Back to previous page

Provision of information or evidence
     17.  - (1) This regulation applies where the Secretary of State requires information or evidence for a determination whether a decision awarding a relevant benefit should be - 

(a) revised under section 9; or

(b) superseded under section 10.

    (2) For the purposes of paragraph (1), the following persons must satisfy the requirements of paragraph (4) - 

(a) a person in respect of whom payment of a benefit has been suspended in the circumstances prescribed in regulation 16(3)(a);

(b) a person who has made an application for a decision of the Secretary of State to be revised or superseded;

(c) a person who fails to comply with the provisions of regulation 32(1) of the Claims and Payments Regulations in so far as they relate to documents, information or facts required by the Secretary of State;

(d) a person who qualifies for income support by virtue of paragraph 7 of Schedule 1B to the Income Support Regulations[27];

(e) a person whose entitlement to benefit is conditional upon his being, or being treated as, incapable of work.

    (3) The Secretary of State shall notify any person to whom paragraph (2) refers of the requirements of this regulation.

    (4) A person to whom paragraph (2) refers must either - 

(a) supply the information or evidence within - 


(i) a period of one month beginning with the date on which the notification under paragraph (3) was sent to him; or

(ii) such longer period as he satisfies the Secretary of State is necessary in order to enable him to comply with the requirement; or



(b) satisfy the Secretary of State within the period of time specified in sub-paragraph (a)(i) that either - 



(i) the information or evidence required of him does not exist; or

(ii) that it is not possible for him to obtain it.

    (5) The Secretary of State may suspend the payment of a relevant benefit, in whole or in part, to any person to whom paragraph (2)(b) to (e) applies who fails to satisfy the requirements of paragraph (4).

    (6) In this regulation, "evidence" includes evidence which a person is required to provide in accordance with regulation 2 of the Social Security (Medical Evidence) Regulations 1976[28].

Termination in cases of failure to furnish information or evidence
     18.  - (1) Subject to paragraphs (2), (3) and (4), the Secretary of State shall decide that where a person - 

(a) whose benefit has been suspended in accordance with regulation 16 and who subsequently fails to comply with an information requirement made in pursuance of regulation 17; or

(b) whose benefit has been suspended in accordance with regulation 17(5),

that person shall cease to be entitled to that benefit from the date on which payment was suspended except where entitlement to benefit ceases on an earlier date other than under this regulation.

    (2) Paragraph (1)(a) shall not apply where not more than one month has elapsed since the information requirement was made in pursuance of regulation 17.

    (3) Paragraph (1)(b) shall not apply where not more than one month has elapsed since the first payment was suspended in accordance with regulation 17.

    (4) Paragraph (1) shall not apply where benefit has been suspended in part under regulation 16 or, as the case may be, regulation 17.

Suspension and termination for failure to submit to medical examination
     19.  - (1) Except where regulation 8 of the Social Security (Incapacity for Work) (General) Regulations 1995[29] applies (where a question arises as to whether a person is capable of work), the Secretary of State may require a person to submit to a medical examination by a medical practitioner where that person is in receipt of a relevant benefit, and either - 

(a) the Secretary of State considers it necessary to satisfy himself as to the correctness of the award of the benefit, or of the rate at which it was awarded; or

(b) that person applies for a revision or supersession of the award and the Secretary of State considers that the examination is necessary for the purpose of making his decision.

    (2) The Secretary of State may suspend payment of a relevant benefit in whole or in part, to a person who fails, without good cause, on two consecutive occasions to submit to a medical examination in accordance with requirements under paragraph (1) except where entitlement to benefit is suspended on an earlier date other than under this regulation.

    (3) Subject to paragraph (4), the Secretary of State may determine that the entitlement to a relevant benefit of a person, in respect of whom payment of such a benefit has been suspended under paragraph (2), shall cease from a date not earlier than the date on which payment was suspended except where entitlement to benefit ceases on an earlier date other than under this regulation.

    (4) Paragraph (3) shall not apply where not more than one month has elapsed since the first payment was suspended under paragraph (2).

Making of payments which have been suspended
     20.  - (1) Subject to paragraphs (2) and (3), payment of a benefit suspended in accordance with regulation 16 shall be made where - 

(a) in a case to which regulation 16(2) or (3)(a)(i) to (iii) applies, the Secretary of State is satisfied that the benefit suspended is properly payable and no outstanding issues remain to be resolved;

(b) in a case to which regulation 16(3)(a)(iv) applies, the Secretary of State is satisfied that he has been notified of the address at which the person is residing;

(c) in a case to which regulation 16(3)(b) applies, an appeal is no longer pending and the benefit suspended remains payable following the determination of the appeal.

