This publication lists the most common benefits that you are likely to be entitled to, and further information is separately available on each.
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1 Personal Independence Payment (PIP) is a new benefit for people who have problems getting around out of doors, or Welfare Rights Service WR12 Updated October 2013 EXTRA CARE SCHEMES who need personal care, supervision or support, due to a disability. PIP will be introduced in County Durham in April 2013 and will replace Disability Living Allowance (DLA) for people of working age. Introduction Benefit entitlements in Extra Care schemes are assessed differently to those in Residential Care Homes. Personal care and support is provided within your home, so entitlements are exactly the same as in private or rented homes in the wider community. Because of the number of services provided the rent will appear high, but Housing Benefit is available to help you meet most of the costs. It is worth taking time to read through this factsheet to understand how entitlement to one benefit can lead to entitlement to another. With your benefits properly maximised, there is no reason why you shouldn t be able to comfortably afford your stay in Extra Care. This publication lists the most common benefits that you are likely to be entitled to, and further information is separately available on each. Attendance Allowance (AA) Attendance Allowance is a benefit for people over 65 who need help with personal care. It is up to the Department for Work and Pensions to decide if you get this benefit. You get the higher rate ( a week) if you need help spread across the day and for a prolonged period or on several shorter occasions at night. You get the lower rate ( a week) if you need help throughout the day or at night. It does not matter how much money you have in savings. Disability Living Allowance (DLA) This is a benefit for those under 65 years of age, and it is similar to Attendance Allowance. The main difference is that it also allows for any problems you may have with your mobility. Note: From April 2013 new claims to DLA are not possible for people aged between 16 and 64 instead, if you are of working age you must claim PIP instead (see below). Existing working age DLA claimants will be transferred to PIP in stages from October 2013 onwards. If you are over the age of 65 and receive DLA you can keep any award of Disability Living Allowance already granted, but you will not be able to claim it for the first time or increase an award of the mobility component should you deteriorate. Disability Living Allowance (Mobility) is paid at or per week. 1
2 Disability Living Allowance (Care) is paid at 79.15, or per week Personal Independence Payment (PIP) This is a benefit for those aged between 16 and 65 years of age, and it is similar to DLA in being targeted at people with severe disabilities. The main difference is the way it is assessed, which is a points-based system that looks at your care needs and mobility problems. If you score enough points in daily living activities you might qualify for one of the two rates of the daily living component. If you score enough point in mobility activites you might qualify for one of the two rates of the mobility component. Personal Independence Payment (Mobility) is paid at or per week. Personal Independence Payment (Mobility) is paid at or per week. Pension Credit This benefit is for those over pensionable age for women (regardless of whether you are a man or a woman the date of entitlement depends on your date of birth) and is means-tested. It tops up your income to a set level if you are below it, in much the same way as Income Support. If you live alone, your weekly income, comprising most benefits other than Attendance Allowance, Disability Living Allowance or PIP, as well as private or occupational pensions, must be less than per week in order to get Pension Credit (Guarantee). If you live alone and are in receipt of Attendance Allowance or Disability Living Allowance (Care) at higher or middle rate, or the PIP daily living component, the weekly threshold is per week, so long as nobody claims Carer s Allowance on your behalf. For every 500 of savings over 10,000, there will be a deduction from your Pension Credit of 1 per week (tariff income). A Savings Credit element is also available once you reach the age of 65. It is intended to reward those who have made private provision for their future, such as savings and investments and personal pensions. There is a maximum savings credit of per week for single claimants or for a couple. Levels of award will vary according to your circumstances. You can receive both, one or neither of the two components of Pension Credit. Housing Benefit Housing Benefit is a benefit to help you to pay your rent. You cannot claim Housing Benefit if you have more than 16,000 in savings, unless you receive Pension Credit (Guarantee), in which case all of your eligible Housing Benefit will be paid. You may still receive partial Housing Benefit even if you re not entitled to Pension Credit. It is important to watch your savings carefully, as loss of Housing Benefit will mean that you could be charged for otherwise free support services. 2
