The Social Security and Child Support (Decisions and Appeals) Regulations 1999

• (ii) in the case of a claimant who is in receipt of income support, jobseeker’s allowance or state pension credit and benefit is paid in advance and the date of notification is the first day of a benefit week from that date and otherwise, from the beginning of the benefit week following the week in which the notification was made; or

• (iii) in any other case, the date of notification of the relevant change of circumstances; or

• (bb) where the decision is advantageous to the claimant and is made on the Secretary of State’s own initiative—

• (i) except where paragraph (ii) applies, from the beginning of the benefit week in which the Secretary of State commenced action with a view to supersession; or

• (ii) in the case of a claimant who is in receipt of income support, jobseeker’s allowance or state pension credit where benefit is paid in advance and the Secretary of State commenced action with a view to supersession on a day which was not the first day of the benefit week, from the beginning of the benefit week following the week in which the Secretary of State commenced such action;

• (bc) where—

• (i) the claimant is a disabled person or a disabled person’s partner;

• (ii) the decision is advantageous to the claimant; and

• (iii) the decision is made in connection with the cessation of payment of a carer’s allowance or carer support payment relating to that disabled person,

the day after the last day for which carer’s allowance or carer support payment was paid to a person other than the claimant or the claimant’s partner;

• (bd) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (be) in the case of a claimant who is in receipt of an employment and support allowance and the claimant makes an application which contains an express statement that he is terminally ill within the meaning of regulation 2(1) of the Employment and Support Allowance Regulations , from the date the claimant became terminally ill;

• (c) where the decision is not advantageous to the claimant—

• (i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (ii) in the case of a disability benefit decision, or an incapacity benefit decision where there has been an incapacity determination or an employment and support allowance decision where there has been a limited capability for work determination (whether before or after the decision), where the Secretary of State is satisfied that in relation to a disability determination embodied in or necessary to the disability benefit decision, or the incapacity determination or an employment and support allowance decision where there has been a limited capability for work determination, the claimant or payee failed to notify an appropriate office of a change of circumstances which regulations under the Administration Act required him to notify, and the claimant or payee, as the case may be, knew or could reasonably have been expected to know that the change of circumstances should have been notified,

• (aa) from the date on which the claimant or payee, as the case may be, ought to have notified the change of circumstances, or

• (bb) if more than one change has taken place between the date from which the decision to be superseded took effect and the date of the superseding decision, from the date on which the first change ought to have been notified, or

• (iii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (iv) in the case of a disability benefit decision, where the change of circumstances is not in relation to the disability determination embodied in or necessary to the disability benefit decision, from the date of the change; or

• (v) in any other case, except in the case of a decision which supersedes a disability benefit decision, from the date of the change.

• (2A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (2B) For the purposes of paragraph (2) “carer support payment” means the carer support payment component of carer support given in accordance with the Carer’s Assistance (Carer Support Payment) (Scotland) Regulations 2023.

• (3) For the purposes of paragraphs (2) and (8) “benefit week” has the same meaning, as the case may be, as in—

• (a) regulation 2(1) of the Income Support Regulations;

• (b) regulation 1(3) of the Jobseeker’s Allowance Regulations;

• (c) regulation 1(2) of the State Pension Credit Regulations; or

• (d) regulation 2(1) of the Employment and Support Allowance Regulations.

• (4) In paragraph (2) a decision which is to the advantage of the claimant includes a decision specified in regulation 30(2)(a) to (f).

• (5) Where the Secretary of State supersedes a decision made by an appeal tribunal, the First-tier Tribunal, the Upper Tribunal or a Commissioner on the grounds specified in regulation 6(2)(c)(i) (ignorance of, or mistake as to, a material fact), the decision under section 10 shall take effect, in a case where, as a result of that ignorance of or mistake as to material fact, the decision to be superseded was more advantageous to the claimant than it would otherwise have been and which either—

• (a) does not relate to a disability benefit decision or an incapacity benefit decision where there has been an incapacity determination; or

• (b) relates to a disability benefit decision or an incapacity benefit decision where there has been an incapacity determination, and the Secretary of State is satisfied that at the time the decision was made the claimant or payee knew or could reasonably have been expected to know of the fact in question and that it was relevant to the decision,

from the date on which the decision of an appeal tribunal, the First-tier Tribunal, the Upper Tribunal or a Commissioner took, or was to take, effect.

