The Social Security (Claims and Payments) Regulations 1979
The Secretary of State for Social Services, in exercise of powers conferred upon him by sections 45(3), 79 to 81, 88 to 90, 146(5), and 115(1) of, and Schedule 13 to, the Social Security Act 1975 M1 and paragraphs 9(1)(a) and (c) of Schedule 3 to the Social Security (Consequential Provisions) Act 1975 M2 and of all other powers enabling him in that behalf, hereby makes the following regulations, which consolidate the regulations hereby revoked and which accordingly by virtue of sections 139(2) and 141(2) of the Social Security Act 1975-and paragraphs 20 of Schedule 15 and 12 of Schedule 16-are not subject to the requirements of sections 139(1) and 141(2) of that Act for prior reference to the National Insurance Advisory Committee and the Industrial Injuries Advisory Council respectively:—
Part IGENERAL
Citation and commencement 1.
These regulations may be cited as the Social Security (Claims and Payments) Regulations 1979 and shall come into operation on 9th July 1979.
Interpretation2.
(1)
In these regulations, unless the context otherwise requires—
“"the Act”” means the Social Security Act 1975;
“"approved place”” means a place approved by the Secretary of State for the purpose of obtaining payment of benefit;
“"benefit order”” means an order for the payment of a weekly sum on account of benefit to which regulation 16 applies or of a weekly instalment of a gratuity;
“"claim for benefit”” includes an application for a declaration that an accident was an industrial accident and an application for the review of an award or a decision for the purpose of obtaining any increase of benefit mentioned in Schedule 1 to these regulations but does not include any other application for the review of an award or a decision and the expression ““claims benefit”” and every reference to a claim shall be construed accordingly;
F1“health care professional” means—
(a)
a registered medical practitioner,
(b)
a registered nurse,
(c)
an occupational therapist or physiotherapist registered with a regulatory body established by an Order in Council under section 60 of the Health Care Act 1999, or
(d)
a member of such other profession, regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002, prescribed by the Secretary of State in accordance with powers under section 39(1) of the Social Security Act 1998.
F2...
“"instrument of payment”” means a serial order, benefit order, or any other instrument whatsoever which is intended to enable a person to obtain payment of benefit;
“"serial order”” means one of a series of orders, including benefit orders, for the payment of a sum on account of benefit which is or has been contained in a book of such orders;
“"unemployment benefit office”” means any office or place appointed by the Secretary of State for the purpose of claiming unemployment benefit; and other expressions have the same meaning as in the Act.
F3(1A)
The provision in paragraph (1) for the interpretation of the words “claim for benefit” shall not be taken to preclude the application of the regulations to a claim for attendance allowance expressed as an application for review of an earlier determination but which discloses no grounds on which such a determination could be reviewed.
(2)
Unless the context otherwise requires, any reference in these regulations to—
(a)
a numbered section is a reference to the section of the Social Security Act 1975 bearing that number;
(b)
a numbered regulation is a reference to the regulation bearing that number in these regulations and any reference in a regulation to a numbered paragraph is a reference to the paragraph of that regulation bearing that number;
(c)
any provision made by or contained in an enactment or instrument shall be construed as a reference to that provision as amended or extended by any enactment or instrument and as including a reference to any provision which it re-enacts or replaces, or which may re-enact or replace it, with or without modification.
(3)
For the purposes of the provisions of these regulations relating to the making of claims every increase of benefit mentioned in Schedule 1 to these regulations shall be treated as a separate benefit.
(4)
The provisions of Schedules 1 and 2 to these regulations shall have effect; and the following provisions of these regulations shall, in relation to any particular benefit, have effect subject to any provision in those Schedules affecting that benefit.
Part IICLAIMS
Claims not required in certain casesF43.
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Manner in which claims are to be madeF54.
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Supply of claim formsF65.
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Claims not on appropriate formsF76.
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Information to be given when making a claim for benefitF87.
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Amendment of claim formsF98.
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Interchange with claims for other benefitsF109.
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Special provision where it is certified that a woman is expected to be confined or where she has been confinedF1110.
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Self-certified claims for first 7 days of a spell of incapacity for workF1210A.
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Forward allowances and disallowances of sickness, invalidity and injury benefit and non-contributory invalidity pensionF1311.