    (2) Where regulation 16(4)(a) applies, payment of a benefit suspended shall be made if, within one month of the date on which he received a copy of the tribunal's decision, the Secretary of State has not notified the claimant in writing that he has requested, pursuant to regulation 53(4), a statement of the reasons for the decision.

    (3) Where regulation 16(4)(b) or (c) applies, payment of a benefit suspended shall be made if the Secretary of State fails to notify the claimant in writing, within one month of the date on which the Secretary of State receives the reasons in writing for the decision on appeal which was pending for the purposes of regulation 16(3)(b), that an appeal or, as the case may be, an application for leave to appeal has been made against the decision.

    (4) Payment of benefit which has been suspended in accordance with regulation 19 for failure to submit to a medical examination shall be made where the Secretary of State is satisfied that it is no longer necessary for the person referred to in that regulation to submit to a medical examination.

Appeals involving issues that arise in other cases
     22. The circumstance prescribed under section 26(6)(c), where an appeal is pending against a decision in the case described in section 26(1)(b) even though an appeal against the decision has not been brought (or, as the case may be, an application for leave to appeal against the decision has not been made) but the time for doing so has not yet expired, is where the Secretary of State - 

(a) certifies in writing that he is considering appealing against that decision; and

(b) considers that, if such an appeal were already determined, it would affect the determination of the appeal described in section 26(1)(a).

Child support decisions involving issues that arise on appeal in other cases
     23.  - (1) For the purposes of section 28ZA(2)(b) of the Child Support Act[30] (prescribed cases and circumstances in which a decision may be made on a prescribed basis), a case which satisfies either of the conditions in paragraph (2) is a prescribed case.

    (2) The conditions referred to in paragraph (1) are that - 

(a) if a decision were not made on the basis prescribed in paragraph (3), the parent with care would become entitled to income support if a claim were made, or to an increased amount of that benefit;

(b) the absent parent is an employed earner or a self-employed earner.

    (3) For the purposes of section 28ZA(2)(b) of the Child Support Act, the prescribed basis on which the Secretary of State may make the decision is as if - 

(a) the appeal in relation to the different maintenance assessment, which is referred to in section 28ZA(1)(b) of that Act had already been determined; and

(b) that appeal had been decided in a way that was the most unfavourable to the applicant for the decision mentioned in section 28ZA(1)(a) of that Act.

    (4) The circumstances prescribed under section 28ZA(4)(c) of the Child Support Act (where an appeal is pending against a decision for the purposes of that section, even though an appeal against the decision has not been brought or, as the case may be, an application for leave to appeal against the decision has not been made but the time for doing so has not expired), are that the Secretary of State - 

(a) certifies in writing that he is considering appealing against that decision; and

(b) he considers that, if such an appeal were to be determined in a particular way - 


(i) there would be no liability for child support maintenance, or

(ii) such liability would be less than would be the case were an appeal not made.

    (5) In this regulation - 

"absent parent" and "parent with care" have the same meaning as in section 54 of the Child Support Act;

"employed earner" and "self-employed earner" have the same meaning as in section 2(1) of the Contributions and Benefits Act.

Child support appeals involving issues that arise in other cases
     24. The circumstances prescribed under section 28ZB(6)(c) of the Child Support Act[31], where an appeal is pending against a decision in the case described in section 28ZB(1)(b) even though an appeal against the decision has not been brought (or, as the case may be, an application for leave to appeal against the decision has not been made), is where the Secretary of State - 

(a) certifies in writing that he is considering appealing against that decision, and

(b) considers that, if such an appeal were already determined, it would affect the determination of the appeal described in section 28ZB(1)(a).

(a) any person appointed by the Secretary of State under regulation 33(1) of the Claims and Payments Regulations (persons unable to act) to act on behalf of another;

(b) any person claiming attendance allowance or disability living allowance on behalf of another under section 66(2)(b) of the Contriburions and Benefits Act or, as the case may be, section 76(3) of that Act (claims on behalf of terminally ill persons);

(c) in relation to a pension scheme, any person who, for the purposes of Part X of the Pension Schemes Act 1993[32], is an employer, member, trustee or manager by virtue of section 146(8) of that Act.