• (6) Any decision made under section 10 in consequence of a decision which is a relevant determination for the purposes of section 27 shall take effect as from the date of the relevant determination.

• (6A) Where—

• (a) there is a decision which is a relevant determination for the purposes of section 27 and the Secretary of State makes a benefit decision of the kind specified in section 27(1)(b);

• (b) there is an appeal against the determination;

• (c) after the benefit decision payment is suspended in accordance with regulation 16(1) and (3)(b)(ii); and

• (d) on appeal a court, within the meaning of section 27, reverses the determination in whole or in part,

a consequential decision by the Secretary of State under section 10 which supersedes his earlier decision under sub-paragraph (a) shall take effect from the date on which the earlier decision took effect.

• (7) A decision which is superseded in accordance with regulation 6(2)(e) or (ee) shall be superseded—

• (a) subject to sub-paragraph (b), from the date on which entitlement arises to the other relevant benefit or Scottish disability benefit referred to in regulation 6(2)(e)(ii) or (ee) or to an increase in the rate of that other relevant benefit or Scottish disability benefit; or

• (b) where the claimant or his partner—

• (i) is not a severely disabled person for the purposes of section 135(5) of the Contributions and Benefits Act (the applicable amount) or section 2(7) of the State Pension Credit Act (guarantee credit) or paragraph 6 of Schedule 4 to the Employment and Support Allowance Regulations;

• (ii) by virtue of his having—

• (aa) a non-dependant as defined by regulation 3 of the Income Support Regulations, regulation 2 of the Jobseeker’s Allowance Regulations or regulation 71 of the Employment and Support Allowance Regulations; or

• (bb) a person residing with him for the purposes of paragraph 1 of Schedule 1 to the State Pension Credit Regulations whose presence may not be ignored in accordance with paragraph 2 of that Schedule,

at the date the superseded decision would, but for this sub-paragraph, have had effect,

from the date on which the claimant or his partner ceased to have a non-dependant or person residing with him or from the date on which the presence of that person was first ignored.

• (7A) Where a decision is superseded in accordance with regulation 6(2)(o), or (oa) the superseding decision shall take effect from the day on which a lump sum, or a payment on account of a lump sum, is paid or repaid if that day is the first day of the benefit week but, if it is not, from the next following such day.

• (8) A decision to which regulation 6(2)(f) applies shall take effect from the beginning of the period specified in regulation 69(6) of the Jobseeker’s Allowance Regulations.

• (8ZA) A decision to which regulation 6(2)(fa) applies shall take effect from the beginning of the period specified in regulation 69A(3) of the Jobseeker’s Allowance Regulations.

• (8ZB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (8A) Where a decision is superseded in accordance with regulation 6(2)(s), the superseding decision shall take effect from the date on which the late or unpaid contribution is treated as paid.

• (9) Except where paragraph (9A) applies, a decision relating to attendance allowance or disability living allowance which is advantageous to the claimant and which is made under section 10 on the basis of a relevant change of circumstances shall take effect from—

• (a) where the decision is made on the Secretary of State’s own initiative—

• (i) the date on which the Secretary of State commenced action with a view to supersession; or

• (ii) subject to paragraph (30), in a case where the relevant circumstances are that there has been a change in the legislation in relation to attendance allowance or disability living allowance, the date on which that change in the legislation had effect;

• (b) where—

• (i) the change is relevant to the question of entitlement to a particular rate of benefit; and

• (ii) the claimant notifies the change before a date one month after he satisfied the conditions of entitlement to that rate or within such longer period as may be allowed under regulation 8,

the date on which he satisfied those conditions;

• (c) where—

• (i) the change is relevant to the question of whether benefit is payable; and

• (ii) the claimant notifies the change before a date one month after the change or within such longer period as may be allowed under regulation 8,

the date on which the change occurred; or

• (d) in any other case, the date of the application for the superseding decision.

