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Statutory Instrument 2006 No. 3398The Personal Injuries (NHS Charges) (Reviews and Appeals) and Road Traffic (NHS Charges) (Reviews and Appeals) (Amendment) Regulations 2006(The document as of February, 2008) STATUTORY INSTRUMENTS2006 No. 3398NATIONAL HEALTH SERVICE, ENGLAND AND WALESROAD TRAFFIC, ENGLAND AND WALESThe Personal Injuries (NHS Charges) (Reviews and Appeals) and Road Traffic (NHS Charges) (Reviews and Appeals) (Amendment) Regulations 2006
The Secretary of State for Health makes the following Regulations in exercise of the powers conferred by sections 7(4) and 16(2) of the Road Traffic (NHS Charges) Act 1999[1] and sections 156(1), (2) and (4), 157, 158(7) and 195(1) and (2) of the Health and Social Care (Community Health and Standards) Act 2003[2]. She has consulted the National Assembly for Wales in accordance with section 195(3) of that Act and the Council on Tribunals in accordance with section 8 of the Tribunals and Inquiries Act 1992[3]: Citation, commencement, application and interpretation 1.—(1) These Regulations may be cited as the Personal Injuries (NHS Charges) (Reviews and Appeals) and Road Traffic (NHS Charges) (Reviews and Appeals) (Amendment) Regulations 2006 and shall come into force on 29th January 2007. (2) These Regulations apply in relation to England and Wales. (3) In these Regulations—
(4) A reference in these Regulations to a numbered section is a reference to that section of the Health and Social Care (Community Health and Standards) Act 2003.
(b) particulars of the proportion by which the damages payable in respect of the claim are to be reduced to reflect the injured person's share in the responsibility for the injury in question. (2) The Secretary of State must review a certificate relating to a claim which, after the certificate is issued, becomes a qualifying claim (as defined in section 153(9)[6]) if, not later than 3 months after the claim becomes a qualifying claim, the report containing the information required by regulation 3(1)(a) (production of report) of the Personal Injuries (NHS Charges) (General) and Road Traffic (NHS Charges) (Amendment) Regulations 2006[7] is sent by the compensator to the Compensation Recovery Unit.
(b) the amount specified in the certificate may be in excess of the amount due to the Secretary of State; (c) incorrect or insufficient information may have been supplied to the Secretary of State by the person to whom the certificate was issued and, in consequence, the amount specified in the certificate was less than it would have been had the information supplied been correct or sufficient; or (d) a ground for an appeal against a certificate may be satisfied. (4) An application for a review under section 156(4) must be in writing on a form approved by the Secretary of State[8] and sent to the Compensation Recovery Unit not later than 3 months after—
(b) if later, the date on which the compensation payment[9] was made. Information to be provided on issue of a certificate
(b) the requirements under section 157(2) that are to be satisfied before an appeal may be made; and (c) the person's right under section 157(4) to apply for the requirement in section 157(2)(b) (payment of amounts specified in certificate) to be waived. Waiver applications and appeals
(ii) if later, the date on which the compensation payment was made; or (b) if the compensator has been granted an extension of the time limit for an appeal against a certificate under regulation 7, one month after the date of that decision. (3) Where the Secretary of State makes a waiver decision[10], the person who made the waiver application shall be—
(b) if the waiver application is refused—
(ii) informed that, if the notice of the decision does not include a statement of the reasons for the 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 the decision. (4) An appeal against a waiver decision shall be in writing on a form approved by the Secretary of State[11] and unless an application has been granted to extend the time for an appeal against a waiver decision under regulation 7, shall be sent to the Compensation Recovery Unit not later than one month after the date of the waiver decision.
(b) particulars of the exceptional financial hardship that would be caused by payment of the amount (or amounts) specified in the certificate. Appeals against certificates
(ii) if later, the date on which the compensation payment is made; (b) where a certificate is confirmed following a review by the Secretary of State under section 156, not later than 3 months after the date of that confirmation;
(ii) if the compensator appeals against that decision, the date on which the appeal is decided or withdrawn. (2) Where the points raised in an appeal against a certificate have not already been the subject of a review under section 156 the Secretary of State, if she thinks it appropriate to do so, may treat an appeal against a certificate as an application for review under section 156(4).