Decisions against which an appeal lies
     26. An appeal shall lie to an appeal tribunal against a decision made by the Secretary of State - 

(a) as to whether a person is entitled to a relevant benefit for which no claim is required by virtue of regulation 3 of the Claims and Payments Regulations[33]; or

(b) as to whether a payment be made out of the social fund to a person to meet expenses for heating by virtue of regulations made under section 138(2) of the Contributions and Benefits Act (payments out of the social fund).

Decisions against which no appeal lies
     27.  - (1) No appeal lies to an appeal tribunal against a decision set out in Schedule 2.

    (2) In paragraph (1) and Schedule 2, "decision" includes determinations embodied in or necessary to a decision.

    (3) An appeal made against a decision specified in paragraph (1) may be struck out in accordance with regulation 46.

Notice of decision against which appeal lies
     28.  - (1) A person with a right of appeal under the Act or these Regulations against any decision of the Secretary of State shall - 

(a) be given written notice of the decision against which the appeal lies;

(b) be informed that, in a case where that written notice does not include a statement of the reasons for that decision, he may, within one month of the date of notification of that decision, request that the Secretary of State provide him with a written statement of the reasons for that decision; and

(c) be given written notice of his right of appeal against that decision.

    (2) Where a written statement of the reasons for the decision is not included in the written notice of the decision and is requested under paragraph (1)(b), the Secretary of State shall provide that statement within 14 days of receipt of the request.

Further particulars required relating to certificate of recoverable benefits appeals or applications
     29.  - (1) An appeal or application under the 1997 Act relating to a certificate of recoverable benefits shall, in addition to any requirements imposed by regulations, include also the following particulars - 

(a) in the case of an appeal, the date of the certificate of recoverable benefits or the decision by the Secretary of State on review against which the appeal is brought, the question under section 11 of the 1997 Act to which the appeal relates and a summary of the arguments relied upon by the appellant to support his contention that the certificate is wrong;

(b) in the case of an application for an extension of time under regulation 32, in relation to the appeal which it is proposed to bring, the particulars required under sub-paragraph (a) together with particulars of the special circumstances on which the application is based.

    (2) Where the appeal or the application for an extension of time is made by a person to whom a compensation payment has been made, a copy of the statement given to that person under section 9 of the 1997 Act or if that statement was not in writing, a written summary of it, shall be sent with that appeal or application.

    (3) Where it appears to the Secretary of State that an appeal or application does not contain the further particulars required under paragraph (1) or is not accompanied by a written statement or summary as required under paragraph (2) he may direct the appellant or applicant to provide such particulars or such a statement or summary.

    (4) Where paragraph (3) applies, the time specified for making the appeal or application may be extended by such period, not exceeding 14 days from the date of the Secretary of State's direction under paragraph (3), as the Secretary of State may determine.

    (5) Where further particulars or a written statement or summary are required under paragraph (3) they shall be sent to or delivered to the Compensation Recovery Unit of the Department of Social Security at Reyrolle Building, Hebburn, Tyne and Wear, NE31 1XB within such period as the Secretary of State may direct.

    (6) The Secretary of State may treat any appeal relating to the certificate of recoverable benefits as an application for review under section 10 of the 1997 Act.

(a) any relevant benefit paid to the appellant is greater or is awarded for a longer period in consequence of the decision made under section 9;

(b) it would have resulted in the amount of relevant benefit in payment being greater but for the operation of any provision of the Administration Act or the Contributions and Benefits Act restricting or suspending the payment of, or disqualifying a claimant from receiving, some or all of the benefit;

(c) as a result of the decision, a denial or disqualification for the receiving of any relevant benefit, is lifted, wholly or in part;

(d) it reverses a decision to pay benefit to a third party;

(e) in consequence of the revised decision, benefit paid is not recoverable under section 71, 71A or 74 of the Administration Act[34] or regulations made under any of those sections, or the amount so recoverable is reduced; or

(f) a financial gain accrued or will accrue to the appellant in consequence of the decision.

    (3) Where a decision as revised under section 16 of the Child Support Act or under section 9 is not more advantageous to the appellant than the decision before it was revised, the appeal shall be treated as though it had been brought against the decision as revised.

    (4) The appellant shall have a period of one month from the date of notification of the decision as revised to make further representations as to the appeal.

    (5) After the expiration of the period specified in paragraph (4), or within that period if the appellant consents in writing, the appeal to the appeal tribunal shall proceed except where, in the light of the further representations from the appellant, the Secretary of State further revises his decision and that decision is more advantageous to the appellant than the decision before it was revised.