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Forward allowance and disallowance of unemployment benefitF1412.
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Special provisions relating to claims for unemployment benefit made during periods connected with public holidaysF1513.
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Time for claiming benefitF1614.
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PART IIIPAYMENTS
Time and manner of payment of certain benefits and of an increase of disablement pensionF1715.
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Time and manner of payment of certain pensions and allowancesF1816.
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F19Payment of certain benefits by direct credit transferF2016A.
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Special provisions relating to payment of constant attendance allowance for persons out of hospital for short periodsF2117.
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Special provision relating to payment of attendance' allowance for persons out of hospital for periods not expected to exceed 13 weeksF2218.
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Time and manner of payment of age additionF2319.
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Time and manner of payments of industrial injuries gratuitiesF2420.
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Time of payment 01 Category C or D retirement pensions etc. to those in receipt of supplementary benefitF2521.
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Extinguishment of right to sums payable by way of benefit which are not obtained within the prescribed timeF2622.
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Information to be given when obtaining payment of benefitF2723.
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Part IVSPECIAL PROVISIONS RELATING TO INDUSTRIAL INJURIES BENEFIT ONLY
Notice of accidents24.
(1)
Every employed earner who suffers personal injury by accident in respect of which benefit may be payable shall give notice of such accident either in writing or orally as soon as is practicable after the happening thereof:
Provided that any such notice required to be given by an employed earner may be given by some other person acting on his behalf.
(2)
Every such notice shall be given to the employer, or (if there is more than one employer) to one of such employers, or to any foreman or other official under whose supervision the employed earner is employed at the time of the accident, or to any person designated for the purpose by the employer, and shall give the appropriate particulars.
(3)
Any entry of the appropriate particulars of an accident made in a book kept for that purpose in accordance with the provisions of regulation 25 shall, if made as soon as practicable after the happening of an accident by the employed earner or by some other person acting on his behalf, be sufficient notice of the accident for the purposes of this regulation.
(4)
In this regulation—
“"employer”” means, in relation to any person, the employer of that person at the time of the accident and “"employers”” shall be construed accordingly; and
“"employed earner”” means a person who is or is treated as an employed earner for the purposes of industrial injuries benefit.
(5)
In this regulation and regulation 25, ““appropriate particulars”” mean the particulars indicated in Schedule 4 to these regulations.
Obligations of employers25.
(1)
Every employer shall take reasonable steps to investigate the circumstances of every accident of which notice is given to him or to his servant or agent in accordance with the provisions of regulation 24 and, if there appear to him to be any discrepancies between the circumstances found by him as a result of his investigation and the circumstances appearing from the notice so given, he shall record the circumstances so found.
(2)
Every employer who is required to do so by the Secretary of State shall furnish to an officer of the Department within such reasonable period as may be required, such information and particulars as shall be required—
(a)
of any accident or alleged accident in respect of which benefit may be payable to, or in respect of the death of, a person employed by him at the time of the accident or alleged accident; or
(b)
of the nature of and other relevant circumstances relating to any occupation prescribed for the purposes of Chapter V of Part II of the Act in which any person to whom or in respect of whose death benefit may be payable under that Chapter was or is alleged to have been employed by him.
(3)
M3Every owner or occupier (being an employer) of any mine or quarry or of any premises to which any of the provisions of the Factories Act 1961 applies and every employer by whom 10 or more persons are normally employed at the same time on or about the same premises in connection with a trade or business carried on by the employer shall, subject to the following provisions of this paragraph—
F28(a)
keep readily accessible a means (whether in a book or books or by electronic means), in a form approved by the Secretary of State, by which a person employed by the employer or some other person acting on his behalf may record the appropriate particulars (as defined in regulation 24) of any accident causing personal injury to that person; and
F28(b)
preserve every such record for the period of at least 3 years from the date of its entry.
Obligations of claimants for,F29 and beneficiaries in receipt of...disablement benefit26.
