Under the DWP’s Special Rules for end of life, a terminal illness diagnosis unlocks the automatic higher rate of Attendance Allowance (£114.60/week as of April 2026), removes the standard 6-month qualifying period, fast-tracks the decision to around 8 working days, and allows a family member to apply on a patient’s behalf even without the patient’s knowledge or consent.

What does “terminal illness” mean for DWP purposes?

How did the 2022 criteria change from 6 months to 12 months?

Before November 2022, DWP Special Rules only applied when a person was not expected to live more than 6 months. The Social Security (Special Rules for End of Life) Act 2022 extended that threshold to 12 months, significantly widening access. Many people with serious but slower-progressing conditions end-stage COPD, advanced heart failure, progressive neurological disease who previously fell outside the rules now qualify.

What does “not surprised if they were to live less than 12 months” mean?

This is the exact clinical standard DWP uses. A clinician does not need to state that death is imminent or certain only that they would not be surprised if the patient died within 12 months as a consequence of a progressive disease. It is a judgment call, not a prediction, which deliberately lowers the bar for qualifying.

Is the SR1 a firm prognosis?

No. The DWP guidance explicitly states: “You do not need to give a specific prognosis.” The clinician describes the progressive disease and its clinical features. There are no negative consequences for the clinician or the patient if the patient lives longer than expected.

Does Special Rules only apply to cancer?

Absolutely not. According to GOV.UK guidance (updated 2025), the following conditions all qualify when at end stage:

• End-stage respiratory disease (COPD, pulmonary fibrosis)
• End-stage heart disease
• End-stage dementia
• Severe frailty, regardless of age
• End-stage liver disease
• End-stage renal failure
• End-stage neurological disease (motor neurone disease, multiple sclerosis, Huntington’s disease)
• End-stage cystic fibrosis

This is not an exhaustive list. Any advanced, progressive, incurable condition where the clinician would not be surprised at death within 12 months qualifies.

The SR1 form  complete walkthrough

Who can complete an SR1?

According to GOV.UK, the following registered clinicians can complete and submit an SR1:

• General practitioners (GPs)
• Consultants
• Hospice doctors
• Specialty doctors
• Senior specialist nurses (clinical nurse specialists, advanced nurse practitioners)

The form cannot be completed by the patient, a family member, or a carer. It must come from one of the above.

What clinical information does the SR1 include?

The clinician provides: the patient’s diagnosis and any other relevant conditions, the date of diagnosis, the patient’s awareness of their diagnosis and prognosis, the date the clinician believes the patient met the Special Rules criteria, the clinical features indicating a severe progressive condition, and the current treatment plan.

Helpful supporting details which improve the strength of the report include notes on poor or no response to treatment, palliative care involvement, symptom management only, no further treatment available or planned, or treatment that is ongoing but unlikely to alter prognosis.

What does the clinician NOT have to include?

A specific prognosis or a predicted date of death. The clinician uses the same language they would with other clinicians clinical observation and judgment, not a life expectancy forecast.

Can a GP charge for the SR1?

GMC-registered GPs and consultants can claim a fee from the DWP for completing an SR1, paid via the DBD36 fee form. Critically, this fee is paid by DWP, not by the patient. The patient should never be charged. If a GP’s surgery attempts to charge you for the SR1, this should be raised with the surgery management and, if necessary, escalated.

Digital SR1 vs paper SR1

The SR1 is available in both digital and paper formats. The digital version does not require a signature. The paper version must be signed and the original copy posted a printed copy of the electronic form is not accepted. Members of the public cannot download or order SR1 forms directly; these must come from the clinician’s surgery, hospital, or hospice.

How is the SR1 sent to DWP?

There are three methods (per GOV.UK guidance, last updated August 2026):

1. Online: Via the DWP’s dedicated portal at send-an-sr1-medical-evidence-form.service.gov.uk
2. By email: To form.e-sr1@dwp.gov.uk from a secure NHS email address (ending @nhs.net, @nhs.uk, @nhs.scot, @nhs.wales.uk, or @gov.uk)
3. By post: To Personal Independence Payment (10), Mail Handling Site A, Wolverhampton, WV98 1AE

The clinician can also give the completed paper form directly to the patient or their representative to send with the AA1 application. Either way, the fee form must be posted separately.

Applying without telling the patient

What is the compassionate rule?

For Attendance Allowance, PIP, and DLA, any person can apply on behalf of someone else even without that person’s knowledge, consent, or formal power of attorney. This is the compassionate rule, designed for situations where a patient does not know their illness is terminal, is too unwell to apply, or is struggling to come to terms with their diagnosis.

This rule does not apply to Universal Credit or Employment and Support Allowance, where only an appointee or someone with power of attorney can act on a person’s behalf.

What does a family member need to apply?

The person applying needs the patient’s full name, address, date of birth, National Insurance number, and bank details. They sign the form on behalf of the patient. No formal legal authority is required for AA claims.

