The Universal Credit, Personal Independence Payment, Jobseeker’s Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations (Northern Ireland) 2016

Made: 4th May 2016

Laid before Parliament: 10th May 2016

Coming into operation in accordance with regulation 1(1)

The Secretary of State for Work and Pensions makes the following Regulations in exercise of the powers conferred by sections 5(1A), 139D(1) and (6), 165(1) and (4) to (6) and 167(1) of the Social Security Administration (Northern Ireland) Act 1992 and Articles 2(2), 8(6), 10(1), (4) and (6), 11(3) and (6), 11A, 12(1), 13(2), (3), (3A), (3B), (5A) and (6), 16(1), 17, 18(1), 20(2), 21(1) to (3), 22, 23, 25(3)(b) and (5)(c), 26(6)(c), 28(1), 31(2) and 74(1) and (3) to (6) of, and paragraph 9 of Schedule 2, paragraphs 1, 4 and 9 of Schedule 3 and Schedule 4 to, the Social Security (Northern Ireland) Order 1998 .

Those powers are exercisable by the Secretary of State by virtue of Article 4(1)(b) of the Welfare Reform (Northern Ireland) Order 2015 .

PART 1 — General

Citation, commencement and application

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• (1) These Regulations may be cited as the Universal Credit, Personal Independence Payment, Jobseeker's Allowance and Employment and Support Allowance (Decisions and Appeals) Regulations (Northern Ireland) 2016 and come into operation—

• (a) in so far as they relate to personal independence payment and for the purposes of this regulation, on 20th June 2016; and

• (b) for all remaining purposes, immediately after the coming into operation of the Universal Credit Regulations.

• (2) These Regulations apply in relation to—

• (a) an employment and support allowance payable under Part 1 of the 2007 Act as amended by Schedule 3 and Part 1 of Schedule 12 to the 2015 Order (to remove references to an income-related allowance);

• (b) a jobseeker's allowance payable under the Jobseekers Order as amended by Part 1 of Schedule 12 to the 2015 Order (to remove references to an income-based allowance);

• (c) personal independence payment; and

• (d) universal credit.

Interpretation

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• (1) In these Regulations—

• “the 1998 Order” means the Social Security (Northern Ireland) Order 1998;

• “the 2007 Act” means the Welfare Reform Act (Northern Ireland) 2007 ;

• “the 2015 Order” means the Welfare Reform (Northern Ireland) Order 2015;

• “the Administration Act” means the Social Security Administration (Northern Ireland) Act 1992 ;

• “appeal” means an appeal to an appeal tribunal;

• “appropriate office” means—in the case of a contributions decision which falls within Part II of Schedule 3 to the 1998 Order (decisions against which an appeal lies), any National Insurance Contributions office of HMRC or any office of the Department; orin any other case, the office of the Department or other place, the address of which is specified on the notification of the original decision referred to in regulation 5(1) (revision on any grounds);

• “assessment period” is to be construed in accordance with regulation 22 of the Universal Credit Regulations (assessment periods);

• “benefit” means a benefit or an allowance in relation to which these Regulations apply;

• “benefit week” has the same meaning as in—regulation 2 of the Employment and Support Allowance Regulations (interpretation), in the case of an employment and support allowance;regulation 2 of the Jobseeker's Allowance Regulations (general interpretation), in the case of a jobseeker's allowance;

• “child” means a person under the age of 16;

• ...

• “claimant” means—any person who has claimed—an employment and support allowance,a jobseeker's allowance,personal independence payment;in the case of universal credit, any person who is a claimant for the purposes of Article 46 of the 2015 Order (interpretation of Part 2); andany other person from whom an amount of benefit is alleged to be recoverable;

• “the Claims and Payments Regulations” means the Universal Credit, Personal Independence Payment, Jobseeker's Allowance and Employment and Support Allowance (Claims and Payments) Regulations (Northern Ireland ) 2016 ;

• “the date of notification”, in relation to a decision of the Department, means the date on which the notification of the decision is treated as having been given or sent in accordance with—regulation 3 (service of documents); orwhere the notification is given or sent using an electronic communication, Schedule 1 to the Claims and Payments Regulations;

• “designated authority” means—the Department; ora person providing services to the Department;

• “electronic communication” has the same meaning as in section 4(1) of the Electronic Communications Act (Northern Ireland) 2001 ;

• “employment and support allowance” means an employment and support allowance in relation to which these Regulations apply;

• “the Employment and Support Allowance Regulations” means the Employment and Support Allowance Regulations (Northern Ireland) 2016 ;

• “family” means the claimant's partner and any—child; orqualifying young person, within the meaning of regulation 6 of the Universal Credit Regulations (meaning of “qualifying young person”),who is a member of the same household as the claimant and for whom the claimant or the claimant's partner is, or both of them are, responsible;

• “the Fraud Act” means the Social Security Fraud Act (Northern Ireland) 2001 ;