• (9A) Where—

• (a) on or after 8th March 2001, the claimant had an award of attendance allowance, carer’s allowance, or the care component of disability living allowance;

• (b) the Secretary of State made a superseding decision in accordance with regulation 6(2)(a) to end that award on the ground that there had been, or it was anticipated that there would be, a relevant change of circumstances as a result of the claimant moving, or planning to move, from Great Britain to an EEA state or Switzerland; and

• (c) the Secretary of State supersedes that decision in accordance with regulation 6(2)(b)(i) on the ground that it was erroneous in point of law,

the superseding decision referred to in sub-paragraph (c) shall take effect from 18th October 2007.

• (10) A decision as to an award of incapacity benefit, which is made under section 10 because section 30B(4) of the Contributions and Benefits Act applies to the claimant, shall take effect as from the date on which he became entitled to the highest rate of the care component of disability living allowance.

• (11) A decision as to an award of incapacity benefit or severe disablement allowance, which is made under section 10 because the claimant is to be treated as incapable of work under regulation 10 of the Social Security (Incapacity for Work) (General) Regulations 1995 (certain persons with a severe condition to be treated as incapable of work), shall take effect as from the date he is to be treated as incapable of work.

• (12) Where this paragraph applies, a decision under section 10 may be made so as to take effect as from such date not more than eight weeks before—

• (a) the application for supersession; or

• (b) where no application is made, the date on which the decision under section 10 is made,

as is reasonable in the particular circumstances of the case.

• (12A) Paragraph (12) applies where–

• (a) the effect of a decision under section 10 is that owner-occupier loan payments are to be made to a claimant in respect of the claimant’s liability to make owner-occupier payments; and

• (b) that decision could not have been made earlier because information necessary to make that decision, requested otherwise than in accordance with paragraph 8 of Schedule 4 to the Loans for Mortgage Interest Regulations (provision of information), had not been supplied to the Secretary of State by the lender.

• (12B) Where a claimant is receiving owner-occupier loan payments and there is a reduction in the amount owing in connection with a qualifying loan or alternative finance arrangement (within the meaning in Schedule 1 to the Loans for Mortgage Interest Regulations (meaning of owner-occupier payments)), a decision made under section 10 takes effect—

• (a) on the first anniversary of the date on which the claimant’s liability to make owner-occupier payments was first met by an owner-occupier loan payment; or

• (b) where the reduction in the amount owing in connection with a qualifying loan or alternative finance arrangement occurred after the first anniversary of the date referred to in sub-paragraph (a), on the next anniversary of that date following the date of the reduction.

• (12C) Where a claimant is receiving owner-occupier loan payments, an insurance payment deduction is made under regulation 14A(1) of the Loans for Mortgage Interest Regulations (insurance payment deduction) in relation to any decision under section 8 or 10 and there is a change in the amount of the owner-occupier payments payable—

• (a) on a qualifying loan or alternative finance arrangement (within the meaning in Schedule 1 to the Loans for Mortgage Interest Regulations (meaning of owner-occupier payments)) to which those payments relate; or

• (b) on a loan or alternative finance arrangement not so qualifying which is secured on the dwelling occupied as the home to which those payments relate,

a decision under section 10 which is made as a result of that change in the amount of the owner-occupier payments payable shall take effect on whichever of the dates referred to in paragraph (12D) is appropriate in the claimant’s case.

• (12D) The date on which a decision under section 10 takes effect for the purposes of paragraph (12C) is—

• (a) the date on which the claimant’s liability to make owner-occupier payments is first met by an owner-occupier loan payment; or

• (b) where the change in the amount of the owner-occupier payments payable occurred after the date referred to in sub-paragraph (a), on the date of the next alteration in the standard rate following the date of that change.

• (12E) In paragraph (12D), “standard rate” has the same meaning as it has in regulation 13 of the Loans for Mortgage Interest Regulations (standard rate to be applied under regulations 11 and 12).

• (12F) Paragraph (12G) applies where—

• (a) a claimant is awarded state pension credit;

• (b) the claimant or the claimant’s partner has reached pensionable age (within the meaning in section 122(1) of the Contributions and Benefits Act);

• (c) the claimant is in receipt of owner-occupier loan payments; and

• (d) after the date from which sub-paragraph (c) applies—

• (i) a non-dependant (within the meaning in regulation 2(1) of the Loans for Mortgage Interest Regulations) begins to reside with the claimant; or

• (ii) there has been a change of circumstances in respect of a non-dependant and this reduces the amount of the owner-occupier loan payments.

