Social Security Administration (Northern Ireland) Act 1992 (c. 8)

(The document as of February, 2008)

-- Back --

Page 2

Pages: P.1 | P.2 | P.3 | P.4 | P.5 | P.6 | P.7 | P.8 | P.9 | P.10 | P.11

for the making on behalf of the Department by members of the staff of any Board or body of payments on account of benefits to which section 5 above applies in circumstances corresponding to those in which the Department itself has the power to make such payments under subsection (1)(s) of that section; and a Board shall have power to enter into any such arrangements.

(2) A payment under any such arrangements shall be treated for the purposes of any statutory provision as if it had been made by the Department.

(3) The Department shall repay a Board or other body such amount as the Department determines to be the reasonable administrative expenses incurred by the Board or body in making payments in accordance with arrangements under this section.

(4) In this section "Board" means a Health and Social Services Board.

Part III Adjudication

Adjudication by the Department

15 Questions for the Department

(1) Subject to this Part of this Act, any of the following questions shall be determined by the Department--

(a) a question whether a person is an earner and, if he is, as to the category of earners in which he is to be included;

(b) subject to subsection (2) below, a question whether the contribution conditions for any benefit are satisfied, or otherwise relating to a person's contributions or his earnings factor;

(d) a question whether a person is or was employed in employed earner's employment for the purposes of Part V of the Contributions and Benefits Act;

(e) a question as to whether a person was, within the meaning of regulations, precluded from regular employment by responsibilities at home;

(f) any question as to which surpluses are to be taken into account under section 45(1) of the Contributions and Benefits Act;

(g) any question arising under any provision of Part XI of the Contributions and Benefits Act or this Act, or under any provision of regulations under that Part, as to--

(i) whether a person is, or was, an employee or employer of another;

(ii) whether an employer is entitled to make any deduction from his contributions payments in accordance with regulations under section 154 of the Contributions and Benefits Act;

(iii) whether a payment falls to be made to an employer in accordance with the regulations;

(iv) the amount that falls to be so deducted or paid;

(v) the amount of an employer's contributions payments for any period for the purposes of regulations under section 154(3) of the Contributions and Benefits Act; or

(vi) whether two or more employers or two or more contracts of service are, by virtue of regulations made under section 159(5) of that Act, to be treated as one; and

(h) any question arising under any provision of Part XII of that Act or this Act, or under any provision of regulations under that Part, as to--

(i) whether a person is, or was, an employee or employer of another;

(ii) whether an employer is entitled to make any deduction from his contributions payments in accordance with regulations under section 163 of the Contributions and Benefits Act;

(iii) whether a payment falls to be made to an employer in accordance with the regulations;

(iv) the amount that falls to be so deducted or paid; or

(v) whether two or more employers or two or more contracts of service are, by virtue of regulations made under section 167(2) of that Act, to be treated as one,

and any question arising under regulations made by virtue of paragraph (c), (d) or (f) of section 160(9) of that Act.

(2) Subsection (1)(b) above includes any question arising--

(a) under section 17(1) of the Contributions and Benefits Act as to whether by regulations under that subsection a person is excepted from liability for Class 4 contributions, or his liability is deferred; or

(b) under regulations made by virtue of section 17(3) or (4) or 18 of that Act;

but not any other question relating to Class 4 contributions, nor any question within section 18(1)(c) below.

(3) Regulations may make provision restricting the persons who may apply to the Department for the determination of any such question as is mentioned in subsection (1) above.

(4) The Department may, if it thinks fit, before determining any such question as is mentioned in subsection (1) above, appoint a person to hold an inquiry into the question, or any matters arising in connection with it, and to report on the question, or on those matters, to the Department.

16 Appeal on question of law

(1) A question of law arising in connection with the determination by the Department of any such question as is mentioned in section 15(1) above may, if the Department thinks fit, be referred for decision to the Court of Appeal.

(2) If the Department determines in accordance with subsection (1) above to refer any question of law to the court, it shall give notice in writing of its intention to do so--

(a) in a case where the question arises on an application made to the Department, to the applicant; and

(b) in any case to such persons as appear to it to be concerned with the question.

(3) Any person aggrieved by the decision of the Department on any question of law within subsection (1) above which is not referred in accordance with that subsection may appeal from that decision to the court.

(4) The Department shall be entitled to appear and be heard on any such reference or appeal.

(5) Rules of court may include provision for regulating references and appeals to the court under this section.

(6) Notwithstanding anything in any Act, the decision of the court on a reference or appeal under this section shall be final.