3 Council Tax Reduction You can get help with your Council Tax by claiming Council Tax Reduction. You cannot claim Council Tax Reduction if you have more than 16,000 of savings, unless you get Pension Credit (Guarantee Credit). Partial benefit awards are available. Carer s Allowance Carer s Allowance is a benefit paid to carers. The rules on qualifying are complex, and it may not always be worth claiming. The claimant must provide care for over 35 hours per week, be over 16 and earn no more than per week. The person cared for must receive Attendance Allowance or middle rate of Disability Living Allowance Care Component before it can be claimed. There is also nothing to stop a qualifying couple claiming as each other s carer. If your carer receives a benefit such as Retirement Pension or Incapacity Benefit, for example, they will not be paid any Carer s Allowance if the amount is or more per week. They will however qualify for a Carer Premium of on top of their Pension Credit or Income Support. Only if Carer s Allowance itself is actually paid will your entitlement to the Severe Disability element of your Pension Credit, worth per week, be lost. A claim for Carer s Allowance by a friend or family member may remove Pension Credit entitlement entirely, which would in turn have an impact on your Housing Benefit and the amount you pay in charges for your care. If in doubt, seek advice about whether or not you would be worse off were Carer s Allowance to be claimed on your behalf. Other Benefits Your benefits such as Retirement Pension, Industrial Injuries Benefits and Works Pensions will continue to be paid in Extra Care. Property/Savings/Capital If you own a home in the community you will have to put it up for sale to claim Housing Benefit and Council Tax Reduction. For Pension Credit purposes, the value of this house is ignored for six months, or longer (if reasonable steps are being taken to sell it), while it is up for sale. Once sold, the money from the sale becomes your capital, and you will almost certainly lose entitlement to means-tested benefits until your savings fall below the permitted levels. A period of self-funding may be inevitable in these circumstances, though you ll qualify for help once your savings dip below the appropriate thresholds. It is worth seeking advice early, as it is still possible to claim Pension Credit (Guarantee) with savings of around 40,000, as a result of the more generous capital rules governing entitlement. If you currently rent another home, Housing Benefit cannot be paid on two homes for more than four weeks, so notice of termination will need to be given promptly. A savings limit of 16,000 applies for Housing Benefit if you don t receive Pension Credit (Guarantee). Entitlement to Housing Benefit not only means that you pay less for your services, but it avoids the need to reclaim every time your savings fluctuate, and the need to repay wrongly paid benefits. 3
4 Moving into Extra Care from a hospital or residential care home? Attendance Allowance/Disability Living Allowance/PIP If you are moving into Extra Care from a hospital or Residential Care Home and were previously paid Attendance Allowance/Disability Living Allowance or PIP before your stay commenced, your benefit can be reinstated when you leave without needing to reclaim. A letter needs to be written to The Disability Living Allowance Unit, Warbreck House, Warbreck Hill, Blackpool, Lancs FY2 0YE to inform them that you are leaving hospital/care on a set date, with details of your new address. A copy of the tenancy agreement and a telephone call to the Disability Benefits Helpline ( ) once you have moved will greatly assist in the lifting of payment restrictions. Welfare Assistance Scheme If you are moving from a residential care home or hospital you may be eligible for help with removal expenses. If you receive a weekly means-tested benefit or will be eligible for one after you ve moved, and you have savings below 500 ( 1000 if you are aged 61 or over), you may be able to claim a Settlement Grant worth up to 500 from your local council s Welfare Assistance Scheme. The grant (paid in vouchers or by a prepayment card) can help you with the cost of essential items such as bedding, kitchenware and furniture. How does a stay in hospital or respite care affect my benefits? Disability Living Allowance, Attendance Allowance and PIP are removed after 28 days (which will then remove your Pension Credit additional amount for severe disability.) Housing Benefit is likely to cease after 52 weeks as your absence from home is then deemed to no longer be temporary. Respite Care is a temporary stay in Residential or Nursing Care. Attendance Allowance/Disability Living Allowance (Care) and PIP can only be paid for 28 days in this type of accommodation. Once you return home you should notify the Department, as you will once more be entitled to receive your benefit. The day that you enter and the day that you leave do not count towards your 28 days. You