Statutory Rule 1999 No. 267

The Social Security and Child Support (Decisions and Appeals) (Amendment No. 2) Regulations (Northern Ireland) 1999

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© Crown Copyright 1999

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(a) after the definition of "the date of notification" there shall be inserted the following definitions - 

" "disability benefit decision" means a decision to award a relevant benefit embodied in or necessary to which is a disability determination;
"disability determination" means - 
(a) in the case of a decision as to an award of an attendance allowance or a disability living allowance, whether the person satisfies any of the conditions in section 64 or, as the case may be, 72(1) or 73(1) to (3) of the Contributions and Benefits Act;

(b) in the case of a decision as to an award of severe disablement allowance, whether the person is disabled for the purpose of section 68 of that Act; or

(c) in the case of a decision as to an award of industrial injuries benefit, whether the existence or extent of any disablement is sufficient for the purposes of section 103 or 108 of that Act or for the benefit to be paid at the rate which was in payment immediately prior to that decision;";



(b) after the definition of "financially qualified panel member" there shall be inserted the following definitions - 

" "incapacity benefit decision" means a decision to award a relevant benefit embodied in or necessary to which is a determination that a person is or is treated as incapable of work under Part XIIA of the Contributions and Benefits Act[3];
"incapacity determination" means a determination whether a person is incapable of work by virtue of the all work test (as defined in regulation 2(1) of the Incapacity for Work Regulations) or whether a person is treated as incapable of work in accordance with regulation 10 or 27 of those Regulations;
"the Incapacity for Work Regulations" means the Social Security (Incapacity for Work) (General) Regulations (Northern Ireland) 1995[4];"; and

(c) after the definition of "party to the proceedings" there shall be inserted the following definition - 

" "payee" means a person to whom a benefit referred to in the definition of "disability determination" or "incapacity benefit decision" is payable;".

    (3) In regulation 3(5) (revision of decisions) - 

(a) in sub-paragraph (b) at the beginning there shall be inserted the words "except in a case to which sub-paragraph (c) applies,"; and

(b) after sub-paragraph (b) there shall be added - 


     " or

(c) where the decision is a disability benefit decision, or is an incapacity benefit decision where there has been an incapacity determination (whether before or after the decision), which was made in ignorance of, or was based on a mistake as to, some material fact in relation to a disability determination embodied in or necessary to the disability benefit decision, or the incapacity determination and - 


(i) as a result of that ignorance of, or mistake as to, that fact, the decision was more advantageous to the claimant than it would otherwise have been but for that ignorance or mistake, and

(ii) the Department is satisfied that the claimant or payee knew or could reasonably have been expected to know of the fact in question and that it was relevant to the decision,".

    (4) In regulation 6(2) (supersession of decisions) after sub-paragraph (f) there shall be added - 

     " or

(g) is an incapacity benefit decision where there has been an incapacity determination (whether before or after the decision) and where, since the decision was made, the Department has received medical evidence following an examination in accordance with regulation 8 of the Incapacity for Work Regulations from a doctor referred to in paragraph (1) of that regulation.".

    (5) In regulation 7(2)(c) (date from which a decision superseded under Article 11 takes effect) for head (ii) there shall be substituted the following heads - 

" (ii) in the case of a disability benefit decision, or an incapacity benefit decision where there has been an incapacity determination (whether before or after the decision), where the Department is satisfied that in relation to a disability determination embodied in or necessary to the disability benefit decision, or the incapacity determination, the claimant or payee failed to notify an appropriate office of a change of circumstances which regulation 32 of the Social Security (Claims and Payments) Regulations (Northern Ireland) 1987[5] required him to notify, and the claimant or, as the case may be, payee knew, or could reasonably have been expected to know, that the change of circumstances should have been notified - 


(aa) from the date on which the claimant or, as the case may be, the payee ought to have notified the change of circumstances, or

(bb) if more than one change has taken place between the date from which the decision to be superseded took effect and the date of the superseding decision, from the date on which the first change ought to have been notified, or



(iii) in any other case, from the date of the change.".

    (6) After regulation 7 there shall be inserted the following regulation - 

" Date from which revised or superseded decision takes effect where entitlement is dependent on another benefit
     7A. Where a person's entitlement to, or receipt of, a benefit ("the first benefit") is a condition of his being entitled to another benefit, allowance or advantage ("the second benefit") and a decision is revised under regulation 3(5)(c) or a superseding decision is made under regulation 6(2) to which regulation 7(2)(c)(ii) applies, the effect of which is that the first benefit ceases to be payable, or becomes payable at a lower rate than was in payment immediately prior to that revision or supersession, the consequent decision as to his entitlement to the second benefit shall take effect from the date of the change in his entitlement to the first benefit.".

    (7) In regulation 20(1) (making of payments which have been suspended) - 

(a) after "regulation 16" there shall be inserted "or 17"; and

(b) after sub-paragraph (c) there shall be added - 


     " or

(d) in a case to which regulation 17(5) applies, the Department is satisfied that the benefit suspended is properly payable and the requirements of regulation 17(4) have been satisfied.".

Sealed with the Official Seal of the Department of Health and Social Services on

L.S.

John O'Neill
Assistant Secretary

11th June 1999.

[2] S.R. 1999 No. 162, to which there are amendments not relevant to these regulationsback

[3] Part XIIA was inserted by Articles 7 and 8(1) of the Social Security (Incapacity for Work) (Northern Ireland) Order 1994 (S.I. 1994/1898 (N.I. 12))back

[4] S.R. 1995 No. 41; relevant amending regulations are S.R. 1995 No. 149, S.R. 1996 No. 601 and S.R. 1997 No. 174back

[5] S.R. 1987 No. 465; relevant amending regulations are S.R. 1992 No. 453, S.R. 1995 No. 367 and S.R. 1996 No. 354back