Social Security Act 1998 (c. 14)

(The document as of February, 2008)

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except that if it appears to him, having regard to the circumstances of the case and in particular to the convenience of the persons who may be parties to the proposed appeal, that he should specify a different court mentioned in paragraphs (a) to (c) above as the appropriate court, it shall be his duty to specify that court as the appropriate court.

(5) In this section--

"the appropriate court", except in subsection (4) above, means the court specified in pursuance of that subsection;
"the relevant place", in relation to an application for leave to appeal from a decision of a Commissioner, means the premises where the person or authority whose decision was the subject of the Commissioner's decision usually exercises his or its functions.

Procedure etc.

16 Procedure

(1) Regulations ("procedure regulations") may make any such provision as is specified in Schedule 5 to this Act.

(2) Procedure regulations prescribing the procedure to be followed in cases before a Commissioner shall provide that any hearing shall be in public except in so far as the Commissioner for special reasons otherwise directs.

(3) It is hereby declared--

(a) that the power to prescribe procedure includes power to make provision as to the representation of one person, at any hearing of a case, by another person whether having professional qualifications or not; and

(b) that the power to provide for the procedure to be followed in connection with the making of decisions by the Secretary of State includes power to make provision with respect to the formulation of the matters to be decided, whether on a reference under section 117 of the Administration Act or otherwise.

(4) Subsection (5) below applies to any issue--

(a) as to whether a Class 1A contribution is payable, or otherwise relating to a Class 1A contribution; or

(b) relating to emoluments in respect of which a Class 1A contribution would be payable but for section 10(8A) of the Contributions and Benefits Act;

and in that subsection, in relation to such an issue, "the relevant person" means the person who is liable or alleged to be liable, or (as the case may be) who would be liable or who it is alleged would be liable, to pay the Class 1A contribution in question.

(5) In proceedings for the determination of an issue to which this subsection applies--

(a) in England and Wales, there shall be available to a witness (other than the relevant person) any privilege against self-incrimination or incrimination of a spouse which is available to a witness in legal proceedings; and

(b) in Scotland, section 3 of the [1853 c. 20.] Evidence (Scotland) Act 1853 (competence and compellability of witnesses) shall apply as it applies to civil proceedings except that the relevant person shall have no privilege against self-incrimination.

(6) If it appears to a Commissioner that a matter before him involves a question of fact of special difficulty, he may direct that in dealing with that matter he shall have the assistance of one or more experts.

In this subsection "expert" means a person appearing to the Commissioner to have knowledge or experience which would be relevant in determining the question of fact of special difficulty.

(7) If it appears to the Chief Commissioner (or, in the case of his inability to act, to such other of the Commissioners as he may have nominated to act for the purpose) that--

(a) an application for leave under section 14(10)(b) above; or

(b) an appeal,

falling to be heard by one of the Commissioners involves a question of law of special difficulty, he may direct that the application or appeal be dealt with, not by that Commissioner alone, but by a tribunal consisting of any three or more of the Commissioners.

If the decision of the tribunal is not unanimous, the decision of the majority shall be the decision of the tribunal; and the presiding Commissioner shall have a casting vote if the votes are equally divided.

(8) Where a direction is given under subsection (7)(a) above, section 14(10)(b) above shall have effect as if the reference to a Commissioner were a reference to such a tribunal as is mentioned in subsection (7) above.

(9) Except so far as it may be applied in relation to England and Wales by procedure regulations, Part I of the [1996 c. 23.] Arbitration Act 1996 shall not apply to any proceedings under this Chapter.

17 Finality of decisions

(1) Subject to the provisions of this Chapter, any decision made in accordance with the foregoing provisions of this Chapter shall be final; and subject to the provisions of any regulations under section 11 above, any decision made in accordance with those regulations shall be final.

