly; and

(d)within a reasonable time period.

(4) Where C has been assessed as having severely limited ability to carry out activities, C is not to be treated as also having limited ability in relation to the same activities.

(5) In this regulation—

“reasonable time period” means no more than twice as long as the maximum period that a person without a physical or mental condition which limits that person’s ability to carry out the activity in question would normally take to complete that activity;

“repeatedly” means as often as the activity being assessed is reasonably required to be completed; and

“safely” means in a manner unlikely to cause harm to C or to another person, either during or after completion of the activity.

Scoring for daily living activities

5.—(1) The score C obtains in relation to daily living activities is determined by adding together the number of points (if any) awarded for each activity listed in column 1 of the table in Part 2 of Schedule 1 (“the daily living activities table”).

(2) For the purpose of paragraph (1), the number of points awarded to C for each activity listed in column 1 of the daily living activities table is the number shown in column 3 of the table against whichever of the descriptors set out in column 2 of the table for the activity applies to C under regulation 7.

(3) Where C has undergone an assessment, C has—

(a)limited ability to carry out daily living activities where C obtains a score of at least 8 points in relation to daily living activities; and

(b)severely limited ability to carry out daily living activities where C obtains a score of at least 12 points in relation to daily living activities.

Scoring for mobility activities

6.—(1) The score C obtains in relation to mobility activities is determined by adding together the number of points (if any) awarded for each activity listed in column 1 of the table in Part 3 of Schedule 1 (“the mobility activities table”).

(2) For the purpose of paragraph (1), the number of points awarded to C for each activity listed in column 1 of the mobility activities table is the number shown in column 3 of the table against whichever of the descriptors set out in column 2 of the table for the activity applies to C under regulation 7.

(3) Where C has undergone an assessment, C has—

(a)limited ability to carry out mobility activities where C obtains a score of at least 8 points in relation to mobility activities; and

(b)severely limited ability to carry out mobility activities where C obtains a score of at least 12 points in relation to mobility activities.

Scoring: further provision

7.—(1) The descriptor which applies to C in relation to each activity in the tables referred to in regulations 5 and 6 is—

(a)where one descriptor is satisfied on over 50 per cent. of the days of the required period, that descriptor;

(b)where two or more descriptors are each satisfied on over 50 per cent. of the days of the required period, the descriptor which scores the higher or highest number of points; and

(c)where no descriptor is satisfied on over 50 per cent. of the days of the required period but two or more descriptors (other than a descriptor which scores 0 points) are satisfied for periods which, when added together, amount to over 50 per cent. of the days of the required period—

(i)the descriptor which is satisfied for the greater or greatest proportion of days of the required period, or

(ii)where both or all descriptors are satisfied for the same proportion, the descriptor which scores the higher or highest number of points.

(2) For the purposes of paragraph (1) a descriptor is satisfied on a day in the required period if it is likely that, if C had been assessed on that day, C would have satisfied that descriptor.

(3) In paragraphs (1) and (2), “required period” means—

(a)in the case where entitlement to personal independence payment falls to be determined, the period of 3 months ending with the prescribed date together with—

(i)in relation to a claim after an interval for the purpose of regulation 15 [F5or 15A], the period of 9 months beginning with the date on which that claim is made,

(ii)in relation to any other claim, the period of 9 months beginning with the day after the prescribed date;

(b)in the case where personal independence payment has been awarded to C—

(i)during the period of 3 months following a determination of entitlement under a claim for the purpose of regulation 15 [F6or 15A], the period of 3 months ending with the prescribed date together with, for each day of the award, the period of 9 months beginning with the day after that date,

(ii)in any other case, for each day of the award, the period of 3 months ending with the prescribed date together with the period of 9 months beginning with the day after that date.

Textual Amendments

Information or evidence required for determining limited or severely limited ability to carry out activities

8.—(1) The Department may require C to provide any information or evidence required to determine whether C has limited ability or severely limited ability to carry out daily living activities or mobility activities.

(2) Where information or evidence is requested under paragraph (1), C must provide the information or evidence to the Department within one month from the date of the request being made or within such longer period as the Department may consider reasonable in the circumstances of the particular case.