• (12G) Where this paragraph applies, a decision made under section 10 shall take effect—

• (a) where there is more than one change of the kind specified in paragraph (12F)(d) in respect of the same non-dependant within the same 26 week period, 26 weeks after the date on which the first such change occurred; and

• (b) in any other circumstances, 26 weeks after the date on which a change specified in paragraph (12F)(d) occurred.

• (13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17G) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (17H) Where the decision is superseded in accordance with regulation 6(2)(a)(i) and the relevant circumstances are that the claimant has a non-dependant who has become entitled to main phase employment and support allowance, the superseding decision shall take effect from the date the main phase employment and support allowance is first paid to the non-dependant.

• (18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (24) Where—

• (a) it has been determined that the amount of a jobseeker’s allowance payable to a young person is to be reduced under regulation 63 of the Jobseeker’s Allowance Regulations because paragraph (1)(b)(iii), (c), (d), (e) or (f) of that regulation (reduced payments under section 17 of the Jobseekers Act) applied in his case; and

• (b) the decision made in consequence of sub-paragraph (a) falls to be superseded by a decision under section 10 because the Secretary of State has subsequently issued a certificate under section 17(4) of the Jobseekers Act with respect to the failure in question,

the decision under section 10 shall take effect as from the same date as the decision made in consequence of sub-paragraph (a) has effect.

• (25) In a case where a decision (“ the first decision ”) has been made that a person failed without good cause to take part in a work-focused interview, the decision under section 10 shall take effect as from—

• (a) the first day of the benefit week to commence for that person following the date of the first decision; or

• (b) in a case where a partner has failed without good cause to take part in a work-focused interview in accordance with regulations made under section 2AA of the Administration Act—

• (i) the first day of the benefit week to commence for the claimant (meaning the person who has been awarded a benefit within section 2AA(2) of the Administration Act at a higher rate referable to that partner) following the date of the first decision; or

• (ii) if that date arises five days or less after the day on which the first decision was made, as from the first day of the second benefit week to commence for the claimant following the date of the first decision.

• (26) In paragraph (25), “benefit week" means any period of 7 days corresponding to the week in respect of which the relevant social security benefit is due to be paid.

• (27) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (28) A decision to which regulation 6(2)(j) or (k) applies shall take effect from the first day of the disqualification period prescribed for the purposes of section 6B or 7 of the Social Security Fraud Act 2001.

• (29) Subject to paragraphs (29A) and (29B), a decision to which regulation 6(2)(1) (state pension credit) refers shall take effect from the day following the day on which the assessed income period ends if that day is the first day of the claimant’s benefit week, but if it is not, from the next following such day.

• (29A) A decision to which regulation 6(2)(l) applies, where—

• (a) the decision is advantageous to the claimant; and

• (b) the information and evidence required under regulation 32(1) of the Claims and Payments Regulations has not been provided within the period allowed under that regulation,

shall take effect from the day the information and evidence required under that regulation is provided if that day is the first day of the claimant’s benefit week, but, if it is not, from the next following such day.

• (29B) A decision to which regulation 6(2)(l) applies, where—

• (a) the decision is disadvantageous to the claimant; and

• (b) the information and evidence required under regulation 32(1) of the Claims and Payments Regulations has not been provided within the period allowed under that regulation,

shall take effect from the day after the period allowed under that regulation expired.

• (29C) Except where there is a change of circumstances during the period in which the Secretary of State was prevented from specifying a new assessed income period under regulation 10(1) of the State Pension Credit Regulations, a decision to which regulation 6(2)(m) applies shall take effect from the day on which the information and evidence required under regulation 32(6)(a) of the Claims and Payments Regulations was provided.

• (30) Where a decision is superseded in accordance with regulation 6(2)(a)(i) and the relevant circumstances are that there has been a change in the legislation in relation to a relevant benefit, the decision under section 10 shall take effect from the date on which that change in the legislation had effect.