(2) If and to the extent that regulations so provide, any finding of fact or other determination embodied in or necessary to such a decision, or on which such a decision is based, shall be conclusive for the purposes of--

(a) further such decisions;

(b) decisions made under the Child Support Act; and

18 Matters arising as respects decisions

(1) Regulations may make provision as respects matters arising--

(a) pending any decision under this Chapter of the Secretary of State, an appeal tribunal or a Commissioner which relates to--

(i) any claim for a relevant benefit;

(ii) any person's entitlement to such a benefit or its receipt;

(iii) statutory sick pay or statutory maternity pay; or

(iv) any person's liability for contributions; or

(b) out of the revision under section 9 above or on appeal of any such decision.

(2) Regulations under subsection (1) above as it applies to child benefit may include provision as to the date from which child benefit is to be payable to a person in respect of a child in a case where, before the benefit was awarded to that person, child benefit in respect of the child was awarded to another person.

Medical examinations

19 Medical examination required by Secretary of State

(1) Before making a decision on a claim for a relevant benefit, or as to a person's entitlement to such a benefit or to statutory sick pay or statutory maternity pay, the Secretary of State may refer the person--

(a) in respect of whom the claim is made; or

(b) whose entitlement is at issue,

to a medical practitioner for such examination and report as appears to the Secretary of State to be necessary for the purpose of providing him with information for use in making the decision.

(2) Subsection (3) below applies where--

(a) the Secretary of State has exercised the power conferred on him by subsection (1) above; and

(b) the medical practitioner requests the person referred to him to attend for or submit himself to medical examination.

(3) If the person fails without good cause to comply with the request, the Secretary of State shall make the decision against him.

20 Medical examination required by appeal tribunal

(1) This section applies where an appeal has been brought under section 12 above against a decision on a claim for a relevant benefit, or as to a person's entitlement to such a benefit or to statutory sick pay or statutory maternity pay.

(2) An eligible person may, if prescribed conditions are satisfied, refer the person--

(a) in respect of whom the claim is made; or

(b) whose entitlement is at issue,

to a medical practitioner for such examination and report as appears to the eligible person to be necessary for the purpose of providing an appeal tribunal with information for use in determining the appeal.

In this subsection "eligible person" means a person who is eligible to be appointed as the sole member of an appeal tribunal, or to be nominated as the chairman of such a tribunal.

(3) At a hearing before an appeal tribunal, except in prescribed cases or circumstances, the tribunal--

(a) may not carry out a physical examination of the person mentioned in subsection (2) above; and

(b) may not require that person to undergo any physical test for the purpose of determining whether he satisfies the condition mentioned in section 73(1)(a) of the Contributions and Benefits Act.

Suspension and termination of benefit

21 Suspension in prescribed circumstances

(1) Regulations may provide for--

(a) suspending payments of a relevant benefit, in whole or in part, in prescribed circumstances;

(b) the subsequent making in prescribed circumstances of any or all of the payments so suspended.

(2) Regulations made under subsection (1) above may, in particular, make provision for any case where--

(a) it appears to the Secretary of State that an issue arises whether the conditions for entitlement to a relevant benefit are or were fulfilled;

(b) it appears to the Secretary of State that an issue arises whether a decision as to an award of a relevant benefit should be revised (under section 9 above) or superseded (under section 10 above);

(d) an appeal is pending against the decision given in a different case by a Commissioner or a court, and it appears to the Secretary of State that if the appeal were to be determined in a particular way an issue would arise whether the award of a relevant benefit (whether the same benefit or not) in the case itself ought to be revised or superseded.

(3) For the purposes of subsection (2) above, an appeal against a decision is pending if--

(a) an appeal against the decision has been brought but not determined;

(b) an application for leave to appeal against the decision has been made but not determined; or

(c) in such circumstances as may be prescribed, 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.

(4) Any reference in this section or section 24 or 25 below to a relevant benefit includes a reference to statutory sick pay and statutory maternity pay.