(b) otherwise issue a fresh certificate. (4) Any appeal under this regulation shall contain the following particulars—
(b) the ground under section 157 to which the appeal relates; and (c) a summary of the arguments relied on by the person making the appeal to support his contention that the certificate is wrong. Appeals – General
(b) that panel member shall determine whether the appeal is to be treated as duly made, and shall inform the appellant, and the Secretary of State of his decision. (6) The date of an appeal shall be—
(b) where a legally qualified panel member determines under paragraph (5)(b) that the appeal is to be treated as duly made, the date on which the appeal was received by the Compensation Recovery Unit. Extension of time for appealing
(b) it is in the interests of justice that the application be granted. (4) For the purposes of paragraph (3) it shall not be considered to be in the interests of justice to grant an application unless the person determining the application is satisfied that—
(b) such special reasons have existed throughout the period beginning with the day following the expiry of the time prescribed, as the case may be, by regulation 4 or 5 for the making of an appeal and ending with the day on which the application for extension of time is made; and (c) such special reasons manifestly constitute a reasonable excuse of compelling weight for the applicant's failure to make an appeal within the prescribed time. (5) In determining whether there are special reasons for granting an application for an extension of time for making an appeal under paragraph (1) the person determining the application shall have regard to the principle that the greater the amount of time that has elapsed between the expiry of the time specified for the making of the appeal and the making of the application for an extension of time, the more cogent should be the special reasons on which the application is based.
(b) that a Commissioner or a court has taken a different view of the law from that previously understood and applied. (7) The person who determines an application for an extension of time for making an appeal shall record a summary of his decision in such written form as has been approved by the President of appeal tribunals appointed under section 5 of the Social Security Act 1998[13].
(b) the particulars required under regulation 5(4) in relation to the appeal against the certificate which it is proposed to bring; and (c) in the case of an application for an extension of time for making an appeal against a waiver decision, the particulars required under regulation 4(5). (11) An application under paragraph (1) which has been refused may not be renewed.
(b) 36 (composition of appeal tribunals)[16]; (c) 38 (consideration and determination of appeals and referrals); (d) 39 (choice of hearing)[17]; (e) 40 (withdrawal of appeal or referral)[18]; (f) 42 (non-disclosure of medical advice or evidence)[19]; (g) 43 (summoning of witnesses and administration of oaths); (h) 46 (appeals which may be struck out)[20]; (i) 47 (reinstatement of struck out appeals)[21]; (j) 49 (procedure at oral hearings)[22]; (k) 51 (postponement and adjournment)[23]; (l) 53 (decisions of appeal tribunals)[24]; (m) 54 (late application for a statement of reasons of tribunal decision)[25]; (n) 55 (record of tribunal proceedings)[26]; (o) 56 (correction of accidental errors)[27]; (p) 57 (setting aside decisions on certain grounds)[28]; (q) 58 (application for leave to appeal to a Commissioner from an appeal tribunal)[29]; and (r) Schedule 3 (qualifications of persons appointed to the panel)[30]. (3) Any reference in the provisions specified in paragraph (2) to a party to the proceedings shall be construed as referring to—
(b) unless otherwise stated, the Secretary of State. (4) Regulation 38 (consideration and determination of appeals and referrals) of the Social Security Regulations shall apply as if the reference to "any provision of these Regulations" were a reference to any provisions of the Social Security Regulations specified in paragraph (2).
(b) in paragraph (1)(b), the reference to "these Regulations" were a reference to regulations 4(5) or 5(4), as the case may be, of these Regulations. (6) Regulations 56(1) (correction of accidental errors) and 57(1) (setting aside decisions on certain grounds) of the Social Security Regulations shall apply as if the reference to "a relevant enactment" were a reference to section 158.
(This note is not part of the Regulations) Part 3 of the Health and Social Care (Community Health and Standards) Act 2003 provides for a scheme for the recovery of charges in cases where an injured person who receives a compensation payment in respect of his injury has received National Health Service hospital treatment or ambulance services. The charges are specified in certificates issued by the Secretary of State, and are payable by persons who pay compensation to the injured person A person to whom a certificate is issued may appeal against the certificate, provided he pays beforehand the amounts specified in the certificate or the Secretary of State waives the requirement to pay. The person may also appeal against the Secretary of State's decision whether to waive the requirement to pay ("the waiver decision"). Regulations 2 to 9 make provision—