17 Review of decisions

(1) Subject to subsection (2) below, the Department may review any decision given by it on any such question as is mentioned in section 15(1) above, if--

(a) new facts have been brought to its notice; or

(b) it is satisfied that the decision--

(i) was given in ignorance of some material fact;

(ii) was based on a mistake as to some material fact; or

(iii) was erroneous in point of law.

(2) A decision shall not be reviewed while an appeal under section 16 above is pending against the decision of the Department on a question of law arising in connection with it, or before the time for so appealing has expired.

(3) On a review any question of law may be referred under subsection (1) of section 16 above or, where it is not so referred, may be the subject of an appeal under subsection (3) of that section, and the other provisions of that section shall apply accordingly.

Adjudication by adjudication officers

18 Claims and questions to be submitted to adjudication officer

(1) Subject to section 52 below, there shall be submitted forthwith to an adjudication officer for determination in accordance with this Part of this Act--

(a) any claim for a benefit to which this section applies;

(b) subject to subsection (2) below, any question arising in connection with a claim for, or award of, such a benefit; and

(i) by reason of section 28(1) of the Contributions and Benefits Act, for receiving unemployment benefit;

(ii) by reason of any regulations under section 32(1) of that Act, for receiving sickness benefit; or

(iii) by reason of any regulations under section 59(1) of that Act, for receiving invalidity benefit.

(2) Subsection (1) above does not apply to any question which falls to be determined otherwise than by an adjudication officer.

(3) Any question as to, or in connection with, entitlement to statutory sick pay or statutory maternity pay may be submitted to an adjudication officer--

(a) by the Department; or

(b) subject to and in accordance with regulations, by the employee concerned,

for determination in accordance with this Part of this Act.

(4) If--

(a) a person submits a question relating to the age, marriage or death of any person; and

(b) it appears to the adjudication officer that the question may arise if the person who has submitted it to him submits a claim to a benefit to which this section applies,

the adjudication officer may determine the question.

(5) Different aspects of the same claim or question may be submitted to different adjudication officers; and for that purpose this section and the other provisions of this Part of this Act with respect to the determination of claims and questions shall apply with any necessary modifications.

(6) This section applies to the following benefits--

(a) benefit as defined in section 121 of the Contributions and Benefits Act;

(b) income support;

(d) disability working allowance;

(e) any social fund payment such as is mentioned in section 134(1)(a) or (2) of the Contributions and Benefits Act;

(f) child benefit;

(g) statutory sick pay; and

(h) statutory maternity pay.

19 Decision of adjudication officer

(1) An adjudication officer to whom a claim or question is submitted under section 18 above (other than a claim which under section 28(12) or (13) or 33(7) below falls to be treated as an application for a review) shall take it into consideration and, so far as practicable, dispose of it, in accordance with this section, and with procedure regulations under section 57 below, within 14 days of its submission to him.

(2) Subject to subsection (3) and section 35 below, the adjudication officer may decide a claim or question himself or refer it to a social security appeal tribunal.

(3) The adjudication officer must decide a claim for or question relating to an attendance allowance, a disability living allowance or a disability working allowance himself.

(4) Where an adjudication officer refers a question as to, or in connection with, entitlement to statutory sick pay or statutory maternity pay to a social security appeal tribunal, the employee and employer concerned shall each be given notice in writing of the reference.

(5) In any other case notice in writing of the reference shall be given to the claimant.

(6) Where--

(a) a case has been referred to a social security appeal tribunal ("the tribunal"); and

(b) the claimant makes a further claim which raises the same or similar questions; and

then the tribunal may proceed to determine the further claim whether or not notice has been given under subsection (4) or (5) above.

Appeals from adjudication officers - general

20 Appeal to social security appeal tribunal

(1) Subject to subsection (3) below, where the adjudication officer has decided a claim or question other than a claim or question relating to an attendance allowance, a disability living allowance or a disability working allowance--

(a) if it relates to statutory sick pay or statutory maternity pay, the employee and employer concerned shall each have a right to appeal to a social security appeal tribunal; and

(b) in any other case the claimant shall have a right to do so.

(2) A person with a right of appeal under this section shall be given such notice of a decision falling within subsection (1) above and of that right as may be prescribed.

(3) No appeal lies under this section where--

(a) in connection with the decision of the adjudication officer there has arisen any question which under or by virtue of this Act falls to be determined otherwise than by an adjudication officer; and

(b) the question has been determined; and

(4) Regulations may make provision as to the manner in which, and the time within which, appeals are to be brought.

(5) Where an adjudication officer has determined that any amount, other than an amount--

(a) of an attendance allowance;

(b) of a disability living allowance;

(d) of statutory sick pay; or

(e) of statutory maternity pay,

is recoverable under or by virtue of section 69 or 72 below, any person from whom he has determined that it is recoverable shall have the same right of appeal to a social security appeal tribunal as a claimant.

