Part IN.I. Claims for and Payments and General Administration of Benefit

Necessity of claimN.I.

1 Entitlement to benefit dependent on claim.N.I.

(1)Except in such cases as may be prescribed, and subject to the following provisions of this section and to section 3 below, no person shall be entitled to any benefit unless, in addition to any other conditions relating to that benefit being satisfied—

(a)he makes a claim for it in the manner, and within the time, prescribed in relation to that benefit by regulations under this Part of this Act; or

(b)he is treated by virtue of such regulations as making a claim for it.

[F1(1A)No person whose entitlement to any benefit depends on his making a claim shall be entitled to the benefit unless subsection (1B) below is satisfied in relation both to the person making the claim and to any other person in respect of whom he is claiming benefit.

(1B)This subsection is satisfied in relation to a person if—

(a)the claim is accompanied by—

(i)a statement of the person’s national insurance number and information or evidence establishing that that number has been allocated to the person; or

(ii)information or evidence enabling the national insurance number that has been allocated to the person to be ascertained; or

(b)the person makes an application for a national insurance number to be allocated to him which is accompanied by information or evidence enabling such a number to be so allocated.

(1C)Regulations may make provision disapplying subsection (1A) above in the case of—

(a)prescribed benefits;

(b)prescribed descriptions of persons making claims; or

(c)prescribed descriptions of persons in respect of whom benefit is claimed,

or in other prescribed circumstances.]

[F2(2)Where under subsection (1) a person is required to make a claim or to be treated as making a claim for a benefit in order to be entitled to it, the person is not entitled to it in respect of any period more than 12 months before the date on which the claim is made or treated as made.

(2A)But subsection (2) does not apply—

(a)to disablement benefit or reduced earnings allowance, or

(b)in a case where a claim for the benefit is made or treated as made by virtue of section 3(2).]

(3)Where a person purports to make a claim on behalf of another—

[F3(za)for personal independence payment by virtue of Article 87 of the Welfare Reform (Northern Ireland) Order 2015; or]

(a)for an attendance allowance by virtue of section 66(1) of the Contributions and Benefits Act;F4...

F4(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

that other shall be regarded for the purposes of this section as making the claim, notwithstanding that it is made without his knowledge or authority.

(4)In this section and section 2 below “benefit” means—

[F5(za)universal credit;]

[F6(zb)state pension or a lump sum under Part 1 of the Pensions Act (Northern Ireland) 2015;]

[F7(zc)bereavement support payment under section 29 of the Pensions Act (Northern Ireland) 2015;]

(a)benefit as defined in section 121 of the Contributions and Benefits Act;

[F8(aa)a jobseeker’s allowance;]and

[F9(ab)state pension credit;]

[F10(ac)an employment and support allowance;]

[F11(ad)personal independence payment.]

(b)any income-related benefit.

(5)This section (which corresponds to section 154A of the 1975 Act, as it had effect immediately before this Act came into force) applies to claims made on or after 1st October 1990 or treated by virtue of regulations under that section or this section as having been made on or after that date.

(6)Schedule 1 to this Act shall have effect in relation to other claims.

Annotations:

Amendments (Textual)

F1S. 1(1A)-(1C) inserted (7.11.1997 for certain purposes and otherwise 1.12.1997) by S.I. 1997/1182 (N.I. 11), art. 18; S.R. 1997/480, art. 2

F6S. 1(4)(zb) inserted (6.4.2016 unless brought into operation earlier by an order under s. 53(1) of the amending Act) by Pensions Act (Northern Ireland) 2015 (c. 5), s. 53(3), Sch. 12 para. 9

F9S. 1(4)(ab) inserted (2.12.2002 for specified purposes, 7.4.2003 in so far as not already in force) by State Pension Credit Act (Northern Ireland) 2002 (c. 14), ss. 11, 21(2), Sch. 1 Pt. 1 para. 2; S.R. 2002/366, art. 2; S.R. 2003/211, art. 2(a)

F10S. 1(4)(ac) inserted (1.7.2008 for specified purposes, 27.7.2008 in so far as not already in force) by Welfare Reform Act (Northern Ireland) 2007 (c. 2), s. 60(1), Sch. 3 para. 4(2); S.R. 2008/276, art. 2(2)(a)(i)(ii)

Modifications etc. (not altering text)

2 Retrospective effect of provisions making entitlement to benefit dependent on claim.N.I.

(1)This section applies where a claim for benefit is made or treated as made at any time on or after 2nd September 1985 (the date on which section 154A of the 1975 Act (general provision as to necessity of claim for entitlement to benefit), as originally enacted, came into force) in respect of a period the whole or any part of which falls on or after that date.

(2)Where this section applies, any question arising as to—

(a)whether the claimant is or was at any time (whether before, on or after 2nd September 1985) entitled to the benefit in question, or to any other benefit on which his entitlement to that benefit depends; or

(b)in a case where the claimant’s entitlement to the benefit depends on the entitlement of another person to a benefit, whether that other person is or was so entitled,

shall be determined as if the relevant claim enactment and any regulations made under or referred to in that enactment had also been in force, with any necessary modifications, at all times relevant for the purpose of determining the entitlement of the claimant, and, where applicable, of the other person, to the benefit or benefits in question (including the entitlement of any person to any benefit on which that entitlement depends, and so on).

(3)In this section “the relevant claim enactment” means section 1 above as it has effect in relation to the claim referred to in subsection (1) above.

(4)In any case where—

(a)a claim for benefit was made or treated as made (whether before, on or after 2nd September 1985, and whether by the same claimant as the claim referred to in subsection (1) above or not), and benefit was awarded on that claim, in respect of a period falling wholly or partly before that date; but

(b)that award would not have been made had the current requirements applied in relation to claims for benefit, whenever made, in respect of periods before that date; and

(c)entitlement to the benefit claimed as mentioned in subsection (1) above depends on whether the claimant or some other person was previously entitled or treated as entitled to that or some other benefit,

then, in determining whether the conditions of entitlement to the benefit so claimed are satisfied, the person to whom benefit was awarded as mentioned in paragraphs (a) and (b) above shall be taken to have been entitled to the benefit so awarded, notwithstanding anything in subsection (2) above.

(5)In subsection (4) above “the current requirements” means—

(a)the relevant claim enactment, and any regulations made under or referred to in that enactment, or referred to in it, as in force at the time of the claim referred to in subsection (1) above, with any necessary modifications; and

(b)subsection (1) (with the omission of the words following “at any time”) and subsections (2) and (3) above.

[F12Work-focused interviews] [F13and work-related activity] N.I.

Annotations:

Amendments (Textual)

F12Ss. 2A, 2B and preceding cross-heading inserted (1.12.1999) by S.I. 1999/3147 (N.I. 11), arts. 1(4), 54

F13Words in s. 2A cross-heading inserted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 2(3), 36(1)(a)

[F142A Claim or full entitlement to certain benefits conditional on work-focused interview.N.I.

(1)Regulations may make provision for or in connection with—

(a)imposing, as a condition falling to be satisfied by a person who—

(i)makes a claim for a benefit to which this section applies, and

[F15(ii)has not attained pensionable age at the time of making the claim (but see subsection (1A)),]

a requirement to take part in [F16one or more work-focused interviews] ;

(b)imposing, at a time when—

(i)a person [F17has not attained pensionable age and is] entitled to such a benefit, and

(ii)any prescribed circumstances exist,

a requirement to take part in [F18one or more work-focused interviews] as a condition of that person continuing to be entitled to the full amount which is payable to him in respect of the benefit apart from the regulations.

[F19(1A)For the purposes of subsection (1) a man born before [F206 December 1953] is treated as attaining pensionable age when a woman born on the same day as the man would attain pensionable age.]

(2)The benefits to which this section applies are—

(a)income support;

(b)housing benefit;

(c)widow’s and bereavement benefits falling within section 20(1)(e) and (ea) of the Contributions and Benefits ActF21...;

(d)incapacity benefit;

(e)severe disablement allowance; and

(f)[F22carer’s allowance].

[F23(2A)No requirement may be imposed by virtue of this section on a person who—

(a)is not a member of a couple, and

(b)is responsible for, and a member of the same household as, a child under the age of one.

(2B)For the purposes of subsection (2A)(b) regulations may make provision—

(a)as to circumstances in which one person is to be treated as responsible or not responsible for another;

(b)as to circumstances in which persons are to be treated as being or not being members of the same household.]

(3)Regulations under this section may, in particular, make provision—

(a)for securing, where a person would otherwise be required to take part in interviews relating to two or more benefits—

(i)that he is only required to take part in one interview, and

(ii)that any such interview is capable of counting for the purposes of all those benefits;

(b)for determining the persons by whom interviews are to be conducted;

(c)conferring power on such persons or the designated authority to determine when and where interviews are to take place (including power in prescribed circumstances to determine that they are to take place in the homes of those being interviewed);

(d)prescribing the circumstances in which persons attending interviews are to be regarded as having or not having taken part in them;

(e)for securing that the appropriate consequences mentioned in subsection (4)(a) or (b) below ensue if a person who has been notified that he is required to take part in an interview—

(i)fails to take part in the interview, and

(ii)does not show, within the prescribed period, that he had good cause for that failure;

(f)prescribing—

(i)matters which are or are not to be taken into account in determining whether a person does or does not have good cause for any failure to comply with the regulations, or

(ii)circumstances in which a person is or is not to be regarded as having or not having good cause for any such failure.

(4)For the purposes of subsection (3)(e) above the appropriate consequences of a failure falling within that provision are—

(a)where the requirement to take part in an interview applied by virtue of subsection (1)(a) above, that as regards any relevant benefit either—

(i)the person in question is to be regarded as not having made a claim for the benefit, or

(ii)if (in the case of an interview postponed in accordance with subsection (7) below) that person has already been awarded the benefit, his entitlement to the benefit is to terminate immediately;

(b)where the requirement to take part in an interview applied by virtue of subsection (1)(b) above, that the amount payable to the person in question in respect of any relevant benefit is to be reduced by the specified amount until the specified time.

(5)Regulations under this section may, in relation to any such reduction, provide—

(a)for the amount of the reduction to be calculated in the first instance by reference to such amount as may be prescribed;

(b)for the amount as so calculated to be restricted, in prescribed circumstances, to the prescribed extent;

(c)where the person in question is entitled to two or more relevant benefits, for determining the extent, and the order, in which those benefits are to be reduced in order to give effect to the reduction required in his case.

(6)Regulations under this section may provide that any requirement to take part in an interview that would otherwise apply to a person by virtue of such regulations—

(a)is, in any prescribed circumstances, either not to apply or not to apply until such time as is specified;

(b)is not to apply if the designated authority determines that an interview—

(i)would not be of assistance to that person, or

(ii)would not be appropriate in the circumstances;

(c)is not to apply until such time as the designated authority determines, if that authority determines that an interview—

(i)would not be of assistance to that person, or

(ii)would not be appropriate in the circumstances,

until that time;

and the regulations may make provision for treating a person in relation to whom any such requirement does not apply, or does not apply until a particular time, as having complied with that requirement to such extent and for such purposes as are specified.

(7)Where—

(a)a person is required to take part in an interview by virtue of subsection (1)(a) above, and

(b)the interview is postponed by or under regulations made in pursuance of subsection (6)(a) or (c) above,

the time to which it is so postponed may be a time falling after an award of the relevant benefit to that person.

[F24(7A)Information supplied in pursuance of regulations under this section shall be taken for all purposes to be information relating to social security.]

(8)In this section—

  • [F25couple” has the meaning given by section 133(1) of the Contributions and Benefits Act;]

  • “the designated authority” means such of the following as may be specified—

    (a)

    a Northern Ireland department;

    (b)

    a person providing services to a Northern Ireland department;

    (c)

    any other body established by or under a statutory provision;

    (d)

    a person providing services to, or authorised to exercise any function of, any such body;

  • “interview” (in subsections (3) to (7) above) means a work-focused interview;

  • “relevant benefit”, in relation to any person required to take part in a work-focused interview, means any benefit in respect to which that requirement applied by virtue of subsection (1)(a) or (b) above;

  • “specified” means prescribed by or determined in accordance with regulations;

  • “work-focused interview”, in relation to a person, means an interview conducted for such purposes connected with employment or training in the case of that person as may be specified;

and the purposes which may be so specified include purposes connected with a person’s existing or future employment or training prospects or needs, and (in particular) assisting or encouraging a person to enhance his employment prospects.]

Annotations:

Amendments (Textual)

F14Ss. 2A, 2B and preceding cross-heading inserted (1.12.1999) by S.I. 1999/3147 (N.I. 11), arts. 1(4), 54

F16Words in s. 2A(1)(a) substituted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 29(4), 36(1)(l)

F17Words in s. 2A(1)(b)(i) substituted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 29(2)(b), 36(1)(l)

F18Words in s. 2A(1)(b) substituted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 29(4), 36(1)(l)

F20Words in s. 2A(1A) substituted (2.6.2012) by Pensions Act (Northern Ireland) 2012 (c. 3), s. 34(2), Sch. 1 para. 1

F21Words in s. 2A(2)(c) omitted (6.4.2017) by virtue of Pensions Act (Northern Ireland) 2015 (c. 5), s. 53(1), Sch. 16 para. 22; S.R. 2017/44, art. 2(2) (with arts. 3, 4)

F22Words in s. 2A(2)(f) substituted (21.10.2002 for certain purposes, otherwise 1.4.2003) by The Deregulation (Carer's Allowance) Order (Northern Ireland) 2002 (S.R. 2002/321), art. 2(2)(b)(i)

[F262AA Full entitlement to certain benefits conditional on work-focused interview for partnerN.I.

(1)Regulations may make provision for or in connection with imposing, at a time when—

(a)a person (“the claimant”) who—

[F27(i)has not attained pensionable age (but see subsection (1A)), and]

[F27(ii)has a partner who has also not attained pensionable age,]

is entitled to a benefit to which this section applies at a higher rate referable to his partner; and

(b)prescribed circumstances exist,

a requirement for the partner to take part in [F28one or more work-focused interviews] as a condition of the benefit continuing to be payable to the claimant at that rate.

[F29(1A)For the purposes of subsection (1) a man born before [F306 December 1953] is treated as attaining pensionable age when a woman born on the same day as the man would attain pensionable age.]

(2)The benefits to which this section applies are—

(a)income support;

(b)an income-based jobseeker’s allowance other than a joint-claim jobseeker’s allowance;

(c)incapacity benefit;

(d)severe disablement allowance; and

(e)[F31carer’s allowance][F32; and

(f)an employment and support allowance.]

(3)For the purposes of this section a benefit is payable to a person at a higher rate referable to his partner if the amount that is payable in his case—

(a)is more than it would be if the person concerned was not a member of a couple; or

(b)includes an increase of benefit for his partner as an adult dependant of his.

(4)Regulations under this section may, in particular, make provision—

(a)for securing, where the partner of the claimant would otherwise be required to take part in work-focused interviews relating to two or more benefits—

(i)that the partner is required instead to take part in only one such interview, and

(ii)that the interview is capable of counting for the purposes of all those benefits;

(b)in a case where the claimant has more than one partner, for determining which of those partners is required to take part in the work-focused interview or requiring each ofthem to take part in such an interview;

(c)for determining the persons by whom work-focused interviews are to be conducted;

(d)conferring power on such persons or the designated authority to determine when and where work-focused interviews are to take place (including power in prescribedcircumstances to determine that they are to take place in the homes of those being interviewed);

(e)prescribing the circumstances in which partners attending work-focused interviews are to be regarded as having or not having taken part in them;

(f)for securing that if—

(i)a partner who has been notified of a requirement to take part in a work-focused interview fails to take part in it, and

(ii)it is not shown (by him or by the claimant), within the prescribed period, that he had good cause for that failure,

the amount payable to the claimant in respect of the benefit in relation to which the requirement applied is to be reduced by the specified amount until the specifiedtime;

(g)prescribing—

(i)matters which are or are not to be taken into account in determining whether a partner does or does not have good cause for any failure to comply with the regulations,or

(ii)circumstances in which a partner is or is not to be regarded as having or not having good cause for any such failure.

(5)Regulations under this section may, in relation to a reduction under subsection (4)(f) above, provide—

(a)for the amount of the reduction to be calculated in the first instance by reference to such amount as may be prescribed;

(b)for the amount as so calculated to be restricted, in prescribed circumstances, to the prescribed extent;

(c)where the claimant is entitled to two or more benefits in relation to each of which a requirement to take part in a work-focused interview applied, for determining theextent to, and the order in, which those benefits are to be reduced in order to give effect to the reduction required in his case.

(6)Regulations under this section may provide that any requirement to take part in a work-focused interview that would otherwise apply to a partner by virtue of suchregulations—

(a)is, in any prescribed circumstances, either not to apply or not to apply until the specified time;

(b)is not to apply if the designated authority determines that such an interview would not be of assistance to him or appropriate in the circumstances;

(c)is not to apply until such time as the designated authority determines (if that authority determines that such an interview would not be of assistance to him orappropriate in the circumstances until that time),

and the regulations may make provision for treating a partner to whom any such requirement does not apply, or does not apply until a particular time, as having complied withthat requirement to such extent and for such purposes as are specified.

[F33(6A)Information supplied in pursuance of regulations under this section shall be taken for all purposes to be information relating to social security.]