22 Suspension for failure to furnish information etc

(1) The powers conferred by this section are exercisable in relation to persons who fail to comply with information requirements.

(2) Regulations may provide for--

(a) suspending payments of a relevant benefit, in whole or in part;

(b) the subsequent making in prescribed circumstances of any or all of the payments so suspended.

(3) In this section and section 23 below "information requirement" means a requirement, made in pursuance of regulations under subsection (1)(hh) of section 5 of the Administration Act, to furnish information or evidence needed for a determination whether a decision on an award of benefit to which that section applies should be revised under section 9 or superseded under section 10 above.

23 Termination in cases of failure to furnish information

Regulations may provide that, except in prescribed cases or circumstances, a person--

(a) whose benefit has been suspended in accordance with regulations under section 21 above and who subsequently fails to comply with an information requirement; or

(b) whose benefit has been suspended in accordance with regulations under section 22 above for failing to comply with such a requirement,

shall cease to be entitled to the benefit from a date not earlier than the date on which payments were suspended.

24 Suspension and termination for failure to submit to medical examination

Regulations may make provision--

(a) enabling the Secretary of State to require a person to whom a relevant benefit has been awarded to submit to medical examination;

(b) for suspending payments of benefit, in whole or in part, in a case of a person who fails to submit himself to a medical examination to which he is required to submit in accordance with regulations under paragraph (a) above;

(d) for entitlement to the benefit to cease, except in prescribed cases or circumstances, from a date not earlier than the date on which payments were suspended.

Decisions and appeals dependent on other cases

25 Decisions involving issues that arise on appeal in other cases

(1) This section applies where--

(a) a decision by the Secretary of State falls to be made under section 8, 9 or 10 above in relation to a particular case; and

(b) an appeal is pending against the decision given in another case by a Commissioner or a court (whether or not the two cases concern the same benefit).

(2) In a case relating to a relevant benefit, the Secretary of State need not make the decision while the appeal is pending if he considers it possible that the result of the appeal will be such that, if it were already determined, there would be no entitlement to benefit.

(3) If the Secretary of State considers it possible that the result of the appeal will be such that, if it were already determined, it would affect the decision in some other way--

(a) he need not, except in such cases or circumstances as may be prescribed, make the decision while the appeal is pending;

(b) he may, in such cases or circumstances as may be prescribed, make the decision on such basis as may be prescribed.

(4) Where the Secretary of State acts in accordance with subsection (3)(b) above, following the determination of the appeal he shall if appropriate revise his decision (under section 9 above) in accordance with that determination.

(5) For the purposes of this section, an appeal against a decision is pending if--

(a) an appeal against the decision has been brought but not determined;

(b) an application for leave to appeal against the decision has been made but not determined; or

(6) In paragraphs (a), (b) and (c) of subsection (5) above, any reference to an appeal, or an application for leave to appeal, against a decision includes a reference to--

(a) an application for, or for leave to apply for, judicial review of the decision under section 31 of the [1981 c. 54.] Supreme Court Act 1981; or

(b) an application to the supervisory jurisdiction of the Court of Session in respect of the decision.

26 Appeals involving issues that arise on appeal in other cases

(1) This section applies where--

(a) an appeal ("appeal A") in relation to a decision under section 8, 9 or 10 above is made to an appeal tribunal, or from an appeal tribunal to a Commissioner; and

(b) an appeal ("appeal B") is pending against a decision given in a different case by a Commissioner or a court (whether or not the two appeals concern the same benefit).

(2) If the Secretary of State considers it possible that the result of appeal B will be such that, if it were already determined, it would affect the determination of appeal A, he may serve notice requiring the tribunal or Commissioner--

(a) not to determine appeal A but to refer it to him; or

(b) to deal with the appeal in accordance with subsection (4) below.