(6) In any case where--

(a) an adjudication officer has decided any claim or question under Part V of the Contributions and Benefits Act; and

(b) the right to benefit under that Part of that Act of any person other than the claimant is or may be, under Part VI of Schedule 7 to that Act, affected by that decision,

that other person shall have the like right of appeal to a social security appeal tribunal as the claimant.

(7) Subsection (2) above shall apply to a person with a right of appeal under subsection (5) or (6) above as it applies to a claimant.

21 Appeal from social security appeal tribunal to Commissioner

(1) Subject to the provisions of this section, an appeal lies to a Commissioner from any decision of a social security appeal tribunal under section 20 above on the ground that the decision of the tribunal was erroneous in point of law.

(2) In the case of statutory sick pay or statutory maternity pay an appeal lies under this section at the instance of any of the following--

(a) an adjudication officer;

(b) the employee concerned;

(d) a trade union, where--

(i) the employee is a member of the union at the time of the appeal and was so immediately before the question at issue arose; or

(ii) the question at issue is a question as to or in connection with entitlement of a deceased person who was at the time of his death a member of the union;

(e) an association of employers of which the employer is a member at the time of the appeal and was so immediately before the question at issue arose.

(3) In any other case an appeal lies under this section at the instance of any of the following--

(a) an adjudication officer;

(b) the claimant;

(d) a person from whom it is determined that any amount is recoverable under section 69 or 72 below.

(4) In a case relating to industrial injuries benefit an appeal lies under this section at the instance of a person whose right to benefit is, or may be, under Part VI of Schedule 7 to the Contributions and Benefits Act, affected by the decision appealed against, as well as at the instance of any person or body such as is mentioned in subsection (3) above.

(5) The following are the cases in which an appeal lies at the instance of a trade union--

(a) where the claimant is a member of the union at the time of the appeal and was so immediately before the question at issue arose;

(b) where that question in any way relates to a deceased person who was a member of the union at the time of his death;

(c) where the case relates to industrial injuries benefit and the claimant or, in relation to industrial death benefit, the deceased, was a member of the union at the time of the relevant accident.

(6) Subsections (2), (3) and (5) above, as they apply to a trade union, apply also to any other association which exists to promote the interests and welfare of its members.

(7) Where the Commissioner holds that the decision was erroneous in point of law, he shall set it aside and--

(a) he shall have power--

(i) to give the decision which he considers the tribunal should have given, if he can do so without making fresh or further findings of fact; or

(ii) if he considers it expedient, to make such findings and to give such decision as he considers appropriate in the light of them; and

(b) in any other case he shall refer the case to a tribunal with directions for its determination.

(8) Subject to any direction of the Commissioner, the tribunal on a reference under subsection (7)(b) above shall consist of persons who were not members of the tribunal which gave the erroneous decision.

(9) No appeal lies under this section without the leave--

(a) of the person who was the chairman of the tribunal when the decision was given or, in a prescribed case, the leave of some other chairman; or

(b) subject to and in accordance with regulations, of a Commissioner.

(10) Regulations may make provision as to the manner in which, and the time within which, appeals are to be brought and applications made for leave to appeal.

22 Appeal from Commissioners on point of law

(1) Subject to subsections (2) and (3) below, an appeal on a question of law shall lie to the appropriate court from any decision of a Commissioner.

(2) No appeal under this section shall lie from a decision except--

(a) with the leave of the Commissioner who gave the decision or, in a prescribed case, with the leave of a Commissioner selected in accordance with regulations; or

(b) if he refuses leave, with the leave of the appropriate court.

(3) An application for leave under this section in respect of a Commissioner's decision may only be made by--

(a) a person who, before the proceedings before the Commissioner were begun, was entitled to appeal to the Commissioner from the decision to which the Commissioner's decision relates;

(b) any other person who was a party to the proceedings in which the first decision mentioned in paragraph (a) above was given;

(d) any other person who is authorised by regulations to apply for leave;

and regulations may make provision with respect to the manner in which and the time within which applications must be made to a Commissioner for leave under this section and with respect to the procedure for dealing with such applications.

(4) On an application to a Commissioner for leave under this section it shall be the duty of the Commissioner to specify as the appropriate court--

(a) the Court of Appeal in Northern Ireland if it appears to him that the relevant place is in Northern Ireland;

(b) the Court of Appeal if it appears to him that the relevant place is in England or Wales; and

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 authority whose decision was the subject of the Commissioner's decision usually exercises its functions.