• (30A) Where a decision is superseded in accordance with regulation 6(2)(a)(ii) and the relevant change of circumstances is the coming into force of a change in the legislation in relation to a relevant benefit, the decision under section 10 shall take effect from the date on which that change in the legislation takes effect.

• (31) Where a decision is superseded in accordance with regulation 6(2)(a)(ii) and the relevant circumstances are that—

• (a) a personal capability assessment has been carried out in the case of a person to whom section 171C(4) of the Contributions and Benefits Act applies; and

• (b) the own occupation test remains applicable to him under section 171B(3) of that Act,

the decision under section 10 shall take effect on the day ... on which the own occupation test is no longer applicable to that person.

• (32) For the purposes of paragraph (31)—

• (a) “personal capability assessment” has the same meaning as in regulation 24 of the Social Security (Incapacity for Work) (General) Regulations 1995;

• (b) “own occupation test” has the same meaning as in section 171B(2) of the Contributions and Benefits Act.

• (33) A decision to which regulation 6(2)(c)(ii) applies shall take effect from the date on which the decision of the appeal tribunal, the First-tier Tribunal, the Upper Tribunal or the Commissioner would have taken effect had it been decided in accordance with the determination of the Upper Tribunal or the Commissioner or the court in the appeal referred to in section 26(1)(b).

• (34) A decision which supersedes a decision specified in regulation 6(2)(n) shall take effect from the effective date of the Secretary of State’s decision to terminate income support which was confirmed by the decision specified in regulation 6(2)(n).

• (35) A decision made in accordance with regulation 6(2)(p), where the failure determination was made before the 13th week of entitlement, shall take effect from the first day of the benefit week following that week.

• (36) A decision made in accordance with regulation 6(2)(p) where paragraph (35) does not apply shall take effect from the first day of the benefit week in which the failure determination was made.

A decision made in accordance with regulation 6(2)(p) shall take effect —

• (a) on the first day of the benefit week in which the failure determination was made where, on the date of that determination, the claimant has not been paid an employment and support allowance since the failure to which that determination relates; or

• (b) in any other case, on the first day of the benefit week after the end of the benefit week in respect of which the claimant was last paid an employment and support allowance.

• (37) A decision made in accordance with regulation 6(2)(q) shall take effect from the first day of the benefit week in which the reduction mentioned in that sub-paragraph ceased to have effect.

• (38) A decision made in accordance with regulation 6(2)(r) that embodies a determination that the claimant has—

• (a) limited capability for work; or

• (b) limited capability for work-related activity; or

• (c) limited capability for work and limited capability for work-related activity

which is the first such determination shall take effect from the day after the last day of the relevant period as defined in regulation 4(4) of the Employment and Support Allowance Regulations.

• (39) A decision made in accordance with regulation 6(2)(r), following an application by the claimant, that embodies a determination that the claimant has limited capability for work-related activity shall take effect from the date of the application.

• (40) A decision made in accordance with regulation 6(2)(r) that embodies a determination that the claimant has—

• (a) limited capability for work; or

• (b) limited capability for work-related activity; or

• (c) limited capability for work and limited capability for work-related activity

where regulation 5 of the Employment and Support Allowance Regulations (assessment phase – previous claimants) applies shall take effect from the beginning of the 14th week of the person’s continuous period of limited capability for work.

• (41) A decision made in accordance with regulation 6(2)(t) shall take effect from the first day of the next benefit week following the day on which the determination mentioned in that sub-paragraph was made.

• (42) A decision made in accordance with regulation 6(2)(u) shall take effect from the first day of the benefit week in which the reduction mentioned in that sub-paragraph ceased to have effect.

• (43) Where the decision is superseded in accordance with regulation 6(2)(sa), the superseding decision shall take effect from the date on which the contributions are treated as paid in accordance with regulation 4(7) of the Social Security (Crediting and Treatment of Contributions, and National Insurance Numbers) Regulations 2001 for the purposes of entitlement to—

• (i) a bereavement benefit;

• (ii) a Category A or Category B retirement pension under Part II of the Contributions and Benefits Act; or

• (iii) a state pension under Part 1 of the Pensions Act 2014.