(3) Where appeal A is referred to the Secretary of State under subsection (2)(a) above, following the determination of appeal B and in accordance with that determination, he shall if appropriate--

(a) in a case where appeal A has not been determined by the tribunal, revise (under section 9 above) his decision which gave rise to that appeal; or

(b) in a case where appeal A has been determined by the tribunal, make a decision (under section 10 above) superseding the tribunal's decision.

(4) Where appeal A is to be dealt with in accordance with this subsection, the appeal tribunal or Commissioner shall either--

(a) stay appeal A until appeal B is determined; or

(b) if the tribunal or Commissioner considers it to be in the interests of the appellant to do so, determine appeal A as if--

(i) appeal B had already been determined; and

(ii) the issues arising on appeal B had been decided in the way that was most unfavourable to the appellant.

In this subsection "the appellant" means the person who appealed or, as the case may be, first appealed against the decision mentioned in subsection (1)(a) above.

(5) Where the appeal tribunal or Commissioner acts in accordance with subsection (4)(b) above, following the determination of appeal B the Secretary of State shall, if appropriate, make a decision (under section 10 above) superseding the decision of the tribunal or Commissioner in accordance with that determination.

(6) For the purposes of this section, an appeal against a decision is pending if--

(a) an appeal against the decision has been brought but not determined;

(b) an application for leave to appeal against the decision has been made but not determined; or

(7) In this section--

(a) the reference in subsection (1)(a) above to an appeal to a Commissioner includes a reference to an application for leave to appeal to a Commissioner; and

(b) any reference in paragraph (a), (b) or (c) of subsection (6) above to an appeal, or to an application for leave to appeal, against a decision includes a reference to--

(i) an application for, or for leave to apply for, judicial review of the decision under section 31 of the [1981 c. 54.] Supreme Court Act 1981; or

(ii) an application to the supervisory jurisdiction of the Court of Session in respect of the decision.

(8) Regulations may make provision supplementing that made by this section.

Cases of error

27 Restrictions on entitlement to benefit in certain cases of error

(1) Subject to subsection (2) below, this section applies where--

(a) the effect of the determination, whenever made, of an appeal to a Commissioner or the court ("the relevant determination") is that the adjudicating authority's decision out of which the appeal arose was erroneous in point of law; and

(b) after the date of the relevant determination a decision falls to be made by the Secretary of State in accordance with that determination (or would, apart from this section, fall to be so made)--

(i) in relation to a claim for benefit;

(ii) as to whether to revise, under section 9 above, a decision as to a person's entitlement to benefit; or

(iii) on an application made under section 10 above for a decision as to a person's entitlement to benefit to be superseded.

(2) This section does not apply where the decision of the Secretary of State mentioned in subsection (1)(b) above--

(a) is one which, but for section 25(2) or (3)(a) above, would have been made before the date of the relevant determination; or

(b) is one made in pursuance of section 26(3) or (5) above.

(3) In so far as the decision relates to a person's entitlement to a benefit in respect of--

(a) a period before the date of the relevant determination; or

(b) in the case of a widow's payment, a death occurring before that date,

it shall be made as if the adjudicating authority's decision had been found by the Commissioner or court not to have been erroneous in point of law.

(4) In deciding whether a person is entitled to benefit in a case where his entitlement depends on his having been entitled to the same or some other benefit before attaining a particular age, subsection (3) above shall be disregarded for the purpose only of deciding whether he was so entitled before attaining that age.

(5) Subsection (1)(a) above shall be read as including a case where--

(a) the effect of the relevant determination is that part or all of a purported regulation or order is invalid; and

(b) the error of law made by the adjudicating authority was to act on the basis that the purported regulation or order (or the part held to be invalid) was valid.

(6) It is immaterial for the purposes of subsection (1) above--

(a) where such a decision as is mentioned in paragraph (b)(i) falls to be made, whether the claim was made before or after the date of the relevant determination;

(b) where such a decision as is mentioned in paragraph (b)(ii) or (iii) falls to be made on an application under section 9 or (as the case may be) 10 above, whether the application was made before or after that date.

