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

(a) revised under Article 10; or

(b) superseded under Article 11.

    (2) For the purposes of paragraph (1), the following persons shall 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(b) a person who has made an application for a decision of the Department to be revised or superseded;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 Department;

(d) a person who qualifies for income support by virtue of paragraph 7 of Schedule 1B to the Income Support Regulations[34];

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

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

    (4) A person to whom paragraph (2) refers shall 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 Department is necessary in order to enable him to comply with the requirements; or



(b) satisfy the Department 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 Department may suspend 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 (Northern Ireland) 1976[35].

Termination in cases of failure to furnish information or evidence
     18.  - (1) Subject to paragraphs (2) to (4), the Department 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 (Northern Ireland) 1995 applies, the Department 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 Department considers it necessary to satisfy itself 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 Department considers that the examination is necessary for the purpose of making its decision.

    (2) The Department 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 Department may determine that 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 Department 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 Department is satisfied that it has been notified of the address at which the person is residing; or

(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 the Department received a copy of the tribunal's decision, it has not notified the claimant in writing that it 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 Department fails to notify the claimant in writing, within one month of the date on which it receives the reasons in writing for the decision on appeal which was pending for the purposes of regulation 16(3)(b), that an appeal against the decision has been brought (or, as the case may be, an application for leave to appeal against the decision has been made).

    (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 Department 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 circumstances prescribed under Article 26(6)(c), where an appeal is pending against a decision in the case described in Article 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, are where the Department - 

(a) certifies in writing that it 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 Article 26(1)(a).

Child support decisions involving issues that arise on appeal in other cases
     23.  - (1) For the purposes of Article 28ZA(2)(b) of the Child Support Order[36], a case which satisfies either of the conditions in paragraph (2) is a prescribed case.

    (2) The conditions 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; or

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

    (3) For the purposes of Article 28ZA(2)(b) of the Child Support Order, the prescribed basis on which the Department may make the decision is as if - 

(a) the appeal in relation to the different maintenance assessment, which is referred to in Article 28ZA(1)(b) of that Order 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 Article 28ZA(1)(a) of that Order.

    (4) The circumstances prescribed under Article 28ZA(4)(c) of the Child Support Order[37], where an appeal is pending against a decision for the purposes of that Article, 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, are where the Department - 

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

(b) 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 meanings as in Article 2(2) of the Child Support Order[38];

"employed earner" and "self-employed earner" have the same meanings 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 Article 28ZB(6)(c) of the Child Support Order[39], where an appeal is pending against a decision in the case described in Article 28ZB(1)(b) of that Order, 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, are where the Department - 

(a) certifies in writing that it 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 Article 28ZB(1)(a) of that Order.

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

(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; 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 134(2) of the Contributions and Benefits Act.

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

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

    (3) An appeal brought 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 Order or these Regulations against any decision of the Department 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 Department 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 Department 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 Recovery of Benefits Order relating to a certificate of recoverable benefits shall, in addition to any requirements specified in regulation 33, include the following particulars - 

(a) in the case of an appeal, the date of the certificate of recoverable benefits or the decision by the Department on review against which the appeal is brought, the question under Article 13 of the Recovery of Benefits Order to which the appeal relates and a summary of the arguments relied on by the appellant to support his contention that the certificate is wrong; and

(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 Article 11 of the Recovery of Benefits Order or if that statement was not in writing, a written summary of it, shall be sent with the appeal or application.

    (3) Where it appears to the Department 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), it 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 Department's direction under paragraph (3), as the Department may determine.

    (5) Where further particulars or a written statement or summary are required under paragraph (3), they shall be sent or delivered to the Department within such period as it may direct.

    (6) The Department may treat any appeal relating to the certificate of recoverable benefits as an application for review under Article 12 of the Recovery of Benefits Order[40].

(a) any relevant benefit paid to the appellant is greater or is awarded for a longer period in consequence of the decision made under Article 10;

(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 for receiving, some or all of the benefit;

(c) as a result of the decision, a denial or disqualification for receiving 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 69, 69A or 72 of the Administration Act 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 Article 18 of the Child Support Order or under Article 10 is not more advantageous to the appellant than the decision before it was revised, the appeal shall be treated as if 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 expiry 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 any further representations from the appellant, the Department further revises its decision and that decision is more advantageous to the appellant than the decision before it was revised.

Time within which appeals are to be brought
     31.  - (1) Where an appeal lies from a decision of the Department to an appeal tribunal, the time within which that appeal shall be brought is, subject to the following provisions of this Part - 

(a) 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, 14 days of the expiry of the period specified in sub-paragraph (a).

    (2) Where the Department - 

(a) revises, or following an application for a revision under regulation 3(1) or (3) does not revise, a decision under Article 18 of the Child Support Order or under Article 10; or

(b) supersedes a decision under Article 19 of that Order[42] or under Article 11,

the period of one month specified in paragraph (1) shall 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 on which the Department issues a notice that it is not revising the decision.

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

(a) not later than one month after the date on which a person making a compensation payment discharges his liability under Article 8 of the Recovery of Benefits Order;

(b) where the certificate is reviewed by the Department in accordance with regulations made under Article 13(5)(c) of that Order, not later than one month after the date on which 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.

[35] S.R. 1976 No. 175; relevant amending regulations are S.R. 1982 No. 153, S.R. 1987 No. 117, S.R. 1992 No. 83, S.R. 1994 No. 468 and S.R. 1995 No. 149back

[36] Article 28ZA(2)(b) was inserted by Article 43 of the Social Security (Northern Ireland) Order 1998back

[37] Article 28ZA(4)(c) was inserted by Article 43 of the Social Security (Northern Ireland) Order 1998back

[38] The definition of "parent with care" was inserted by paragraph 2(a) of Schedule 3 to the Child Support (Northern Ireland) Order 1995 (S.I. 1995/2702 (N.I. 13))back

[39] Article 28ZB(6)(c) was inserted by Article 43 of the Social Security (Northern Ireland) Order 1998back

[40] Article 12(1) was substituted by paragraph 120(1) of Schedule 6 to the Social Security (Northern Ireland) Order 1998 (S.I. 1998/1506 (N.I. 10))back

[41] Article 18 was substituted by Article 40 of the Social Security (Northern Ireland) Order 1998back

[42] Article 19(3) and (5) was substituted by Article 41 of the Social Security (Northern Ireland) Order 1998back

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