(3) Where C fails without good reason to comply with the request referred to in paragraph (1), a negative determination in relation to the component to which the failure related must be made.

Claimant may be called for a consultation to determine whether the claimant has limited or severely limited ability to carry out activities

9.—(1) Where it falls to be determined whether C has limited ability or severely limited ability to carry out daily living activities or mobility activities, C may be required to do either or both of the following—

(a)attend for and participate in a consultation in person;

(b)participate in a consultation by telephone [F7or by video].

(2) Subject to paragraph (3), where C fails without good reason to attend for or participate in a consultation referred to in paragraph (1), a negative determination must be made.

(3) Paragraph (2) does not apply unless—

(a)written notice of the date, time and, where applicable, place for the consultation is sent to C at least 7 days in advance; or

(b)C agrees, whether in writing or otherwise, to accept a shorter period of notice of those matters.

(4) In paragraph (3), reference to written notice includes notice sent by electronic communication where C has agreed to accept correspondence in that way and “electronic communication” has the meaning given in section 4(1) of the Electronic Communications Act (Northern Ireland) 2001(5).

(5) In this regulation, a reference to consultation is to a consultation with a person approved by the Department.

Textual Amendments

Matters to be taken into account in determining good reason in relation to regulations 8 and 9

10.  The matters to be taken into account in determining whether C has good reason under regulation 8(3) or 9(2) include—

(a)C’s state of health at the relevant time; and

(b)the nature of any disability that C has.

Re-determination of ability to carry out activities

11.  Where it has been determined that C has limited ability or severely limited ability to carry out either or both daily living activities or mobility activities, the Department may, for any reason and at any time, determine afresh in accordance with regulation 4 whether C continues to have such limited ability or severely limited ability.

PART 3Required period condition

Required period condition: daily living component

12.—(1) C meets the required period condition for the purposes of Article 83(1) where—

(a)if C had been assessed at every time in the period of 3 months ending with the prescribed date, it is likely that the Department would have determined at that time that C had limited ability to carry out daily living activities; and

(b)if C were to be assessed at every time in the period of 9 months beginning with the day after the prescribed date, it is likely that the Department would determine at that time that C had limited ability to carry out daily living activities.

(2) C meets the required period condition for the purposes of Article 83(2) where—

(a)if C had been assessed at every time in the period of 3 months ending with the prescribed date, it is likely that the Department would have determined at that time that C had severely limited ability to carry out daily living activities; and

(b)if C were to be assessed at every time in the period of 9 months beginning with the day after the prescribed date, it is likely that the Department would determine at that time that C had severely limited ability to carry out daily living activities.

Required period condition: mobility component

13.—(1) C meets the required period condition for the purposes of Article 84(1) where—

(a)if C had been assessed at every time in the period of 3 months ending with the prescribed date, it is likely that the Department would have determined at that time that C had limited ability to carry out mobility activities; and

(b)if C were to be assessed at every time in the period of 9 months beginning with the day after the prescribed date, it is likely that the Department would determine at that time that C had limited ability to carry out mobility activities.

(2) C meets the required period condition for the purposes of Article 84(2) where—

(a)if C had been assessed at every time in the period of 3 months ending with the prescribed date, it is likely that the Department would have determined at that time that C had severely limited ability to carry out mobility activities; and

(b)if C were to be assessed at every time in the period of 9 months beginning with the day after the prescribed date, it is likely that the Department would determine at that time that C had severely limited ability to carry out mobility activities.

The prescribed date

14.  Except where regulation 15(2) or (3) [F8or regulation 15A(2) or (3)] applies, the prescribed date is—

(a)where C has made a claim for personal independence payment which has not been determined, the date of that claim or, if later, the earliest date in relation to which, if C had been assessed in relation to C’s ability to carry out daily living activities or, as the case may be, mobility activities, at every time in the previous 3 months, it is likely that the Department would have determined at that time that C had limited ability or, as the case may be, severely limited ability to carry out those activities; and

(b)where C has an award of either or both components, each day of that award.