(7) In this section--

"adjudicating authority" means--
(a)
the Secretary of State;
(b)
any former officer, tribunal or body; or
(c)
any officer, tribunal or body in Northern Ireland corresponding to a former officer, tribunal or body;
"benefit" means--
(a)
benefit under Parts II to V of the Contributions and Benefits Act, other than Old Cases payments;
(b)
benefit under Part II of the [1975 c. 14.] Social Security Act 1975 (in respect of a period before 1st July 1992 but not before 6th April 1975);
(c)
benefit under the [1946 c. 67.] National Insurance Act 1946 or [1965 c. 51.] 1965, or the [1946 c. 62.] National Insurance (Industrial Injuries) Act 1946 or [1965 c. 52.] 1965 (in respect of a period before 6th April 1975);
(d)
a jobseeker's allowance;
(e)
any benefit corresponding to a benefit mentioned in paragraphs (a) to (d) above; and
(f)
any income-related benefit;
"the court" means the High Court, the Court of Appeal, the Court of Session, the High Court or Court of Appeal in Northern Ireland, the House of Lords or the Court of Justice of the European Community;
"former officer, tribunal or body" means any of the following, that is to say--
(a)
an adjudication officer or, in the case of a decision given on a reference under section 21(2) or 25(1) of the Administration Act, a social security appeal tribunal, a disability appeal tribunal or a medical appeal tribunal;
(b)
an adjudicating medical practitioner appointed under section 49 of that Act or a specially qualified adjudicating medical practitioner appointed in accordance with regulations under section 62(2) of that Act; or
(c)
the National Assistance Board, the Supplementary Benefits Commission, the Attendance Allowance Board, a benefit officer, an insurance officer or a supplement officer.

(8) For the purposes of this section, any reference to entitlement to benefit includes a reference to entitlement--

(a) to any increase in the rate of a benefit; or

(b) to a benefit, or increase of benefit, at a particular rate.

(9) The date of the relevant determination shall, in prescribed cases, be determined for the purposes of this section in accordance with any regulations made for that purpose.

(10) Regulations made under subsection (9) above may include provision--

(a) for a determination of a higher court to be treated as if it had been made on the date of a determination of a lower court or a Commissioner; or

(b) for a determination of a lower court or a Commissioner to be treated as if it had been made on the date of a determination of a higher court.

28 Correction of errors and setting aside of decisions

(1) Regulations may make provision with respect to--

(a) the correction of accidental errors in any decision or record of a decision made under any relevant enactment; and

(b) the setting aside of any such decision in a case where it appears just to set the decision aside on the ground that--

(i) a document relating to the proceedings in which the decision was given was not sent to, or was not received at an appropriate time by, a party to the proceedings or a party's representative or was not received at an appropriate time by the body or person who gave the decision; or

(ii) a party to the proceedings or a party's representative was not present at a hearing related to the proceedings.

(2) Nothing in subsection (1) above shall be construed as derogating from any power to correct errors or set aside decisions which is exercisable apart from regulations made by virtue of that subsection.

(3) In this section "relevant enactment" means any enactment contained in--

(a) this Chapter;

(b) the Contributions and Benefits Act;

(d) the Jobseekers Act; or

(e) the [1997 c. 27.] Social Security (Recovery of Benefits) Act 1997.

Industrial accidents

29 Decision that accident is an industrial accident

(1) Where, in connection with any claim for industrial injuries benefit, it is decided that the relevant accident was or was not an industrial accident--

(a) an express declaration of that fact shall be made and recorded; and

(b) subject to subsection (3) below, a claimant shall be entitled to have the issue whether the relevant accident was an industrial accident decided notwithstanding that his claim is disallowed on other grounds.