(7)In this section—

  • [F34couple” has the meaning given by section 133(1) of the Contributions and Benefits Act;]

  • designated authority” means such of the following as may be specified—

    (a)

    a Northern Ireland department;

    (b)

    a person providing services to a Northern Ireland department;

    (c)

    any other body established by or under a statutory provision;

    (d)

    a person providing services to, or authorised to exercise any function of, any such body;

  • partner” means a person who is a member of the same couple as the claimant;

  • specified” means prescribed by or determined in accordance with regulations;

  • work-focused interview” has the same meaning as in section 2A above.]

Annotations:

Amendments (Textual)

F26S. 2AA inserted (10.9.2003) by Social Security Act (Northern Ireland) 2002 (c. 10), ss. 5, 9(1); S.R. 2003/396, art. 2

F27S. 2AA(1)(a)(i)(ii) substituted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 29(3)(a), 36(1)(l)

F28Words in s. 2AA(1) substituted (13.8.2010) by Welfare Reform Act (Northern Ireland) 2010 (c. 13), ss. 29(4), 36(1)(l)

F31Words in s. 2AA(2)(e) substituted (21.10.2002 for certain purposes, otherwise 1.4.2003) by The Deregulation (Carer's Allowance) Order (Northern Ireland) 2002 (S.R. 2002/321), arts. 1(1)(b), 2(2)(b)(ii)

F32S. 2AA(2)(f) and word added (1.7.2008 for specified purposes, 27.10.2008 in so far as not already in force) by Welfare Reform Act (Northern Ireland) 2007 (c. 2), s. 60(1), Sch. 3 para. 4(3); S.R. 2008/276, art. 2(2)(c), Sch. Pt. 1

[F352B Supplementary provisions relating to work-focused interviews.N.I.

(1)Chapter II of Part II of the Social Security (Northern Ireland) Order 1998 (social security decisions and appeals) shall have effect in relation to relevant decisions [F36made under regulations under section 2A or 2AA above] subject to and in accordance with subsections (3) to (8) below (and in those subsections “the 1998 Order” means that Order).

(2)For the purposes of this section a “relevant decision” [F37, in relation to regulations under section 2A above, is a decision] that a person—

(a)has failed to comply with a requirement to take part in an interview which applied to him by virtue of the regulations, or

(b)has not shown, within the prescribed period mentioned in section 2A(3)(e)(ii) above, that he had good cause for such a failure.

[F38(2A)For the purposes of this section a “relevant decision”, in relation to regulations under section 2AA above, is a decision that—

(a)the partner of a person entitled to a benefit has failed to comply with a requirement to take part in an interview which applied to the partner by virtue of the regulations, or

(b)it has not been shown, within the prescribed period mentioned in section 2AA(4)(f)(ii) above, that the partner had good cause for such a failure.]

(3)Article 9(1)(c) of the 1998 Order (decisions falling to be made under certain statutory provisions are to be made by the Department) shall have effect subject to any provisions of regulations under section 2A [F39or 2AA] above by virtue of which relevant decisions fall to be made otherwise than by the Department.

(4)For the purposes of each of Articles 10 and 11 of the 1998 Order (revision and supersession of decisions of Department) any relevant decision made otherwise than by the Department shall be treated as if it were such a decision made by the Department (and accordingly may be revised by it under Article 10 or superseded by a decision made by it under Article 11).

(5)Subject to any provisions of regulations under either Article 10 or 11 of the 1998 Order, any relevant decision made, or (by virtue of subsection (4) above) treated as made, by the Department may be—

(a)revised under Article 10 by a person or authority exercising functions under regulations under section 2A [F40or 2AA] above other than the Department, or

(b)superseded under Article 11 by a decision made by such a person or authority,

as if that person or authority were the Department.

(6)Regulations shall make provision for conferring (except in any prescribed circumstances) a right of appeal under Article 13 of the 1998 Order (appeal to appeal tribunal) against—

(a)any relevant decision, and

(b)any decision under Article 11 of that Order superseding any such decision,

whether made by the Department or otherwise.

(7)Subsections (4) to (6) above apply whether—

(a)the relevant decision, or

(b)(in the case of subsection (6)(b)) the decision under Article 11 of the 1998 Order,

is as originally made or has been revised (by the Department or otherwise) under Article 10 of that Order; and regulations under subsection (6) above may make provision for treating, for the purposes of Article 13 of that Order, any decision made or revised otherwise than by the Department as if it were a decision made or revised by it.

(8)Article 13 of the 1998 Order shall not apply to any decision falling within subsection (6) above except in accordance with regulations under that subsection.

(9)In the following provisions, namely—

(a)section 3(1) of the Social Security Act 1998 (use of information), and

(b)Article 69(6) of the Welfare Reform and Pensions (Northern Ireland) Order 1999 (supply of information),

any reference to information relating to social security includes any information supplied by a person for the purposes of an interview which he is required to take part in by virtue of section 2A [F41or 2AA] above.

(10)In this section “interview” means a work-focused interview within the meaning of section 2A above.]

[F422C Optional work-focused interviews.N.I.

(1)Regulations may make provision for conferring on the prescribed authorities functions in connection with conducting work-focused interviews in cases where such interviews are requested or consented to by persons to whom this section applies.

(2)This section applies to [F43

(a)persons making claims for or entitled to any of the benefits listed in section 2A(2) above or any prescribed benefit; and

(b)partners of persons entitled to any of the benefits listed in section 2AA(2) above or any prescribed benefit,]

and it so applies regardless of whether such persons have, in accordance with regulations under section 2A [F44or 2AA] above, already taken part in interviews conducted under such regulations.

(3)The functions which may be conferred on the prescribed authorities by regulations under this section include functions relating to—

(a)the obtaining and receiving of information for the purposes of work-focused interviews conducted under the regulations;

(b)the recording and forwarding of information supplied at, or for the purposes of, such interviews;

(c)the taking of steps to identify potential employment or training opportunities for persons taking part in such interviews.

(4)Regulations under this section may make different provision for different areas.

(5)In this section—

  • “authorities” means a Northern Ireland department and any other body established by or under a statutory provision;

  • “work-focused interview”, in relation to a person to whom this section applies, means an interview conducted for such purposes connected with employment or training in the case of such a person as may be prescribed; and the purposes which may be so prescribed include—

    (a)

    purposes connected with the existing or future employment or training prospects or needs of such a person, and

    (b)

    (in particular) assisting or encouraging such a person to enhance his employment prospects.]

[F452DWork-related activityN.I.

(1)Regulations may make provision for or in connection with imposing on a person who—

(a)is entitled to income support, and

(b)is not a lone parent of a child under the age of 3,

a requirement to undertake work-related activity in accordance with regulations as a condition of continuing to be entitled to the full amount of income support payable apart from the regulations.

(2)Regulations may make provision for or in connection with imposing on a person (“P”) who—

(a)is under pensionable age, and

(b)is a member of a couple the other member of which (“C”) is entitled to a benefit to which subsection (3) applies at a higher rate referable to P,

a requirement to undertake work-related activity in accordance with regulations as a condition of the benefit continuing to be payable to C at that rate.

(3)The benefits to which this subsection applies are—

(a)income support;

(b)an income-based jobseeker's allowance other than a joint-claim jobseeker's allowance; and

(c)an income-related employment and support allowance.

(4)Regulations under this section may, in particular, make provision—

(a)prescribing circumstances in which a person is to be subject to any requirement imposed by the regulations (a “relevant requirement”);

(b)for notifying a person of a relevant requirement;

(c)prescribing the time or times at which a person who is subject to a relevant requirement is required to undertake work-related activity and the amount of work-related activity the person is required at any time to undertake

(d)prescribing circumstances in which a person who is subject to a relevant requirement is, or is not, to be regarded as undertaking work-related activity;

(e)in a case where C is a member of more than one couple, for determining which of the members of the couples is to be subject to a relevant requirement or requiring each of them to be subject to a relevant requirement;

(f)for securing that the appropriate consequence follows if—

(i)a person who is subject to a relevant requirement has failed to comply with the requirement, and

(ii)it is not shown, within a prescribed period, that the person had good cause for that failure;

(g)prescribing the evidence which a person who is subject to a relevant requirement needs to provide in order to show compliance with the requirement;

(h)prescribing matters which are, or are not, to be taken into account in determining whether a person had good cause for any failure to comply with a relevant requirement;

(i)prescribing circumstances in which a person is, or is not, to be regarded as having good cause for any such failure.

(5)For the purposes of subsection (4)(f) the appropriate consequence is that the amount of the benefit payable is to be reduced by the prescribed amount until the prescribed time.

(6)Regulations under subsection (5) may, in relation to any such reduction, provide—

(a)for the amount of the reduction to be calculated in the first instance by reference to such amount as may be prescribed;

(b)for the amount as so calculated to be restricted, in prescribed circumstances, to the prescribed extent.

(7)Regulations under this section may include provision that in such circumstances as the regulations may provide a person's obligation under the regulations to undertake work-related activity at a particular time is not to apply, or is to be treated as not having applied.

(8)Regulations under this section must include provision for securing that lone parents are entitled (subject to meeting any prescribed conditions) to restrict the times at which they are required to undertake work-related activity.

(9)For the purposes of this section and sections 2E and 2F—

(a)couple” has the meaning given by section 133(1) of the Contributions and Benefits Act;

(b)lone parent” means a person who—

(i)is not a member of a couple, an

(ii)is responsible for, and a member of the same household as, a child;

(c)prescribed” means specified in, or determined in accordance with, regulations;

(d)work-related activity”, in relation to a person, means activity which makes it more likely that the person will obtain or remain in work or be able to do so;

(e)any reference to a person attaining pensionable age is, in the case of a man born before [F466 December 1953] , a reference to the time when a woman born on the same day as the man would attain pensionable age;

(f)any reference to a benefit payable to C at a higher rate referable to P is a reference to any case where the amount payable is more than it would be if C and P were not members of the same couple.

(10)For the purposes of this section regulations may make provision—

(a)as to circumstances in which one person is to be treated as responsible or not responsible for another;

(b)as to circumstances in which persons are to be treated as being or not being members of the same household.

(11)Information supplied in pursuance of regulations under this section is to be taken for all purposes to be information relating to social security.

2EAction plans in connection with work-focused interviewsN.I.

(1)The Department must in prescribed circumstances provide a document (referred to in this section as an “action plan”) prepared for such purposes as may be prescribed to a person who is subject to a requirement imposed under section 2A or 2AA in relation to any of the following benefits.

(2)The benefits are—

(a)income support;

(b)an income-based jobseeker's allowance other than a joint-claim jobseeker's allowance; and

(c)an income-related employment and support allowance.

(3)Regulations may make provision about—

(a)the form of action plans;

(b)the content of action plans;

(c)the review and updating of action plans.

(4)Regulations under this section may, in particular, make provision for action plans which are provided to a person who is subject under section 2D to a requirement to undertake work-related activity to contain particulars of activity which, if undertaken, would enable the requirement to be met.

(5)Regulations may make provision for reconsideration of an action plan at the request of the person to whom it is provided and may, in particular, make provision about

(a)the circumstances in which reconsideration may be requested;

(b)the period within which any reconsideration must take place;

(c)the matters to which regard must be had when deciding on reconsideration whether the plan should be changed;

(d)notification of the decision on reconsideration;

(e)the giving of directions for the purpose of giving effect to the decision on reconsideration.

(6)In preparing any action plan, the Department must have regard (so far as practicable) to its impact on the well-being of any person under the age of 16 who may be affected by it.

2FDirections about work-related activityN.I.

(1)In prescribed circumstances, the Department may by direction given to a person subject to a requirement imposed under section 2D provide that the activity specified in the direction is—

(a)to be the only activity which, in the person's case, is to be regarded as being work-related activity; or

(b)to be regarded, in the person's case, as not being work-related activity.

(2)But a direction under subsection (1) may not specify medical or surgical treatment as the only activity which, in any person's case, is to be regarded as being work-related activity.

(3)A direction under subsection (1) given to any person—

(a)must be reasonable, having regard to the person's circumstances;

(b)must be given to the person by being included in an action plan provided to the person under section 2E; and

(c)may be varied or revoked by a subsequent direction under subsection (1).

(4)Where a direction under subsection (1) varies or revokes a previous direction, it may provide for the variation or revocation to have effect from a time before the giving of the direction.

2GContracting-outN.I.

(1)The following functions of the Department may be exercised by, or by employees of, such person (if any) as the Department may authorise for the purpose, namely—

(a)conducting interviews under section 2A or 2AA;

(b)providing documents under section 2E;

(c)giving, varying or revoking directions under section 2F.

(2)Regulations may provide for any of the following functions of the Department to be exercisable by, or by employees of, such person (if any) as the Department may authorise for the purpose

(a)any function under regulations under any of sections 2A to 2F, except the making of an excluded decision (see subsection (3));

(b)the function under Article 10(1) of the 1998 Order (revision of decisions) so far as relating to decisions (other than excluded decisions) that relate to any matter arising under regulations under any of sections 2A to 2F;

(c)the function under Article 11(1) of the 1998 Order (superseding of decisions) so far as relating to decisions (other than excluded decisions) of the Department that relate to any matter arising under regulations under any of sections 2A to 2F;

(d)any function under Chapter 2 of Part 2 of the 1998 Order (social security decisions), except Article 25(2) and (3) (decisions involving issues arising on appeal in other cases), which relates to the exercise of any of the functions within paragraphs (a) to (c).

(3)Each of the following is an “excluded decision” for the purposes of subsection (2)—

(a)a decision about whether a person has failed to comply with a requirement imposed by regulations under section 2A, 2AA or 2D;

(b)a decision about whether a person had good cause for failure to comply with such a requirement;

(c)a decision about the reduction of a benefit in consequence of a failure to comply with such a requirement.

(4)Regulations under subsection (2) may provide that a function to which that subsection applies may be exercised—

(a)either wholly or to such extent as the regulations may provide,

(b)either generally or in such cases as the regulations may provide, and

(c)either unconditionally or subject to the fulfilment of such conditions as the regulations may provide.

(5)An authorisation given by virtue of any provision made by or under this section may authorise the exercise of the function concerned—

(a)either wholly or to such extent as may be specified in the authorisation,

(b)either generally or in such cases as may be so specified, and

(c)either unconditionally or subject to the fulfilment of such conditions as may be so specified;

but, in the case of an authorisation given by virtue of regulations under subsection (2), this subsection is subject to the regulations.

(6)An authorisation given by virtue of any provision made by or under this section—

(a)may specify its duration

(b)may be revoked at any time by the Department, and

(c)does not prevent the Department or any other person from exercising the function to which the authorisation relates.

(7)Anything done or omitted to be done by or in relation to an authorised person (or an employee of that person) in, or in connection with, the exercise or purported exercise of the function concerned is to be treated for all purposes as done or omitted to be done by or in relation to the Department.

(8)But subsection (7) does not apply—

(a)for the purposes of so much of any contract made between the authorised person and the Department as relates to the exercise of the function, or

(b)for the purposes of any criminal proceedings brought in respect of anything done by the authorised person (or an employee of that person).

(9)Any decision which an authorised person makes in exercise of the function concerned has effect as a decision of the Department under Article 9 of the 1998 Order.

(10)Where—

(a)the authorisation of an authorised person is revoked at any time, and

(b)at the time of the revocation so much of any contract made between the authorised person and the Department as relates to the exercise of the function is subsisting,

the authorised person is entitled to treat the contract as repudiated by the Department (and not as frustrated by reason of the revocation).

(11)In this section—

(a)the 1998 Order” means the Social Security (Northern Ireland) Order 1998;

(b)authorised person” means a person authorised to exercise any function by virtue of any provision made by or under this section;

(c)references to functions of the Department under any enactment (including one comprised in regulations) include functions which the Department has by virtue of the application of Article 9(1)(c) of the 1998 Order in relation to the enactment.

2HGood cause for failure to comply with regulationsN.I.

(1)This section applies to any regulations made under section 2A, 2AA or 2D that prescribe matters to be taken into account in determining whether a person has good cause for any failure to comply with the regulations.

(2)The provision made by the regulations prescribing those matters must include provision relating to—

(a)the person's physical or mental health or condition

(b)the availability of child care.]

[F47Bereavement benefits]N.I.

Annotations:

Amendments (Textual)

F47S. 3 and preceding cross-heading substituted (24.4.2000 for certain purposes, otherwise 9.4.2001) by S.I. 1999/3147 (N.I. 11), art. 67, Sch. 8 para. 16 (with art. 75); S.R. 2000/133, art. 2(3)(a), Sch. Pt. I

[F483 Late claims for bereavement benefit where death is difficult to establish.N.I.

(1)This section applies where a person’s spouse [F49or civil partner] has died or maybe presumed to have died on or after the appointed day and the circumstances are such that—

(a)more than 12 months have elapsed since the date of death; and

(b)either—

(i)the spouse’s [F50or civil partner's] body has not been discovered or identified or, if it has been discovered and identified, the surviving spouse [F49or civil partner] does not know that fact; or

(ii)less than 12 months have elapsed since the surviving spouse [F49or civil partner] first knew of the discovery and identification of the body.

