The Social Security (Attendance Allowance and Disability Living Allowance) (Miscellaneous Amendments) Regulations (Northern Ireland) 1997

Citation, commencement and interpretation

1.—(1) These Regulations may be cited as the Social Security (Attendance Allowance and Disability Living Allowance) (Miscellaneous Amendments) Regulations (Northern Ireland) 1997 and shall come into operation on 25th August 1997.

(2) The Interpretation Act (Northern Ireland) 1954(1) shall apply to these Regulations as it applies to a Measure of the Assembly.

Amendment of the Social Security (Attendance Allowance) Regulations

2.—(1) The Social Security (Attendance Allowance) Regulations (Northern Ireland) 1992(2) shall be amended in accordance with paragraphs (2) and (3).

(2) In regulation 1(2) (interpretation) after the definition of “the Act” there shall be inserted the following definition—

“the Administration Act” means the Social Security Administration (Northern Ireland) Act 1992;.

(3) After regulation 8B (exemption from regulation 8A)(3) there shall be inserted the following regulations—

Medical examination in prescribed circumstances

8C.(1) The prescribed circumstances in which a person who is awarded attendance allowance shall be required to attend for, or submit to, a medical examination, are where the Department is undertaking an investigation under section 28(7A) of the Administration Act (reviews of decisions of adjudication officers)(4).

(2) An examination under paragraph (1) shall be conducted by a medical practitioner who is—

(a)approved by the Department; or

(b)engaged by an organisation approved by the Department.

Withholding of benefit in prescribed circumstances

8D.(1) Subject to paragraph (2), where a person who is receiving attendance allowance is required by the Department to attend for, or submit to, a medical examination under regulation 8C and fails to comply with that requirement on more than one occasion, that allowance may be withheld, in whole or in part, from a date, not earlier than the second such occasion, as the Department shall determine.

(2) Paragraph (1) shall not apply where—

(a)a person who is required to attend for, or submit to, a medical examination proves to the satisfaction of the Department that he has good cause for failing to comply with that requirement;

(b)a person who is required to attend for, or submit to, a medical examination produces such evidence as is acceptable to the Department in place of a medical examination; or

(c)the Department otherwise has available to it such evidence as is acceptable to it.

(3) For the purposes of paragraph (2)(a), the matters which are to be taken into account in determining whether a person has good cause shall include—

(a)whether he was outside Northern Ireland at the relevant time;

(b)his state of health at the relevant time; and

(c)the nature of any disability from which he suffers.

Payment of withheld benefit

8E.(1) Where the Department is satisfied that no question arises in connection with its investigation referred to in regulation 8C(1), payment of the amount withheld and the attendance allowance shall be made forthwith.

(2) Where a question arose in connection with an investigation referred to in regulation 8C(1) in respect of which—

(a)the Department made an application for the review of a person’s entitlement to attendance allowance under section 28 of the Administration Act; and

(b)an adjudication officer has made a determination,

payment of the attendance allowance shall be made in accordance with the adjudication officer’s determination, on review, of the person’s entitlement.

(3) Where paragraph (1) or (2) does not apply and attendance allowance is withheld under regulation 8D for a period of more than 3 months, the Department shall—

(a)make, with a view to review, an application to the adjudication officer on the ground that the person failed to attend for, or submit to, medical examination; and

(b)make such payments as are determined, on review, by the adjudication officer..

Amendment of the Social Security (Disability Living Allowance) Regulations

3.  After regulation 5 of the Social Security (Disability Living Allowance) Regulations (Northern Ireland) 1992 (late claim by a person previously entitled to benefit)(5) there shall be inserted the following regulations—

Medical examination in prescribed circumstances

5A.(1) The prescribed circumstances in which a person who is awarded disability living allowance shall be required to attend for, or submit to, a medical examination, are where the Department is undertaking an investigation under section 28(7A) of the Administration Act (reviews of decisions of adjudication officers).

(2) An examination under paragraph (1) shall be conducted by a medical practitioner who is—

(a)approved by the Department; or

(b)engaged by an organisation approved by the Department.

Withholding of benefit in prescribed circumstances

5B.(1) Subject to paragraph (2), where a person who is receiving disability living allowance is required by the Department to attend for, or submit to, a medical examination under regulation 5A and fails to comply with that requirement on more than one occasion, that allowance may be withheld, in whole or in part, from a date, not earlier than the second such occasion, as the Department shall determine.

(2) Paragraph (1) shall not apply where—

(a)a person who is required to attend for, or submit to, a medical examination proves to the satisfaction of the Department that he has good cause for failing to comply with that requirement;

(b)a person who is required to attend for, or submit to, a medical examination produces such evidence as is acceptable to the Department in place of a medical examination; or

(c)the Department otherwise has available to it such evidence as is acceptable to it.

(3) For the purposes of paragraph (2)(a), the matters which are to be taken into account in determining whether a person has good cause shall include—

(a)whether he was outside Northern Ireland at the relevant time;

(b)his state of health at the relevant time; and

(c)the nature of any disability from which he suffers.

Payment of withheld benefit

5C.(1) Where the Department is satisfied that no question arises in connection with its investigation referred to in regulation 5A(1), payment of the amount withheld and the disability living allowance shall be made forthwith.

(2) Where a question arose in connection with an investigation referred to in regulation 5A(1) in respect of which—

(a)the Department made an application for the review of a person’s entitlement to disability living allowance under section 28 of the Administration Act; and

(b)an adjudication officer has made a determination,

payment of the disability living allowance shall be made in accordance with the adjudication officer’s determination, on review, of the person’s entitlement.

(3) Where paragraph (1) or (2) does not apply and disability living allowance is withheld under regulation 5B for a period of more than 3 months, the Department shall—

(a)make, with a view to review, an application to the adjudication officer on the ground that the person failed to attend for, or submit to, medical examination; and

(b)make such payments as are determined, on review, by the adjudication officer..

Amendment of the Social Security (Adjudication) Regulations

4.  After regulation 67 of the Social Security (Adjudication) Regulations (Northern Ireland) 1995 (review in social fund maternity or funeral expenses cases)(6) there shall be inserted the following regulation—

Review in attendance allowance and disability living allowance cases

67A.(1) Failure by a person to attend for, or submit to, a medical examination under the provisions made under section 55A of the Administration Act(7) is prescribed as a relevant change of circumstances for the purposes of section 28(2)(b) or 33(1)(b) of that Act.

(2) In the case where an award of attendance allowance or disability living allowance falls to be reviewed under section 28(2)(b) or 33(1)(b) of the Administration Act in the circumstances prescribed under paragraph (1), the decision given on review shall have effect from the date determined by the Department under regulation 8D(1) of the Social Security (Attendance Allowance) Regulations (Northern Ireland) 1992 or regulation 5B(1) of the Social Security (Disability Living Allowance) Regulations (Northern Ireland) 1992 (withholding of benefit in prescribed circumstances), as the case may be..

Sealed with the Official Seal of the Department of Health and Social Services for Northern Ireland on

L.S.

John O'Neill

Assistant Secretary

31st July 1997.