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The Social Security (Claims and Payments) Regulations 1979

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This is the original version (as it was originally made).

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

Claims not required in certain cases E+W+S+N.I.

3.  Benefit may be paid without a claim being made for it in the following cases:—

(a)in the C8.se of a Category C retirement pension, to a beneficiary who is in receipt of—

(i)another retirement pension under the Act; or

(ii)widow's benefit under Chapter I of Part II of the Act; or

(iii)benefit by virtue of section 39(4) corresponding to a widow's pension or a widowed mother's allowance;

(b)in the case of a Category D retirement pension, to a beneficiary who—

(i)was ordinarily resident in Great Britain on the day on which he attained 80 years of age; and

(ii)is in receipt of another retirement pension under the Act;

(c)age addition in any case;

(d)in the case of a Category A or B retirement pension—

(i)to any woman over the age of 65 on her ceasing to be entitled to widowed mother's allowance, or

(ii)to any woman in receipt of widow's pension on her attaining the age of 65.

Manner in which claims are to be made E+W+S+N.I.

4.  Every claim for benefit shall be made in writing to the Secretary of State on the form approved by him for the purpose of the benefit for which the claim is made, or in such other manner, being in writing, as he may accept as sufficient in the circumstances of any particular case or class of cases; and, subject to any directions given by the Secretary of State in any particular case or class of cases, a person claiming unemployment benefit shall attend in person at an unemployment benefit office.

Supply of claim forms E+W+S+N.I.

5.  Forms of claim shall be supplied without charge by such persons as the Secretary of State may appoint or authorise for that purpose.

Claims not on appropriate forms E+W+S+N.I.

6.  Where a claim for benefit has been made on an approved form other than the form appropriate to the benefit claimed, the Secretary of State may treat the claim as if it had been made on the appropriate form, so however that the Secretary of State may in any such case require the claimant to complete the appropriate form.

Information to be given when making a claim for benefit E+W+S+N.I.

7.—(1) Every person who makes a claim for benefit shall furnish such certificates, documents, information and evidence for the purpose of determining the claim as may be required by the Secretary of State and, if reasonably so required, shall for that purpose attend at such office or place as the Secretary of State may direct.

(2) Every person who makes a claim for a widowed mother's allowance, child's special allowance, benefit in respect of a child or for an increase of benefit in respect of a child, shall, in particular, furnish such certificate relating to the birth of the child and such other information to show that that person is entitled or may be treated by regulations as if he were entitled to child benefit in respect of that child as the Secretary of State may require.

(3) Every person who makes a claim for an increase of benefit in respect of an adult dependant shall, in particular, furnish, if required, the following information concerning such dependant:—

(a)his identity, date of birth, usual place of residence, occupation and relationship to the claimant;

(b)his position in regard to benefit under the Act, available sources of income and the amounts contributed by any person towards his maintenance; and

(c)in the case of an increase in respect of a wife or husband, a certificate of the marriage;

together with a declaration signed by the dependant confirming the information given.

(4) Every person who makes a claim for a death grant shall, in particular, furnish the following information:—

(a)if required by the Secretary of State, a death certificate relating to the deceased; and, where the claim is in respect of the death of a child, such certificate relating to the birth of the child, and such other information as the Secretary of State may reasonably require in support of any contention that immediately before the death of the child or the person by whom the contribution condition is to be satisfied, as the case may be, that person was entitled to child benefit in respect of that child; in this sub-paragraph a child includes a person referred to in section 32(4)(a) or (b);

(b)if required by the Secretary of State, the estimate or account of the undertaker.

(5) In this regulation “"child benefit”” means benefit under Part I of the Child Benefit Act 1975 F1.

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Amendments (Textual)

Amendment of claim forms E+W+S+N.I.

8.—(1) If, owing to the absence of due signature or of due certification, a claim is defective at the date of its receipt by the Secretary of State, he may, in his discretion, refer the claim to the claimant, and if the form is returned duly signed and certified within one month from the day on which it is so referred, the Secretary of State may treat the claim as if it had been duly made in the first instance.

(2) Any person who has made a claim for benefit in accordance with the provisions of these regulations may amend his claim, at any time before a decision has been given thereon, by notice in writing delivered or sent to the Secretary of State, and any claim so amended may be treated as if it had been made as so amended in the first instance.

Interchange with claims for other benefits E+W+S+N.I.

9.—(1) Where it appears that a person who has made a claim for benefit specified in column (1) of Schedule 3 to these regulations may be entitled to the benefit specified opposite thereto in column (2) of that Schedule, any such claim may be treated as a claim in the alternative for that benefit.

(2) Where it appears that a person who has made a claim for benefit is not entitled thereto, but that some other person may be entitled to an increase of benefit in respect of him, the claim may be treated as if it were a claim by such other person for an increase of benefit in respect of the claimant.