(2)Where this section applies, notwithstanding that any time prescribed for making a claim for a bereavement benefit in respect of the death has elapsed, then—

(a)in any case falling within paragraph (b)(i) of subsection (1) above, where it has been decided under Article 9 of the Social Security (Northern Ireland) Order 1998 that the spouse [F49or civil partner] has died or is presumed to have died; or

(b)in any case falling within paragraph (b)(ii) of subsection (1) above where the identification was made not more than 12 months before the surviving spouse [F49or civil partner] first knew of the discovery and identification of the body,

such a claim may be made or treated as made at any time before the expiration of the period of 12 months beginning with the date on which that decision was made or, as the case may be, the date on which the surviving spouse [F49or civil partner] first knew of the discovery and identification.

F51(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4)In subsection (1) above “the appointed day” means the day appointed for the coming into operation of Articles 51 to 53 of the Welfare Reform and Pensions (Northern Ireland) Order 1999.]

[F52(5)In subsection (2) “bereavement benefit” means—

(a)bereavement support payment, or

(b)widowed parent's allowance.]

4 Treatment of payments of benefit to certain widows.N.I.

In any case where—

(a)a claim for a widow’s pension or a widowed mother’s allowance is made, or treated as made, before 14th August 1990 (the date of the coming into operation of paragraph 16(2) of Schedule 6 to the M1Social Security (Northern Ireland) Order 1990); and

(b)the Department has made a payment to or for the claimant on the ground that, if the claim had been received immediately after that date, she would have been entitled to that pension or allowance, or entitled to it at a higher rate, for the period in respect of which the payment is made,

the payment so made shall be treated as a payment of that pension or allowance; and, if and to the extent that an award of the pension or allowance, or an award at a higher rate, is made for the period in respect of which the payment was made, the payment shall be treated as made in accordance with that award.

Claims and payments regulationsN.I.

5 Regulations about claims for and payments of benefit.N.I.

(1)Regulations may provide—

(a)for requiring a claim for a benefit to which this section applies to be made by such person, in such manner and within such time as may be prescribed;

(b)for treating such a claim made in such circumstances as may be prescribed as having been made at such date earlier or later than that at which it is made as may be prescribed;

(c)for permitting such a claim to be made, or treated as if made, for a period wholly or partly after the date on which it is made;

(d)for permitting an award on such a claim to be made for such a period subject to

[F53(i)the condition that the requirements for entitlement are satisfied at a prescribed time after the making of the award, or

(ii)other prescribed conditions;]

[F54(e)for any such award to be revised under Article 10 of the Social Security (Northern Ireland) Order 1998, or superseded under Article 11 of that Order, if any of [F55the conditions referred to in paragraph (d)] are found not to have been satisfied;]

(f)for the disallowance on any ground of a person’s claim for a benefit to which this section applies to be treated as a disallowance of any further claim by that person for that benefit until the grounds of the original disallowance have ceased to exist;

(g)for enabling one person to act for another in relation to a claim for a benefit to which this section applies [F56(including in particular, in the case of a benefit to be claimed by persons jointly, enabling one person to claim for such persons jointly)] and for enabling such a claim to be made and proceeded with in the name of a person who has died;

F57(h). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F57(hh). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(i)for a claim for any one benefit to which this section applies to be treated, either in the alternative or in addition, as a claim for any other such benefit that may be prescribed;

(j)for the person to whom, time when and manner in which a benefit to which this section applies is to be paid and for the information and evidence to be furnished in connection with the payment of such a benefit;

(k)for notice to be given of any change of circumstances affecting the continuance of entitlement to such a benefit or payment of such a benefit [F58or of any other change of circumstance of a prescribed description] ;

(l)for the day on which entitlement to such a benefit is to begin or end;

(m)for calculating the amounts of such a benefit according to a prescribed scale or otherwise adjusting them so as to avoid fractional amounts or facilitate computation;

(n)for extinguishing the right to payment of such a benefit if payment is not obtained within such period, not being less than 12 months, as may be prescribed from the date on which the right is treated under the regulations as having arisen;

[F59(o)for suspending payment, in whole or in part, where it appears to the Department that a question arises whether—

(i)the conditions for entitlement are or were fulfilled;

(ii)an award ought to be revised;

(iii)an appeal ought to be brought against an award;]

[F60(p)for withholding payments of a benefit to which this section applies in prescribed circumstances and for subsequently making withheld payments in prescribed circumstances;]

(q)for the circumstances and manner in which payments of such a benefit may be made to another person on behalf of the beneficiary for any purpose, which may be to discharge, in whole or in part, an obligation of the beneficiary or any other person;

(r)for the payment or distribution of such a benefit to or among persons claiming to be entitled on the death of any person and for dispensing with strict proof of their title;

[F61(s)for the making of a payment on account of such a benefit—

(i)in cases where it is impracticable for a claim to be made or determined immediately, or for an award to be determined or paid in full immediately,

(ii)in cases of need, or

(iii)in cases where the Department considers in accordance with prescribed criteria that the payment can reasonably be expected to be recovered;]

[F62(t)for treating any payment on account made by virtue of paragraph (s) above as made on account of any benefit to which this section applies that is subsequently awarded or paid.]

[F63(1A)Regulations may make provision for requiring a person of a prescribed description to supply any information or evidence which is, or could be, relevant to—

(a)a claim or award relating to a benefit to which this section applies, or

(b)potential claims or awards relating to such a benefit.]

(2)This section applies to the following benefits—

[F64(za)universal credit;]

[F65(zb)state pension or a lump sum under Part 1 of the Pensions Act (Northern Ireland) 2015;]

[F66(zc)bereavement support payment under section 29 of the Pensions Act (Northern Ireland) 2015;]

(a)benefit as defined in section 121 of the Contributions and Benefits Act;

[F67(aa)a jobseeker’s allowance;]

[F68(ab)state pension credit;]

[F69(ac)an employment and support allowance;]

[F70(ad)personal independence payment;]

(b)income support;

F71(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F71(d). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(e)housing benefit;

(f)any social fund payments such as are mentioned in section 134(1)(a) or (2) of the Contributions and Benefits Act;

[F72(fa)health in pregnancy grant;]

(g)child benefit; and

(h)Christmas bonus.

F73(2A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F74(2B)The power in subsection (1)(j) to make provision for the person to whom a benefit is to be paid includes, in the case of a benefit awarded to persons jointly, power to make provision for the Department to determine to which of them all or any part of a payment should be made, and in particular for the Department—

(a)to determine that payment should be made to whichever of those persons they themselves nominate, or

(b)to determine that payment should be made to one of them irrespective of any nomination by them.]

[F75(3)Subsection (1)(o) above shall have effect in relation to housing benefit as if the reference to the Department were a reference to the authority paying the benefit.]

(4)Subsection (1)(g), (j), (m), (q) and (r) above shall have effect as if statutory sick pay and statutory maternity pay were benefits to which this section applies.

[F76“(4A)Subsection (1)(g), (j), (m), (q) and (r) above shall have effect as if—

(a)[F77statutory paternity pay, statutory adoption pay and statutory shared parental pay] were benefits to which this section applies; and

(b)for the words “Regulations may” at the beginning of subsection (1) there were substituted the words “ The Department for Employment and Learning may by regulations subject to negative resolution (within the meaning of section 166(12)) ”.]

[F78(5)As it has effect in relation to [F79universal credit or] housing benefit subsection (1)(q) above authorises provision requiring the making of payments of benefit to another person, on behalf of the beneficiary, in such circumstances as may be prescribed.]

Annotations:

Amendments (Textual)

F54S. 5(1)(e) substituted (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(1), Sch. 6 para. 60(1)(a); S.R. 1999/310, art. 2(1)(b), Sch. 1; S.R. 1999/371, art. 2(b), Sch. 1, S.R. 1999/407, art. 2(b), Sch., S.R. 1999/428, art. 2(b), Sch. 1 and S.R. 1999/472, art. 2(1), Sch. 1 (subject to art. 2(2) of the said S.R. 1999/472)

F59S. 5(1)(o) ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999, 29.11.1999 and 2.7.2001 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), art. 78(1), Sch. 6 para. 60(1)(b); S.R. 1999/310, art. 2(1)(b), Sch. 1; S.R. 1999/371, art. 2(b), Sch. 1, S.R. 1999/407, art. 2(b), Sch., S.R. 1999/428, art. 2(b), Sch. 1; S.R. 1999/472, art. 2(1), Sch. 1 (subject to art. 2(2) of the said S.R. 1999/472) and S.R 2001/260, art. 2(a)

S. 5(1)(o) repealed (2.7.2001 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 2001/260, art. 2

F60S. 5(1)(p) ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999, 29.11.1999 and 2.7.2001 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), art. 78(1), Sch. 6 para. 60(1)(b); S.R. 1999/310, art. 2(1)(b), Sch. 1; S.R. 1999/371, art. 2(b), Sch. 1, S.R. 1999/407, art. 2(b), Sch., S.R. 1999/428, art. 2(b), Sch. 1, S.R. 1999/472, art. 2(1), Sch. 1 (subject to art. 2(2) of the said S.R. 1999/472) and S.R. 2001/260, art. 2(a)

S. 5(1)(p) repealed (2.7.2001 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 2001/260, art. 2

F62S. 5(1)(t) added (retrospectively) by S.I. 1993/1579 (N.I. 8), art. 3(1)(4)

F65S. 5(2)(zb) inserted (6.4.2016 unless brought into operation earlier by an order under s. 53(1) of the amending Act) by Pensions Act (Northern Ireland) 2015 (c. 5), s. 53(3), Sch. 12 para. 10

F68S. 5(2)(ab) inserted (2.12.2002 for certain purposes, 7.4.2003 in so far as not already in force) by State Pension Credit Act (Northern Ireland) 2002 (c. 14), ss. 11, 21(2), Sch. 1 Pt. 1 para. 3(a); S.R. 2002/366, art. 2(1)(i); S.R. 2003/211, art. 2(a)

F69S. 5(2)(ac) inserted (1.7.2008 for specified purposes, 27.10.2008 in so far as not already in force) by Welfare Reform Act (Northern Ireland) 2007 (c. 2), s. 60(1), Sch. 3 para. 4(4); S.R. 2008/276, art. 2(2)(c), Sch. Pt. 1

F71S. 5(2)(c)(d) repealed (8.4.2003) by Tax Credits Act 2002 (c. 21), s. 61, Sch. 6; S.I. 2003/962, art. 2(4)(e), Sch. 2 (with art. 3)

F72S. 5(2)(fa) inserted (21.7.2008 for specified purposes, 1.1.2009 in so far as not already in force) by Health and Social Care Act 2008 (c. 14), ss. 135(1), 170; S.I. 2008/3137, art. 2

F75S. 5(3) repealed (2.7.2001 for certain purposes, otherwise

prosp.) by S.I. 1998/1506 (N.I. 10), art. 78(1), Sch. 6 para. 60(2), Sch. 7; S.R. 2001/260, art. 2

F77Words in s. 5(4A)(a) substituted (15.3.2015 for specified purposes, 5.4.2015 in so far as not already in force) by Work and Families Act (Northern Ireland) 2015 (c. 1), s. 23(1), Sch. 1 para. 3(2); S.R. 2015/86, arts. 3(2)(i), 4(2)(h), 5 (with art. 7(2))

F78S. 5(5) inserted (retrospectively) by S.I. 1995/2597 (N.I. 20), art. 3(1)(2)

Modifications etc. (not altering text)

C9S. 5 extended by S.I. 1991/2628 (N.I. 23), art. 40 (as substituted 22.11.2000 for specified purposes, otherwise prosp.) by Child Support, Pensions and Social Security Act (Northern Ireland) 2000 (c. 4), ss. 20, 68(1)(2) (with s. 66(6)); S.R. 2000/358, art. 2(b), Sch. Pt. II

C11S. 5(1) modified (1.7.1998) by S.I. 1998/1506 (N.I. 10), arts. 1(3)(c)(d), 77, Sch. 5 para. 5

C12S. 5(1) modified (1.7.2008 for specified purposes, 27.10.2008 in so far as not already in force) by Welfare Reform Act (Northern Ireland) 2007 (c. 2), ss. 5(2), 60(1); S.R. 2008/276, art. 2(2)(c), Sch. Pt. 1

F80[ Sharing of functions as regards certain claims and information]N.I.

Annotations:

Amendments (Textual)

F80S. 5A and preceding cross-heading inserted (1.12.1999) by S.I. 1999/3147 (N.I. 11), arts. 1(4), 68

[F815A Sharing of functions as regards certain claims and information.N.I.

(1)Regulations may, for the purpose of supplementing the persons or bodies to whom claims for relevant benefits may be made, make provision as regards any relevant benefit, for claims for that benefit to be made to any relevant authority (if such claims could not otherwise be made to that authority).

(2)Regulations may make provision for or in connection with—

(a)the forwarding by a relevant authority of—

(i)claims received by virtue of any provision authorised by subsection (1) above, and

(ii)information or evidence supplied in connection with making such claims (whether supplied by persons making the claims or by other persons);

(b)the receiving and forwarding by a relevant authority of information or evidence relating to social security [F82or work] matters supplied by, or the obtaining by a relevant authority of such information or evidence from—

(i)persons making, or who have made, claims for a relevant benefit, or

(ii)other persons in connection with such claims,

including information or evidence not relating to the claims or benefit in question;

(c)the recording by a relevant authority of information or evidence relating to social security [F82or work] matters supplied to, or obtained by, the authority and the holding by the authority of such information or evidence (whether as supplied or obtained or as recorded);

(d)the giving of information or advice with respect to social security [F82or work] matters by a relevant authority to persons making, or who have made, claims for a relevant benefit.

[F83(e)the verification by a relevant authority of information or evidence supplied to or obtained by the authority in connection with a claim for or an award of a relevant benefit.]

(3)In paragraphs (b) [F84, (d) and (e)] of subsection (2) above—

(a)references to claims for a relevant benefit are to such claims whether made as mentioned in subsection (1) above or not; and

(b)references to persons who have made such claims include persons to whom awards of benefit have been made on the claims.

(4)Regulations under this section may make different provision for different areas.

(5)Regulations under any other statutory provision may make such different provision for different areas as appears to the Department expedient in connection with any exercise by regulations under this section of the power conferred by subsection (4) above.

(6)In this section—

(a)“benefit” includes child support (any reference to a claim being read, in relation to child support, as a reference to an application [F85(or an application treated as having been made)] under the Child Support (Northern Ireland) Order 1991 for a [F86maintenance calculation]);

(b)“relevant authority” means—

(i)a Northern Ireland department,

(ii)a person providing services to a Northern Ireland department,

(iii)any other body established by or under a statutory provision, or

(iv)a person providing services to, or authorised to exercise any function of, such a body;

(c)“relevant benefit” means housing benefit or any other benefit prescribed for the purposes of this section;

(d)[F87 “social security or work matters” ] means matters relating to social security, child support or war pensions [F88, or employment or training] and in this paragraph “war pension ” means a war pension within the meaning of section 25 of the Social Security Act 1989 (establishment and functions of war pensions committees).]

Annotations:

Amendments (Textual)

F81S. 5A and preceding cross-heading inserted (1.12.1999) by S.I. 1999/3147 (N.I. 11), arts. 1(4), 68

F84Words in s. 5A(3) substituted (29.6.2007) by Welfare Reform Act (Northern Ireland) 2007 (c. 2), ss. 38(2)(b), 60(2)(a)

[F895BUse of social security informationN.I.

(1)A relevant authority may use for a relevant purpose any social security information which it holds.

(2)Regulations may make provision as to the procedure to be followed by a relevant authority for the purposes of any function it has relating to the administration of a specified benefit if the authority holds social security information which—

(a)is relevant for the purposes of anything which may or must be done by the authority in connection with a claim for or an award of the benefit, and

(b)was used by another relevant authority in connection with a claim for or an award of a different specified benefit or was verified by that other authority in accordance with regulations under section 5A(2)(e) above.

(3)A relevant purpose is anything which is done in relation to a claim which is made or which could be made for a specified benefit if it is done for the purpose of—

(a)identifying persons who may be entitled to such a benefit;

(b)encouraging or assisting a person to make such a claim;

(c)advising a person in relation to such a claim.

(4)Social security information means—

(a)information relating to social security, child support or war pensions;

(b)evidence obtained in connection with a claim for or an award of a specified benefit.

(5)A specified benefit is a benefit which is specified in regulations for the purposes of this section.

(6)Expressions used in this section and in section 5A have the same meaning in this section as in that section.

(7)This section does not affect any power which exists apart from this section to use for one purpose social security information obtained in connection with another purpose.]

Industrial injuries benefitN.I.

6 Notification of accidents, etc.N.I.

Regulations may provide—

(a)for requiring the prescribed notice of an accident in respect of which industrial injuries benefit may be payable to be given within the prescribed time by the employed earner to the earner’s employer or other prescribed person;

(b)for requiring employers—

(i)to make reports, to such person and in such form and within such time as may be prescribed, of accidents in respect of which industrial injuries benefit may be payable;

(ii)to furnish to the prescribed person any information required for the determination of claims, or of questions arising in connection with claims or awards;

(iii)to take such other steps as may be prescribed to facilitate the giving notice of accidents, the making of claims and the determination of claims and of questions so arising.

7 Medical examination and treatment of claimants.N.I.

(1)Regulations may provide for requiring claimants for disablement pension—

(a)to submit themselves from time to time to medical examination for the purpose of determining the effect of the relevant accident, or the treatment appropriate to the relevant injury or loss of faculty;

(b)to submit themselves from time to time to appropriate medical treatment for the injury or loss of faculty.