• “fraud penalty”, in relation to any claimant of an employment and support allowance, a jobseeker's allowance or universal credit, means any period during which the provisions of section 5B, 6 or 8 of the Fraud Act apply to the award;

• “HMRC” means Her Majesty's Revenue and Customs;

• “jobseeker's allowance” means a jobseeker's allowance in relation to which these Regulations apply;

• “the Jobseeker's Allowance Regulations” means the Jobseeker's Allowance Regulations (Northern Ireland) 2016 ;

• “the Jobseekers Order” means the Jobseekers (Northern Ireland) Order 1995 ;

• “limited capability for work” has the same meaning as in—section 1(4) of the 2007 Act in relation to an employment and support allowance;Article 43(1) of the 2015 Order in relation to universal credit;

• “limited capability for work determination” means—where the determination relates to an employment and support allowance, a determination whether a person has limited capability for work following a limited capability for work assessment in accordance with regulation 15(1) of the Employment and Support Allowance Regulations or a determination that a person is to be treated as having limited capability for work in accordance with regulation 16 or 25 of those Regulations;where the determination relates to universal credit, a determination whether a person has limited capability for work following a limited capability for work assessment referred to in regulation 40(2) of the Universal Credit Regulations or a determination that a person is to be treated as having limited capability for work in accordance with regulation 40(6) of those Regulations;

• “negative determination” has the same meaning as in Article 85(6) of the 2015 Order (ability to carry out daily living activities or mobility activities);

• “official error” means an error made by—an officer of the Department or HMRC acting as such which was not caused or materially contributed to by any person outside the Department or HMRC;a person employed by, and acting on behalf of, a designated authority which was not caused or materially contributed to by any person outside that authority,but excludes any error of law which is shown to have been such by a subsequent decision of a Commissioner, or of the court (as defined in Article 27(7) of the 1998 Order );

• “partner” means one of a couple within the meaning of Article 45 of the 2015 Order (couples);

• “personal independence payment” means an allowance payable under Part 5 of the 2015 Order (personal independence payment);

• “relevant benefit” has the same meaning as in Chapter II of Part II of the 1998 Order (decisions and appeals) ;

• “Scottish disability benefit” means, as the context requires, any of the following benefits—adult disability payment within the meaning given in regulation 2 of the Disability Assistance for Working Age People (Scotland) Regulations 2022 in circumstances where regulation 53(1) of those Regulations applies; ...child disability payment within the meaning given in regulation 2 of the Disability Assistance for Children and Young People (Scotland) Regulations 2021 in circumstances where regulation 36(1) of those Regulations applies;... pension age disability payment within the meaning given in regulation 2 of the Disability Assistance for Older People (Scotland) Regulations 2024 in circumstances where regulation 45(1) of those Regulations applies; or Scottish adult disability living allowance within the meaning given in regulation 2 of the Disability Assistance (Scottish Adult Disability Living Allowance) Regulations 2025 in circumstances where regulation 48(1) of those Regulations applies;

• “terminally ill”, in relation to a claimant, means that the claimant is suffering from a progressive disease and that death in consequence of that disease can reasonably be expected within 12 months;

• “universal credit” means the benefit payable under Part 2 of the 2015 Order (universal credit);

• “the Universal Credit Regulations” means the Universal Credit Regulations (Northern Ireland) 2016 ;

• “writing” includes writing produced by means of electronic communications used in accordance with regulation 4 (electronic communications).

• (2) ... The Interpretation Act (Northern Ireland) 1954 applies to these Regulations as it applies to an Act of the Northern Ireland Assembly.

• (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Service of documents

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• (1) Where, under any provision of these Regulations, any notice or other document is given or sent by post to the Department, it is to be treated as having been given or sent on the day on which it is received by the Department.

• (2) Where, under any provision of these Regulations, the Department sends a notice or other document by ordinary post to a person's last known address, it is to be treated as having been given or sent on the day on which it was posted.

Electronic communications

4

Schedule 1 to the Claims and Payments Regulations (electronic communications) applies to the delivery of electronic communications to or by the Department for the purposes of these Regulations in the same manner as it applies to the delivery of electronic communications for the purposes of those Regulations.

PART 2 — Revision

CHAPTER 1 — Revision on any grounds

Revision on any grounds

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• (1) Any decision of the Department under Article 9 or 11 of the 1998 Order (“the original decision”) may be revised by the Department if—

• (a) the Department commences action leading to the revision within one month of the date of notification of the original decision; or

• (b) an application for a revision is received by the Department at an appropriate office within—

• (i) one month of the date of notification of the original decision (but subject to regulation 38(4) (correction of accidental errors)),

• (ii) 14 days of the expiry of that period if a written statement of the reasons for the decision is requested under regulation 7 (consideration of revision before appeal) or 50 (notice of a decision against which an appeal lies) and that statement is provided within the period specified in head (i),

• (iii) 14 days of the date on which that statement was provided if the statement was requested within the period specified in head (i) but was provided after the expiry of that period, or

• (iv) such longer period as may be allowed under regulation 6 (late application for a revision).