Textual Amendments

The prescribed date: claims for personal independence payment after an interval

15.—(1) Paragraphs (2) and (3) apply where—

(a)C makes a claim for personal independence payment (“the new claim”);

(b)C had a previous award [F9for personal independence payment or adult disability payment] which ended not more than 2 years before the date on which the new claim is made;

(c)the previous award referred to in sub-paragraph (b) [F10where that award was in respect of personal independence payment or adult disability payment] consisted of the same component as the one to which C is entitled (or would be entitled if C met the required period condition) under the new claim; and

(d)the Department determines that the entitlement under the new claim results from—

(i)substantially the same physical or mental condition or conditions for which the previous award was made, or

(ii)a new physical or mental condition which developed as a result of a condition for which the previous award was made.

(2) In relation to the determination of entitlement under the new claim—

(a)the prescribed date for the purposes of regulations 12(1)(a) and (2)(a) and 13(1)(a) and (2)(a) is the date on which the previous award ended [F11where that award was in respect of personal independence payment or adult disability payment]; and

(b)regulations 12(1)(b) and (2)(b) and 13(1)(b) and (2)(b) have effect in relation to the new claim as if, for “the prescribed date” there were substituted “the date on which the new claim for personal independence payment is made”.

(3) Where C is awarded either or both components under the new claim, in relation to continued entitlement to that component or, as the case may be, those components, for the period of 3 months following the date of the new claim—

(a)the prescribed date for the purposes of regulations 12(1)(a) and (2)(a) and 13(1)(a) and (2)(a) is the date on which the previous award ended [F12where that award was in respect of personal independence payment or adult disability payment]; and

(b)regulations 12(1)(b) and (2)(b) and 13(1)(b) and (2)(b) have effect in relation to that award as if, for “the prescribed date” there were substituted “each day of the award”.

(4) This regulation is subject to regulation 26.

Textual Amendments

[F13The prescribed date: claims for personal independence payment after award of child disability payment

15A.—(1) Where C makes a claim for personal independence payment (“the new claim”) and had a previous award of child disability payment, which ended not more than 2 years before the date on which the new claim is made, and is aged 16 years or over at the date of the new claim, paragraphs (2), (3) and (4) apply.

(2) In relation to determination of entitlement under the new claim—

(a)the prescribed date for the purposes of regulations 12(1)(a) and (2)(a) and 13(1)(a) and (2)(a) is the date on which the previous award ended, where that award was in respect of child disability payment;

(b)regulations 12(1)(b) and (2)(b) and 13(1)(b) and (2)(b) have effect in relation to the new claim as if, for the words “the prescribed date” there were substituted “the date on which the new claim for personal independence payment is made”.

(3) Where C is awarded either or both components under the new claim, in relation to entitlement to that component or, as the case may be, those components, for the period of 3 months following the date of the new claim—

(a)the prescribed date for the purposes of regulations 12(1)(a) and (2)(a) and 13(1)(a) and (2)(a) is the date on which the previous award ended, where that award was in respect of child disability payment; and

(b)regulations 12(1)(b) and (2)(b) and 13(1)(b) and (2)(b) have effect in relation to that award as if for the words “the prescribed date” there were substituted “each day of the award”.

(4) C is to be regarded as meeting such of the conditions (as modified by paragraphs (2) and (3) above) in—

(a)regulation 12(1)(a) or (2)(a) (required period condition: daily living component);

(b)regulation 13(1)(a) or (2)(a) (required period condition: mobility component),

as are relevant to C’s new claim, regardless of whether those conditions have been met.]

Textual Amendments

PART 4Residence and presence conditions

Conditions relating to residence and presence in Northern Ireland

16.  Subject to the following provisions of this Part, the prescribed conditions for the purposes of Article 82(3) as to residence and presence in Northern Ireland are that on any day for which C claims personal independence payment C—

(a)is present in Northern Ireland;

(b)has been present in Northern Ireland for a period of, or periods amounting in aggregate to, not less than 104 weeks out of the 156 weeks immediately preceding that day;

(c)is habitually resident in the United Kingdom, the Republic of Ireland, the Isle of Man or the Channel Islands; and

(d)is a person—

(i)who is not subject to immigration control within the meaning of section 115(9) of the Immigration and Asylum Act 1999(6), or

(ii)to whom, by virtue of regulation 2 of the Social Security (Immigration and Asylum) Consequential Amendments Regulations (Northern Ireland) 2000(7), section 115 of that Act does not apply for the purpose of personal independence payment.