(2)Regulations under subsection (1) above requiring persons to submit themselves to medical examination or treatment may—

(a)require those persons to attend at such places and at such times as may be required; and

(b)with the consent of the Department of Finance and Personnel provide for the payment by the Department to those persons of travelling and other allowances (including compensation for loss of remunerative time).

8 Obligations of claimants.N.I.

(1)Subject to subsection (3) below, regulations may provide for disqualifying a claimant for the receipt of industrial injuries benefit—

(a)for failure without good cause to comply with any requirement of regulations to which this subsection applies (including in the case of a claim for industrial death benefit, a failure on the part of some other person to give the prescribed notice of the relevant accident);

(b)for wilful obstruction of, or other misconduct in connection with, any examination or treatment to which he is required under regulations to which this subsection applies to submit himself, or in proceedings under this Act for the determination of his right to benefit or to its receipt,

or for suspending proceedings on the claim or payment of benefit as the case may be, in the case of any such failure, obstruction or misconduct.

(2)The regulations to which subsection (1) above applies are—

(a)any regulations made by virtue of section 5(1)(h), (j) or (k) above, so far as relating to industrial injuries benefit; and

(b) regulations made by virtue of section 6 or 7 above.

(3)Regulations under subsection (1) above providing for disqualification for the receipt of benefit for any of the following matters, that is to say—

(a)for failure to comply with the requirements of regulations under section 7(1) or (2) above;

(b)for obstruction of, or misconduct in connection with, medical examination or treatment,

shall not be made so as to disentitle a claimant to benefit for a period exceeding 6 weeks on any disqualification.

Disability working allowanceN.I.

F909 Initial claims and repeat claims.N.I.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Annotations:

Amendments (Textual)

The social fundN.I.

10 Necessity of application for certain payments.N.I.

[F91(1)A social fund payment such as is mentioned in section 134(1)(b) of the Contributions and Benefits Act may be awarded to a person only if an application for such a payment has been made by him or on his behalf in such form and manner as may be prescribed.

(2)The Department may by regulations—

(a)make provision with respect to the time at which an application for such a social fund payment is to be treated as made;

(b)prescribe conditions that must be satisfied before any determination in connection with such an application may be made or any award of such a payment may be paid;

(c)prescribe circumstances in which such an award becomes extinguished.]

[F92Health in pregnancy grantN.I.

Annotations:

Amendments (Textual)

F92S. 10A and crossheading inserted (21.7.2008 for specified purposes, 1.1.2009 in so far as not already in force) by Health and Social Care Act 2008 (c. 14), ss. 135(3), 170; S.I. 2008/3137, art. 2

10ANecessity of application for health in pregnancy grantN.I.

(1)No person is entitled to health in pregnancy grant unless she claims it in the manner, and within the time, prescribed in relation to health in pregnancy grant by regulations under section 5.

(2)No person is entitled to health in pregnancy grant unless subsection (3) or (4) is satisfied in relation to her.

(3)This subsection is satisfied in relation to a person if her claim for health in pregnancy grant is accompanied by—

(a)a statement of her national insurance number and information or evidence establishing that that number has been allocated to her; or

(b)information or evidence enabling the national insurance number that has been allocated to her to be ascertained.

(4)This subsection is satisfied in relation to a person if she makes an application for a national insurance number to be allocated to her which is accompanied by information or evidence enabling a national insurance number to be allocated to her.

(5)The Commissioners for Her Majesty's Revenue and Customs may by regulations make provision disapplying subsection (2) in the case of prescribed descriptions of persons making a claim.]

Child benefitN.I.

11 Necessity of application for child benefit.N.I.

(1)Subject to the provisions of this Act, no person shall be entitled to child benefit unless he claims it in the manner, and within the time, prescribed in relation to child benefit by regulations under section 5 above.

[F93(1A)No person shall be entitled to child benefit unless subsection (1B) below is satisfied in relation to him.

(1B)This subsection is satisfied in relation to a person if—

(a)his claim for child benefit is accompanied by—

(i)a statement of his national insurance number and information or evidence establishing that that number has been allocated to him; or

(ii)information or evidence enabling the national insurance number that has been allocated to him to be ascertained; or

(b)he makes an application for a national insurance number to be allocated to him which is accompanied by information or evidence enabling such a number to be so allocated.

(1C)Regulations may make provision disapplying subsection (1A) above in the case of—

(a)prescribed descriptions of persons making claims, or

(b)prescribed descriptions of children [F94or qualifying young persons] in respect of whom child benefit is claimed,

or in other prescribed circumstances.]

(2)Except where regulations otherwise provide, no person shall be entitled to child benefit for any week on a claim made by him after that week if child benefit in respect of the same child [F95or qualifying young person] has already been paid for that week to another person, whether or not that other person was entitled to it.

Annotations:

Amendments (Textual)

F93S. 11(1A)-(1C) inserted (18.4.2000 for certain purposes, otherwise 15.5.2000) by S.I. 1999/3147 (N.I. 11), art. 66 (with art. 75); S.R. 2000/133, art. 2(2)

F94Words in s. 11(1C) inserted (10.4.2006) by Child Benefit Act 2005 (c. 6), s. 6(2), Sch. 1 para. 46(2)

F95Words in s. 11(2) inserted (10.4.2006) by Child Benefit Act 2005 (c. 6), s. 6(2), Sch. 1 para. 46(3)

Modifications etc. (not altering text)

[F9611AElection not to receive child benefitN.I.

(1)A person (“P”) who is entitled to child benefit in respect of one or more children may elect for all payments of the benefit to which P is entitled not to be made.

(2)An election may be made only if P reasonably expects that, in the absence of the election, P or another person would be liable to a high income child benefit charge in respect of the payments to which the election relates made for weeks in the first tax year.

(3)An election has effect in relation to payments made for weeks beginning after the election is made.

(4)But where entitlement to child benefit is backdated, an election may have effect in relation to payments for weeks beginning in the period of three months ending immediately before the claim for the benefit was made.

(5)An election may be revoked.

(6)A revocation has effect in relation to payments made for weeks beginning after the revocation is made.

(7)But if—

(a)P makes an election which results in all payments, in respect of child benefit, to which P is entitled for one or more weeks in a tax year not being paid, and

(b)had no election been made, neither P nor any other person would have been liable to a high income child benefit charge in relation to the payments,

P may, no later than two years after the end of the tax year, revoke the election so far as it relates to the payments.

(8)Subsections (2) to (7) are subject to directions under subsection (9).

(9)The Commissioners for Her Majesty's Revenue and Customs may give directions as to—

(a)the form of elections and revocations under this section, the manner in which they are to be made and the time at which they are to be treated as made, and

(b)the circumstances in which, if child benefit is not being paid to a person at the full rate or the Commissioners are satisfied that there are doubts as to a person's entitlement to child benefit for a child, an election or revocation is not to have effect or its effect is to be postponed.

(10)For the purposes of this section—

  • child” includes a qualifying young person;

  • first tax year”, in relation to an election, means the tax year in which the first week beginning after the election is made falls;

  • week” means a period of 7 days beginning with a Monday; and a week is in a tax year if (and only if) the Monday with which it begins is in the tax year.]

Annotations:

Amendments (Textual)

F96S. 11A inserted (with effect in accordance with Sch. 1 para. 7 of the amending Act) by Finance Act 2012 (c. 14), Sch. 1 para. 4

Statutory sick payN.I.

12 Duties of employees etc. in relation to statutory sick pay.N.I.

(1)Any employee who claims to be entitled to statutory sick pay from his employer shall, if so required by his employer, provide such information as may reasonably be required for the purpose of determining the duration of the period of entitlement in question or whether a period of entitlement exists as between them.

(2)The Department may by regulations [F97made with the concurrence of the Inland Revenue] direct—

(a)that medical information required under subsection (1) above shall, in such cases as may be prescribed, be provided in a prescribed form;

(b)that an employee shall not be required under subsection (1) above to provide medical information in respect of such days as may be prescribed in a period of incapacity for work.

(3)Where an employee asks an employer of his to provide him with a written statement, in respect of a period before the request is made, of one or more of the following—

(a)the days within that period which the employer regards as days in respect of which he is liable to pay statutory sick pay to that employee;

(b)the reasons why the employer does not so regard the other days in that period;

(c)the employer’s opinion as to the amount of statutory sick pay to which the employee is entitled in respect of each of those days,

the employer shall, to the extent to which the request was reasonable, comply with it within a reasonable time.

Annotations:

Amendments (Textual)

F97Words in s. 12(2) inserted (1.4.1999) by S.I. 1999/671, art. 4, Sch. 3 para. 41; S.R. 1999/149, art. 2(c), Sch. 2 (subject to arts. 3-6 of that S.R.)

Statutory maternity payN.I.

13 Duties of women etc. in relation to statutory maternity pay.N.I.

(1)A woman shall provide the person who is liable to pay her statutory maternity pay—

(a)with evidence as to her pregnancy and the expected date of confinement in such form and at such time as may be prescribed; and

(b)where she commences work after her confinement but within the maternity pay period, with such additional information as may be prescribed.

F98[(1A)Any regulations for the purposes of subsection (1) above must be made with the concurrence of the Inland Revenue.]

(2)Where a woman asks an employer or former employer of hers to provide her with a written statement, in respect of a period before the request is made, of one or more of the following—

(a)the weeks within that period which he regards as weeks in respect of which he is liable to pay statutory maternity pay to the woman;

(b)the reasons why he does not so regard the other weeks in that period; and

(c)his opinion as to the amount of statutory maternity pay to which the woman is entitled in respect of each of the weeks in respect of which he regards himself as liable to make a payment,

the employer or former employer shall, to the extent to which the request was reasonable, comply with it within a reasonable time.

Annotations:

Amendments (Textual)

F98S. 13(1A) inserted (1.4.1999) by S.I. 1999/671, art. 4, Sch. 3 para. 42; S.R. 1999/149, art. 2(c), Sch. 2 (subject to arts. 3-6 of that S.R.)

[F99 Payments in respect of mortgage interest, etc.N.I.

Annotations:

Amendments (Textual)

F99S. 13A and cross-heading inserted (retrospective to 1.7.1992) by S.I. 1992/1309 (N.I. 9), art. 3(2), Sch. para. 1

F10013A Payment out of benefit of sums in respect of mortgage interest, etc.]N.I.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F10113BExpenses in respect of vehicle hire, etc.N.I.

(1)This section applies where—

(a)a relevant benefit component is payable in respect of a person (“the beneficiary”),

(b)an agreement has been entered into by or on behalf of the beneficiary with a relevant provider for the lease or hire purchase of a motor vehicle, and

(c)by virtue of regulations under section 5(1), the Department pays all or part of the relevant benefit component to the relevant provider for the purpose of discharging, in whole or in part, an obligation of the beneficiary under the agreement.

(2)Regulations may make provision—

(a)for the expenses of the Department in administering the making of payments to relevant providers to be defrayed, in whole or in part, at the expense of relevant providers, whether by requiring them to pay prescribed fees or by deducting and retaining a prescribed part of the payments that would otherwise be made to them or by such other method as may be prescribed;

(b)for the recovery from a relevant provider of any fees or other sums due from that provider under paragraph (a).

(3)In this section—

  • relevant benefit component” means—

    (a)

    the mobility component of disability living allowance, if it is payable at the higher rate (see section 73(11)(a) of the Contributions and Benefits Act), or

    (b)

    the mobility component of personal independence payment, if it is payable at the enhanced rate (see Article 84(2) of the Welfare Reform (Northern Ireland) Order 2015);

  • relevant provider” means a person whose business consists of or includes the supply by way of lease or hire purchase of motor vehicles to persons in respect of whom a relevant benefit component is payable.]

Emergency paymentsN.I.

14 Emergency payments by Health and Social Services Boards and other bodies.N.I.

(1)The Department may make arrangements—

(a)with a Board; or

(b)with any other body,

for the making on behalf of the Department by members of the staff of any Board or body of payments on account of benefits to which section 5 above applies in circumstances corresponding to those in which the Department itself has the power to make such payments under subsection (1)(s) of that section; and a Board shall have power to enter into any such arrangements.

(2)A payment under any such arrangements shall be treated for the purposes of any statutory provision as if it had been made by the Department.

(3)The Department shall repay a Board or other body such amount as the Department determines to be the reasonable administrative expenses incurred by the Board or body in making payments in accordance with arrangements under this section.

(4)In this section “Board” means a Health and Social Services Board.

Part II E+W+S+N.I. Adjudication

Annotations:

Modifications etc. (not altering text)

C15Part II (ss. 15-68): Power to modify conferred (1.7.1992) by Social Security Contributions and Benefits (Northern Ireland) Act 1992 (c. 7), ss. 116(2), 171(8), 173(4) (with s. 108(5))

Part II (ss. 15-68): Power to modify conferred (1.7.1992) by Social Security Contributions and Benefits (Northern Ireland) Act 1992 (c. 7), ss. 117(1), 171(8), 173(4) (with s. 108(5))

Part II (ss. 15-68): Power to modify conferred (1.7.1992) by Social Security Contributions and Benefits (Northern Ireland) Act 1992 (c. 7), ss. 119, 171(8), 173(4) (with s. 108(5))

Part II (ss. 15-68) amended (25.8.1995) by S.R. 1995/293, reg. 43(2)

Part II (ss. 15-68) applied (with modifications) (25.8.1995) by S.R. 1995/293, reg. 44(2)(a)

Part II (ss. 15-68): power to modify (temp.) conferred (24.3.1999) by S.I. 1999/671, arts. 1(2)(c), 14(2)(a)

Part. II (ss. 15-68) (except ss. 22 and 50) ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3) (with transitory provisions in Sch. 5); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

Adjudication by the DepartmentN.I.

[F10215 Questions for the Department.N.I.

(1)Subject to this Part of this Act, any of the following questions shall be determined by the Department—

(a)a question whether a person is an earner and, if he is, as to the category of earners in which he is to be included;

(b)subject to subsection (2) below, a question whether the contribution conditions for any benefit are satisfied, or otherwise relating to a person’s contributions or his earnings factor;

(c)a question whether a Class 1A contribution is payable or otherwise relating to a Class 1A contribution;

(d)a question whether a person is or was employed in employed earner’s employment for the purposes of Part V of the Contributions and Benefits Act;

(e)a question as to whether a person was, within the meaning of regulations, precluded from regular employment by responsibilities at home;

(f)any question as to which surpluses are to be taken into account under section 45(1) of the Contributions and Benefits Act;

(g)any question arising under any provision of Part XI of the Contributions and Benefits Act or this Act, or under any provision of regulations [F103or an order]] under that Part, as to—

(i)whether a person is, or was, an employee or employer of another;

(ii)whether an employer is entitled to make any deduction from his contributions payments in accordance with [F104an order under section 155A] of the Contributions and Benefits Act;

(iii)whether a payment falls to be made to an employer in accordance with the regulations [F105or order];

(iv)the amount that falls to be so deducted or paid;

(v)the amount of an employer’s contributions payments for any period for the purposes of [F106an order under section 155A] of the Contributions and Benefits Act; or

(vi)whether two or more employers or two or more contracts of service are, by virtue of regulations made under section 159(5) of that Act, to be treated as one; F107. . .

(h)any question arising under any provision of Part XII of that Act or this Act, or under any provision of regulations under that Part, as to—

(i)whether a person is, or was, an employee or employer of another;

(ii)whether an employer is entitled to make any deduction from his contributions payments in accordance with regulations under section 163 of the Contributions and Benefits Act;

(iii)whether a payment falls to be made to an employer in accordance with the regulations;

(iv)the amount that falls to be so deducted or paid; or

(v)whether two or more employers or two or more contracts of service are, by virtue of regulations made under section 167(2) of that Act, to be treated as one [F108; and

(i)any question arising under Article 29 of the Jobseekers (Northern Ireland) Order 1995, or under any provision of regulations under that Article, as to—

(i)whether a person is, or was, an employee or employer of another;

(ii)whether an employer is entitled to make any deduction from his contributions payments in accordance with regulations under Article 29 of that Order;

(iii)whether a payment falls to be made to an employer in accordance with those regulations;

(iv)the amount that falls to be so deducted or paid; or

(v)whether two or more employers are, by virtue of regulations under Article 29 of that Order, to be treated as one.]

and any question arising under regulations made by virtue of paragraph (c), (d) or (f) of section 160(9) of that Act.

(2)Subsection (1)(b) above includes any question arising—

(a)under section 17(1) of the Contributions and Benefits Act as to whether by regulations under that subsection a person is excepted from liability for Class 4 contributions, or his liability is deferred; or

(b)under regulations made by virtue of section 17(3) or (4) or 18 of that Act;

but not any other question relating to Class 4 contributions, nor any question within section 18(1)(c) below.

(3)Regulations may make provision restricting the persons who may apply to the Department for the determination of any such question as is mentioned in subsection (1) above.

(4)The Department may, if it thinks fit, before determining any such question as is mentioned in subsection (1) above, appoint a person to hold an inquiry into the question, or any matters arising in connection with it, and to report on the question, or on those matters, to the Department.