(b) for the Secretary of State to inform a person to whom a certificate is issued of particulars relating to appeals against certificates (regulation 3); (c) as to the manner and timing of applying for a waiver of the requirement in section 157(2)(b) to pay the amount specified in the certificate before appealing against the certificate and for appealing a waiver decision. (regulation 4); (d) as to the manner and timing of appealing against a certificate (regulation 5); (e) for general matters relating to appeals against waiver decisions or certificates (regulation 6); (f) as to the grounds on which, and manner by which, an application can be made for an extension of the time limits for making an appeal against a waiver decision or certificate (regulation 7); (g) for the application of certain provisions (modified appropriately) of the Social Security Regulations relating to procedural matters of the appeal tribunal to appeals against waiver decisions and certificates (regulation 8). (h) for the consolidation of appeals against certificates relating to the same injury (regulation 9). Regulation 10 corrects an error in the Road Traffic (NHS Charges) (Reviews and Appeals) Regulations 1999 (S.I. 1999/786) by removing an incorrect cross reference to section 9 of the Road Traffic (NHS Charges) Act 1999 ("the 1999 Act"). Notes: [1] 1999 c.3.back [2] 2003 c.43.back [3] 1992 c.53. Section 8 was amended by S.I. 2001/3649 and Schedule 1, paragraph 41 was substituted by the Social Security Act 1998 (c.14), Schedule 7, paragraph 121.back [4] 1998 c.14. Section 2 was amended by the State Pensions Credit Act 2002 (c.16), sections 11 and 21, Schedule 1, paragraphs 4 and 5 and Schedule 3. Section 3 was amended by the Employment Act 2002 (c.22), sections 50 and 54, Schedule 6, paragraphs 1(c) and 8, Schedule 8 and the Pensions Act 2004 (c.35), section 236 and Schedule 10, paragraph 1. Section 5 was amended by S.I. 1999/678. Section 6 was amended by the Constitutional Reform Act 2005 (c.4), section 15, Schedule 4, paragraphs 271 and 272, S.I. 1999/1042 and S.I. 2000/253.back [5] S.I. 1999/991.back [6] Section 153(9) was amended by the Health Act 2006 (c.28), section 73.back [7] S.I. 2006/3388back [8] The approved form is obtainable from the Compensation Recovery Unit, Durham House, Washington, Tyne and Wear, NE38 7SF.back [9] See section 150(3) of the 2003 Act for the definition of compensation payment.back [10] See section 157(6) of the 2003 Act for the meaning of waiver decision.back [11] The approved form is obtainable from the Compensation Recovery Unit, Durham House, Washington, Tyne and Wear, NE38 7SF.back [12] The approved forms referred to in this regulation are obtainable from the Compensation Recovery Unit, Durham House, Washington, Tyne and Wear, NE38 7SF.back [13] 1998 c.14.back [14] 1998. c 14. Section 12 was amended by the Social Security Contributions (Transfer of Functions etc) Act 1999 (1999. c.2), sections 18 and 26(3), Schedule 7, paragraph 25 and Schedule 10, Part 1.back [15] S.I. 1999/991. Revoked in so far as relating to a child benefit or guardian's allowance under the Social Security Contributions and Benefits Act 1992 by S.I. 2003/916 and Paragraphs (1) and (3) were amended by S.I. 1999/991.back [16] S.I. 1999/991. Paragraphs (1), (2) and (6) to (8) were amended by S.I. 2000/1596, paragraphs (2), (5) and (7) were amended by S.I. 1999/1466 and paragraphs (2), (5) and (9) were amended by S.I. 2004/3368.back [17] S.I. 1999/991. Provision heading and paragraphs (1) to (4) were amended by S.I. 2004/3368.back [18] S.I. 1999/991. Paragraph (1) was amended by S.I. 1999/2570.back [19] S.I. 1999/991. Paragraphs (1) and (3) were amended by S.I. 2000/1596.back [20] S.I. 1999/991. Paragraphs (1) and (4) were amended by S.I. 2004/3368.back [21] S.I. 1999/991. Paragraphs (1) and (2) were amended by S.I. 2002/1379 and paragraph (2) was amended by S.I. 2004/3368.back [22] S.I. 1999/991. Paragraphs (6), (9), (10)and (13) were amended by S.I. 2002/1379 and Paragraph (7) was amended by S.I. 2002/1379 and S.I. 2005/337.back [23] S.I. 1999/991. Paragraph (5) was revoked by S.I. 2002/1379.back [24] S.I. 1999/991. Paragraph (3) was amended by S.I. 1999/2677 and S.I. 2005/337, Paragraph (4) was amended by S.I. 2002/1379 and S.I. 2005/337 and Paragraph (4A) was inserted by 2005/337.back [25] S.I. 1999/991. Paragraph (1) was amended by S.I. 2000/1596 and S.I. 2005/337, paragraphs (6), (10), (11) and (12) were amended by S.I. 2002/1379 and paragraph (13) was amended by S.I. 2002/1379 and S.I. 2005/337.back [26] S.I. 1999/991. Paragraphs (2) to (4) were amended by S.I. 2005/337.back [27] S.I. 1999/991. Paragraph (1) was amended by S.I. 2000/1596 and S.I. 2005/337 and paragraph (2) was amended by S.I. 2005/337.back [28] S.I. 1999/991. Paragraphs (2), (3) and (6) to (12) were amended by S.I. 2002/1379 and paragraph (4A) was inserted by S.I. 2005/337.back [29] S.I. 1999/991. Paragraph (1) was amended by S.I. 2002/1379 and S.I. 2005/337, paragraph (1A) was inserted by S.I. 2005/337, paragraph (2) was amended by S.I. 1999/2570, paragraph (3) was revoked by S.I. 2002/1379, paragraph (4) was amended by S.I. 2002/1379, paragraph (5) was amended by S.I. 2005/337 and paragraph (6) was amended by S.I. 2002/1379.back [30] S.I. 1999/991. Paragraphs (2) and (3) were amended by S.I. 2005/337 and paragraph (4) was amended by S.I. 2002/1379.back [31] S.I. 1999/786.back ISBN 0 11 075549 9 -- Back --
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