The Social Security (Adjudication) Regulations (Northern Ireland) 1995

Procedure on claim or question involving questions for determination by the Department

19.—(1) Where an adjudication officer has decided any claim or question on an assumption of facts as to which there appeared to him to be no dispute, but concerning which, had a question arisen, that question would have fallen for determination by the Department, it shall be deemed to be a sufficient compliance with the requirements of regulation 18 as to notification to the claimant, to give him notice in writing informing him of the decision and of the reasons for it and that, if he is dissatisfied with the decision, he should reply to that effect, giving the reasons for his dissatisfaction.

(2) Where—

(a) the claimant replies to the notice referred to in paragraph (1) expressing his dissatisfaction with the decision;

(b) after any appropriate investigations and explanations have been made, the claimant nonetheless remains dissatisfied with the decision; and

(c) an adjudication officer certifies that the sole ground for dissatisfaction appears to be the assumption referred to in paragraph (1)

the claimant shall be notified in writing of his right to apply for the determination by the Department of the question arising on the assumption.

(3) Where the Department’s decision—

(a) upholds the assumption, section 20(3) of the Administration Act shall apply as if the adjudication officer had given the certificate therein referred to;

(b) does not uphold the assumption, the Department’s decision may be treated by the adjudication officer as an application for the review of the adjudication officer’s decision, and, for the purposes of regulation 59 (review of decisions involving payment or increase of benefit other than industrial injuries benefit, income support, family credit or disability working allowance), the date of the claimant’s application for the Department’s decision shall be treated as the date of the application for review.