Annotations:

Amendments (Textual)

F102S. 15 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16); and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

S. 15 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

F103Words in s. 15(1)(g) inserted (6.4.1995) by S.R. 1995/69, art. 6(2)(a)(i)

F104Words in s. 15(1)(g)(ii) substituted (6.4.1995) by S.R. 1995/69, art. 6(2)(a)(ii)

F105Words in s. 15(1)(g)(iii) inserted (6.4.1995) by S.R. 1995/69, art. 6(2)(a)(iii)

F106Words in s. 15(1)(g)(v) substituted (6.4.1995) by S.R. 1995/69, art. 6(2)(a)(iv)

F107Word in s. 15(1) omitted (6.4.1996) and repealed (7.10.1996) by S.I. 1996/2705 (N.I. 15), arts. 2, 40(3), Sch. 2, para. 24, Sch. 3; S.R. 1996/26, art. 2; S.R. 1996/401, art. 2

F108S. 15(1)(i) and the preceding word inserted (6.4.1996) by S.I. 1995/2705 (N.I. 15), art. 2, Sch. 2 para. 24; S.I. 1996/26, art. 2(e)

Modifications etc. (not altering text)

C16S. 15 applied (7.2.1994) by 1993 c. 49, s. 166(2); S.R. 1994/17, art. 2

C17S. 15(1) extended (7.2.1994) by 1993 c. 49, s. 165(1); S.R. 1994/17, art. 2

S. 15(1) excluded (7.2.1994) by 1993 c. 49, s. 165(4); S.R. 1994/17, art. 2

[F10916 Appeal on question of law.N.I.

(1)A question of law arising in connection with the determination by the Department of any such question as is mentioned in section 15(1) above may, if the Department thinks fit, be referred for decision to the Court of Appeal.

(2)If the Department determines in accordance with subsection (1) above to refer any question of law to the court, it shall give notice in writing of its intention to do so—

(a)in a case where the question arises on an application made to the Department, to the applicant; and

(b)in any case to such persons as appear to it to be concerned with the question.

(3)Any person aggrieved by the decision of the Department on any question of law within subsection (1) above which is not referred in accordance with that subsection may appeal from that decision to the court.

(4)The Department shall be entitled to appear and be heard on any such reference or appeal.

(5)Rules of court may include provision for regulating references and appeals to the court under this section.

(6)Notwithstanding anything in any Act, the decision of the court on a reference or appeal under this section shall be final.]

Annotations:

Amendments (Textual)

F109S. 16 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

S. 16 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

Modifications etc. (not altering text)

C18S. 16 applied (7.2.1994) by 1993 c. 49, s. 166(2); S.R. 1994/17, art. 2

s. 16 modified (6.4.1996 for certain purposes otherwise 6.4.1997) by 1993 c. 49, s. 165(7)(8) as added by S.I. 1995/3213 (N.I. 22), art. 147, Sch. 3 para. 60; S.R. 1996/91, art. 2, Sch. Pt. IV; S.R. 1997/192, art. 2

[F11017 Review of decisions.N.I.

(1)Subject to subsection (2) below, the Department may review any decision given by it on any such question as is mentioned in section 15(1) above, if—

(a)new facts have been brought to its notice; or

(b)it is satisfied that the decision—

(i)was given in ignorance of some material fact;

(ii)was based on a mistake as to some material fact; or

(iii)was erroneous in point of law.

(2)A decision shall not be reviewed while an appeal under section 16 above is pending against the decision of the Department on a question of law arising in connection with it, or before the time for so appealing has expired.

(3)On a review any question of law may be referred under subsection (1) of section 16 above or, where it is not so referred, may be the subject of an appeal under subsection (3) of that section, and the other provisions of that section shall apply accordingly.]

Annotations:

Amendments (Textual)

F110S. 17 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

S. 17 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22 and subject to art. 2(2) of that S.R.)

Modifications etc. (not altering text)

C19S. 17 applied (7.2.1994) by 1993 c. 49, s. 166(2); S.R. 1994/17, art. 2

s. 17 modified (6.4.1996 for certain purposes, otherwise 6.4.1997) by 1993 c. c. 49, s. 165(7)(8) as added by S.I. 1995/3213 (N.I. 22), art. 147, Sch. 3 para. 60(c); S.R. 1996/91, art. 2, Sch. Pt. IV; S.R. 1997/192, art. 2

Adjudication by adjudication officersN.I.

[F11118 Claims and questions to be submitted to adjudication officer.N.I.

(1)Subject to section 52 below, there shall be submitted forthwith to an adjudication officer for determination in accordance with this Part of this Act—

(a)any claim for a benefit to which this section applies;

(b)subject to subsection (2) below, any question arising in connection with a claim for, or award of, such a benefit; F112. . .

[F113(c)any question whether, if he otherwise had a right to it, a person would be disqualified under or by virtue of any provision of the Contributions and Benefits Act for receiving a benefit to which this section applies][F114; and

(d) any question whether a jobseeker’s allowance is not payable to a person by virtue of Article 21 of the Jobseekers (Northern Ireland) Order 1995.]

(2)Subsection (1) above does not apply to any question which

[F115(a)may be determined by an adjudication officer under Article 11(6) or 12(5) of the Jobseekers (Northern Ireland) Order 1995; or

(b) falls to be determined otherwise than by an adjudication officer.]

(3)Any question as to, or in connection with, entitlement to statutory sick pay or statutory maternity pay may be submitted to an adjudication officer—

(a)by the Department; or

(b)subject to and in accordance with regulations, by the employee concerned,

for determination in accordance with this Part of this Act.

(4)If—

(a)a person submits a question relating to the age, marriage or death of any person; and

(b)it appears to the adjudication officer that the question may arise if the person who has submitted it to him submits a claim to a benefit to which this section applies,

the adjudication officer may determine the question.

(5)Different aspects of the same claim or question may be submitted to different adjudication officers; and for that purpose this section and the other provisions of this Part of this Act with respect to the determination of claims and questions shall apply with any necessary modifications.

(6)This section applies to the following benefits—

(a)benefit as defined in section 121 of the Contributions and Benefits Act;

[F116(aa)a jobseeker’s allowance;]

(b)income support;

(c)family credit;

(d)disability working allowance;

(e)any social fund payment such as is mentioned in section 134(1)(a) or (2) of the Contributions and Benefits Act;

(f)child benefit;

(g)statutory sick pay; and

(h)statutory maternity pay.]

Annotations:

Amendments (Textual)

F111S. 18 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 18 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art., 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F112Word in s. 18(1)(b) omitted (17.7.1996) and repealed (7.10.1996) by S.I. 1995/2705 (N.I. 15), art. 40(1)(2), Sch. 2, para. 25(2), SCh. 3; S.R. 1996/285, art. 2, Sch; S.R. 1996/401, art. 2

F114S. 18(1)(d) and the word immediately preceding it inserted (17.7.1996) by S.I. 1995/2705 (N.I. 15), art. 40(1), Sch. 2, para. 25(2); S.R. 1996/285, art. 2, Sch.

Modifications etc. (not altering text)

C20S. 18(1) excluded (7.2.1994) by 1993 c. 49, s. 165(4); S.R. 1994/17, art. 2

[F11719 Decision of adjudication officer.N.I.

(1)An adjudication officer to whom a claim or question is submitted under section 18 above (other than a claim which under section 28(12) or (13) or 33(7) below falls to be treated as an application for a review) shall take it into consideration and, so far as practicable, dispose of it, in accordance with this section, and with procedure regulations under section 57 below, within 14 days of its submission to him.

(2)Subject to subsection (3) and section 35 below, the adjudication officer may decide a claim or question himself or refer it to a social security appeal tribunal.

(3)The adjudication officer must decide a claim for or question relating to an attendance allowance, a disability living allowance or a disability working allowance himself.

(4)Where an adjudication officer refers a question as to, or in connection with, entitlement to statutory sick pay or statutory maternity pay to a social security appeal tribunal, the employee and employer concerned shall each be given notice in writing of the reference.

(5)In any other case notice in writing of the reference shall be given to the claimant.

(6)Where—

(a)a case has been referred to a social security appeal tribunal (“the tribunal”); and

(b)the claimant makes a further claim which raises the same or similar questions; and

(c)that further claim is referred to the tribunal by the adjudication officer,

then the tribunal may proceed to determine the further claim whether or not notice has been given under subsection (4) or (5) above.]

Annotations:

Amendments (Textual)

F117S. 19 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 19 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

Appeals from adjudication officers - generalE+W+S+N.I.

[F11820 Appeal to social security appeal tribunal.N.I.

(1)Subject to subsection (3) below, where the adjudication officer has decided a claim or question other than a claim or question relating to an attendance allowance, a disability living allowance or a disability working allowance—

(a)if it relates to statutory sick pay or statutory maternity pay, the employee and employer concerned shall each have a right to appeal to a social security appeal tribunal; and

(b)in any other case the claimant shall have a right to do so.

(2)A person with a right of appeal under this section shall be given such notice of a decision falling within subsection (1) above and of that right as may be prescribed.

(3)No appeal lies under this section where—

(a)in connection with the decision of the adjudication officer there has arisen any question which under or by virtue of this Act falls to be determined otherwise than by an adjudication officer; and

(b)the question has been determined; and

(c)the adjudication officer certifies that the decision on that question is the sole ground of his decision.

(4)Regulations may make provision as to the manner in which, and the time within which, appeals are to be brought.

(5)Where an adjudication officer has determined that any amount, other than an amount—

(a)of an attendance allowance;

(b)of a disability living allowance;

(c)of a disability working allowance;

(d)of statutory sick pay; or

(e)of statutory maternity pay,

is recoverable under or by virtue of section 69 or 72 below, any person from whom he has determined that it is recoverable shall have the same right of appeal to a social security appeal tribunal as a claimant.

(6)In any case where—

(a)an adjudication officer has decided any claim or question under Part V of the Contributions and Benefits Act; and

(b)the right to benefit under that Part of that Act of any person other than the claimant is or may be, under Part VI of Schedule 7 to that Act, affected by that decision,

that other person shall have the like right of appeal to a social security appeal tribunal as the claimant.

(7)Subsection (2) above shall apply to a person with a right of appeal under subsection (5) or (6) above as it applies to a claimant.]

Annotations:

Amendments (Textual)

F118S. 20 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 20 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C22S. 20 excluded (14.11.1994) by S.R. 1987/82, reg. 64(2) (as substituted by S.R. 1994/396, reg. 2(2))

S. 20 modified (25.8.1995) by S.R. 1995/293, reg. 46

S. 20 excluded (25.8.1995) by S.R. 1995/293, reg. 54

S. 20 excluded (1.7.1998) by S.R. 1998/1506 (N.I. 10), arts. 1(3)(c)(d), 77, Sch. 5 para. 3

[F11921 Appeal from social security appeal tribunal to Commissioner.N.I.

(1)Subject to the provisions of this section, an appeal lies to a Commissioner from any decision of a social security appeal tribunal under section 20 above on the ground that the decision of the tribunal was erroneous in point of law.

(2)In the case of statutory sick pay or statutory maternity pay an appeal lies under this section at the instance of any of the following—

(a)an adjudication officer;

(b)the employee concerned;

(c)the employer concerned;

(d)a trade union, where—

(i)the employee is a member of the union at the time of the appeal and was so immediately before the question at issue arose; or

(ii)the question at issue is a question as to or in connection with entitlement of a deceased person who was at the time of his death a member of the union;

(e)an association of employers of which the employer is a member at the time of the appeal and was so immediately before the question at issue arose.

(3)In any other case an appeal lies under this section at the instance of any of the following—

(a)an adjudication officer;

(b)the claimant;

(c)in any of the cases mentioned in subsection (5) below, a trade union; and

(d)a person from whom it is determined that any amount is recoverable under section 69 or 72 below.

(4)In a case relating to industrial injuries benefit an appeal lies under this section at the instance of a person whose right to benefit is, or may be, under Part VI of Schedule 7 to the Contributions and Benefits Act, affected by the decision appealed against, as well as at the instance of any person or body such as is mentioned in subsection (3) above.

(5)The following are the cases in which an appeal lies at the instance of a trade union—

(a)where the claimant is a member of the union at the time of the appeal and was so immediately before the question at issue arose;

(b)where that question in any way relates to a deceased person who was a member of the union at the time of his death;

(c)where the case relates to industrial injuries benefit and the claimant or, in relation to industrial death benefit, the deceased, was a member of the union at the time of the relevant accident.

(6)Subsections (2), (3) and (5) above, as they apply to a trade union, apply also to any other association which exists to promote the interests and welfare of its members.

(7)Where the Commissioner holds that the decision was erroneous in point of law, he shall set it aside and—

(a)he shall have power—

(i)to give the decision which he considers the tribunal should have given, if he can do so without making fresh or further findings of fact; or

(ii)if he considers it expedient, to make such findings and to give such decision as he considers appropriate in the light of them; and

(b)in any other case he shall refer the case to a tribunal with directions for its determination.

(8)Subject to any direction of the Commissioner, the tribunal on a reference under subsection (7)(b) above shall consist of persons who were not members of the tribunal which gave the erroneous decision.

(9)No appeal lies under this section without the leave—

(a)of the person who was the chairman of the tribunal when the decision was given or, in a prescribed case, the leave of some other chairman; or

(b)subject to and in accordance with regulations, of a Commissioner.

(10)Regulations may make provision as to the manner in which, and the time within which, appeals are to be brought and applications made for leave to appeal.]

Annotations:

Amendments (Textual)

F119S. 21 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 21 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C24S. 21(7)-(10) applied (5.2.1996 for certain purposes and otherwise 7.10.1996) by S.I. 1995/2705, art. 13(8); S.R. 1996/26, art. 2(b), Sch.; S.R. 1996/401, art. 2(b)

S. 21(7)-(10) applied (5.9.1997 for certain purposes and otherwise 6.10.1997) by S.I. 1997/1183 (N.I. 12), art. 15(3); S.R. 1997/400, art. 2(1), Sch. Pt. II

22 Appeal from Commissioners on point of law.E+W+S+N.I.

(1)Subject to subsections (2) and (3) below, an appeal on a question of law shall lie to the appropriate court from any decision of a Commissioner.

(2)No appeal under this section shall lie from a decision except—

(a)with the leave of the Commissioner who gave the decision or, in a prescribed case, with the leave of a Commissioner selected in accordance with regulations; or

(b)if he refuses leave, with the leave of the appropriate court.

(3)An application for leave under this section in respect of a Commissioner’s decision may only be made by—

(a)a person who, before the proceedings before the Commissioner were begun, was entitled to appeal to the Commissioner from the decision to which the Commissioner’s decision relates;

(b)any other person who was a party to the proceedings in which the first decision mentioned in paragraph (a) above was given;

[F120(c)the Department, in a case where it is not entitled to apply for leave by virtue of paragraph (a) or (b) above;]

(d)any other person who is authorised by regulations to apply for leave;

and regulations may make provision with respect to the manner in which and the time within which applications must be made to a Commissioner for leave under this section and with respect to the procedure for dealing with such applications.

(4)On an application to a Commissioner for leave under this section it shall be the duty of the Commissioner to specify as the appropriate court—

(a)the Court of Appeal in Northern Ireland if it appears to him that the relevant place is in Northern Ireland;

(b)the Court of Appeal if it appears to him that the relevant place is in England or Wales; and

(c)the Court of Session if it appears to him that the relevant place is in Scotland,

except that if it appears to him, having regard to the circumstances of the case and in particular to the convenience of the persons who may be parties to the proposed appeal, that he should specify a different court mentioned in paragraphs (a) to (c) above as the appropriate court, it shall be his duty to specify that court as the appropriate court.

(5)In this section—

(6)The powers to make regulations conferred by this section shall be exercisable by the Lord Chancellor.

Annotations:

Amendments (Textual)

F120S. 22(3)(c) ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 6 para. 61(1); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 22(3)(c) repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F121Definition in s. 22(5) substituted (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(1), Sch. 6 para. 61(b); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C25S. 22 modified (10.3.1999 for certain purposes, otherwise 1.6.1999) by S.I. 1991/2628 (N.I. 23), art. 43A as inserted by S.I. 1998/1506 (N.I. 10), art. 78(1), Sch. 6 para. 29; S.R. 1999/102, art. 2(a), Sch. Pt. I; S.R. 1999/246, art. 2, Sch. 1

Reviews - generalN.I.

[F12223 Review of decisions.N.I.

(1)Subject to the following provisions of this section, any decision under this Act of an adjudication officer, a social security appeal tribunal or a Commissioner (other than a decision relating to an attendance allowance, a disability living allowance or a disability working allowance) may be reviewed at any time by an adjudication officer or, on a reference by an adjudication officer, by a social security appeal tribunal, if—

(a)the officer or tribunal is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b)there has been any relevant change of circumstances since the decision was given;

(c)it is anticipated that a relevant change of circumstances will so occur;

(d)the decision was based on a decision of a question which under or by virtue of this Act falls to be determined otherwise than by an adjudication officer, and the decision of that question is revised; or

(e)the decision falls to be reviewed under [F123Article 8(6) or 9(7) of the Jobseekers (Northern Ireland) Order 1995].

(2)Any decision of an adjudication officer (other than a decision relating to an attendance allowance, a disability living allowance or a disability working allowance) may be reviewed, upon the ground that it was erroneous in point of law, by an adjudication officer or, on a reference from an adjudication officer, by a social security appeal tribunal.

