Fillable Printable Attendance Allowance Form - UK
Fillable Printable Attendance Allowance Form - UK
Attendance Allowance Form - UK
1. Where to send the completed form
2. Print the form
Please print the form and fill it in with a pen.
Please send the completed form and any supporting documents to:
Attendance Allowance Unit
Mail Handling Site A
Wolverhampton
WV98 2AD
Please return the completed claim form as soon as you can as we can only
consider paying benefit from the day we receive it.
Check you have signed and dated the consent at question 18 and declaration
at question 51.
For help or advice you can call the Attendance Allowance Service Centre
on 0345 605 6055.
Calls to 0345 numbers cost no more than a standard geographic call, and
count towards any free or inclusive minutes in your landline or mobile
phone contract.
Textphone: 0345 604 5312 for people who do not speak or hear clearly.
We cannot accept claim forms returned by email.
Claiming Attendance Allowance
for people aged 65 or over
AA1A June 2015
Attendance Allowance
for people aged 65 or over
Notes
If you want help filling in the claim form,
phone the Attendance Allowance Service Centre on 0345 605 6055.
We can also arrange interpreters if you phone or visit us.
Phone 0345 605 6055.
If you have speech or hearing difficulties, you can contact the
Attendance Allowance Service Centre by textphone on 0345 604 5312.
Our textphone service does not receive messages from mobile phones.
Or you can contact an organisation like Citizens Advice.
This pack is available in
large print or braille.
Please phone 0345 605 6055.
Contents Page
Things to get together before you fill in the claim form 3
How to fill in the claim form 3
What is Attendance Allowance and can I get it? 4
What do ‘help with personal care’ and ‘supervise’ mean? 5
When can I claim Attendance Allowance? 5
How is Attendance Allowance worked out?
Lower rate of Attendance Allowance 6
Higher rate of Attendance Allowance 6
About how your disabilities affect you 6
About medical examinations 6
Do you normally live in Great Britain? 7
Special rules
Getting Attendance Allowance under the special rules means: 8
Claiming under the special rules for someone else 8
How to claim under the special rules 8
How to get a DS1500 report 8
About your illnesses or disabilities and the treatment or help you receive
Consent 9
About the aids and adaptations you use 9
About being in hospital, a care home or a similar place 10
How we pay you
If we pay you too much money 10
How the Department for Work and Pensions collects and uses information 10
Help and advice about other benefits 11
What happens next 12
2
3
Before you fill in the claim form, it will be useful to have ready some
of the things listed below. Do not worry if you do not have all of
them.
• Your National Insurance number. You can find this on your National
Insurance number card, letters from the Department for Work and
Pensions, or payslips.
• The name of your GP and the address of your GP’s surgery.
• Details of your medication or an up-to-date printed prescription list if
you have one.
• Details of anyone you have seen about your illnesses or disabilities in
the last 12 months, apart from your GP.
• Your hospital record number (if you know it). You can find this on
your appointment card or letter.
• If you have been in a hospital, a care home or similar place - the
dates you went in and came out, and the name and address of the
place you stayed.
Things to get together before you fill in the
claim form
Please use black ink to fill in the form. Do not worry if you are not sure
how to spell something or you make a mistake. If you want to correct
a mistake, please cross it out with a pen – do not use correction fluid.
Please tick the box to show
your answer. For example:
Yes
P
You do not have to fill in the form in one go. Take your time so that
you can describe all the help you need.
How to fill in the claim form
No
You may also find it helpful to keep a record – write down a list of things
you have needed help with or found difficult over one or two days. If
you have good days and bad days, or your disability varies over time,
you may want to keep a record of your needs over a good day and over
a bad day. Start from the time you get up in the morning, through 24
hours, to the time you get up the following morning. You can send in
the record with your form if you want to.
4
You may get Attendance Allowance if:
• you are 65 or over when you make your claim
• you are not entitled to Disability Living Allowance
• you are not entitled to Personal Independence Payment
• your disability means that you need help with your personal care
(see page 5) or you need someone to supervise you for your own or
someone else’s safety (see page 5), and
• you have needed that help for at least six months.
Even if you are not actually getting the help you need, you can still
get Attendance Allowance.
If you are under 65, you may be able to get Personal Independence
Payment instead. Contact the Personal Independence Payment Helpline
if you want to ask us about a Personal Independence Payment (see
Help and advice about other benefits on page 11).
Attendance Allowance is to help with extra costs if you have a disability
severe enough that you need someone to help look after you and you
are aged 65 or older when you claim.
You may not think of yourself as disabled, but if you have a health
condition or illness that means you need the sort of help we tell you
about in these notes, you may be able to get Attendance Allowance.
