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PART 12Determinations and appeals

CHAPTER 2Appeals to Board of Medical Referees

Appeals against determinations based on medical evidence

164.—(1) A member (P) who wishes to appeal against a scheme manager’s determination on an issue of a medical nature may do so to a board of medical referees in accordance with the provisions of regulations 165 (notice of appeal) to 172 (notices etc).

(2) Subject to paragraph (3), where a determination is—

(a)made with regard to an opinion obtained under regulation 162(2) (role of IQMP in determinations by the scheme manager) or medical evidence relied on as mentioned in regulation 162(7); or

(b)reconsidered under regulation 163(4) (review of medical opinion) with regard to a response under paragraph (2) of that regulation,

the scheme manager must, within 14 days of making, confirming or revising the determination (as the case may be), send to P the documents mentioned in paragraph (4).

(3) Nothing in paragraph (2) requires the supply of documents that have already been supplied under regulation 162(8) or 163(5).

(4) The documents are—

(a)a copy of the opinion, response or evidence (as the case may be);

(b)an explanation of the procedure for appeals under this Chapter; and

(c)a statement that if P wishes to appeal against the scheme manager’s determination on an issue of a medical nature, P must give written notice to the scheme manager, stating P’s name and address and the grounds of appeal, not later than 28 days after P receives the last of the documents required to be supplied under this paragraph, or within such longer period as the scheme manager may allow.