(6) The powers to make regulations conferred by this section shall be exercisable by the Lord Chancellor.

Reviews - general

23 Review of decisions

(1) Subject to the following provisions of this section, any decision under this Act of an adjudication officer, a social security appeal tribunal or a Commissioner (other than a decision relating to an attendance allowance, a disability living allowance or a disability working allowance) may be reviewed at any time by an adjudication officer or, on a reference by an adjudication officer, by a social security appeal tribunal, if--

(a) the officer or tribunal is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b) there has been any relevant change of circumstances since the decision was given;

(d) the decision was based on a decision of a question which under or by virtue of this Act falls to be determined otherwise than by an adjudication officer, and the decision of that question is revised; or

(e) the decision falls to be reviewed under section 57(4) or (5) of the Contributions and Benefits Act.

(2) Any decision of an adjudication officer (other than a decision relating to an attendance allowance, a disability living allowance or a disability working allowance) may be reviewed, upon the ground that it was erroneous in point of law, by an adjudication officer or, on a reference from an adjudication officer, by a social security appeal tribunal.

(3) Regulations may provide that a decision may not be reviewed on the ground mentioned in subsection (1)(a) above unless the officer or tribunal is satisfied as mentioned in that paragraph by fresh evidence.

(4) In its application to family credit, subsection (1)(b) and (c) above shall have effect subject to section 127(3) of the Contributions and Benefits Act (change of circumstances not to affect award or rate during specified period).

(5) Where a decision is reviewed on the ground mentioned in subsection (1)(c) above, the decision given on the review--

(a) shall take effect on the day prescribed for that purpose by reference to the date on which the relevant change of circumstances is expected to occur; and

(b) shall be reviewed again if the relevant change of circumstances either does not occur or occurs otherwise than on that date.

24 Procedure for reviews

(1) A question may be raised with a view to a review under section 23 above by means of an application in writing to an adjudication officer, stating the grounds of the application.

(2) On receipt of any such application, the adjudication officer shall proceed to deal with or refer any question arising on it in accordance with sections 19 to 21 above.

(3) Regulations may provide for enabling, or requiring, in prescribed circumstances, a review under section 23 above notwithstanding that no application for a review has been made under subsection (1) above.

25 Reviews under s. 23 - supplementary

(1) Regulations--

(a) may prescribe what are, or are not, relevant changes of circumstances for the purposes of section 23 above; and

(b) may make provision restricting the payment of any benefit, or any increase of benefit, to which a person would, but for this subsection, be entitled by reason of a review in respect of any period before or after the review (whether that period falls wholly or partly before or after the making of the regulations).

(2) Regulations under subsection (1)(b) above shall not restrict the payment to or for a woman of so much of--

(a) any widow's benefit, any invalidity pension under section 40 of the Contributions and Benefits Act or any Category A or Category B retirement pension; or

(b) any increase of such a benefit or pension,

as falls to be paid by reason of a review which takes place by virtue of section 23(1)(a) or (b) above in consequence of a claim for a widowhood benefit, within the meaning of section 3 above, which is made or treated as made by virtue of that section.

26 Appeals following reviews or refusals to review

A decision given on a review under section 23 above, and a refusal to review a decision under that section, shall be subject to appeal in like manner as an original decision, and sections 19 to 21 above shall, with the necessary modifications, apply in relation to a decision given on such a review as they apply to the original decision of a question.

27 Review after claimant appeals

Where a claimant has appealed against a decision of an adjudication officer and the decision is reviewed by an adjudication officer under section 23 above--

(a) if the adjudication officer considers that the decision which he has made on the review is the same as the decision that would have been made on the appeal had every ground of the claimant's appeal succeeded, the appeal shall lapse; but

(b) in any other case, the review shall be of no effect and the appeal shall proceed accordingly.

Attendance allowance, disability living allowance and disability working allowance

28 Reviews of decisions of adjudication officers

(1) On an application under this section made within the prescribed period, a decision of an adjudication officer under section 19 above which relates to an attendance allowance, a disability living allowance or a disability working allowance may be reviewed on any ground subject, in the case of a disability working allowance, to section 128(6) of the Contributions and Benefits Act.

(2) On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above which relates to an attendance allowance or a disability living allowance may be reviewed if--

(a) the adjudication officer is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b) there has been any relevant change of circumstances since the decision was given;

(d) the decision was erroneous in point of law; or

(e) the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(3) Regulations may prescribe what are, or are not, relevant changes of circumstances for the purposes of subsection (2)(b) and (c) above.