(3)Regulations may provide that a decision may not be reviewed on the ground mentioned in subsection (1)(a) above unless the officer or tribunal is satisfied as mentioned in that paragraph by fresh evidence.

(4)In its application to family credit, subsection (1)(b) and (c) above shall have effect subject to section 127(3) of the Contributions and Benefits Act (change of circumstances not to affect award or rate during specified period).

(5)Where a decision is reviewed on the ground mentioned in subsection (1)(c) above, the decision given on the review—

(a)shall take effect on the day prescribed for that purpose by reference to the date on which the relevant change of circumstances is expected to occur; and

(b)shall be reviewed again if the relevant change of circumstances either does not occur or occurs otherwise than on that date.]

Annotations:

Amendments (Textual)

F122S. 23 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 23 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C26Ss. 23-27 modified (25.8.1995) by S.R. 1995/293, reg. 46

S. 23 restricted (25.8.1995) by S.R. 1995/293, regs. 63(1), 67

C27S. 23(1)(b)(c) modified (12.12.1995) by S.R. 1995/293, reg. 63(7)-(11) (as amended by S.R. 1995/434, reg. 3)

C28S. 23(2) restricted (28.2.1994) by S.R. 1987/82, reg. 64A(3A) (as inserted by S.R. 1994/21, reg. 2(2))

[F12424 Procedure for reviews.N.I.

(1)A question may be raised with a view to a review under section 23 above by means of an application in writing to an adjudication officer, stating the grounds of the application.

(2)On receipt of any such application, the adjudication officer shall proceed to deal with or refer any question arising on it in accordance with sections 19 to 21 above.

(3)Regulations may provide for enabling, or requiring, in prescribed circumstances, a review under section 23 above notwithstanding that no application for a review has been made under subsection (1) above.]

Annotations:

Amendments (Textual)

F124S. 24 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S.24 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C29Ss. 23-27 modified (25.8.1995) by S.R. 1995/293, regs. 46, 67

[F12525 Reviews under s. 23 - supplementary.N.I.

(1)Regulations—

(a)may prescribe what are, or are not, relevant changes of circumstances for the purposes of section 23 above; and

(b)may make provision restricting the payment of any benefit, or any increase of benefit, to which a person would, but for this subsection, be entitled by reason of a review in respect of any period before or after the review (whether that period falls wholly or partly before or after the making of the regulations).

(2)Regulations under subsection (1)(b) above shall not restrict the payment to or for a woman of so much of—

(a)any widow’s benefit, any [F126incapacity benefit] under section 40 of the Contributions and Benefits Act or any Category A or Category B retirement pension; or

(b)any increase of such a benefit or pension,

as falls to be paid by reason of a review which takes place by virtue of section 23(1)(a) or (b) above in consequence of a claim for a widowhood benefit, within the meaning of section 3 above, which is made or treated as made by virtue of that section.]

Annotations:

Amendments (Textual)

F125S. 25 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 25 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C30Ss. 23-27 modified (25.8.1995) by S.R. 1995/293, regs. 46, 67

[F12726 Appeals following reviews or refusals to review.N.I.

A decision given on a review under section 23 above, and a refusal to review a decision under that section, shall be subject to appeal in like manner as an original decision, and sections 19 to 21 above shall, with the necessary modifications, apply in relation to a decision given on such a review as they apply to the original decision of a question.]

Annotations:

Amendments (Textual)

F127S. 26 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 26 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C31Ss. 23-27 modified (25.8.1995) by S.R. 1995/293, regs. 46, 67

[F12827 Review after claimant appeals.N.I.

Where a claimant has appealed against a decision of an adjudication officer and the decision is reviewed by an adjudication officer under section 23 above—

(a)if the adjudication officer considers that the decision which he has made on the review is the same as the decision that would have been made on the appeal had every ground of the claimant’s appeal succeeded, the appeal shall lapse; but

(b)in any other case, the review shall be of no effect and the appeal shall proceed accordingly.]

Annotations:

Amendments (Textual)

F128S. 27 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 27 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C32Ss. 23-27 modified (25.8.1995) by S.R. 1995/293, regs. 46, 67

Attendance allowance, disability living allowance and disability working allowanceN.I.

[F12928 Reviews of decisions of adjudication officers.N.I.

(1)On an application under this section made within the prescribed period, a decision of an adjudication officer under section 19 above which relates to an attendance allowance, a disability living allowance or a disability working allowance may be reviewed on any ground subject, in the case of a disability working allowance, to section 128(6) of the Contributions and Benefits Act.

(2)On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above which relates to an attendance allowance or a disability living allowance may be reviewed if—

(a)the adjudication officer is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b)there has been any relevant change of circumstances since the decision was given;

(c)it is anticipated that a relevant change of circumstances will so occur;

(d)the decision was erroneous in point of law; or

(e)the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(3)Regulations may prescribe what are, or are not, relevant changes of circumstances for the purposes of subsection (2)(b) and (c) above.

(4)On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above that a person is or was at any time terminally ill for the purposes of section 66(1), 72(5) or 73(12) of the Contributions and Benefits Act may be reviewed if there has been a change of medical opinion with respect to his condition or his reasonable expectation of life.

(5)On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above which relates to a disability working allowance may be reviewed if—

(a)the adjudication officer is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b)subject to section 128(6) of the Contributions and Benefits Act, there has been any prescribed change of circumstances since the decision was given;

(c)the decision was erroneous in point of law; or

(d)the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(6)The claimant shall be given such notification as may be prescribed of a decision which may be reviewed under this section and of his right to a review under subsection (1) above.

(7)A question may be raised with a view to a review under this section by means of an application made in writing to an adjudication officer stating the grounds of the application and supplying such information and evidence as may be prescribed.

[F130(7A)The Department may undertake investigations to obtain information and evidence for the purposes of making applications under subsection (7) above.]

(8)Regulations—

(a)may provide for enabling or requiring, in prescribed circumstances, a review under this section notwithstanding that no application under subsection (7) above has been made; and

(b)if they do so provide, shall specify under which provision of this section a review carried out by virtue of any such regulations falls.

(9)Reviews under this section shall be carried out by adjudication officers.

(10)Different aspects of any question which arises on such a review may be dealt with by different adjudication officers; and for this purpose this section and the other provisions of this Part of this Act which relate to reviews under this section shall apply with any necessary modifications.

(11)If a review is under subsection (1) above, the officer who took the decision under review shall not deal with any question which arises on the review.

(12)Except in prescribed circumstances, where a claim for a disability living allowance in respect of a person already awarded such an allowance by an adjudication officer is made or treated as made during the period for which he has been awarded the allowance, it shall be treated as an application for a review under this section.

(13)Where—

(a)a claim for an attendance allowance, a disability living allowance or a disability working allowance in respect of a person has been refused; and

(b)a further claim for the same allowance is made in respect of him within the period prescribed under subsection (1) above,

the further claim shall be treated as an application for a review under that subsection.]

Annotations:

Amendments (Textual)

F129S. 28 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 28 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C33S. 28(2)(d) restricted (28.2.1994) by S.R. 1987/82, reg. 64A(3A) (as inserted by S.R. 1994/21, reg. 2(2))

[F13129 Further reviews.N.I.

(1)Subsections (2), (4) and (5) of section 28 above shall apply to a decision on a review under subsection (1) of that section as they apply to a decision of an adjudication officer under section 19 above but as if the words “made after the end of the prescribed period” were omitted from each subsection.

(2)Subsections (1), (2), (4) and (5) of section 28 above shall apply—

(a)to a decision on a review under subsection (2), (4) or (5) of that section; and

(b)to a refusal to review a decision under subsection (2), (4) or (5) of that section,

as they apply to a decision of an adjudication officer under section 19 above.

(3)The claimant shall be given such notification as may be prescribed—

(a)of a decision on a review under section 28 above;

(b)if the review was under section 28(1), of his right of appeal under section 31 below; and

(c)if it was under section 28(2), (4) or (5), of his right to a further review under section 28(1).]

Annotations:

Amendments (Textual)

F131S. 29 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 29 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F13230 Reviews of decisions as to attendance allowance, disability living allowance or disability working allowance - supplementary.N.I.

(1)An award of an attendance allowance, a disability living allowance or a disability working allowance on a review under section 28 above replaces any award which was the subject of the review.

(2)Where a person who has been awarded a disability living allowance consisting of one component applies or is treated as applying for a review under section 28 above and alleges that he is also entitled to the other component, the adjudication officer need not consider the question of his entitlement to the component which he has already been awarded or the rate of that component.

(3)Where a person who has been awarded a disability living allowance consisting of both components applies or is treated as applying for a review under section 28 above and alleges that he is entitled to one component at a rate higher than that at which it has been awarded, the adjudication officer need not consider the question of his entitlement to the other component or the rate of that component.

(4)Where a person has been awarded a component for life, on a review under section 28 above the adjudication officer shall not consider the question of his entitlement to that component or the rate of that component or the period for which it has been awarded unless—

(a)the person awarded the component expressly applies for the consideration of that question; or

(b)[F133there has been supplied to the adjudication officer by the Department, or is otherwise available to him, information] which gives him reasonable grounds for believing that entitlement to the component, or entitlement to it at the rate awarded or for that period, ought not to continue.

(5)No decision which relates to an attendance allowance or a disability living allowance shall be reviewed under section 28 above on the ground that the person is or was at any time terminally ill, within the meaning of section 66(2) of the Contributions and Benefits Act, unless an application for review is made expressly on that ground either—

(a)by the person himself; or

(b)by any other person purporting to act on his behalf, whether or not that other person is acting with his knowledge or authority;

and a decision may be so reviewed on such an application, notwithstanding that no claim under section 66(1), 72(5) or 73(12) of that Act has been made.

(6)Where a decision is reviewed under section 28 above on the ground that it is anticipated that a change of circumstances will occur, the decision given on review—

(a)shall take effect on the day prescribed for that purpose by reference to the date on which the change of circumstances is expected to occur; and

(b)shall be reviewed again if the change of circumstances either does not occur or occurs otherwise than on that date.

(7)Where a claimant has appealed against a decision of an adjudication officer under section 31 below and the decision is reviewed again under section 28(2), (4) or (5) above by an adjudication officer, then—

(a)if the adjudication officer considers that the decision which he has made on the review is the same as the decision that would have been made on the appeal had every ground of the appeal succeeded, then the appeal shall lapse; but

(b)in any other case, the review shall be of no effect and the appeal shall proceed accordingly.

(8)Regulations may make provision restricting the payment of any benefit, or any increase of benefit, to which a person would, but for this subsection, be entitled by reason of a review in respect of any period before or after the review (whether that period falls wholly or partly before or after the making of the regulations).

(9)Where an adjudication officer has determined that any amount paid by way of an attendance allowance, a disability living allowance or a disability working allowance is recoverable under or by virtue of section 69 below, any person from whom he has determined that it is recoverable shall have the same right of review under section 28 above as a claimant.

(10)This Act and the Contributions and Benefits Act shall have effect in relation to a review by virtue of subsection (9) above as if any reference to the claimant were a reference to the person from whom the adjudication officer has determined that the amount in question is recoverable.]

Annotations:

Amendments (Textual)

F132S. 30 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 30 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F13431 Appeals following reviews.N.I.

(1)Where an adjudication officer has given a decision on a review under section 28(1) above, the claimant or such other person as may be prescribed may appeal—

(a)in prescribed cases, to a disability appeal tribunal; and

(b)in any other case, to a social security appeal tribunal.

(2)Regulations may make provision as to the manner in which, and the time within which, appeals are to be brought.

(3)An award on an appeal under this section replaces any award which was the subject of the appeal.

(4)Where a person who has been awarded a disability living allowance consisting of one component alleges on an appeal that he is also entitled to the other component, the tribunal need not consider the question of his entitlement to the component which he has already been awarded or the rate of that component.

(5)Where a person who has been awarded a disability living allowance consisting of both components alleges on an appeal that he is entitled to one component at a rate higher than that at which it has been awarded, the tribunal need not consider the question of his entitlement to the other component or the rate of that component.

(6)The tribunal shall not consider—

(a)a person’s entitlement to a component which has been awarded for life;

(b)the rate of a component so awarded; or

(c)the period for which a component has been so awarded,

unless—

(i)the appeal expressly raises that question; or

(ii)information is available to the tribunal which gives it reasonable grounds for believing that entitlement to the component, or entitlement to it at the rate awarded or for that period, ought not to continue.]

Annotations:

Amendments (Textual)

F134S. 31 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 31 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

[F13532 Appeal from social security appeal tribunals or disability appeal tribunals to Commissioners and appeals from Commissioners.N.I.

(1)Subject to the provisions of this section, an appeal lies to a Commissioner from any decision of a social security appeal tribunal or disability appeal tribunal under section 31 above on the ground that the decision of the tribunal was erroneous in point of law.

(2)An appeal lies under this section at the instance of any of the following—

(a)an adjudication officer;

(b)the claimant;

(c)a trade union—

(i)where the claimant is a member of the union at the time of the appeal and was so immediately before the question at issue arose;

(ii)where that question in any way relates to a deceased person who was a member of the union at the time of his death; and

(d)a person from whom it is determined that any amount is recoverable under section 69 below.

(3)Subsection (2) above, as it applies to a trade union, applies also to any other association which exists to promote the interests and welfare of its members.

(4)Subsections (7) to (10) of section 21 above have effect for the purposes of this section as they have effect for the purposes of that section.

(5)Section 22 above applies to a decision of a Commissioner under this section as it applies to a decision of a Commissioner under section 21 above.]

Annotations:

Amendments (Textual)

F135S. 32 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 32 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

[F13633 Reviews of decisions on appeal.N.I.

(1)Any decision under this Act of a social security appeal tribunal, a disability appeal tribunal or a Commissioner which relates to an attendance allowance or a disability living allowance may be reviewed at any time by an adjudication officer if—

(a)he is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b)there has been any relevant change of circumstances since the decision was given;

(c)it is anticipated that a relevant change of circumstances will so occur;

(d)the decision was that a person is or was at any time terminally ill for the purposes of section 66(1), 72(5) or 73(12) of the Contributions and Benefits Act and there has been a change of medical opinion with respect to his condition or his reasonable expectation of life; or

(e)the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(2)Regulations may prescribe what are, or are not, relevant changes of circumstances for the purposes of subsection (1)(b) and (c) above.

(3)Any decision under this Act of a social security appeal tribunal, a disability appeal tribunal or a Commissioner which relates to a disability working allowance may be reviewed at any time by an adjudication officer if—

(a)he is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b)subject to section 128(6) of the Contributions and Benefits Act, there has been any prescribed change of circumstances since the decision was given; or

(c)the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(4)A question may be raised with a view to a review under this section by means of an application made in writing to an adjudication officer, stating the grounds of the application and supplying such information and evidence as may be prescribed.

(5)Regulations may provide for enabling or requiring, in prescribed circumstances, a review under this section notwithstanding that no application for a review has been made under subsection (4) above.

(6)Reviews under this section shall be carried out by adjudication officers.

(7)Except in prescribed circumstances, where a claim for a disability living allowance in respect of a person already awarded such an allowance on an appeal is made or treated as made during the period for which he has been awarded the allowance, it shall be treated as an application for a review under this section.

(8)Subsections (1), (2), (4) and (5) of section 28 above shall apply—

(a)to a decision on a review under this section; and

(b)to a refusal to review a decision such as is mentioned in subsection (1) above,

as they apply to a decision of an adjudication officer under section 19 above.

(9)The person whose claim was the subject of the appeal the decision on which has been reviewed under this section shall be given such notification as may be prescribed—

(a)of the decision on the review; and

(b)of his right to a further review under section 28(1) above.

(10)Regulations may make provision restricting the payment of any benefit, or any increase of benefit, to what a person would, but for this subsection, be entitled by reason of a review in respect of any period before or after the review (whether that period falls wholly or partly before or after the making of the regulations).

(11)Where a decision is reviewed on the ground mentioned in subsection (1)(c) above, the decision given on the review—

(a)shall take effect on the day prescribed for that purpose by reference to the date on which the relevant change of circumstances is expected to occur; and

(b)shall be reviewed again if the relevant change of circumstances either does not occur or occurs otherwise than on that date.

(12)Sections 28(10) and 30(1) to (5) above shall apply in relation to a review under this section as they apply to a review under section 28 above.]

Annotations:

Amendments (Textual)

F136S. 33 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 33 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Questions first arising on appealN.I.

[F13734 Questions first arising on appeal.N.I.

(1)Where a question which but for this section would fall to be determined by an adjudication officer first arises in the course of an appeal to a social security appeal tribunal, a disability appeal tribunal or a Commissioner, the tribunal, subject to subsection (2) below, or the Commissioner may, if they or he think fit, proceed to determine the question notwithstanding that it has not been considered by an adjudication officer.

(2)A social security appeal tribunal may not determine a question by virtue of subsection (1) above if an appeal in relation to such a question would have lain to a disability appeal tribunal.]

Annotations:

Amendments (Textual)

F137S. 34 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 34 repealed (29.11.1999 for certain purposes, otherwiseprosp..) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Reference of special questionsN.I.

[F13835 Reference of special questions.N.I.

