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Regulation 35 Exceptional loss award: general

Original text. Later amendments are not shown.

(1)

An eligible infected person (“P”) is eligible for an exceptional loss award where—

(a)

P has—

(i)

suffered exceptional reduced PAYE earnings,

(ii)

suffered exceptional reduced self-employment earnings,

(iii)

incurred excess actual past care costs, or

(iv)

incurred excess deemed past care costs in relation to a level of care, and

(b)

an application has been made in relation to P in accordance with—

(i)

Chapter 2 of Part 6, and

(ii)

paragraphs (3) to (7).

(2)

An exceptional loss award may only include—

(a)

one of the following (whether or not it also includes an amount by way of an award mentioned in sub-paragraph (b))—

(i)

an amount by way of a financial loss (PAYE earnings) award, or

(ii)

an amount by way of a financial loss (self-employment earnings) award;

(b)

one of the following (whether or not it also includes an amount by way of an award mentioned in sub-paragraph (a))—

(i)

an amount by way of a care (excess actual costs) award, or

(ii)

an amount by way of a care (excess deemed costs) award.

(3)

An application for an exceptional loss award may only be made in relation to P if—

(a)

an application for a severe health condition award has been made in relation to P, or

(b)

the relevant person has indicated that no such application is to be made in relation to P.

(4)

Where the relevant person seeks to establish that the exceptional loss award should include an amount by way of a financial loss (PAYE earnings) award, the application must be accompanied by evidence which establishes—

(a)

P’s age when P first suffered exceptional reduced PAYE earnings,

(b)

P’s actual gross earnings in the 12-month period which ended with the month before P first suffered exceptional reduced PAYE earnings,

(c)

P’s actual gross earnings in respect of at least 2 out of 3 years of each rolling period of 3 years within the period which—

(i)

begins with the year in which P first suffered exceptional reduced PAYE earnings, and

(ii)

ends with the earlier of—

(aa)

if P is deceased, the year in which P died,

(bb)

the year in which P attained the age of 65, or

(cc)

the year immediately before the year in which the date of the application falls, and

(d)

that P’s exceptional reduced PAYE earnings were due to an infection or any associated treatment.

(5)

If the period described in paragraph (4)(c)(i) and (ii) is shorter than 3 years, then the application must be accompanied by evidence which establishes P’s actual gross earnings in each year of that period.

(6)

Where the relevant person seeks to establish that the exceptional loss award should include an amount by way of a financial loss (self-employment earnings) award, the application must be accompanied by evidence which establishes—

(a)

P’s self-employment earnings and PAYE earnings—

(i)

in each tax year of the pre-reduction period, and

(ii)

in each tax year of the post-reduction period in respect of which the relevant person seeks to establish that P has suffered exceptional reduced self-employment earnings, and

(b)

that P’s exceptional reduced self-employment earnings were due to an infection or any associated treatment.

(7)

In paragraph (6)(a)—

  • “the pre-reduction period” is the period which—

    1. (a)

      begins with the tax year which is 5 years before the tax year in which P first suffered exceptional reduced self-employment earnings, and

    2. (b)

      ends with the tax year which is immediately before the tax year in which P first suffered exceptional reduced self-employment earnings,

  • “the post-reduction period” is the period which—

    1. (a)

      begins with the tax year in which P first suffered exceptional reduced self-employment earnings, and

    2. (b)

      ends with the earlier of—

      1. (i)

        if P is deceased, the tax year in which P died,

      2. (ii)

        the tax year in which P attained the age of 65, or

      3. (iii)

        the tax year immediately before the year in which the date of the application falls.

(8)

Where the relevant person seeks to establish that the exceptional loss award should include an amount by way of a care (excess actual costs) award, the application must be accompanied by evidence which establishes the amount of money that was paid to obtain commercially-provided care for P during the relevant period.

(9)

Where the relevant person seeks to establish that the exceptional loss award should include an amount by way of a care (excess deemed costs) award in relation to a level of care, the application must be accompanied by evidence which establishes that money was paid to obtain commercially-provided care of that level for P for a period of 6 months during the relevant period.

(10)

If the application is accompanied by evidence establishing that P has incurred excess deemed past care costs in relation to a higher level of care than any applicable level of care, that evidence is to be treated as evidence establishing that P has incurred excess deemed past care costs in relation to the highest applicable level of care in relation to which it has not otherwise been established that P has incurred excess deemed past care costs.

(11)

In paragraph (10), “applicable level of care” means a level of care in respect of which a care (excess deemed costs) award (see regulation 40) may comprise an amount in relation to P.