(1)
Subject to the following provisions of this regulation, every claimant for, and every beneficiary in receipt ofF30... disablement benefit shall comply with every notice given to him by the Secretary of State which requires him either—
(a)
to submit himself to a medical examination F31F32in person, by telephone or by video by a F33F34health care professional approved by the Secretary of State who has experience in the issues specified in regulation 12(1) of the Social Security and Child Support (Decisions and Appeals) Regulations 1999 for the purpose of determining the effects of the relevant accident or the treatment appropriate to the relevant injury or loss of faculty; or
(b)
to submit himself to such medical treatment for the said injury or loss of faculty as is considered appropriate in his case by the medical practitioner in charge of the case F35....
(2)
Every notice given to a claimant or beneficiary requiring him to submit himself to medical examination shall be given in writing and shall specify the time and place for examination and shall not require the claimant or beneficiary to submit himself F36to examination before the expiration of the period of 6 days beginning with the date of the notice or such shorter period as may be reasonable in the circumstances.
(3)
Every claimant and every beneficiary who, in accordance with' the foregoing provisions of this regulation, is required to submit himself to a medical examination or to medical treatment—
(a)
shall attend at every such place and at every such time as may be required; and
(b)
may, in the discretion of the Secretary of State, be paid such travelling and other allowances (including compensation for loss of remunerative time) as the Secretary of State may with the consent of the Minister for the Civil Service determine.
F37(4)
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Withdrawal of claims for disablement benefitF3827.
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Part VMISCELLANEOUS PROVISIONS
Persons unable to actF3928.
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Payments on deathF4029.
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Payment of benefit to third partyF4130.
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Breach of regulations31.
If any person contravenes or fails to comply with any requirement of these regulations (not being a requirement to give notice of an accident or a requirement to submit himself to medical treatment or examination) in respect of which no special penalty is provided, he shall for such offence be liable on summary conviction to a penalty not exceeding F42£200 or, where the offence consists of continuing any such contravention or failure after conviction thereof, F42£20 for each day on which it is so continued.
RevocationsF4332.
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SCHEDULE 1SHOWING PRESCRIBED TIMES FOR CLAIMING BENEFIT AND DISQUALIFICATIONS FOR BENEFIT ARISING BY REASON OF LATE CLAIMS
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SCHEDULE 2CONTAINING MISCELLANEOUS SPECIAL PROVISIONS RELATING TO INJURY BENEFIT, UNEMPLOYMENT BENEFIT, SICKNESS BENEFIT, INVALIDITY BENEFIT, NON-CONTRIBUTORY INVALIDITY PENSION, MATERNITY ALLOWANCE AND RETIREMENT PENSIONS, INCLUDING PROVISIONS WHICH VARY THE PRESCRIBED TIMES UNDER SCHEDULE 1
F45...
SCHEDULE 3BENEFIT CLAIMED AND BENEFIT FOR WHICH THE CLAIM MAY BE TREATED AS A CLAIM IN THE ALTERNATIVE
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SCHEDULE 4PARTICULARS TO BE GIVEN OF ACCIDENTS
(1)
Full name, address and occupation of injured person;
(2)
Date and time of accident;
(3)
Place where accident happened;
(4)
Cause and nature of injury;
(5)
Name, address and occupation of person giving the notice, if other than the injured person.
SCHEDULE 5REGULATIONS REVOKED
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(This Note is not part of the Regulations.)
These Regulations are made for the purpose only of consolidating the Social Security (Claims and Payments) Regulations 1975 with subsequent amending regulations. They provide for the manner in which claims for and payments of benefits under the Social Security Act 1975 are to be made.
Part I of the Regulations contains general provisions including definitions.
Part II (with Schedules 1 to 3) includes provisions concerning circumstances when claims are not required, how claims for benefits are to be made-the forms and information required, amendments and interchange with other claims-forward allowance and disallowance of certain benefits, time limits for claims and disqualification for late claim.
Part III contains provisions concerning time and manner of payment of benefits, extinguishment of rights where benefits not obtained within specified time limits and information to be given by persons in receipt of benefit.
Part IV (with Schedule 4) relates to industrial injuries benefit and includes provisions that require notice to be given of accidents, impose obligations on employers, claimants and beneficiaries and enable claims for disablement benefit to be withdrawn.
Part V contains miscellaneous provisions relating to persons unable to act, payment on death, payment to third parties, penalties for breach of the regulations and, with Schedule 5, specifies provisions that are revoked.