(1)Subject to subsection (2) below—

(a)if on consideration of any claim or question an adjudication officer is of opinion that there arises any question which under or by virtue of this Act falls to be determined otherwise than by an adjudication officer, he shall refer the question for such determination; and

(b)if on consideration of any claim or question a social security appeal tribunal or Commissioner is of opinion that any such question arises, the tribunal or Commissioner shall direct it to be referred by an adjudication officer for such determination.

(2)The person or tribunal making or directing the reference shall then deal with any other question as if the referred question had not arisen.

(3)The adjudication officer, tribunal or Commissioner may—

(a)postpone the reference of, or dealing with, any question until other questions have been determined;

(b)in cases where the determination of any question disposes of a claim or any part of it, make an award or decide that an award cannot be made, as to the claim or that part of it, without referring or dealing with, or before the determination of, any other question.]

Annotations:

Amendments (Textual)

F138S. 35 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 35 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C36S. 35 modified (25.8.1995) by S.R. 1995/293, reg. 46

Adjudication officers and the Chief Adjudication OfficerN.I.

[F13936 Adjudication officers.N.I.

(1)Adjudication officers shall be appointed by the Department, subject to the consent of the Department of Finance and Personnel as to number, and may include officers of the Department of Social Security appointed with the concurrence of the Secretary of State.

(2)An adjudication officer may be appointed to perform all the functions of adjudication officers under any enactment or such functions of such officers as may be specified in his instrument of appointment.]

Annotations:

Amendments (Textual)

F139S. 36 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 36 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F14037 The Chief Adjudication Officer.N.I.

(1)The Department shall appoint for Northern Ireland a Chief Adjudication Officer.

(2)It shall be the duty of the Chief Adjudication Officer to advise adjudication officers on the performance of their functions under this or any other enactment.

(3)The Chief Adjudication Officer shall keep under review the operation of the system of adjudication by adjudication officers and matters connected with the operation of that system.

(4)The Chief Adjudication Officer shall report annually in writing to the Department on the standards of adjudication and the Department shall publish his report.]

Annotations:

Amendments (Textual)

F140S. 37 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 37 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Social security appeal tribunalsN.I.

[F14138 Panels for appointment to social security appeal tribunals.N.I.

(1)The President shall constitute for the whole of Northern Ireland to act for such areas as he thinks fit and to be composed of such persons as he thinks fit to appoint, panels of persons to act as members of social security appeal tribunals.

(2)The panel for an area shall be composed of persons appearing to the President to have knowledge or experience of conditions in the area and to be representative of persons living or working in the area.

(3)Before appointing members of a panel, the President shall take into consideration any recommendations from such organisations or persons as he considers appropriate.

(4)The members of the panels shall hold office for such period as the President may direct, but the President may at any time terminate the appointment of any member of a panel.]

Annotations:

Amendments (Textual)

F141S. 38 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 38 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F14239 Constitution of social security appeal tribunals.N.I.

(1)A social security appeal tribunal shall consist of a chairman and two other persons.

(2)The members other than the chairman shall be drawn from the appropriate panel constituted under section 38 above.

(3)The President shall nominate the chairman.

(4)The President may nominate as chairman—

(a)himself;

(b)one of the full-time chairmen appointed under section 49(1)(b) below; or

(c)a person drawn from the panel appointed by the Lord Chancellor under section 49(1)(c) below.

(5)If practicable, at least one of the members of the appeal tribunal hearing a case shall be of the same sex as the claimant.

(6)Schedule 2 to this Act shall have effect for supplementing this section.]

Annotations:

Amendments (Textual)

F142S. 39 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 39 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

Disability appeal tribunalsN.I.

[F14340 Panels for appointment to disability appeal tribunals.N.I.

(1)The President shall constitute for the whole of Northern Ireland, to act for such areas as he thinks fit and be composed of such persons as he thinks fit to appoint, panels of persons to act as members of disability appeal tribunals.

(2)There shall be two panels for each area.

(3)One panel shall be composed of medical practitioners.

(4)The other shall be composed of persons who are experienced in dealing with the needs of disabled persons—

(a)in a professional or voluntary capacity; or

(b)because they are themselves disabled,

but may not include medical practitioners.

(5)In considering the appointment of members of the panels the President shall have regard to the desirability of appointing disabled persons.

(6)Before appointing members of a panel, the President shall take into consideration any recommendations from such organisations or persons as he considers appropriate.

(7)The members of the panels shall hold office for such periods as the President may direct, but the President may at any time terminate the appointment of any member of a panel.]

Annotations:

Amendments (Textual)

F143S. 40 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 40 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F14441 Constitution of disability appeal tribunals.N.I.

(1)A disability appeal tribunal shall consist of a chairman and two other persons.

(2)Of the members of a tribunal other than the chairman, one shall be drawn from the panel mentioned in subsection (3) of section 40 above.

(3)The other shall be drawn from the panel mentioned in subsection (4) of that section.

(4)The President shall nominate the chairman.

(5)The President may nominate as chairman—

(a)himself;

(b)one of the full-time chairmen appointed under section 49(1)(b) below; or

(c)a person drawn from the panel appointed by the Lord Chancellor under section 49(1)(c) below.

(6)In summoning members of a panel to serve on a tribunal, the clerk to the tribunal shall have regard to the desirability of at least one of the members of the tribunal being a disabled person.

(7)If practicable, at least one of the members of the tribunal shall be of the same sex as the claimant.

(8)Schedule 2 to this Act shall have effect for supplementing this section.]

Annotations:

Amendments (Textual)

F144S. 41 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 41 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Adjudication in relation to industrial injuries and disablement benefitN.I.

[F14542 Declaration that accident is an industrial accident.N.I.

(1)Where, in connection with any claim for industrial injuries benefit, it is determined that the relevant accident was or was not an industrial accident, an express declaration of that fact shall be made and recorded and (subject to subsection (3) below) a claimant shall be entitled to have the question whether the relevant accident was an industrial accident determined notwithstanding that his claim is disallowed on other grounds.

(2)Subject to subsection (3) below and to section 58 below, any person suffering personal injury by accident shall be entitled, if he claims the accident was an industrial accident, to have that question determined, and a declaration made and recorded accordingly, notwithstanding that no claim for benefit has been made in connection with which the question arises; and this Part of this Act applies for that purpose as if the question had arisen in connection with a claim for benefit.

(3)The adjudication officer, social security appeal tribunal or Commissioner (as the case may be) may refuse to determine the question whether an accident was an industrial accident if satisfied that it is unlikely to be necessary to determine the question for the purposes of any claim for benefit; but any such refusal of an adjudication officer or social security appeal tribunal shall be subject to appeal to a social security appeal tribunal or Commissioner, as the case may be.

(4)Subject to the provisions of this Part of this Act as to appeal and review, any declaration under this section that an accident was or was not an industrial accident shall be conclusive for the purposes of any claim for industrial injuries benefit in respect of that accident.

(5)Where subsection (4) above applies—

(a)in relation to a death occurring before 11th April 1988; or

(b)for the purposes of section 60(2) of the Contributions and Benefits Act,

it shall have effect as if at the end there were added the words “ whether or not the claimant is the person at whose instance the declaration was made ”.

(6)For the purposes of this section (but subject to section 58(3) below), an accident whereby a person suffers personal injury shall be deemed, in relation to him, to be an industrial accident if—

(a)it arises out of and in the course of his employment;

(b)that employment is employed earner’s employment for the purposes of Part V of the Contributions and Benefits Act;

(c)payment of benefit is not under section 94(5) of that Act precluded because the accident happened while he was outside Northern Ireland.

(7)A decision under this section shall be final except that sections 23 to 27 above apply to a decision under this section that an accident was or was not an industrial accident as they apply to a decision under sections 19 to 21 above if, but only if, the adjudication officer or social security appeal tribunal, as the case may be, is satisfied that the decision under this section was given in consequence of any wilful non-disclosure or misrepresentation of a material fact.]

Annotations:

Amendments (Textual)

F145S. 42 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 42 repealed (29.11.1999 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C38S. 42 excluded (25.8.1995) by S.R. 1995/293, reg. 44(1)

[F14643 Disablement questions.N.I.

(1)In relation to industrial injuries benefit F147. . ., the “disablement questions” are the questions—

(a)F148. . . whether the relevant accident has resulted in a loss of faculty;

(b)F149. . . at what degree the extent of disablement resulting from a loss of faculty is to be assessed, and what period is to be taken into account by the assessment;

but questions relating to the aggregation of percentages of disablement resulting from different accidents are not disablement questions (and accordingly fall to be determined by an adjudication officer).

(2)Subject to and in accordance with regulations, the disablement questions shall be referred to and determined—

(a)by an adjudicating medical practitioner;

(b)by two or more adjudicating medical practitioners;

(c)by a medical appeal tribunal; F150. . .

F150(d). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3)Where—

(a)the case of a claimant for disablement benefit has been referred by the adjudication officer to one or more adjudicating medical practitioners for determination of the disablement questions; and

(b)on that or any subsequent reference, the extent of the disablement is provisionally assessed,

the case shall again be referred under this section, to one or more adjudicating medical practitioners as regulations may provide for the purposes of such subsequent references, not later than the end of the period taken into account by the provisional assessment.

(4)Where, in the case of a claimant for disablement benefit, the extent of any disablement of his resulting from an aggregable accident (that is to say, an accident other than the one which is the basis of the claim in question) has been assessed in accordance with paragraph 6(3) of Schedule 6 to the Contributions and Benefits Act at less than 14 per cent., then—

(a)the adjudication officer may refer the disablement questions relating to the aggregable accident to one or more adjudicating medical practitioners for fresh determination; and

(b)on any such reference—

(i)those questions shall be determined as at the first day of the common period; and

(ii)the period to be taken into account shall be the period beginning with that day.

(5)In subsection (4) above “the first day of the common period” means whichever is the later of—

(a)the first day of the period taken into account by the assessment of the extent of the claimant’s disablement resulting from the accident which is the basis of the claim in question;

(b)the first day of the period taken into account by the assessment of the extent of his disablement resulting from the aggregable accident.

(6)In the following provisions of this Act “adjudicating medical practitioner” means, in relation to any case, one such practitioner, unless regulations applicable to cases of that description provide for references to more than one.]

Annotations:

Amendments (Textual)

F146S. 43 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 43 repealed (29.11.1999 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F147Words in s. 43(1) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), art. 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

F148Words in s. 43(1)(a) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), art. 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

F149Words in s. 43(1)(b) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), art. 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332) )

F150S. 43(2)(d) and the preceding word repealed by S.I. 1999/3147 (N.I. 11), art. 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

[F15144 Medical appeals and references.N.I.

(1)This section has effect where the case of a claimant for disablement benefit F152. . . has been referred by the adjudication officer to an adjudicating medical practitioner for determination of the disablement questions.

(2)Subject to subsection (3) below, if the claimant is dissatisfied with the decision of the adjudicating medical practitioner, he may appeal in the prescribed manner and within the prescribed time, and the case shall be referred to a medical appeal tribunal.

(3)If—

(a)the Department notifies the adjudication officer within the prescribed time that it is of the opinion that any decision of the adjudicating medical practitioner ought to be considered by a medical appeal tribunal; or

(b)the adjudication officer is of the opinion that any such decision ought to be so considered,

the adjudication officer shall refer the case to a medical appeal tribunal for their consideration, and the tribunal may confirm, reverse or vary the decision in whole or in part as on an appeal.]

Annotations:

Amendments (Textual)

F151S. 44 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 44 repealed (29.11.1999 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F152Words in s. 44(1) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), arts. 1(2), 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

[F15345 Review of medical decisions.N.I.

(1)Any decision under this Act of an adjudicating medical practitioner or a medical appeal tribunal may be reviewed at any time by an adjudicating medical practitioner if satisfied that the decision was given in ignorance of a material fact or was based on a mistake as to a material fact.

(2)Any decision under this Act of an adjudicating medical practitioner may be reviewed at any time by such a practitioner if he is satisfied that the decision was erroneous in point of law.

(3)Regulations may provide that a decision may not be reviewed under subsection (1) above unless the adjudicating medical practitioner is satisfied as mentioned in that subsection by fresh evidence.

(4)Any assessment of the extent of the disablement resulting from the relevant loss of faculty may also be reviewed by an adjudicating medical practitioner if he is satisfied that since the making of the assessment there has been an unforeseen aggravation of the results of the relevant injury.

(5)Where in connection with a claim for disablement benefit made after 20th October 1953 it is decided that the relevant accident has not resulted in a loss of faculty, the decision—

(a)may be reviewed under subsection (4) above as if it were an assessment of the extent of disablement resulting from a relevant loss of faculty; but

(b)subject to any further decision on appeal or review, shall be treated as deciding the question whether the relevant accident had so resulted both for the time about which the decision was given and for any subsequent time.

(6)For the purposes of subsection (5) above, a final assessment of the extent of the disablement resulting from a loss of faculty made for a period limited by reference to a definite date shall be treated as deciding that at that date the relevant accident had not resulted in a loss of faculty.

(7)An assessment made, confirmed or varied by a medical appeal tribunal shall not be reviewed under subsection (4) above without the leave of a medical appeal tribunal, and (notwithstanding the provisions of Part V of the Contributions and Benefits Act) on a review under that subsection the period to be taken into account by any revised assessment shall only include a period before the date of the application for the review if and in so far as regulations so provide.

(8)Subject to the foregoing provisions of this section, an adjudicating medical practitioner may deal with a case on a review in any manner in which he could deal with it on an original reference to him, and in particular may in any case relating to disablement benefit make a provisional assessment notwithstanding that the assessment under review was final.

(9)Section 44 above applies to an application for a review under this section and to a decision of an adjudicating medical practitioner in connection with such an application as it applies to an original claim for disablement benefit F154. . . and to a decision of an adjudicating medical practitioner in connection with such a claim.

(10)In subsection (6) above the reference to a final assessment does not include an assessment made for the purpose of section 12(1)(a) or (b) of the M2National Insurance (Industrial Injuries) Act (Northern Ireland) 1946 as originally enacted and having the effect that benefit is not payable.]

Annotations:

Amendments (Textual)

F153S. 45 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 45 repealed (29.11.1999 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F154Words in s. 45(9) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), art. 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

Modifications etc. (not altering text)

C39S. 45(1) modified (25.8.1995) by S.R. 1995/293, art. 36(1)

S. 45(1) restricted (25.8.1995) by S.R. 1995/293, reg. 61

C40S. 45(2) modified (25.8.1995) by S.R. 1995/293, reg. 36(1)

C41S. 45(5) excluded (25.8.1995) by S.R. 1995/293, reg. 44(1)

C42S. 45(7) excluded (25.8.1995) by S.R. 1995/293, reg. 51

C43S. 45(8) modified (25.8.1995) by S.R. 1995/293, art. 52

Marginal Citations

[F15546 Appeal etc. on question of law to Commissioner.N.I.

(1)Subject to this section, an appeal lies to a Commissioner from any decision of a medical appeal tribunal (if given after 6th April 1987) on the ground that the decision is erroneous in point of law, at the instance of—

(a)an adjudication officer;

(b)the claimant;

(c)a trade union of which the claimant was a member at the time of the relevant accident F156. . .; or

(d)the Department.

(2)Subsection (1) above, as it applies to a trade union, applies also to any other association which exists to promote the interests and welfare of its members.

(3)No appeal lies under subsection (1) above without the leave—

(a)of the person who was the chairman of the medical appeal tribunal when the decision was given or, in a prescribed case, the leave of some other chairman of a medical appeal tribunal; or

(b)subject to and in accordance with regulations, of a Commissioner,

and regulations may make provision as to the manner in which, and the time within which, appeals are to be brought and applications made for leave to appeal.

(4)On any such appeal, the question of law arising for the decision of the Commissioner and the facts on which it arises shall be submitted for his consideration in the prescribed manner.

(5)Where the Commissioner holds that the decision was erroneous in point of law he shall set it aside and refer the case to a medical appeal tribunal with directions for its determination.

(6)Subject to any direction of the Commissioner, the tribunal on a reference under subsection (5) above shall consist of persons who were not members of the tribunal which gave the erroneous decision.]

Annotations:

Amendments (Textual)

F155S. 46 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwise prosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 46 repealed (29.11.1999 for certain purposes, otherwise prosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F156Words in s. 46(1)(c) repealed (3.11.2000 for certain purposes, otherwise 6.4.2001) by S.I. 1999/3147 (N.I. 11), arts. 1(2), 76, Sch. 10 Pt. IV; S.R. 2000/332, art. 2(3)-(5) (subject to art. 3 of the said S.R. 2000/332 (as amended by S.R. 2001/114, art. 3) and to art. 4 of the said S.R. 2000/332)

Modifications etc. (not altering text)

Adjudicating medical practitioners and medical appeal tribunalsN.I.

[F15747 Adjudicating medical practitioners.N.I.

(1)Adjudicating medical practitioners shall be appointed by the Department.

(2)The Department may make arrangements whereby any adjudicating medical practitioners for the purposes of the Great Britain Administration Act shall be adjudicating medical practitioners for the purposes of this Act.

(3)Subject to subsections (1) and (2) above, the appointment of adjudicating medical practitioners shall be determined by regulations.]

Annotations:

Amendments (Textual)

F157S. 47 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 47 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F15848 Constitution of medical appeal tribunals.N.I.

(1)A medical appeal tribunal shall consist of a chairman and two other persons.