Absence from Northern Ireland

17.—(1) Where C is temporarily absent from Northern Ireland, C is treated as present in Northern Ireland for the purposes of regulation 16(a) and (b) for the first 13 weeks of absence.

(2) C is temporarily absent if, at the beginning of the period of absence, C’s absence is unlikely to exceed 52 weeks.

Absence from Northern Ireland to receive medical treatment

18.—(1) Where C is temporarily absent from Northern Ireland, C is treated as present in Northern Ireland for the purposes of regulation 16(a) and (b) for the first 26 weeks of that absence, where—

(a)C’s absence is solely in connection with arrangements made for the medical treatment of C for a disease or bodily or mental disablement which commenced before C left Northern Ireland; and

(b)the arrangements referred to in sub-paragraph (a) relate to medical treatment—

(i)outside Northern Ireland,

(ii)during the period whilst C is temporarily absent from Northern Ireland, and

(iii)by, or under the supervision of, a person appropriately qualified to carry out that treatment.

(2) In this regulation, “temporarily absent” has the same meaning as in regulation 17(2).

Absence from Northern Ireland in special cases

19.—(1) Where C is absent from Northern Ireland, C is treated as present in Northern Ireland for the purposes of regulation 16(a) and (b), where—

(a)C is abroad in the capacity of—

(i)a member of Her Majesty’s forces,

(ii)an aircraft worker, or

(iii)a mariner;

(b)C is in employment prescribed for the purposes of section 120 of the Social Security Contributions and Benefits Act 1992(8) (employment at sea (continental shelf operations)) in connection with continental shelf operations; or

(c)C is living with a person mentioned in sub-paragraph (a)(i) and is the spouse, civil partner, son, daughter, step-son, step-daughter, father, father-in-law, step-father, mother, mother-in-law or step-mother of that person.

(2) In this regulation and regulation 20 “a member of Her Majesty’s forces” means a member of “the regular forces” or “the reserve forces” as defined in section 374 of the Armed Forces Act 2006(9), other than a person who is specified in Schedule 2, who is—

(a)over the age of 16; and

(b)not absent on desertion.

(3) In this regulation—

“aircraft worker” means a person who is employed under a contract of service either as a pilot, commander, navigator or other member of the crew of any aircraft, or in any other capacity on board any aircraft where—

(a)

the employment in that other capacity is for the purposes of the aircraft or its crew or of any passengers or cargo or mail carried on that aircraft; and

(b)

the contract is entered into in the United Kingdom with a view to its performance (in whole or in part) while the aircraft is in flight,

but does not include a person who is in employment as a member of Her Majesty’s forces;

“mariner” means a person who is in employment under a contract of service either as a master or member of the crew of any ship or vessel, or in any other capacity on board any ship or vessel where—

(a)

the employment in that other capacity is for the purposes of that ship or vessel or the crew or any passengers or cargo or mail carried by the ship or vessel; and

(b)

the contract is entered into in the United Kingdom with a view to its performance (in whole or in part) while the ship or vessel is on voyage,

but does not include a person who is in employment as a member of Her Majesty’s forces.

Serving members of Her Majesty’s forces and their family members – further provision

20.  C is treated as habitually resident in Northern Ireland for the purposes of regulation 16(c) where—

(a)C is resident outside Northern Ireland in the capacity as a member of Her Majesty’s forces; or

(b)C is living with a person mentioned in paragraph (a) and is the spouse, civil partner, son, daughter, step-son, step-daughter, father, father-in-law, step-father, mother, mother-in-law or step-mother of that person.

Terminal illness

21.  Where C is terminally ill and makes a claim for personal independence payment expressly on that ground, regulation 16 applies as if paragraph (b) were omitted.