Time within which an appeal is to be brought
     31.  - (1) Where an appeal lies from a decision of the Secretary of State to an appeal tribunal, except in the case of a decision of the Secretary of State under section 3 or 3A of the Vaccine Damage Payments Act, the time within which that appeal must be brought is, subject to the following provisions of this Part - 

(a) within one month of the date of notification of the decision against which the appeal is brought; or

(b) where a written statement of reasons for that decision is requested, within 14 days of the expiry of the period specified in sub-paragraph (a).

    (2) Where the Secretary of State - 

(a) revises, or following an application for a revision under regulation 3(1) or (3) does not revise, a decision under section 16 of the Child Support Act or under section 9, or

(b) supersedes a decision under section 17 of the Child Support Act or under section 10,

the period of one month specified in paragraph (1) shall begin to run from the date of notification of the revision or supersession of the decision, or following an application for a revision under regulation 3(1) or (3), the date the Secretary of State issues a notice that he is not revising the decision.

    (3) An appeal against a certificate of recoverable benefits must be brought - 

(a) not later than one month after the date a person making a compensation payment discharges his liability under section 6 of the 1997 Act;

(b) where the certificate is reviewed by the Secretary of State in accordance with regulations made under section 11(5)(c) of the 1997 Act, not later than one month after the date the certificate is confirmed, or, as the case may be, a fresh certificate is issued; or

(c) where an agreement is made under which an earlier compensation payment is treated as having been made in final discharge of a claim made by or in respect of an injured person and arising out of the accident, injury or disease, not later than one month after the date of that agreement.

    (4) Where a dispute arises as to whether an appeal was brought within the time limit specified in this regulation, the dispute shall be referred to, and be determined by, a legally qualified panel member.

    (5) The time limit specified in this regulation for bringing an appeal may be extended in accordance with regulation 32.

Late appeals
     32.  - (1) The time within which an appeal must be brought may be extended where the conditions specified in paragraphs (2) to (8) are satisfied, but no appeal shall in any event be brought more than one year after the expiration of the last day for appealing under regulation 31.

    (2) An application for an extension of time under this regulation shall be made in accordance with regulation 33 and shall be determined by a legally qualified panel member.

    (3) An application under this regulation shall contain particulars of the grounds on which the extension of time is sought, including details of any relevant special circumstances for the purposes of paragraph (4).

    (4) An application for an extension of time shall not be granted unless the panel member is satisfied that - 

(a) if the application is granted there are reasonable prospects that the appeal will be successful;

(b) it is in the interests of justice for the application to be granted.

    (5) For the purposes of paragraph (4) it is not in the interests of justice to grant an application unless the panel member is satisfied that - 

(a) the special circumstances specified in paragraph (6) are relevant to the application; or

(b) some other special circumstances exist which are wholly exceptional and relevant to the application,

and as a result of those special circumstances, it was not practicable for the application to be made within the time limit specified in regulation 31.

    (6) For the purposes of paragraph (5)(a), the special circumstances are that - 

(a) the applicant or a spouse or dependant of the applicant has died or suffered serious illness;

(b) the applicant is not resident in the United Kingdom; or

(c) normal postal services were disrupted.

    (7) In determining whether it is in the interests of justice to grant the application, the panel member shall have regard to the principle that the greater the amount of time that has elapsed between the expiration of the time within which the appeal is to be brought under regulation 31 and the making of the application for an extension of time, the more compelling should be the special circumstances on which the application is based.

    (8) In determining whether it is in the interests of justice to grant an application, no account shall be taken of the following - 

(a) that the applicant or any person acting for him was unaware of or misunderstood the law applicable to his case (including ignorance or misunderstanding of the time limits imposed by these Regulations); or

(b) that a Commissioner or a court has taken a different view of the law from that previously understood and applied.

    (9) An application under this regulation for an extension of time which has been refused may not be renewed.

    (10) The panel member who determines an application under this regulation shall record a summary of his decision in such written form as has been approved by the President.

    (11) As soon as practicable after the decision is made a copy of the decision shall be sent or given to every party to the proceedings.

[28] S.I. 1976/615; relevant amending instruments are S.I. 1982/699, 1992/247 and 1994/2975.back

[29] S.I. 1995/311.back

[30] Section 28ZA was inserted by section 43 of the Social Security Act 1998.back

[31] Section 28ZB was inserted by section 43 of the Social Security Act 1998.back

[32] 1993 c.48.back

[33] The relevant amending instruments are S.I. 1989/136, S.I. 1994/2943 and S.I. 1996/1460.back

[34] Section 71A was inserted by section 18 of the Jobseekers Act 1995 (c.18).back