could, for example, have 14 weekends of respite care, entering and leaving on a Friday/Monday. A break of 29 days or more out of respite care will return you to zero. If possible, try to plan your pattern of respite care to avoid losing benefit. Claiming Benefits There is no reason why any of these benefits cannot be claimed before you move into an extra care scheme, though some might only become payable once you ve moved. Disability Living Allowance/Attendance Allowance/PIP Claim forms can be obtained from your local Department for Work and Pensions office or by telephoning the Benefits Enquiry Line on (PIP: ). Claims can take several months to process, so this should be done as soon as possible. Supporting evidence which describes your needs, perhaps from your Social Worker/Care Manager or GP, will greatly increase the chances of success. 4
5 Pension Credit If you think you may qualify then you will need to obtain a form PC1 from your local benefit office. Alternatively, you could call and claim over the telephone. Information about income and capital will be important, and the Pension Service will require proof of any private or occupational pensions. If you are making a claim for Attendance Allowance/PIP, claim Pension Credit at the same time so that you do not lose any backdated money. Housing Benefit & Council Tax Reduction The Housing Association running the scheme should make the claim for you, or arrange for it to be done, as part of their property management service. How much will I have to pay for care? Extra Care is paid for in a similar way to most Home Care services, except that care packages are provided at a fixed cost, rather than being based on the number of hours of assessed need. Financial Assessments also consider more of your benefit income for charges because of the levels of service provided. Before you move, a Finance Officer from the County Council will calculate your charges according to the information you provide about your income and expenditure. Attendance Allowance, Disability Living Allowance care component and the PP daily living component, as well the additional amount for severe disability (Pension Credit), are all taken into account as income. The mobility components of Disability Living Allowance and PIP are ignored, and if you spend a regular amount of money on items relating to a disability (e.g. incontinence pads, taxis to regular medical appointments or a special diet), this can be taken into account in the assessment and you will pay less. Think carefully about any disability related expenditure that you may have before you are assessed. In Extra Care Schemes, General Counselling & Support forms part of your package. If you are entitled to Housing Benefit you will not pay these support charges. A joint assessment for personal care and support charges will be applied to tenants not in receipt of Housing Benefit. You should not be left with an income below your Pension Credit threshold (not including Severe Disability addition) plus 25%, or be expected to pay a charge greater than 75% of the rate for Residential Care. The cost of care packages in Extra Care is currently well below this upper threshold. Those who are entirely self-funding (perhaps because they possess substantial capital) will be expected to meet the full cost of the package, as well as their rent, until capital levels diminish. Rent Rents in Extra Care schemes may seem high compared to normal rents, but many services and facilities are included in the charges. 5
6 Rent is payable to a Housing Association (the landlord) and they will be able to advise you of the current level when you express an interest in a tenancy. Please note that Housing Benefit will cover the bulk of your rent if you are entitled, but that you may need to pay part or all of the costs yourself once income and capital have been assessed. You must also remember that if you receive Pension Credit Guarantee, you will automatically receive full Housing Benefit and Council Tax Reduction. Extra help with benefits Once your tenancy begins, the support of the Welfare Rights Service is available, and the County s Finance Teams will assist in getting your benefit entitlements in place prior to your move should you require help. Further information and advice If you are a resident of County Durham, Welfare Rights can give you advice on your benefit entitlements, check that you are receiving the right benefits, and give advice on how to ask for a reconsideration of a decision or appeal against it. If you are currently receiving a social care service we can even represent you at an appeal hearing. If you would like advice about asking for a reconsideration of a decision or appealing against one, please contact us by any of the methods given below. Contacting the Welfare Rights Service By telephone: By By post: Public Advice Line (9 am 12 noon) welfare.rights@durham.gov.uk Welfare Rights Early Intervention and Involvement Service Children and Adults Services Durham County Council Crook Civic Centre North Terrace Crook County Durham DL15 9ES 6
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