Persons residing in Northern Ireland to whom a relevant EU Regulation applies

22.  Regulation 16(b) does not apply in relation to a claim for personal independence payment where on any day—

(a)C is habitually resident in Northern Ireland;

(b)a relevant EU Regulation(10) applies; and

(c)C can demonstrate a genuine and sufficient link to the United Kingdom social security system.

Persons residing in an EEA state F14... or in Switzerland to whom a relevant EU Regulation applies

23.  Regulation 16(a) to (c) does not apply in relation to entitlement to the daily living component of personal independence payment where on any day—

(a)C is habitually resident in—

(i)an EEA state F15..., or

(ii)Switzerland;

(b)a relevant EU Regulation applies; and

(c)C can demonstrate a genuine and sufficient link to the United Kingdom social security system.

Textual Amendments

[F16Persons in receipt of an equivalent Scottish benefit who move from Scotland to Northern Ireland

23ZA.—[F17(1)] Where regulation 36(1) of the Disability Assistance for Children and Young People (Scotland) Regulations 2021 applies to C, regulation 16(c) of these Regulations is treated as not satisfied for the period set out in regulation 36(1) of those Regulations.

[F18(2) Where regulation 53(1) of the Disability Assistance for Working Age People (Scotland) Regulations 2022 applies to C, regulation 16(c) of these Regulations is treated as not satisfied for the period set out in regulation 53(1) of those Regulations.]]

Textual Amendments

F17Reg. 23ZA(1): reg. 23ZA renumbered as reg. 23ZA(1) (coming into force in accordance with reg. 1(1) of the amending S.I.) by The Scotland Act 2016 (Social Security) (Adult Disability Payment and Child Disability Payment) (Amendment) Regulations 2022 (S.I. 2022/335), reg. 10

[F19[F20Refugees and certain persons with leave to enter or remain in the United Kingdom]

23A.—(1) Regulation 16(b) does not apply in relation to a claim for personal independence payment where C has—

(a)been granted refugee status or humanitarian protection under the immigration rules; F21...

(b)leave to enter or remain in the United Kingdom as the dependant of a person granted refugee status or humanitarian protection under the immigration rules.

[F22(c)leave to enter or remain in the United Kingdom granted under the immigration rules by virtue of—

(i)the Afghan Relocations and Assistance Policy; or

(ii)the previous scheme for locally-employed staff in Afghanistan (sometimes referred to as the ex-gratia scheme);

(d)been granted discretionary leave outside the immigration rules as a dependant of a person referred to in sub-paragraph (c); F23...

(e)leave granted under the Afghan Citizens Resettlement Scheme]; F24[F25...

(f)leave to enter or remain in the United Kingdom granted under or outside the immigration rules [F26, a right] of abode in the United Kingdom within the meaning given in section 2 of the Immigration Act 1971 [F27or does not require leave to enter or remain in the United Kingdom in accordance with section 3ZA of that Act,] where C—

(i)was residing in Ukraine immediately before 1st January 2022; and

(ii)left Ukraine in connection with the Russian invasion which took place on 24th February 2022]; [F28F29...

(g)leave to enter or remain in the United Kingdom granted under or outside the immigration rules, a right of abode in the United Kingdom within the meaning given in section 2 of the Immigration Act 1971 or does not require leave to enter or remain in the United Kingdom in accordance with section 3ZA of that Act, where C—

(i)was residing in Sudan before 15th April 2023; and

(ii)left Sudan in connection with the violence which rapidly escalated on 15th April 2023 in Khartoum and across Sudan.][F30or

(h)leave to enter or remain in the United Kingdom granted under or outside the immigration rules, a right of abode in the United Kingdom within the meaning given in section 2 of the Immigration Act 1971 or does not require leave to enter or remain in the United Kingdom in accordance with section 3ZA of that Act, where C—

(i)was residing in Israel, the West Bank, the Gaza Strip, East Jerusalem, the Golan Heights or Lebanon immediately before 7th October 2023; and

(ii)left Israel, the West Bank, the Gaza Strip, East Jerusalem, the Golan Heights or Lebanon in connection with the Hamas terrorist attack in Israel on 7th October 2023 or the violence which rapidly escalated in the region following the attack.]