(4) On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above that a person is or was at any time terminally ill for the purposes of section 66(1), 72(5) or 73(12) of the Contributions and Benefits Act may be reviewed if there has been a change of medical opinion with respect to his condition or his reasonable expectation of life.

(5) On an application under this section made after the end of the prescribed period, a decision of an adjudication officer under section 19 above which relates to a disability working allowance may be reviewed if--

(a) the adjudication officer is satisfied that the decision was given in ignorance of, or was based on a mistake as to, some material fact;

(b) subject to section 128(6) of the Contributions and Benefits Act, there has been any prescribed change of circumstances since the decision was given;

(d) the decision was to make an award for a period wholly or partly after the date on which the claim was made or treated as made but subject to a condition being fulfilled and that condition has not been fulfilled,

but regulations may provide that a decision may not be reviewed on the ground mentioned in paragraph (a) above unless the officer is satisfied as mentioned in that paragraph by fresh evidence.

(6) The claimant shall be given such notification as may be prescribed of a decision which may be reviewed under this section and of his right to a review under subsection (1) above.

(7) A question may be raised with a view to a review under this section by means of an application made in writing to an adjudication officer stating the grounds of the application and supplying such information and evidence as may be prescribed.

(8) Regulations--

(a) may provide for enabling or requiring, in prescribed circumstances, a review under this section notwithstanding that no application under subsection (7) above has been made; and

(b) if they do so provide, shall specify under which provision of this section a review carried out by virtue of any such regulations falls.

(9) Reviews under this section shall be carried out by adjudication officers.

(10) Different aspects of any question which arises on such a review may be dealt with by different adjudication officers; and for this purpose this section and the other provisions of this Part of this Act which relate to reviews under this section shall apply with any necessary modifications.

(11) If a review is under subsection (1) above, the officer who took the decision under review shall not deal with any question which arises on the review.

(12) Except in prescribed circumstances, where a claim for a disability living allowance in respect of a person already awarded such an allowance by an adjudication officer is made or treated as made during the period for which he has been awarded the allowance, it shall be treated as an application for a review under this section.

(13) Where--

(a) a claim for an attendance allowance, a disability living allowance or a disability working allowance in respect of a person has been refused; and

(b) a further claim for the same allowance is made in respect of him within the period prescribed under subsection (1) above,

the further claim shall be treated as an application for a review under that subsection.

29 Further reviews

(1) Subsections (2), (4) and (5) of section 28 above shall apply to a decision on a review under subsection (1) of that section as they apply to a decision of an adjudication officer under section 19 above but as if the words "made after the end of the prescribed period" were omitted from each subsection.

(2) Subsections (1), (2), (4) and (5) of section 28 above shall apply--

(a) to a decision on a review under subsection (2), (4) or (5) of that section; and

(b) to a refusal to review a decision under subsection (2), (4) or (5) of that section,

as they apply to a decision of an adjudication officer under section 19 above.

(3) The claimant shall be given such notification as may be prescribed--

(a) of a decision on a review under section 28 above;

(b) if the review was under section 28(1), of his right of appeal under section 31 below; and

30 Reviews of decisions as to attendance allowance, disability living allowance or disability working allowance - supplementary

(1) An award of an attendance allowance, a disability living allowance or a disability working allowance on a review under section 28 above replaces any award which was the subject of the review.

(2) Where a person who has been awarded a disability living allowance consisting of one component applies or is treated as applying for a review under section 28 above and alleges that he is also entitled to the other component, the adjudication officer need not consider the question of his entitlement to the component which he has already been awarded or the rate of that component.

(3) Where a person who has been awarded a disability living allowance consisting of both components applies or is treated as applying for a review under section 28 above and alleges that he is entitled to one component at a rate higher than that at which it has been awarded, the adjudication officer need not consider the question of his entitlement to the other component or the rate of that component.

(4) Where a person has been awarded a component for life, on a review under section 28 above the adjudication officer shall not consider the question of his entitlement to that component or the rate of that component or the period for which it has been awarded unless--

(a) the person awarded the component expressly applies for the consideration of that question; or

(b) information is available to the adjudication officer which gives him reasonable grounds for believing that entitlement to the component, or entitlement to it at the rate awarded or for that period, ought not to continue.

(5) No decision which relates to an attendance allowance or a disability living allowance shall be reviewed under section 28 above on the ground that the person is or was at any time terminally ill, within the meaning of section 66(2) of the Contributions and Benefits Act, unless an application for review is made expressly on that ground either--

(a) by the person himself; or

Pages: P.1 | P.2 | P.3 | P.4 | P.5 | P.6 | P.7 | P.8 | P.9 | P.10 | P.11

-- Back --

Stat