Effective date for late notifications of change of circumstances

8

• (1) For the purposes of regulation 7(2) and (9), a longer period of time may be allowed for the notification of a change of circumstances in so far as it affects the effective date of the change where the conditions specified in the following provisions of this regulation are satisfied.

• (2) An application for the purposes of regulation 7(2) or (9) shall be made by the claimant or a person acting on his behalf.

• (3) The application referred to in paragraph (2) shall—

• (a) contain particulars of the relevant change of circumstances and the reasons for the failure to notify the change of circumstances on an earlier date; and

• (b) be made—

• (i) within 13 months of the date the change occurred; or

• (ii) in the case of an application for the purposes of regulation 7(9)(b), within 13 months of the date on which the claimant satisfied the conditions of entitlement to the particular rate of benefit.

• (4) An application under this regulation shall not be granted unless the Secretary of State is satisfied or the Board are satisfied that—

• (a) it is reasonable to grant the application;

• (b) the change of circumstances notified by the applicant is relevant to the decision which is to be superseded; and

• (c) special circumstances are relevant to the application and as a result of those special circumstances it was not practicable for the applicant to notify the change of circumstances within one month of the change occurring.

• (5) In determining whether it is reasonable to grant the application, the Secretary of State or the Board shall have regard to the principle that the greater the amount of time that has elapsed between the date one month after the change of circumstances occurred and the date the application for the purposes of regulation 7(2) or (9) is made, the more compelling should be the special circumstances on which the application is based.

• (6) In determining whether it is reasonable to grant an application, no account shall be taken of the following—

• (a) that the applicant or any person acting for him was unaware of, or misunderstood, the law applicable to his case (including ignorance or misunderstanding of the time limits imposed by these Regulations); or

• (b) that the Upper Tribunal or a court has taken a different view of the law from that previously understood and applied.

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

CHAPTER III — OTHER MATTERS

Certificates of recoverable benefits

9

A certificate of recoverable benefits may be reviewed under section 10 of the 1997 Act where the Secretary of State is satisfied that—

• (a) a mistake (whether in computation of the amount specified or otherwise) occurred in the preparation of the certificate;

• (b) the benefit recovered from a person who makes a compensation payment (as defined in section 1 of the 1997 Act) is in excess of the amount due to the Secretary of State;

• (c) incorrect or insufficient information was supplied to the Secretary of State by the person who applied for the certificate and in consequence the amount of benefit specified in the certificate was less than it would have been had the information supplied been correct or sufficient; or

• (d) a ground for appeal is satisfied under section 11 of the 1997 Act .

Effect of a determination as to capacity for work

10

• (1) This regulation applies to a determination whether a person—

• (a) is capable or incapable of work;

• (b) is to be treated as capable or incapable of work;

• (c) has or does not have limited capability for work; or

• (d) is to be treated as having or not having limited capability for work.

• (2) A determination (including a determination made following a change of circumstances) as set out in paragraph (1) which is embodied in or necessary to a decision under Chapter II of Part I of the Act or on which such a decision is based shall be conclusive for the purposes of any further decision.

Secretary of State to determine certain matters

11

Where, in relation to a determination for any purpose to which Part XIIA of the Contributions and Benefits Act or Part 1 of the Welfare Reform Act applies, an issue arises as to—

• (a) whether a person is, or is to be treated as, capable or incapable of work in respect of any period; or

• (aa) whether a person is, or is to be treated as, having or not having limited capability for work; or

• (b) whether a person is terminally ill,

that issue shall be determined by the Secretary of State, notwithstanding that other matters fall to be determined by another authority.

Decision of the Secretary of State relating to industrial injuries benefit

12

• (1) This regulation applies where, for the purpose of a decision of the Secretary of State relating to a claim for industrial injuries benefit under Part V of the Contributions and Benefits Act an issue to be decided is—

• (a) the extent of a personal injury for the purposes of section 94 of that Act;

• (b) whether the claimant has a disease prescribed for the purposes of section 108 of that Act or the extent of any disablement resulting from such a disease; or

• (c) whether the claimant has a disablement for the purposes of section 103 of that Act or the extent of any such disablement.