[F31(1A) Regulation 16(c) shall not apply in relation to a claim for personal independence payment where [F32any sub-paragraph in paragraph (1)] applies to C.]

(2) For the purposes of this regulation “immigration rules” means the rules laid before Parliament under section 3(2) of the Immigration Act 1971.]

Textual Amendments

PART 5Rate of personal independence payment

Rate of personal independence payment

24.—(1) The prescribed weekly rates of the daily living component for the purposes of Article 83(3) are—

(a)the standard rate, [F33£72.65]; and

(b)the enhanced rate, [F34£108.55].

(2) The prescribed weekly rates of the mobility component for the purposes of Article 84(3) are—

(a)the standard rate, [F35£28.70]; and

(b)the enhanced rate, [F36£75.75].

Textual Amendments

PART 6Provisions relating to age

Exceptions to Article 88 where entitlement exists or claim made before relevant age

25.  Article 88(1) does not apply where C has reached the relevant age if C—

(a)was entitled to an award of either or both components on the day preceding the day on which C reached the relevant age; or

(b)made a claim for personal independence payment before reaching the relevant age and that claim was not determined before C reached that age but an award of either or both components would be made in respect of C but for Article 88(1).

Claim for personal independence payment after an interval and after reaching the relevant age

26.—(1) Where C has reached the relevant age and makes a new claim in the circumstances set out in regulation 15 the following exceptions apply.

(2) The exceptions referred to in paragraph (1) are—

(a)Article 88(1) does not apply;

(b)the reference to “2 years” in regulation 15(1)(b) is to be read as “one year”;

(c)where C is assessed as having severely limited ability to carry out mobility activities for the purposes of the new claim—

(i)C is entitled to the enhanced rate of the mobility component only if C was entitled to that rate of that component under the previous award [F37of personal independence payment or adult disability payment], and

(ii)where C is not entitled to the enhanced rate of that component because of head (i), C is entitled to the standard rate of that component provided that C was entitled to that rate of that component under the previous award [F37of personal independence payment or adult disability payment]; and

(d)where C is assessed as having limited ability to carry out mobility activities for the purposes of the new claim, C is entitled to the standard rate of the mobility component only if C was entitled to that component, at either rate, under the previous award [F38of personal independence payment or adult disability payment].

Textual Amendments

Revision and supersession of an award after the person has reached the relevant age

27.—(1) Subject to paragraph (2), Article 88(1) does not apply where—

(a)C has reached the relevant age and is entitled to an award (“the original award”) of either or both components pursuant to an exception in regulation 25 or 26; and

(b)that award falls to be revised or superseded.

[F39(2) Where the original award includes an award of the mobility component and is superseded—

(a)pursuant to regulation 23 of the Decisions and Appeals Regulations for a relevant change of circumstance which occurred after C reached the relevant age; or

(b)pursuant to regulation 26(1)(a) of the Decisions and Appeals Regulations, where—

(i)the application for supersession was made by C after C reached the relevant age, or

(ii)the supersession proceedings were initiated by the Department after C reached the relevant age,

the restrictions in paragraph (3) apply in relation to the supersession.]

[F40(2A) In paragraph (2) the “Decisions and Appeals Regulations” means the Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations (Northern Ireland) 2016.]

(3) The restrictions referred to in paragraph (2) are—

(a)where the original mobility component award is for the standard rate then, regardless of whether the award would otherwise have been for the enhanced rate, the Department—

(i)may only make an award for the standard rate of that component, and

(ii)may only make such an award where entitlement results from substantially the same condition or conditions for which the mobility component in the original award was made;

(b)where the original mobility component award is for the enhanced rate, the Department may only award that rate of that component where entitlement results from substantially the same condition or conditions for which the mobility award was made.

(4) Where the original award does not include an award of the mobility component but C had a previous award of that component, for the purpose of this regulation entitlement under that previous award is to be treated as if it were under the original award provided that the entitlement under the previous award ceased no more than one year prior to the date on which the supersession takes or would take effect.