(2)The members other than the chairman shall be medical practitioners appointed by the President after consultation with such academic medical bodies as appear to him to be appropriate.

(3)The President shall nominate the chairman.

(4)The President may nominate as chairman—

(a)himself;

(b)one of the full-time chairmen appointed under section 49(1)(b) below; or

(c)a person drawn from the panel appointed by the Lord Chancellor under section 49(1)(c) below.

(5)The Department may make arrangements whereby a medical appeal tribunal for the purposes of the Great Britain Administration Act shall be a medical appeal tribunal for the purposes of this Act.

(6)Subject to subsections (1) to (4) above, the constitution of medical appeal tribunals shall be determined by regulations.

(7)Schedule 2 to this Act shall have effect for supplementing this section.]

Annotations:

Amendments (Textual)

F158S. 48 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 48 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

The President and chairmen of tribunalsN.I.

[F15949 The President of social security appeal tribunals, medical appeal tribunals and disability appeal tribunals and chairmen.N.I.

(1)The Lord Chancellor may appoint for Northern Ireland—

(a)a President of social security appeal tribunals, medical appeal tribunals and disability appeal tribunals;

(b)full-time chairmen of such tribunals; and

(c)a panel of persons who may be appointed part-time chairmen of such tribunals.

(2)A person is qualified to be appointed President if he is a barrister or solicitor of at least 10 years’ standing.

(3)A person is qualified to be appointed a full-time chairman if he is a barrister or solicitor of at least 7 years’ standing.

(4)A person is qualified to be appointed to the panel referred to in subsection (1)(c) above if he is a barrister or solicitor of at least 5 years’ standing.

(5)Schedule 2 to this Act shall have effect for supplementing this section.]

Annotations:

Amendments (Textual)

F159S. 49 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 49 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Social Security CommissionersN.I.

50 Appointment of Commissioners.N.I.

(1)Her Majesty may from time to time appoint for Northern Ireland, from among persons who are barristers or solicitors of at least 10 years’ standing—

(a)a Chief Social Security Commissioner; and

(b)[F160other Social Security Commissioners].

(2)[F161In order to facilitate the disposal of the business of Social Security Commissioners, the Northern Ireland Judicial Appointments Commission may appoint]

(a)a member of the bar of Northern Ireland or [F162solicitor of the Court of Judicature of Northern Ireland] of at least 10 years’ standing;

(b)a person who has a 10 year general qualification within the meaning of section 71 of the M3Courts and Legal Services Act 1990; or

(c)an advocate or solicitor in Scotland of at least 10 years’ standing,

to be a Social Security Commissioner (but to be known as a deputy Commissioner) for such period or on such occasions as the [F163Commission determines with the agreement of the [F164Department of Justice]].

(3)Schedule 2 to this Act shall have effect for supplementing this section.

References to medical practitioners, the Disability Living Allowance Advisory Board etc.N.I.

[F16551 Power of adjudicating authorities to refer matters to experts.N.I.

(1)An authority to which this section applies may refer any question of special difficulty arising for decision by the authority to one or more experts for examination and report.

(2)The authorities to which this section applies are—

(a)an adjudication officer;

(b)an adjudicating medical practitioner, or two or more such practitioners acting together;

(c)a specially qualified adjudicating medical practitioner appointed by virtue of section 60 below, or two or more such practitioners acting together;

(d)a social security appeal tribunal;

(e)a disability appeal tribunal;

(f)a medical appeal tribunal;

(g)a Commissioner;

(h)the Department.

(3)Regulations may prescribe cases in which a Commissioner shall not exercise the power conferred by subsection (1) above.

(4)In this section “expert” means a person appearing to the authority to have knowledge or experience which would be relevant in determining the question of special difficulty.]

Annotations:

Amendments (Textual)

F165S. 51 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 51 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F16652 Claims relating to attendance allowance, disability living allowance and disability working allowance.N.I.

(1)Before a claim for an attendance allowance, a disability living allowance or a disability working allowance or any question relating to such an allowance is submitted to an adjudication officer under section 18 above the Department may refer the person in respect of whom the claim is made or the question is raised to a medical practitioner for such examination and report as appears to the Department to be necessary—

(a)for the purpose of providing the adjudication officer with information for use in determining the claim or question; or

(b)for the purpose of general monitoring of claims for attendance allowances, disability living allowances and disability working allowances.

(2)An adjudication officer may refer—

(a)a person in respect of whom such a claim is made or such a question is raised;

(b)a person [F167in respect of whom an application for a review under section 28 or 33 above has been made or is treated as having been made,],

to a medical practitioner for such examination and report as appears to the adjudication officer to be needed to enable him to reach a decision on the claim or question or the matter under review.

(3)The Department may direct adjudication officers to refer for advice to a medical practitioner who is an officer of the Department any case falling within a specified class of cases relating to attendance allowance or disability living allowance, and an adjudication officer may refer for advice any case relating to attendance allowance or disability living allowance to such a medical practitioner without such a direction.

(4)An adjudication officer may refer for advice any case relating to disability working allowance to such a medical practitioner.

(5)A medical practitioner who is an officer of the Department and to whom a case or question relating to an attendance allowance or a disability living allowance is referred under section 51 above or subsection (3) above may refer the case or question to the Disability Living Allowance Advisory Board for advice.

(6)Such a medical practitioner may obtain information about such a case or question from another medical practitioner.

(7)A medical practitioner who is an officer of the Department and to whom a question relating to disability working allowance is referred under section 51 above may obtain information about it from another medical practitioner.

[F168(7A)Any reference in subsections (3) to (7) above to a medical practitioner who is an officer of the Department includes a reference to a medical practitioner who is provided by any person in pursuance of a contract entered into with the Department.]

(8)Where—

(a)the Department has exercised the power conferred on it by subsection (1) above or an adjudication officer has exercised the power conferred on him by subsection (2) above; and

(b)the medical practitioner requests the person referred to him to attend for or submit himself to medical examination; but

(c)he fails without good cause to do so,

the adjudication officer shall decide the claim or question or matter under review against him.]

Annotations:

Amendments (Textual)

F166S. 52 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 52 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F16953 Medical examination etc. in relation to appeals to disability appeal tribunals.N.I.

(1)Where an appeal has been brought under section 31 above, a person who may be nominated as chairman of a disability appeal tribunal may, if prescribed conditions are satisfied, refer the claimant to a medical practitioner for such examination and report as appears to him to be necessary for the purpose of providing a disability appeal tribunal with information for use in determining the appeal.

(2)At a hearing before a disability appeal tribunal, except in prescribed circumstances, the tribunal —

(a)may not carry out a physical examination of the claimant; and

(b)may not require the claimant to undergo any physical test for the purpose of determining whether he satisfies the condition mentioned in section 73(1)(a) of the Contributions and Benefits Act.]

Annotations:

Amendments (Textual)

F169S. 53 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 53 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Determination of questions of special difficultyN.I.

[F17054 Assessors.N.I.

(1)Where it appears to an authority to which this section applies that a matter before the authority involves a question of fact of special difficulty, then, unless regulations otherwise provide, the authority may direct that in dealing with that matter they shall have the assistance of one or more assessors.

(2)The authorities to which this section applies are—

(a)two or more adjudicating medical practitioners acting together;

(b)two or more specially qualified adjudicating medical practitioners, appointed by virtue of section 60 below, acting together;

(c)a social security appeal tribunal;

(d)a disability appeal tribunal;

(e)a medical appeal tribunal;

(f)a Commissioner;

(g)the Department.]

Annotations:

Amendments (Textual)

F170S. 54 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 54 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F17155 Tribunal of 2 or 3 Commissioners.N.I.

(1)If it appears to the Chief Social Security Commissioner (or, in the case of his inability to act, to such other of the Commissioners as he may have nominated to act for the purpose) that an appeal falling to be heard by one of the Commissioners involves a question of law of special difficulty, he may direct that the appeal be dealt with, not by that Commissioner alone, but by a Tribunal consisting of any 2 or 3 of the Commissioners.

(2)If the decision of the Tribunal is not unanimous, the decision of the majority, or, in the case of a Tribunal consisting of 2 Commissioners, the decision of the presiding member, shall be the decision of the Tribunal.]

Annotations:

Amendments (Textual)

F171S. 55 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 55 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

[F172 Medical examinations]N.I.

Annotations:

Amendments (Textual)

F172S. 55A and the precedingcross-heading inserted (1.7.1997) by S.I. 1997/1182 (N.I. 11), art. 17; S.R. 1997/316, art. 2, Sch.

[F173F17455A Medical examinations of persons awarded attendance allowance or disability living allowance.N.I.

Regulations may make provision—

(a)enabling the Department to require a person to whom attendance allowance or disability living allowance has been awarded to submit to medical examination in prescribed circumstances;

(b)for withholding payments of benefit in prescribed circumstances where a person has failed to submit himself to a medical examination to which he has been required to submit in accordance with regulations under paragraph (a) above; and

(c)for the subsequent making in prescribed circumstances of payments withheld in accordance with regulations under paragraph (b) above.]

Annotations:

Amendments (Textual)

F173S. 55A and the precedingcross-heading inserted (1.7.1997) by S.I. 1997/1182 (N.I. 11), art. 17; S.R. 1997/316, art. 2, Sch.

F174S. 55A ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 55A repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

RegulationsN.I.

[F17556 Regulations as to determination of questions and matters arising out of, or pending, reviews and appeals.N.I.

(1)Subject to the provisions of this Act, provision may be made by regulations for the determination—

(a)by the Department; or

(b)by a person or tribunal appointed or constituted in accordance with the regulations,

of any question arising under or in connection with the Contributions and Benefits Act [F176, the Jobseekers (Northern Ireland) Order 1995]]or the former legislation, including a claim for benefit.

(2)In this section “the former legislation” means the National Insurance Acts (Northern Ireland) 1965 to 1974 and the National Insurance (Industrial Injuries) Acts (Northern Ireland) 1965 to 1974 and the 1975 Act and Part III of the 1986 Order.

(3)Regulations under subsection (1) above may modify, add to or exclude any provisions of this Part of this Act, so far as relating to any questions to which the regulations relate.

(4)It is hereby declared for the avoidance of doubt that the power to make regulations under subsection (1) above includes power to make regulations for the determination of any question arising as to the total or partial recoupment of unemployment benefit [F177or a jobseeker’s allowance]in pursuance of regulations under [F178Article 18 of the Industrial Tribunals (Northern Ireland) Order 1996] (including any decision as to the amount of benefit).

(5)Regulations under subsection (1) above may provide for the review by the Department of decisions on questions determined by it.

(6)The Lord Chancellor may by regulations provide—

(a)for officers authorised by him to determine any question which is determinable by a Commissioner and which does not involve the determination of any appeal, application for leave to appeal or reference;

(b)for the procedure to be followed by any such officer in determining any such question;

(c)for the manner in which determinations of such questions by such officers may be called in question.

(7)A determination which would have the effect of preventing an appeal, application for leave to appeal or reference being determined by a Commissioner is not a determination of the appeal, application or reference for the purposes of subsection (6) above.

(8)Regulations under subsection (1) above may provide—

(a)for the reference to the Court of Appeal for decision of any question of law arising in connection with the determination of a question by the Department; and

(b)for appeals to that court from the decision of the Department on any such question of law;

and subsections (5) and (6) of section 16 above shall apply to a reference or appeal under this subsection as they apply to a reference or appeal under subsections (1) to (3) of that section.

Annotations:

Amendments (Textual)

F175S. 56 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 56 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F178Words in s. 56(4) substituted (24.9.1996) by S.I. 1996/1921 (N.I. 18), art. 26, SCh. 1 para. 8

Modifications etc. (not altering text)

C45S. 56 extended (7.2.1994) by 1993 c. 49, s. 163(3); S.R. 1994/17, art. 2

[F17957 Procedure.N.I.

(1)Regulations (in this section referred to as “procedure regulations”) may make any such provision as is specified in Schedule 3 to this Act.

(2)Procedure regulations may deal differently with claims and questions relating to—

(a)benefit under Parts II to IV of the Contributions and Benefits Act;

(b)industrial injuries benefit;

(c)each of the other benefits to which section 18 above applies.

(3)At any inquiry held by virtue of procedure regulations the witnesses shall, if the person holding the inquiry thinks fit, be examined on oath; and the person holding the inquiry shall have power to administer oaths for that purpose.

(4)In proceedings for the determination of a question mentioned in section 15(1)(c) above (including proceedings on an inquiry), there shall be available to a witness (other than the person who is liable, or alleged to be liable, to pay the Class 1A contribution in question) any privilege against self-incrimination or incrimination of a spouse which is available to a witness in legal proceedings.

(5)It is hereby declared—

(a)that the power to prescribe procedure includes power to make provision as to the representation of one person, at any hearing of a case, by another person whether having professional qualifications or not; and

(b)that the power to provide for the manner in which questions arising for determination by the Department are to be raised includes power to make provision with respect to the formulation of any such questions, whether arising on a reference under section 111 below or otherwise.

(6)Except so far as it may be applied by procedure regulations, [F180Part I of the Arbitration Act 1996] shall not apply to any proceedings under this Part of this Act.]

Annotations:

Amendments (Textual)

F179S. 57 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 57 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

F180Words in s. 57(6) substituted (31.1.1997) by 1996 c. 23, s. 107(1), Sch. 3, para. 55; S.I. 1996/3146, art. 3 (subject to arts. 4-6, Sch. 2)

[F18158 Finality of decisions.N.I.

(1)Subject to the provisions of this Part of this Act, the decision of any claim or question in accordance with the foregoing provisions of this Part of this Act shall be final; and subject to the provisions of any regulations under section 56 above, the decision of any claim or question in accordance with those regulations shall be final.

(2)Subsection (1) above shall not make any finding of fact or other determination embodied in or necessary to a decision, or on which it is based, conclusive for the purpose of any further decision.

(3)A decision (given under subsection (2) of section 42 above or otherwise) that an accident was an industrial accident is to be taken as determining only that paragraphs (a), (b) and (c) of subsection (5) of that section are satisfied in relation to the accident, and neither any such decision nor the reference to an adjudicating medical practitioner or a medical appeal tribunal under section 43 above of the disablement questions in connection with any claim to or award of disablement benefit is to be taken as importing a decision as to the origin of any injury or disability suffered by the claimant, whether or not there is an event identifiable as an accident apart from any injury that may have been received; but—

(a)a decision that on a particular occasion when there was no such event a person had an industrial accident by reason of an injury shall be treated as a decision that, if the injury was suffered by accident on that occasion, the accident was an industrial accident; and

(b)a decision that an accident was an industrial accident may be given, and a declaration to that effect be made and recorded in accordance with section 42 above, without its having been found that personal injury resulted from the accident (saving always the discretion under subsection (3) of that section to refuse to determine the question if it is unlikely to be necessary for the purposes of a claim for benefit).

(4)Notwithstanding anything in subsection (2) or (3) above (but subject to the provisions of this Part of this Act as to appeal and review), where for purposes of disablement pension or disablement gratuity in respect of an accident it has been found by an adjudicating medical practitioner or a medical appeal tribunal, on the determination or last determination of the disablement questions, that an injury resulted in whole or in part from the accident, then for purposes of industrial death benefit in respect of that accident the finding shall be conclusive that the injury did so result.

(5)Subsections (2) to (4) above shall apply as regards the effect to be given in any proceedings to any decision, or to a reference under section 43 above, whether the decision was given or reference made or the proceedings were commenced before or after the passing of the M4National Insurance Act 1972 (section 5 of which originally contained the provisions contained in this section), except that it shall not affect the determination of any appeal under section 46 above from a decision of a medical appeal tribunal given before the passing of that Act, nor affect any proceedings consequent on such an appeal from a decision so given; and accordingly—

(a)any decision given before the passing of that Act that a claimant was not entitled to industrial death benefit may be reviewed in accordance with this Part of this Act to give effect to subsection (4) above; and

(b)the references in subsections (2) and (3) above to provisions of this Act, and the reference in this subsection to section 43 above shall (so far as necessary) include the corresponding provisions of previous Acts.]

Annotations:

Amendments (Textual)

F181S. 58 ceased to have effect (5.7.1999, 6.9.1999, 5.10.1999, 18.10.1999 and 29.11.1999 for different purposes, otherwiseprosp.) by virtue of S.I. 1998/1506 (N.I. 10), arts. 1(2), 39(3); S.R. 1999/310, art. 2(1)(b), Sch. 1 (with arts. 4, 14); S.R. 1999/371, art. 2(b), Sch. 1 (with arts. 4, 18); S.R. 1999/407, art. 2(b), Sch. (with art. 4); S.R. 1999/428, art. 2(b), Sch. 1 (with arts. 4, 16) and S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

S. 58 repealed (29.11.1999 for certain purposes, otherwiseprosp.) by S.I. 1998/1506 (N.I. 10), arts. 1(2), 78(2), Sch. 7; S.R. 1999/472, art. 2(1), Sch. 1 (with arts. 20-22) (subject to art. 2(2) of the said S.R. 1999/472)

Modifications etc. (not altering text)

C46S. 58(1) excluded (25.8.1995) by S.R. 1995/293, reg. 54(2)

Marginal Citations

[F18259 Regulations about supplementary matters relating to determinations.N.I.

(1)Regulations may make provision as respects matters arising—

(a)