(3) Where it appears that a person who has made a claim for an increase of benefit in respect of a child or adult dependant is not entitled thereto but that some other person may be entitled to an increase of benefit in respect of that child or adult dependant, the claim may be treated as if it were a claim by that other person for such an increase.

(4) Where it appears that a person who has made a claim for a guardian's allowance in respect of any child is not entitled thereto, but that the claimant, or the wife or husband of the claimant, may be entitled to an increase of benefit for that child, the claim may be treated as if it were a claim by the claimant or the wife or husband of the claimant for an increase of benefit for that child.

(5) A claim for benefit under the Supplementary Benefits Act 1976 F2 may be treated as a claim also for attendance allowance, or an invalid care allowance.

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Amendments (Textual)

Special provision where it is certified that a woman is expected to be confined or where she has been confined E+W+S+N.I.

10.—(1) Where in a certificate issued or having effect as issued under the Social Security (Medical Evidence) Regulations 1916 F3 it has been certified that it is to be expected that a woman will be confined, and either—

(a)a claim for sickness or invalidity benefit or non-contributory invalidity pension is made by that woman on or after the date of that certificate; or

(b)a claim for maternity allowance so made by that woman is treated under the provisions of regulation 9(1) as a claim in the alternative for sickness or invalidity benefit or non-contributory invalidity pension;

any such claim may, unless the Secretary of State otherwise directs, be treated as a claim for sickness or invalidity benefit or non-contributory invalidity pension made in respect of any days in the period beginning with the 11th week before the expected week of confinement and ending either—

(i)on the last day of the 6th week after the week in which the confinement occurs, or

(ii)on the last day of the 6th week after the week in which it was expected that the confinement would occur~

whichever is the later.

(2) Where, in a certificate issued under the Social Security (Medical Evidence) Regulations 1976 it has been certified that a woman has been confined and she claims maternity allowance within the prescribed time, her claim may be treate'd in the alternative as a claim for sickness or invalidity benefit or non-contributory invalidity pension for the period beginning with the date of her confinement and ending 6 weeks after the week in which—

(i)she was confined, or

(ii)it was expected that she would be confined,

whichever is the later.

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Annotations are used to give authority for changes and other effects on the legislation you are viewing and to convey editorial information. They appear at the foot of the relevant provision or under the associated heading. Annotations are categorised by annotation type, such as F-notes for textual amendments and I-notes for commencement information (a full list can be found in the Editorial Practice Guide). Each annotation is identified by a sequential reference number. For F-notes, M-notes and X-notes, the number also appears in bold superscript at the relevant location in the text. All annotations contain links to the affecting legislation.

Amendments (Textual)

Forward allowances and disallowances of sickness, invalidity and injury benefit and no·n -contributory invalidity pension E+W+S+N.I.

11.—(1) Subject to the following paragraphs, where a medical certificate has been issued in respect of the person named therein (“"the claimant””)—

(a)a claim for sickness, invalidity or injury benefit or non-contributory invalidity pension based on the medical certificate shall, unless in any case the Secretary of State otherwise directs, be treated as if made by the claimant for the period specified in that certificate;

(b)on any such claim the benefit may be awarded for the whole or part of that period after the date of the claim but not exceeding 13 weeks or such shorter period as the Secretary of State may in a particular case direct;

(c)if on any such claim the benefit is awarded for part only of the period in respect of which the claim is treated as if made, further decisions in accordance with paragraph (1)(b) awarding such benefit may be given on the same claim.

(2) Any decision awarding benefit by virtue of paragraph (1) shall be subject to the condition that the claimant continues to satisfy the requirements for the payment thereof during the period to which the award relates and if these requirements are found not to have been satisfied at some time during the said period the award shall be reviewed.

(3) Where a claim for sickness benefit is disallowed on the grounds that—

(a)the contribution condition in paragraph 1(2) of Schedule 3 to the Act is not satisfied; or

(b)although that contribution condition is satisfied, neither the contribution condition in paragraph 1(3) of the said Schedule 3 nor the requirements of regulations made under section 33(2) (partial satisfaction of contribution conditions) are satisfied;

the decision disallowing that claim shall, subject to the provisions of section 104 (review of decisions), be treated as a decision disallowing any further claim within the meaning of paragraph 3(c) of column (1) of Schedule 1 to these regulations by that person for that benefit until the grounds for the original disallowance have ceased to exist.

(4) Where a claim for invalidity benefit is disallowed on the grounds that the claimant has not been entitled to sickness benefit for 168 days in the relevant period of interruption of employment, the decision disallowing that claim shall, subject to the provisions of section 104, be treated as a decision disallowing any further claim (being a continuation claim within the meaning of the said paragraph 3(c)) by that person for that benefit until the grounds for the original disallowance have ceased to exist.