• (2) In connection with making a decision to which this regulation applies, the Secretary of State may refer an issue, together with any relevant evidence or information available to him, including any evidence or information provided by or on behalf of the claimant, to a health care professional approved by the Secretary of State who has experience in such of the issues specified in paragraph (1) as are relevant to the decision, for such 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.

• (3) In making a decision to which this regulation applies, the Secretary of State shall have regard to (among other factors)—

• (a) all relevant medical reports provided to him in connection with that decision; and

• (b) the experience, in such of the issues specified in paragraph (1) as are relevant to the decision, of any health care professional who has provided a report, including a health care professional approved by the Secretary of State who has provided a report following an examination required by the Secretary of State under section 19.

Income support and social fund determinations on incomplete evidence

13

• (1) Where, for the purpose of a decision under section 8 (decisions by Secretary of State) or 10 (decisions superseding earlier decisions)—

• (a) a determination falls to be made by the Secretary of State in respect of a claimant of income support, state pension credit or employment and support allowance as to—

• (i) the amount to be included in an owner-occupier loan payment under regulation 10 of the Loans for Mortgage Interest Regulations (calculation of each loan payment); or

• (ii) what housing costs are to be included in the claimant’s applicable amount (in the case of income support or employment and support allowance) or the claimant’s appropriate minimum guarantee (in the case of state pension credit); and

• (b) it appears to the Secretary of State that the Secretary of State is not in possession of all of the evidence or information which is relevant for the purposes of such a determination,

the Secretary of State shall make the determination on the assumption that the amounts to be included in an owner-occupier loan payment, the claimant’s applicable amount, or the claimant’s appropriate minimum guarantee, as the case may be, are those that can be immediately determined.

• (2) Where, for the purpose of a decision under section 8 or 10—

• (a) a determination falls to be made by the Secretary of State as to whether—

• (i) in relation to any person, the applicable amount falls to be reduced or disregarded to any extent by virtue of section 126(3) of the Contributions and Benefits Act (persons affected by trade disputes);

• (ii) for the purposes of regulation 12 of the Income Support Regulations, a person is by virtue of that regulation to be treated as receiving relevant education; ...

• (iii) in relation to any claimant, the applicable amount includes severe disability premium by virtue of regulation 17(1)(d) or 18(1)(e), and paragraph 13 of Schedule 2 to, the Income Support Regulations; or

• (iv) in relation to any claimant, the applicable amount includes the severe disability premium by virtue of regulation 67(1) or 68(1) of, and paragraph 6 of Schedule 4 to, the Employment and Support Allowance Regulations ; and

• (b) it appears to the Secretary of State that he is not in possession of all of the evidence or information which is relevant for the purposes of such a determination,

he shall make the determination on the assumption that the relevant evidence or information which is not in his possession is adverse to the claimant.

• (3) Where, for the purposes of a decision under section 8 or 10—

• (a) a determination falls to be made by the Secretary of State as to whether a claimant’s appropriate minimum guarantee includes an additional amount in accordance with regulation 6(4) of, and paragraph 1 of Schedule I to, the State Pension Credit Regulations ; and

• (b) it appears to the Secretary of State that he is not in possession of all the evidence or information which is relevant for the purpose of such a determination,

he shall make the determination on the assumption that the relevant evidence or information which is not in his possession is adverse to the claimant.

Effect of alteration in the component rates of income support and jobseeker’s allowance

14

• (1) Section 159 of the Administration Act (effect of alteration in the component rates of income support) shall not apply to any award of income support in force in favour of a person where there is applicable to that person—

• (a) any amount determined in accordance with regulation 17(2) to (7) of the Income Support Regulations; or

• (b) any protected sum determined in accordance with Schedule 3A or 3B of those Regulations ; or

• (c) any transitional addition, personal expenses addition or special transitional addition applicable under Part II of the Income Support (Transitional) Regulations 1987 (transitional protection).

• (2) Where section 159 of the Administration Act does not apply to an award of income support by virtue of paragraph (1), a decision under section 10 may be made in respect of that award for the sole purpose of giving effect to any change made by an order under section 150 of the Administration Act.

• (3) Section 159A of the Administration Act (effect of alterations in the component rates of jobseeker’s allowance) shall not apply to any award of a jobseeker’s allowance in force in favour of a person where there is applicable to that person any amount determined in accordance with regulation 87 of the Jobseeker’s Allowance Regulations.