Will the patient find out they’re terminally ill through this process?

No. The DWP will not mention terminal illness, Special Rules, or the SR1 in any correspondence sent to the patient. You do not need to tell the patient you are applying under Special Rules only that you are applying for Attendance Allowance.

Where do payments go?

Payments are made to the patient’s bank account, not the account of the person who made the application. If the patient lacks capacity and you need control over their finances, you would need to apply separately to become their DWP appointee.

The Special Rules application process  step by step

Step 1: Ask the patient’s GP, consultant, hospice doctor, or specialist nurse to complete an SR1 form. They may send it directly to DWP, or give it to you to include with the application.

Step 2: Call the Attendance Allowance helpline on 0800 731 0122 (Monday–Friday, 8am–6pm, free from mobiles and landlines) and specifically mention you are applying under the DWP Special Rules. This flags the application for fast-track processing. Payments can be backdated to the date of this call if the form is returned within 6 weeks.

Step 3: When completing the AA1 application form (available online or by post), tick the box in Question 1 to confirm you are applying under the Special Rules.

Step 4: Skip questions 21–46. These cover care and supervision needs under Special Rules, you do not need to answer them.

Step 5: Complete only the personal details sections: name, address, date of birth, National Insurance number, bank details, and contact information.

Step 6: Submit the AA1 either online (where you can also upload the SR1 digitally) or by post to Freepost DWP Attendance Allowance. If the SR1 is not yet available, send the AA1 with a covering note explaining the SR1 will follow this protects the backdating date.

Step 7: DWP fast-tracks Special Rules claims, with a typical processing target of around 8 working days. Citizens Advice notes most applicants receive a decision letter within approximately 2 weeks.

What Special Rules skip on the AA1 form

Under Special Rules, the following sections of the standard AA1 form are not required:

• All care and supervision questions (questions 21–46)
• Descriptions of day and night care needs
• Duration and frequency of need
• The medications section (in most cases)

What you DO still need to complete

Even under Special Rules, these sections matter and errors here cause delays:

• Bank details  incorrect account numbers are among the most common reasons for payment delays
• Correct correspondence address  DWP will write to this address; make sure it reaches the right person
• Signature  if applying on behalf of someone else, sign clearly and include a brief note explaining your relationship
• Additional supporting evidence  while not required, attaching a GP letter, hospital discharge summary, or palliative care referral letter strengthens the claim

What happens if the patient lives longer than 12 months?

Is there a penalty for living longer?

No. There are no negative consequences for the patient or the clinician if the patient outlives the prognosis. The DWP makes this explicit in its guidance. The award simply continues.

How long does a Special Rules AA award last?

According to Marie Curie (updated April 2025), Attendance Allowance awards under Special Rules are normally made for 3 years. If the patient is still living at the 3-year point, the award will be reviewed.

What happens at renewal?

At the 3-year review, DWP will reassess whether the Special Rules criteria still apply. If the patient’s condition remains terminal under the 12-month criterion, a new SR1 can support a continuation of the higher rate. If the patient’s prognosis has improved significantly, DWP may move them to a standard AA assessment.

Should you report prognosis changes?

If a patient’s condition improves materially for example, a cancer responds unexpectedly well to treatment and life expectancy increases substantially beyond 12 months this should be reported to DWP. Standard Attendance Allowance assessment will then apply, and the patient may need to re-qualify under the normal rules.

Special Rules for non-cancer conditions  condition-specific notes

Motor neurone disease (MND)

MND is a rapidly progressive, invariably fatal neurological disease. Most people with MND will meet the Special Rules threshold soon after diagnosis given the rate of deterioration. The clinician should note the specific MND variant, degree of motor function loss, and any respiratory involvement or feeding tube dependency.

End-stage COPD

End-stage COPD typically involves severe breathlessness at rest, frequent hospitalisations, oxygen dependency, and minimal exercise tolerance. The SR1 should reflect FEV1 measurements, frequency of acute exacerbations, and any palliative treatment.

End-stage heart failure

End-stage heart failure (NYHA Class IV) involves symptoms at rest, repeated hospital admissions, and management that prioritises comfort over cure. The SR1 should reference ejection fraction, hospitalisation frequency, and any referral to a palliative cardiology team.

End-stage kidney disease (not dialysis-eligible)

For patients who are not offered, or who have declined, renal replacement therapy, the clinician should note GFR levels, symptom burden, and conservative kidney management care plans.

End-stage liver disease

Decompensated cirrhosis with complications such as recurrent ascites, hepatic encephalopathy, or varices will typically qualify. The SR1 should reference MELD score, transplant eligibility, and ongoing symptoms.

End-stage dementia

Advanced dementia characterised by the loss of ability to communicate, total dependence for all personal care, and susceptibility to complications such as aspiration pneumonia qualifies under Special Rules. The SR1 should note the dementia stage, swallowing difficulties, and any palliative care involvement.