(5) Where a claim for non-contributory invalidity pension is disallowed on the grounds that the claimant has not—

(a)been incapable of work for 196 consecutive days; or

(b)satisfied the requirements of regulation 3 of the Social Security (Non-Contributory Invalidity Pension) Regulations 1975 F4 (residence and presence conditions);

the decision disallowing that claim shall, subject to the provisions of section 104 (review of decisions), be treated as a decision disallowing any further claim (being a continuation claim within the meaning of the said paragraph 3(c)) by that person for that pension until the grounds for the original dis-allowance have ceased to exist.

(6) For the purposes of paragraphs (1) to (5) a medical certificate means—

(a)a doctor's statement issued in the. form prescribed in Part II of Schedule 1 to the Social Security (Medical Evidence) Regulations 1976, or having effect as so issued, which advises the claimant to refrain from work for the period specified in it; or

(b)a certificate issued by a person accepted by the Secretary of State as an appropriate person which certifies on the form approved by the Secretary of State that the claimant is in hospital and is expected to remain there for the period specified in it; or

(c)a doctor's statement in the form of a special statement issued by a doctor on the form approved by the Secretary of State in which that doctor advises the claimant to refrain from work for a specified period of not more than one month, on the basis of a written report which—

(i)was received by that doctor from another doctor (other than a partner, assistant or other deputy of the doctor issuing the statement), and

(ii)was issued on a date not more than one n10nth earlier than the date of the statement;

and in this sub-paragraph “"doctor”” means a registered medical practitioner not being the claimant.

(7) Where a claim for non-contributory invalidity pension is made by a woman who claims by virtue of the exception to section 36(2) (incapable of performing normal household duties) that claim shall, unless in any case the Secretary of State otherwise directs, be treated as if made by her for—

(a)the period specified by a registered medical practitioner not being the claimant, on a form approved by the Secretary of State, as being that during which it is to be expected that the claimant is likely to continue to remain as restricted in her ability to perform the normal household duties in her own home or, if shorter, during which she should refrain from work; or

(b)where applicable, the period of any award of—

(i)attendance allowance payable at the higher rate specified in paragraph 1 of Part III of Schedule 4 to the Act, or

(ii)an increase of disablement pension where constant attendance is needed payable at the higher rate specified in paragraph 7 of Part V of Schedule 4 to the Act, or

(iii)an increase of allowance where constant attendance is needed in cases of exceptionally severe disablement payable by virtue of regulations made under section 159(3)(b) (payments for pre-1948 cases), or

(iv)increase of allowance where constant attendance is needed in cases of exceptionally severe disablement payable under any scheme made under section 5 of the Industrial Injuries and Diseases (Old Cases) Act 1975 F5, or

(v)constant attendance allowance payable at the higher rate specified for exceptional cases of very severe disablement under any Personal Injuries Scheme or Service Pensions Instrument defined in regulation 2(1) of the Social Security (Overlapping Benefits) Regulations 1975 F6; or

(c)the period specified in a certificate issued in respect of her which complies with paragraph (6)(b),

in any case beginning on the first day for which non-contributory invalidity pension is claimed.

(8) The reference in paragraph (1)(b) to “"that period”” shall be construed, in relation to a claim to which paragraph (7) applies, as a reference to the period applicable under the latter paragraph, and paragraphs (1)(c) and (2) shall be construed accordingly.

(9) Where a decision awarding non-contributory invalidity pension (by virtue of the exception to section 36(2» by reference to a period treated. as applicable under paragraph (7) is reviewed under paragraph (2), and it appears that the beneficiary may be entitled to such a pension otherwise than by virtue of that exception, the claim shall never-the-less be treated as made for the period that is or would have been applicable under paragraph (7).

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Amendments (Textual)

Forward allowance and disallowance of unemployment benefit E+W+S+N.I.

12.—(1) Where it appears to the Secretary of State that there are, will be or are likely to be circumstances making impracticable or unduly difficult the normal operation of the provisions governing or the practice relating to the claiming, awarding or payment of unemployment benefit he may so certify; and a certificate under this regulation may be expressed—

(a)as having effect either generally or in relation to any case or class of case or to a specified area or specified areas; and

(b)either as having effect until a specified day or as continuing to have effect until revoked by the Secretary of State.

(2) While such a certificate has effect, the following provisions of this paragraph shall apply as respects claims for unemployment benefit (being, if the certificate is not of general effect, claims made in the case, class of case, area or areas, as the case may be, to which the certificate relates)—

(a)a claim for unemployment benefit made—

(i)while such certificate has effect; or

(ii)within 28 days before the date upon which the certificate is issued, whether or not benefit has already been allowed on such claim; or

(iii)while a previous certificate under this regulation had effect so as to allow that claim to be treated as made for a period after the date on which it was made,

may be treated by an insurance officer as a claim for that benefit for a period, to be specified in his decision, not exceeding 13 weeks after the date of the claim;

(b)on any claim so treated benefit may be awarded for the whole or part of the specified period other than, in the case of a claim made before the certificate is issued, any part of the period for which benefit has already been allowed;

(c)if on any claim so treated benefit is awarded for part only of the specified period, further decisions awarding benefit for the remainder of that period or ~ny part of it may be given on the same claim.

