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Apply for Special Category Mechanism for hepatitis C stage 1

If you have hepatitis C stage 1 and are registered with us, you can apply for a Special Category Mechanism (SCM). The SCM could give you higher annual payments.

You may be eligible if your:

  • infection, its treatment or associated conditions, has a long-term negative impact on your ability to carry out daily activities
  • condition has worsened, but is not stage 2

SCM recognises the impact of your infection and linked conditions and the effects of treatment. The scheme aims to respond to your changing health and needs.

We have guidance for healthcare professionals (PDF: 252KB) which includes important information in regards to date changes available.
 

How much you could get

If you’re currently a stage 1 beneficiary and successfully apply for Special Category Mechanism, you can claim:

  • regular payments - currently £18,000 a year
  • annual winter fuel costs of £519

The payment amounts and assessment criteria may be reviewed in the future. This helps us respond to the changing needs of beneficiaries and latest clinical evidence.

Check if you're eligible

You may qualify for regular payments, equivalent to those receivable at Stage 2 if:

  • you’re a successful stage 1 applicant
  • you feel the infection, its treatment or associated conditions has a long-term negative impact on your ability to carry out daily activities
  • the infection has worsened, but is not covered by the stage 2 conditions

If your Special Category Mechanism application is refused, you can reapply after 6 months if your condition has worsened.

You'll need to confirm that you have:

  • autoimmune disease which was due to, or worsened by, interferon treatment
    This includes:
    - Coombes positive haemolytic anaemia
    - idiopathic fibrosing alveolitis of the lung
    - rheumatoid arthritis

  • sporadic porphyria cutanea tarda (causing photosensitivity with blistering)

  • immune thrombocytopenic purpura, if autoimmune with antiplatelet antibodies

  • type 2 or 3 mixed cryoglobulinaemia
    If accompanied by:
    - cerebral vasculitis
    - dermal vasculitis
    - peripheral neuropathy with neuropathic pain

  • been affected in performing your daily duties due to the infection or the treatment

How to apply

To apply you'll need to download and complete an application form for Special Category Mechanism payments (PDF: 212KB).

Alternatively, we can post an application form to you. To request this, contact us.

Medical practitioner's evidence

As part of the application we'll need a medical practitioner to provide evidence for the answers you give on the application form.

This should be your hospital hepatologist doctor or viral hepatitis nurse. If you are not under the care of either you may wish to discuss your application with your GP. They may be able to refer you or provide the information we need.

The medical practitioner completes the form to confirm your current condition.

Endorsement of your application without evidence

It may be that the medical practitioner cannot, or does not, provide evidence for any elements of your answers. They may provide an endorsement based on professional judgement or balance of probability.

In this case, your application will go to a clinical assessor to review. They'll provide advice on how best to proceed. We'll write to you to give:

  • an indication of how long this will take
  • reassurance that, if your application is approved, we'll backdate payments to when we received your application

What happens next

We'll provide a decision on all applications as soon as possible. It may take longer if we need to ask you or your doctor for further information.

If the evidence clearly supports your answers on the application form, a clinical assessor will approve your application.

If your medical practitioner provides an endorsement only, a clinical review will need to take place. A clinical assessor will decide whether to approve your application.

If your application is unsuccessful

If you wish to appeal the decision, you should contact us within 3 months from the date on the letter. We may consider appeals received after 3 months, but only if you can provide a good reason for not contacting us earlier.

Find out how to appeal.