• (2) Paragraph (1) does not apply—

• (a) in respect of a relevant change of circumstances which occurred since the decision had effect or, in the case of an advance award under regulation 31, 32 or 33 of the Claims and Payments Regulations, since the decision was made;

• (b) where the Department has information or evidence which indicates that a relevant change of circumstances will occur;

• (c) in respect of a decision which relates to an employment and support allowance or personal independence payment where the claimant is terminally ill, unless the application for a revision contains an express statement that the claimant is terminally ill.

Late application for a revision

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• (1) The Department may extend the time limit specified in regulation 5(1) (revision on any grounds) for making an application for a revision if all of the following conditions are met.

• (2) The first condition is that the person wishing to apply for the revision has applied to the Department at an appropriate office for an extension of time.

• (3) The second condition is that the application—

• (a) explains why the extension is sought;

• (b) contains sufficient details of the decision to which the application relates to enable it to be identified; and

• (c) is made within 12 months of the latest date by which the application for revision should have been received by the Department in accordance with regulation 5(1)(b)(i) to (iii).

• (4) The third condition is that the Department is satisfied that it is reasonable to grant the extension.

• (5) The fourth condition is that the Department is satisfied that due to special circumstances it was not practicable for the application for revision to be made within the time limit specified in regulation 5(1)(b)(i) to (iii).

• (6) In determining whether it is reasonable to grant an extension of time, the Department must have regard to the principle that the greater the amount of time that has elapsed between the end of the time limit specified in regulation 5(1)(b)(i) to (iii) and the date of the application, the more compelling should be the special circumstances on which the application is based.

• (7) An application under this regulation which has been refused may not be renewed.

Consideration of revision before appeal

7

• (1) This regulation applies in a case where—

• (a) the Department gives a person written notice of a decision under Article 9 or 11 of the 1998 Order (whether as originally made or as revised under Article 10 of that Order); and

• (b) that notice includes a statement to the effect that there is a right of appeal in relation to the decision only if the Department has considered an application for a revision of the decision.

• (2) In a case to which this regulation applies, a person has a right of appeal under Article 13(2) of the 1998 Order in relation to the decision only if the Department has considered on an application whether to revise the decision under Article 10 of that Order.

• (3) The notice referred to in paragraph (1) must inform the person—

• (a) of the time limit under regulation 5(1) (revision on any grounds) for making an application for a revision; and

• (b) that, where the notice does not include a statement of the reasons for the decision (“written reasons”), the person may, within one month of the date of notification of the decision, request that the Department provide written reasons.

• (4) Where written reasons are requested under paragraph (3)(b), the Department must provide that statement within 14 days of receipt of the request or as soon as practicable afterwards.

• (5) Where, as the result of paragraph (2), there is no right of appeal against a decision, the Department may treat any purported appeal as an application for a revision under Article 10 of the 1998 Order.

CHAPTER 2 — Revision on specific grounds

Introduction

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A decision of the Department under Article 9 or 11 of the 1998 Order may be revised at any time by the Department in any of the cases and circumstances set out in this Chapter.

Official error, mistake etc.

9

A decision may be revised where the decision—

• (a) arose from official error; or

• (b) was made in ignorance of, or was based on a mistake as to, some material fact and as a result is more advantageous to a claimant than it would otherwise have been.

Decisions against which no appeal lies

10

A decision may be revised where the decision is one which is—

• (a) specified in Schedule 2 to the 1998 Order (decisions against which no appeal lies); or

• (b) prescribed by regulation 49(2) (decisions which may or may not be appealed).

Decisions where there is an appeal

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• (1) A decision may be revised where there is an appeal against the decision within the time prescribed by the Social Security and Child Support (Decisions and Appeals) Regulations (Northern Ireland) 1999 but the appeal has not been decided.

• (2) Where—

• (a) the Department makes a decision under Article 9 or 11 of the 1998 Order or such a decision is revised under Article 10(1) of that Order (“decision A”);

• (b) the claimant appeals against decision A;

• (c) after the appeal has been made, but before it results in a decision by the appeal tribunal, the Department makes another decision (“decision B”) which—

• (i) supersedes decision A, or

• (ii) decides a further claim by the claimant;

• (d) after the making of the decision B, the appeal tribunal makes a decision on the appeal (“decision C”); and

• (e) the Department would have made decision B differently if, at the time, it had been aware of decision C,

the Department may revise decision B.

Award of another benefit

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Where—

• (a) the Department makes a decision to award a benefit to a claimant (“the original award”); and

• (b) an award of another relevant benefit or Scottish disability benefit or of an increase in the rate of another relevant benefit or Scottish disability benefit is made to the claimant or, in the case of universal credit, to a member of the claimant's family, for a period which includes the date on which the original award took effect,

the Department may revise the original award.

Advance awards etc.