(2) Subject to subsection (3) and section 30 below, any person suffering personal injury by accident shall be entitled, if he claims the accident was an industrial accident--

(a) to have that issue decided; and

(b) to have a declaration made and recorded accordingly,

notwithstanding that no claim for benefit has been made in connection with which the issue arises; and this Chapter shall apply for that purpose as if the issue had arisen in connection with a claim for benefit.

(3) The Secretary of State, an appeal tribunal or a Commissioner (as the case may be) may refuse to decide the issue whether an accident was an industrial accident if satisfied that it is unlikely to be necessary to decide the issue for the purposes of any claim for benefit; and this Chapter shall apply as if any such refusal were a decision on the issue.

(4) Subject to sections 9 to 15 above, any declaration under this section that an accident was or was not an industrial accident shall be conclusive for the purposes of any claim for industrial injuries benefit in respect of that accident.

(5) Where subsection (4) above applies--

(a) in relation to a death occurring before 11th April 1988; or

(b) for the purposes of section 60(2) of the Contributions and Benefits Act,

it shall have effect as if at the end there were added the words "whether or not the claimant is the person at whose instance the declaration was made".

(6) For the purposes of this section (but subject to section 30 below), an accident whereby a person suffers personal injury shall be deemed, in relation to him, to be an industrial accident if--

(a) it arises out of and in the course of his employment;

(b) that employment is employed earner's employment for the purposes of Part V of the Contributions and Benefits Act; and

(c) payment of benefit is not under section 94(5) of that Act precluded because the accident happened while he was outside Great Britain.

(7) A decision under this section shall be final except that sections 9 and 10 above apply to a decision under this section that an accident was or was not an industrial accident as they apply to a decision under section 8 above if, but only if, the Secretary of State is satisfied that the decision under this section was given in consequence of any wilful non-disclosure or misrepresentation of a material fact.

30 Effect of decision

(1) A decision (given under subsection (2) of section 29 above or otherwise) that an accident was an industrial accident is to be taken as determining only that paragraphs (a), (b) and (c) of subsection (6) of that section are satisfied in relation to the accident.

(2) Subject to subsections (3) and (4) below, no such decision is to be taken as importing a decision as to the origin of any injury or disability suffered by the claimant, whether or not there is an event identifiable as an accident apart from any injury that may have been received.

(3) A decision that, on a particular occasion when there was no event so identifiable, a person had an industrial accident by reason of an injury shall be treated as a decision that, if the injury was suffered by accident on that occasion, the accident was an industrial accident.

(4) A decision that an accident was an industrial accident may be given, and a declaration to that effect be made and recorded in accordance with section 29 above, without its having been found that personal injury resulted from the accident.

(5) Subsection (4) above has effect subject to the discretion under section 29(3) above to refuse to decide the issue if it is unlikely to be necessary for the purposes of a claim for benefit.

Other special cases

31 Incapacity for work

(1) Regulations may provide that a determination that a person is disqualified for any period in accordance with regulations under section 171E of the Contributions and Benefits Act shall have effect for such purposes as may be prescribed as a determination that he is to be treated as capable of work for that period, and vice versa.

(2) Provision may be made by regulations for matters of such descriptions as may be prescribed to be determined by the Secretary of State, notwithstanding that other matters fall to be determined by another authority.

(3) Nothing in this section shall be taken to prejudice the generality of the power conferred by section 17(2) above.

32 Industrial diseases

Regulations shall provide for applying the provisions of this Chapter, subject to any prescribed additions or modifications, in relation to decisions made or falling to be made under sections 108 to 110 of the Contributions and Benefits Act.

33 Christmas bonus

(1) A decision by the Secretary of State that a person is entitled or not entitled to payment of a qualifying benefit in respect of a period which includes a day in the relevant week shall be conclusive for the purposes of section 148 of the Contributions and Benefits Act.

(2) In this section, expressions to which a meaning is assigned by section 150 of that Act have that meaning.

Housing benefit and council tax benefit

34 Determination of claims and reviews

(1) Regulations shall provide that, where a person claims--

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