Textual Amendments

PART 7Payability when person is residing in certain accommodation or is detained in custody

Care home residents

28.—(1) Subject to paragraph (3) and regulation 30, no amount of personal independence payment which is attributable to the daily living component is payable in respect of C for any period during which C meets the condition in Article 90(2).

(2) For the purpose of Article 90(2) the specified statutory provisions are—

(a)Article 5, 15 or 36 of the Health and Personal Social Services (Northern Ireland) Order 1972(11);

(b)the Mental Health (Northern Ireland) Order 1986(12);

(c)section 8 of the Carers and Direct Payments Act (Northern Ireland) 2002(13); or

(d)any other statutory provision relating to persons under a disability or to young persons or to education or training except—

(i)Articles 50 and 51 of the Education and Libraries (Northern Ireland) Order 1986(14),

(ii)Article 30 of the Education and Libraries (Northern Ireland) Order 1993(15), or

(iii)Article 3 of the Education (Student Support) (Northern Ireland) Order 1998(16).

(3) Subject to paragraph (4), paragraph (1) does not apply in the case of C, where C is a person—

(a)who has not attained the age of 18 and to whom—

(i)Article 17(b) of the Children (Northern Ireland) Order 1995(17) applies because C’s health is likely to be significantly impaired, or further impaired, without the provision of services for C, or

(ii)Article 17(c) of that Order applies; or

(b)who is accommodated outside the United Kingdom if the costs of any qualifying services are borne wholly or partly by an education authority pursuant to its powers under Article 11 of the Education (Northern Ireland) Order 1996(18).

(4) Paragraph (3)(a) only applies during any period in which the Regional Health and Social Care Board or the Health and Social Care trust looking after C places C in a private dwelling with a family, or with a relative of C, or with some other suitable person.

(5) In this regulation—

“Health and Social Care trust” means a body as established under Article 10 of the Health and Personal Social Services (Northern Ireland) Order 1991(19);

“the Regional Health and Social Care Board” means the body established under section 7 of the Health and Social Care (Reform) Act (Northern Ireland) 2009(20).

[F41Hospital in-patients aged 18 or over]

29.—(1) Subject to [F42paragraph (3) and] regulation 30, no amount of personal independence payment which is attributable to either component is payable in respect of C for any period during which C meets the condition in Article 91(2).

(2) For the purposes of Article 91(3), the costs of treatment, accommodation or any related services are borne out of public funds if C is undergoing medical or other treatment as an in-patient in—

(a)a hospital or similar institution under the Health and Personal Social Services (Northern Ireland) Order 1972 or the Health and Personal Social Services (Northern Ireland) Order 1991(21); or

(b)a hospital or similar institution maintained or administered by the Defence Council.

[F43(3) This regulation does not apply if C was under the age of 18 on the day on which C entered the hospital or similar institution referred to in Article 91(2) to begin C’s current period as an in-patient.]

Textual Amendments

Payability exceptions: care homes and hospitals

30.—(1) Subject to paragraphs (2) to (5), regulation 28(1) or, as the case may be, regulation 29(1) does not apply to C in respect of the first 28 days of any period during which C is someone to whom that regulation applies.

(2) Where, on the day on which C’s entitlement to personal independence payment commences, C meets the condition in Article 90(2) or 91(2), paragraph (1) does not apply to C in respect of any period of consecutive days, beginning with that day, on which C continues to satisfy that condition.

(3) Regulation 28 or, as the case may be, regulation 29 does not apply where C is residing in a hospice and is terminally ill, and the Department has been informed that C is terminally ill—

(a)on a claim for personal independence payment;

(b)on an application for a revision or a supersession of an award of personal independence payment; or

(c)in writing in connection with an award of, a claim for, or an application for a revision or a supersession of an award of, personal independence payment.

(4) In paragraph (3) “hospice” means a hospital or other institution whose primary function is to provide palliative care for persons resident there who are suffering from a progressive disease in its final stages, other than—

(a)a hospital or similar institution under the Health and Personal Social Services (Northern Ireland) Order 1972 or the Health and Personal Social Services (Northern Ireland) Order 1991; or

(b)a hospital or similar institution maintained or administered by the Defence Council.

