The National Health Service (Optical Charges and Payments) (Scotland) Regulations 1998

Eligibility – supply of optical appliancesS

8.—(1) A payment shall be made as provided for by this Part of these Regulations to meet, or to contribute towards, the cost incurred (whether by way of charge under the Act or otherwise) for the supply of an optical appliance for which a prescription has been given in consequence of a testing of sight of an eligible person–

(a)which took place under the Act; or

(b)which took place otherwise than under the Act F1....

(2) An eligible person is a person who at the time of [F2the payment for] the supply of the optical appliance is any of the following:–

(a)a child;

(b)a person under the age of 19 years and receiving qualifying full-time education within the meaning of paragraph 7 of Schedule 11 to the Act(1);

(c)a person whose resources are treated, in accordance with paragraph (3), as being less than his requirements;

(d)a person whose income resources, as calculated in accordance with regulation [F38] of, and Schedule 1 to, the Remission Regulations for the purposes of remission of charges under the Act, are equal to or exceed his requirements as so calculated but whose patient’s contribution is nil or is less than the face value of a voucher issued to him under this Part of these Regulations and whose capital resources do not exceed the capital limit;

(e)a person to whom a prescription is issued for a complex appliance.

(3) A person’s resources shall be treated as being less than his requirements if–

(a)he is in receipt of income support;

(b)he is a member of the same family as a person who is in receipt of income support;

F4(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F5(d). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(e)his income resources as calculated in accordance with regulation [F68] of, and Schedule 1 to, the Remission Regulations for the purposes of remission of charges under the Act, are less than his requirements as so calculated [F7 or exceeds his requirements as so calculated by fifty per cent or less of the amount of the charge [F8referred to in regulation 3(2)(b) (supply of drugs and appliances) of the National Health Service (Free Prescriptions and Charges for Drugs and Appliances) (Scotland) Regulations 2011(2)] and his capital resources as so calculated do not exceed the capital limit;

(f)he is a member of the same family as a person described in paragraph (e) of this paragraph;

F9(g). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F10(h). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(i)he is in receipt of an income-based jobseeker’s allowance; or

(j)he is a member of the same family as a person described in sub-paragraph (i) of this paragraph.

[F11(k)he is a member of a family–

(i)one member of which is receiving–

(aa)working tax credit and child tax credit; or

(bb)working tax credit which includes a disability element [F12or severe disability element]; or

(cc)child tax credit, but is not eligible for working tax credit;”;

and

(ii)where the relevant income of the person or persons to whom an award of a tax credit is made under section 14 of the Tax Credits Act 2002 is determined at the time of the award not to exceed [F13£15,050]; or

(l)he is a member of a family in respect of whom there is a current notice of entitlement under regulation 12A].

[F14(m)he is in receipt of pension credit guarantee credit; or

(n)he is a member of the same family as a person described in sub-paragraph (m) of this paragraph.]

[F15(o)he is in receipt of income-related employment and support allowance; F16...

(p)he is a member of the same family as a person described in sub-paragraph (o) of this paragraph] [F17; or

[F18(q)in the relevant assessment period he—

(i)received universal credit, either as a single person or as a member of a couple, where he had earned income or, in the case of a couple, the couple had combined earned income, of £435.00 or less and—

(aa)the universal credit award did not include the child element; and

(bb)he or, in the case of a couple, both members of the couple, did not have limited capability for work;

(ii)received universal credit, either as a single person or as a member of a couple, where he had earned income or, in the case of a couple, the couple had combined earned income, of £935.00 or less and either, or both, of the following sub-paragraphs apply—

(aa)the universal credit award included the child element;

(bb)he or, in the case of a couple, either member or both members of the couple, had limited capability for work; or

(iii)was a qualifying young person for whom a recipient referred to in sub-paragraph (ii) was responsible (within the meaning of Part 1 of the Welfare Reform Act 2012 and regulations made thereunder).]

[F19(4) In paragraph (3)–

[F20(a)in sub-paragraphs (b), (f) and (n), “family” has the meaning given to it by section 137(1) of the Social Security Contributions and Benefits Act 1992, as it applies to income support;]

(b)in sub paragraph (j), “family” has the meaning given to it by section 35 of the Jobseekers Act 1995; and

(c)in sub paragraphs (k) and (l), “family” has the meaning given to it by regulation 2(2) of the Tax Credits (Definition and Calculation of Income) Regulations 2002.

[F21(d)in sub-paragraph (p), “family” has the meaning given to it by regulation 2 of the Employment and Support Allowance Regulations 2008.]

[F22(e)in sub-paragraph (q)—

(i)“assessment period” means the assessment period for the purposes of universal credit as specified in regulation 21 of the Universal Credit Regulations (assessment periods);

(ii)“child element” means the child element of universal credit within the meaning of regulation 24(1) of the Universal Credit Regulations (the child element);

(iii)“couple” has the meaning given in section 39 of the Welfare Reform Act 2012 (couples);

(iv)“earned income” means a person’s earned income within the meaning of Chapter 2 of Part 6 of the Universal Credit Regulations (earned income);

[F23(v) “limited capability for work” means limited capability for work or limited capability for work and work-related activity as construed in accordance with regulations 39 and 40 respectively of the Universal Credit Regulations 2013 (limited capability for work; limited capability for work and work-related activity);]

F24(vi). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(vii)“qualifying young person” has the meaning given in regulation 5 of the Universal Credit Regulations (meaning of “qualifying young person”);

[F25(viia)“relevant assessment period” means the assessment period immediately preceding that in which the supply of the optical appliance is paid for;]

(viii)“single person” has the meaning given in section 1(2)(a) of the Welfare Reform Act 2012 (universal credit); and

(ix)“the Universal Credit Regulations” means the Universal Credit Regulations 2013.]

F26(f). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .]

[F27(4A) In relation to paragraph (3)(q), where paragraph (4B) applies, a person is to be treated as a person of a description specified by regulation 8(2) for the purposes of regulation 20.

(4B) This paragraph applies where the conditions in heads (i), (ii) or (iii) of paragraph (3)(q) are satisfied in the assessment period in which the optical appliance is paid for and—

(a)there is no relevant assessment period; or

(b)none of those conditions were satisfied in the relevant assessment period.]

(5) For the purposes of regulation 10 and other provisions of this Part as they apply to payments where the testing of sight was by or on behalf of [F28a Health Board], a person is also an eligible person if, because of the frequency with which the condition of his eyes changes, he is considered by the F29... [F30Health Board] to be non-tolerant of his existing optical appliance.]]