Your disability may be physical, or you may have mental-health
problems, learning difficulties, sight, hearing or speech difficulties.
• Attendance Allowance is not usually affected by your income or
savings (but, if you get Constant Attendance Allowance with
another benefit, this will be paid instead, or reduce the amount of
your Attendance Allowance).
• Attendance Allowance is not taken off other benefits and tax
credits you may receive.
• You don’t usually need to have paid any National Insurance
contributions to claim Attendance Allowance.
• You do not have to pay tax on the Attendance Allowance
you receive.
• If you get Attendance Allowance, you may get extra money with
other benefits (see page 11).
You can find out more about Attendance Allowance by visiting
www.gov.uk or by phoning the AA Helpline - see page 1.
What is Attendance Allowance and can I get it?
5
‘Help with personal care’ means day-to-day help with things like:
• washing (or getting into or out of a bath or shower)
• dressing
• eating
• going to or using the toilet, or
• telling people what you need or making yourself understood (if you
have a problem, such as learning difficulties, that makes this hard).
You can normally only get Attendance Allowance when you have
needed help for six months (unless you claim under the special rules –
see page 8). If you claim straight away, we will deal with your claim as
soon as possible.
What do ‘help with personal care’ and ‘supervise’ mean?
When can I claim Attendance Allowance?
‘Supervise’ means that you need someone to watch over you to help
you avoid substantial danger to yourself or other people.
This could mean:
• when you take medicines or have treatment
• keeping you away from danger that you may not know is there
• avoiding danger you could face because you cannot control the
way you behave, and
• stopping you from hurting yourself or other people.
You may need help with personal care or supervision because you:
• find it hard to move your arms or legs or have no control
over them
• get breathless easily or are in pain, or
• have behaviour difficulties, mental-health problems, or you
get confused.
6
Higher rate of Attendance Allowance
You may get the higher rate if you need:
• help with personal care or someone to supervise you throughout
the day and also during the night.
You may also be able to get this rate if you claim under the special rules
(see page 8).
There are fixed amounts of money for Attendance Allowance. You can
find the current rates in the leaflet called Benefit and Pension Rates.
You can get this leaflet from any Jobcentre Plus.
The rates are also on our website at www.gov.uk
How is Attendance Allowance worked out?
There are two rates of Attendance Allowance:
• lower rate, and
• higher rate.
The rate you get is based on how much help you need.
Lower rate of Attendance Allowance
You may get the lower rate of Attendance Allowance if you need:
• help with personal care frequently throughout the day
• help with personal care during the night
• someone to supervise you continually throughout the day to help
you avoid substantial danger
• someone to watch over you at night to help you avoid substantial
danger, or
• someone with you when you are on dialysis.
You may not think of yourself as disabled, but if you have a health
condition or illness that means you need the sort of help we tell you
about in these notes, you may be able to get Attendance Allowance.
We know that disabilities can affect people more on one day than
another – they have good days and bad days. We know that your
disability may vary over a period of time. Please try to tell us as much
as you can about how your disability varies.
We also know that help needed during the day and help needed during
the night can be different. There are separate questions for you to tell
us about the different sort of help you might need.
About how your disabilities affect you
These notes give you more help and advice with some of
the questions in the claim form
About medical examinations
If we cannot get a clear picture of how your illnesses or disabilities
affect you, we may ask a health care professional to examine you.
Medical Services, who arrange medical examinations for us will contact
you if an examination is required.
7
Austria
Italy (including Sicily, Sardinia and
Elba but not Vatican City and San
Marino)
Belgium Latvia
Bulgaria Liechtenstein
Croatia Lithuania
Cyprus Luxemburg
Czech Republic Malta
Denmark (but not the Faroe Islands
and not Greenland)
Netherlands
Estonia Norway
Finland (but not the Aland Islands) Poland
France (including Corsica,
Guadeloupe, Martinique, Reunion and
French Guiana but not Monaco)
Portugal
Germany Romania
Greece (Including Crete and the
Greek Islands)
Slovakia
Hungary Slovenia
Iceland
Spain (including the Balearic Islands,
the Canary Islands and the Spanish
enclaves of Ceuta and Melilla)
Republic of Ireland Sweden
If you’re not British, Swiss or a national of the following countries, send us your passport,
travel documents and any letters you have from the Home Office with the form.
7
To be entitled to AA you normally have to have lived in the UK for two years out of
the last three and not be subject to Immigration Control. You may be able to meet
this condition if you are, or have been, living in another EEA state or Switzerland.
These rules do not apply if you are terminally ill and qualify under special rules.
