Completed by GP/Secondary care specialist confirming medical condition, if death could reasonably be expected within 6 months.
Allows fast tracking of claims under special rules with no qualifying period for:
- Employment and Support Allowance
- Personal Independent Payment
- Attendance Allowance
- Disability Living Allowance
Once completed hand to the patient, their representative or send it directly to the DWP. Ensure that patient/representative have made their own application for the claim.