(5) Regulation 28(1) does not apply to a case where, during any period the total cost of qualifying services(22) are met—

(a)out of the resources of the person for whom the qualifying services are provided, or partly out of that person’s own resources and partly with assistance from another person or a charity; or

(b)on that person’s behalf by another person or a charity.

Prisoners and detainees

31.—(1) Subject to paragraph (2), Article 92 does not apply in respect of the first 28 days of any period during which C is a person to whom that Article would otherwise apply.

(2) Where, on the day on which C’s entitlement to personal independence payment commences, C is a person to whom that Article applies, paragraph (1) does not apply to C in respect of any period of consecutive days, beginning with that day, on which C continues to be a person to whom that Article applies.

(3) Article 92 does not apply to C in respect of any period after the conclusion of criminal proceedings as a result of which C is detained in a hospital or similar institution in Northern Ireland as a person suffering from mental disorder unless C satisfies the conditions set out in paragraph (4).

(4) The conditions referred to in paragraph (3) are that C is—

(a)detained under Article 53 of the Mental Health (Northern Ireland) Order 1986(23) (removal to hospital of persons serving sentences of imprisonment, etc.); and

(b)being detained on or before the day on which C would be entitled to be released within the meaning of Article 56(3) of that Order(24) (further provisions as to prisoners under sentence).

(5) For the purposes of this regulation—

(a)“hospital or similar institution” means any place (not being a prison, a juvenile justice centre or a young offenders centre and not being at or in any such place) in which persons suffering from mental disorder are or may be received for care or treatment;

(b)criminal proceedings against any person are deemed to be concluded upon that person being found insane in those proceedings with the effect that that person cannot be tried or the trial of that person cannot proceed.

(6) Article 92 does not apply to C where—

(a)C is undergoing imprisonment or detention in legal custody outside Northern Ireland; and

(b)in similar circumstances in Northern Ireland, C would have been excepted from the application of that Article by virtue of the operation of any provision of this regulation.

Periods of residence

32.—(1) In these Regulations, a “period of residence” is a period during which C—

(a)meets the condition in Article 90(2);

(b)meets the condition in Article 91(2); or

(c)is a person who is undergoing imprisonment or detention in legal custody.

(2) Subject to paragraph (3), for the purposes of Article 92 and regulations 28 and 29, a period of residence—

(a)begins on the day after the day on which C enters a care home, hospital or similar institution or commences a period of imprisonment or detention in legal custody; and

(b)ends on the day before the day on which C leaves a care home, hospital or similar institution or on which a period of imprisonment or detention in legal custody ends.

(3) Where, immediately following a period of residence for the purpose of sub-paragraphs (a), (b) or (c) of paragraph (1), C commences another period of residence for the purpose of any of those sub-paragraphs, the earlier period of residence is deemed to end on the day on which C leaves the care home, hospital or similar institution or, as the case may be, on which the period of imprisonment or detention ends.

(4) Subject to paragraph (5), for the purposes of regulation 30(1) and 31(1)—

(a)two or more distinct periods of residence separated by an interval not exceeding 28 days, or by two or more such intervals, are to be treated as a continuous period equal in duration to the total duration of such distinct periods and ending on the last day of the later or last such period; and

(b)any period or periods to which those regulations refer are to be taken into account and aggregated with any other period referred to in those regulations.

(5) Where the periods referred to in paragraph (4)(a) are both or all periods to which Article 92 (prisoners) applies, paragraph (4) is to have effect with the following modifications—

(a)omit “subject to paragraph (5),” and “30(1) and”;

(b)in sub-paragraph (a) for “28 days” substitute “one year”; and

(c)in sub-paragraph (b)–

(i)for “those regulations refer” substitute “that regulation refers”, and

(ii)for “in those regulations” substitute “in that regulation”.

Signed by authority of the Secretary of State for Work and Pensions.

Justin Tomlinson

Parliamentary Under Secretary of State,

Department for Work and Pensions