Also, if you have come to Great Britain from a country that is part of the European
Economic Area (EEA), or Switzerland, then depending on your circumstances you
may not have to wait for this period of time before you can get AA.
If you or a member of your family live in another country that is part of the EEA, or
in Switzerland, then you may be able to get AA if the UK is responsible for paying
you sickness benefits.
You can find more information about claiming AA when you live in another country
that is part of the EEA, or in Switzerland on our website www.gov.uk
8
Do you normally live in Great Britain?
8
12
Special rules
We have special rules for people who are terminally ill (this means
people who have a progressive disease and are not expected to live
longer than another six months).
So that we can deal with your claim as quickly as possible, it is
important that you send a DS1500 report with your claim. The notes
below tell you how to get a DS1500 report.
If you don’t have the DS1500 report by the time you have filled in the
claim form, send us the claim form straight away. Please send the
DS1500 when you can.
Getting Attendance Allowance under the special rules means:
• getting the higher rate of Attendance Allowance
• getting paid straight away (this means you do not have to wait
until you have needed help for six months − but changes like those
on page 10, question 44 of these notes may still affect how much
money you get), and
• we deal with your claim more quickly.
Claiming under the special rules for someone else
You can claim under the special rules for someone else. You do not
have to tell them you are claiming for them. Tell us about them on the
claim form. We will normally write to them about whether they can get
Attendance Allowance, but we will not tell them anything about the
special rules.
If you are filling in this form as part of your job, you do not need to tell
us your National Insurance number or date of birth at question 13.
How to get a DS1500 report
Ask your doctor or specialist for a DS1500 report.
This is a report about your medical condition. You won’t have to pay for
it. You can ask the doctor’s receptionist, a nurse or a social worker to
arrange this for you. You do not have to see the doctor. Most doctors’
practices provide DS1500 reports very quickly. Ask for the report in a
sealed envelope if you do not want anyone to see it.
How to claim under the special rules
Please fill in the claim form. Tick the box at question 19 of the claim
form to show you are claiming under the special rules.
If you do not tick this box, we cannot normally pay you under the
special rules.
9
Consent
We may need to contact your GP, or the people or organisations
involved with you, for information about your condition(s) or treatment.
This may include medical information.
This is so that a clear understanding is gained by the department of
your current needs. You do not have to agree to us contacting these
people or organisations but if you do not agree, we may be unable to
make sure you are entitled to the benefit you are claiming.
18
About your illnesses or disabilities and the
treatment or help you receive
We want to know if you use any aids or adaptations to help you do
things. For example:
• a hoist, monkey pole or bed-raiser may help you get out of bed
• a commode, raised toilet seat or rails may help you with your
toilet needs
• bath rails, a shower seat or a hoist may help you bath
or shower
• a long-handled shoehorn, button hook, zip pull or sock aid may
help you dress
• a stairlift, raised chair, wheelchair or rails may help you move
about indoors
• a walking stick, walking frame, crutches or artificial limbs may
help you get around
• special cutlery or a feeding cup may help you eat and drink, or
• a hearing aid, textphone, magnifier or braille terminal may help
you communicate.
We also want you to tell us if you need help to use the aids or
adaptations, and if you do, what help you get from another person.
25
About the aids and adaptations you use
45
By care home, we mean a home such as a residential care home,
nursing home, hospice or similar place.
We need to know if:
• you are in a hospital, a care home or similar place when you
make your claim, and
• the local authority or NHS pay anything towards the cost of
your stay.
If you are awarded Attendance Allowance when you are in hospital, a
care home or a similar place, we cannot pay you until you come out.
But if you are a private patient or resident, paying for your stay without
help from public funds, we will be able to pay you.
We may still be able to pay you if you are claiming under the special
rules and you are in a hospice.
About being in hospital, a care home or a similar place
10
If we pay you too much money
We have the right to take back any money we pay that you are not
entitled to. This may be because of the way the system works for
payments into an account.
For example, you may give us some information, which means you are
entitled to less money. Sometimes we may not be able to change the
amount we have already paid you. This means we will have paid you
money that you are not entitled to. We will contact you before we take
back any money.
When we collect information about you we may use it for any of our
purposes. These include dealing with:
l social security benefits and allowances
l child support
l employment and training
l financial planning for retirement
l occupational and personal pension schemes.
We may get information about you from others for any of our purposes
if the law allows us to do so. We may also share information with
certain other organisations if the law allows us to.
To find out more about how we use information, visit our website at
www.dwp.gov.uk/privacy-policy or contact any of our offices.
48
How we pay you
How the Department for Work and Pensions
collects and uses information
