The Social Security (Adjudication) Regulations 1995

1. Introductory Text

2. PART I GENERAL

   1. 1. Citation, commencement and interpretation.

3. PART II COMMON PROVISIONS

   1. 2. Procedure in connection with determinations; and right to representation.

   2. 3. Manner of making applications, appeals or references; and time limits.

   3. 4. Oral hearings and inquiries.

   4. 5. Postponement and adjournment.

   5. 6. Withdrawal of applications, appeals and references.

   6. 7. Striking-out of proceedings for want of prosecution.

   7. 8. Non-disclosure of medical evidence.

   8. 9. Correction of accidental errors in decisions.

   9. 10. Setting aside decisions on certain grounds.

   10. 11. Provisions common to regulations 9 and 10.

4. PART III ADJUDICATING AUTHORITIES

   1. SECTION A —

      THE SECRETARY OF STATE

      1. 12. Construction of Section A.

      2. 13. Application for decision of the Secretary of State on principal questions.

      3. 14. Procedure for inquiries.

      4. 15. The Secretary of State’s decision and statement of grounds.

      5. 16. Review of reference.

      6. 17. Questions for determination by the Secretary of State.

   2. SECTION B—

      ADJUDICATION OFFICERS

      1. 18. Notification of decisions.

      2. 19. Procedure on claim or question involving questions for determination by the Secretary of State.

      3. 20. Reference by an employee of questions relating to statutory sick pay or statutory maternity pay for determination by an adjudication officer.

      4. 21. Reference of a special question in child benefit cases.

   3. SECTION C—

      APPEAL TRIBUNALS

      1. 22. Oral hearing of appeals and references.

      2. 23. Decisions of appeal tribunals.

      3. 24. Application for leave to appeal to a Commissioner from an appeal tribunal.

   4. SECTION D—

      DISABILITY ADJUDICATION

      1. 25. Prescribed period.

      2. 26. Manner of making applications for review under section 30(1) of the Administra-tion Act.

      3. 27. Appeal to a disability appeal tribunal.

      4. 28. Persons who may appeal to disability appeal tribunals and appeal tribunals.

      5. 29. Procedure for disability appeal tribunals.

      6. 30. Examination and report by a medical practitioner.

      7. 31. Persons who may not act as members of disability appeal tribunals.

      8. 32. Application for leave to appeal to a Commissioner from a disability appeal tribunal.

      9. 33. Procedure of a disability appeal tribunal on receipt of a Commissioner’s decision.

   5. SECTION E—

      MEDICAL ADJUDICATION

      1. 34. Construction of Section E.

      2. 35. Appointment of adjudicating medical practitioners and specially qualified adjudicating medical practitioners.

      3. 36. Determination of medical questions.

      4. 37. Decisions of adjudicating medical authorities.

      5. 38. Medical appeal tribunals.

      6. 39. Application for leave to appeal to a Commissioner from a medical appeal tribunal.

      7. 40. Disqualification from acting as an adjudicating medical authority or as a member thereof or as a member of a medical appeal tribunal.

      8. 41. Application for review involving review of decision of a medical appeal tribunal.

      9. 42. Procedure of a medical appeal tribunal on receipt of a Commissioner’s decision.

5. PART IV PROVISIONS RELATING TO PARTICULAR BENEFITS OR PROCEDURES

   1. SECTION A—

      PRESCRIBED DISEASES

      1. 43. Construction of Section A.

      2. 44. Application of Part II of the Administration Act and of these Regulations.

      3. 45. Reference of diagnosis and recrudescence questions for medical report.

      4. 46. Procedure on receipt of medical report.

      5. 47. Restriction of adjudication officer’s power to determine diagnosis and recrudesc-ence questions.

      6. 48. Appeal against decision of adjudication officer.

      7. 49. Appeal or reference to a medical appeal tribunal.

      8. 50. Powers of medical appeal tribunal upon determining the question referred.

      9. 51. Review of previous assessment following recrudescence decision.

      10. 52. Review on ground of unforeseen aggravation.

      11. 53. Review of decision on diagnosis or recrudescence question.

      12. 54. Additional provisions relating to the powers and decisions of specially qualified adjudicating medical practitioners and special medical boards.

   2. SECTION B—

      INCOME SUPPORT

      1. 55. Notification of decisions in income support cases.

      2. 56. Income support and social fund questions not immediately determinable.

   3. SECTION C—

      REVIEW OF DECISIONS

      1. 57. Date from which revised decision has effect on a review.

      2. 58. Review of decisions in cases to which section 69(1) of the Administration Act applies.

      3. 59. Review of decisions involving payment or increase of benefit other than industrial injuries benefit, disability working allowance, income support or family credit.

      4. 60. Review of decisions involving payment or increase of industrial injuries benefit.

      5. 61. Review of medical decisions on grounds of ignorance of or mistake as to a material fact.

      6. 62. Period to be taken into account by assessments revised on ground of unforeseen aggravation.

      7. 63. Review in income support cases.

      8. 64. Repayment of student loan not a change of circumstances.

      9. 65. Review in family credit cases.

      10. 66. Review in disability working allowance cases.

      11. 67. Review in social fund maternity, funeral or heating expenses cases.

6. PART V TRANSITIONAL PROVISIONS AND REVOCATIONS

   1. 68. Transitional provisions.

   2. 69. Revocations.

7. Signature

8. SCHEDULES

   1. Schedule 1

      Provisions conferring powers exercised in making these Regulations.

   2. Schedule 2

      Time limits for making applications, appeals or references.

   3. Schedule 3

      Modification of Part II of the Administration Act in its application to benefit and claims and questions to which Part IV of these Regulations apply.

   4. Schedule 4

      Revocations.

9. Explanatory Note