Progressive neurological conditions

Multiple sclerosis (progressive forms), Huntington’s disease, Parkinson’s disease at advanced stage, and progressive supranuclear palsy may all qualify. Emphasis should be placed on rate of deterioration and loss of function.

Coordinating Special Rules AA with other support

DS1500 vs SR1  what changed?

The DS1500 form has been discontinued and replaced entirely by the SR1. If you see references to DS1500 in older guidance, disregard them. The SR1 is the current form for England, Scotland, and Wales.

Special Rules for other DWP benefits

The SR1 also unlocks Special Rules for PIP (for those under State Pension age), Employment and Support Allowance, Universal Credit, and Disability Living Allowance for children. A single SR1 can support multiple benefit claims simultaneously the clinician does not need to complete a separate form for each benefit.

NHS Continuing Healthcare fast-track

A terminal diagnosis can also trigger a fast-track assessment for NHS Continuing Healthcare (CHC), which funds care needs at a much higher level than AA alone. This is a separate NHS process from DWP benefits, but both can be pursued at the same time. A palliative care coordinator or social worker can help initiate the CHC fast-track referral.

What NOT to do under Special Rules

• Don’t fill in the care questions unnecessarily. Completing questions 21–46 when applying under Special Rules can create confusion and slow processing.
• Don’t wait for the SR1 before submitting the AA1. Submit the AA1 as soon as possible to protect the backdating start date. Include a covering letter stating the SR1 will follow.
• Don’t miss the SR1 tick box in Question 1. If this box is not ticked, DWP will process the claim under standard rules triggering the full assessment, 6-month waiting period, and lower potential award.
• Don’t apply under standard rules if Special Rules applies. The standard process is longer, requires evidence of care needs, and may result in a lower rate.

What happens next  taking action today

If you are supporting someone with a terminal illness, the first step is a conversation with their GP or specialist about completing an SR1. Ask them directly. Most clinicians are familiar with the process and if they are not, you can share the GOV.UK guidance for healthcare professionals or contact the Marie Curie Support Line on 0800 090 2309 for guidance.

Once the SR1 is in progress, call the Attendance Allowance helpline on 0800 731 0122, mention Special Rules, and request the form. Time matters every week of delay is a week of payments that cannot be recovered if the claim is submitted late.

Frequently Asked Questions

Who can complete an SR1 form?
A GP, hospital consultant, hospice doctor, specialty doctor, or senior specialist nurse (such as a clinical nurse specialist or advanced nurse practitioner). The patient, their family members, and carers cannot complete the SR1.

Does the SR1 form cost the patient money?
No. The SR1 is free to the patient. GMC-registered GPs and consultants claim their fee directly from DWP via a separate fee form. You should never be asked to pay for the SR1.

What if the GP refuses to complete an SR1?
GPs are not legally obliged to complete SR1 forms, but are encouraged to do so promptly. If a GP declines, ask a hospital consultant, hospice doctor, or specialist nurse involved in the patient’s care. Contact the Marie Curie Support Line on 0800 090 2309 for guidance on escalating the request.

Can you apply under Special Rules without an SR1?
You can submit the AA1 form without the SR1 and you should, to protect the backdating date. However, DWP will require SR1 medical evidence before making a decision. Submit the AA1 with a covering note confirming the SR1 will follow.

What’s the difference between SR1 and DS1500?
The DS1500 has been fully replaced by the SR1. They served the same purpose, but the SR1 reflects the updated 12-month prognosis standard introduced in 2022. DS1500 forms are no longer accepted.

Do you have to tell the patient they’re terminally ill to apply under Special Rules?
No. For Attendance Allowance claims, a family member or representative can apply on behalf of the patient without their knowledge. DWP will not mention terminal illness or Special Rules in any correspondence to the patient.

How quickly are Special Rules claims decided?
The DWP targets approximately 8 working days for Special Rules claims. Citizens Advice reports that most applicants receive a decision letter within about 2 weeks.

Does Special Rules AA affect other benefits?
Receiving AA can make other benefits more generous for example, it may entitle a carer to Carer’s Allowance, or it may be used as a gateway benefit to access Pension Credit top-ups. AA itself is tax-free and does not reduce any other means-tested benefits. For a detailed breakdown, see our Attendance Allowance benefits cascade guide.

Can you apply under Special Rules for a family member living abroad?
The Special Rules and the SR1 process apply in England, Scotland, and Wales. Northern Ireland follows a similar but separate process administered by the Department for Communities NI. Different rules apply for those living outside the UK Attendance Allowance eligibility in those circumstances depends on residency and immigration status.

What happens to AA if the patient recovers or their prognosis improves significantly?
If a patient’s condition materially improves beyond the 12-month threshold, this should be reported to DWP. The claim will then be reviewed under standard Attendance Allowance rules. Awards made under Special Rules are normally set for 3 years; reviews take place at that point if the patient is still living.