(3) Any decision awarding unemployment benefit under paragraph (2) shall be subject to the condition that the claimant continues to satisfy the requirements for payment thereof during the period to which the award relates, and if the said requirements are found not to have been satisfied at some time during the said period the award shall be reviewed.

(4) Whele a person's claim for unemployment benefit has been disallowed on any grounds and in the decision disallowing that claim it is stated that the decision is to be treated as a disallowance of any further claim by that person for unemployment benefit for days specified in the decision until the expiration of a period specified in the decision (not being a period expiring more than 12 months after the date on which the decision is given) or, if the grounds of the original disallowance have ceased to exist before the expiration of the specified period, until they have ceased to exist, the decision shall, subject to the provisions of section 104, be so treated.

Special provisions relating to claims for unemployment benefit made during periods connected with public holidays E+W+S+N.I.

13.—(1) In this regulation:—

(a)"public holiday”” means, as the case may be, Christmas Day, Good Friday or a Bank Holiday under the Banking and Financial Dealings Act 1971 F7; and “"Christmas and New Year holidays”” and “"Good Friday and Easter Monday”” shall be construed accordingly and shall in each case be treated as one period;

(b)"office closure”” means a period during which an unemployment benefit office is closed in connection with a public holiday;

(c)in computing any period of time Sundays shall not be disregarded.

(2) Where any claim for unemployment benefit, other than a claim to which regulation 12(2) applies, is made during one of the periods set out in paragraph (3), the following provisions shall apply—

(a)a claim for unemployment benefit may be treated by an insurance officer as a claim for that benefit for a period, to be specified in his decision, not exceeding 21 days after the date of the claim;

(b)on any claim so treated, benefit may be awarded as if the provisions of sub-paragraphs (b) and (c) of paragraph (2) and the provisions of paragraph (3) of regulation 12 applied.

(3) For the purposes of paragraph (2) the periods are—

(a)in the case of Christmas and New Year holidays, a period beginning with the start of the 21st day before the first day of office closure and ending at midnight between the last day of office closure and the following day;

(b)in the case of Good Friday and Easter Monday and in the case of any other public holiday a period beginning with the start of the 14th day before the first day of office closure and ending at midnight between the last day of office closure and the following day.

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Annotations are used to give authority for changes and other effects on the legislation you are viewing and to convey editorial information. They appear at the foot of the relevant provision or under the associated heading. Annotations are categorised by annotation type, such as F-notes for textual amendments and I-notes for commencement information (a full list can be found in the Editorial Practice Guide). Each annotation is identified by a sequential reference number. For F-notes, M-notes and X-notes, the number also appears in bold superscript at the relevant location in the text. All annotations contain links to the affecting legislation.

Amendments (Textual)

Time for claiming benefit E+W+S+N.I.

14.—(1) Subject to the provisions of Schedule 2 to these regulations—

(a)the prescribed time for claiming any benefit specified in column (1) of Schedule 1 to these regulations shall be the appropriate time specified opposite that benefit in column (2) of that Schedule; and

(b)if a person fails to make his claim for any such benefit within the prescribed time, he shall be disqualified for the receipt of benefit to the extent specified opposite thereto in column (3) of that Schedule.

(2) If in any case the claimant proves that there was good cause for the failure to make the claim before the date on which it was made, the prescribed time for making that claim shall (subject to the provisions of section 82(2)) be extended to the date on which the claim is made:

Provided that the foregoing provisions of this paragraph shall not apply to—

(a)a claim for a maternity grant in respect of expectation of the claimant's confinement; or

(b)a claim for a maternity allowance in respect of expectation of the claimant's confinement so that the prescribed time for making that claim is extended to the date of the confinement or to any date thereafter.

(3) If in any case the claimant proves that—

(a)on a date earlier than the date on which the claim was made, apart from satisfying the condition of making a claim, he was entitled to the benefit; and

(b)throughout the period between the earlier date and the date on which the claim was made there was good cause for delay in making such claim;

he shall not (subject to the provisions of section 82(2) be disqualified under Schedule 1 to these regulations for receiving any benefit to which he would have been entitled if the claim had been made on the said earlier date:

Provided that, where the claimant is a woman claiming a maternity allowance in respect of expectation of her confinement, the foregoing provisions of this paragraph shall apply only if the claim is made before the date of the confinement.

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