• (4) Where section 159A of the Administration Act does not apply to an award of a jobseeker’s allowance by virtue of paragraph (3), a decision under section 10 may be made in respect of that award for the sole purpose of giving effect to any change made by an order under section 150 of the Administration Act.

• (5) Section 159B of the Administration Act (effect of alterations affecting state pension credit) shall not apply to any award of state pension credit in favour of a person where in relation to that person the appropriate minimum guarantee includes an amount determined under paragraph 6 of Part III of Schedule I to the State Pension Credit Regulations .

• (6) Where section 159B of the Administration Act does not apply to an award of state pension credit by virtue of paragraph (5), a decision under section 10 may be made in respect of that award for the sole purpose of giving effect to any change made to an award under section 150 of the Administration Act.

Jobseeker’s allowance determinations on incomplete evidence

15

Where, for the purpose of a decision under section 8 or 10—

• (a) a determination falls to be made by the Secretary of State as to whether—

• (i) in relation to any person, the applicable amount falls to be reduced or disregarded to any extent by virtue of section 15 of the Jobseekers Act (persons affected by trade disputes); or

• (ii) for the purposes of regulation 54(2) to (4) of the Jobseeker’s Allowance Regulations (relevant education), a person is by virtue of that regulation, to be treated as receiving relevant education; and

• (b) it appears to the Secretary of State that he is not in possession of all of the evidence or information which is relevant for the purposes of such a determination,

he shall make the determination on the assumption that the relevant evidence or information which is not in his possession is adverse to the claimant.

PART III — SUSPENSION, TERMINATION AND OTHER MATTERS

CHAPTER I — SUSPENSION AND TERMINATION

Suspension in prescribed cases

16

• (1) Subject to paragraph (2), the Secretary of State or the Board may suspend payment of a relevant benefit, in whole or in part, in the circumstances prescribed in paragraph (3).

• (2) The Secretary of State shall suspend payment of a jobseeker’s allowance in the circumstances prescribed in paragraph (3)(a)(i) or (ii) where the issue or one of the issues is whether a person, who has claimed a jobseeker’s allowance, is or was available for employment or whether he is or was actively seeking employment.

• (3) The prescribed circumstances are that—

• (a) it appears to the Secretary of State or the Board that—

• (i) an issue arises whether the conditions for entitlement to a relevant benefit are or were fulfilled;

• (ii) an issue arises whether a decision as to an award of a relevant benefit should be revised under section 9 or superseded under section 10;

• (iii) an issue arises whether any amount paid or payable to a person by way of, or in connection with a claim for, a relevant benefit is recoverable under section 71 (overpayments), 71A (recovery of jobseeker’s allowance: severe hardship cases ) or 74 (income support and other payments) of the Administration Act or regulations made under any of those sections; or

• (iv) the last address notified to him or them of a person who is in receipt of a relevant benefit is not the address at which that person is residing; or

• (b) an appeal is pending against—

• (i) a decision of the First-tier Tribunal, the Upper Tribunal or a court;

• (ii) a decision given in a different case by the Upper Tribunal or a court, and it appears to the Secretary of State or the Board that, if the appeal were to be determined in a particular way, an issue would arise as to whether the award of a relevant benefit (whether the same benefit or not) in the case itself ought to be revised or superseded.

• (4) For the purposes of section 21(3)(c) an appeal is pending where a decision of the First-tier Tribunal, the Upper Tribunal or a court has been made and the Secretary of State—

• (a) is awaiting receipt of that decision or (in the case of a decision of the First-tier Tribunal) is considering whether to apply for a statement of the reasons for it, or has applied for such a statement and is awaiting receipt thereof; or

• (b) has received that decision or (in the case of a decision of the First-tier Tribunal) the statement of the reasons for it, and is considering whether to apply for permission to appeal, or, where leave to appeal has been granted, is considering whether to appeal;

and the Secretary of State shall give written notice of his proposal to make a request for a statement of the reasons for a tribunal decision, to apply for permission to appeal, or to appeal, as soon as reasonably practicable.

Provision of information or evidence

17

• (1) This regulation applies where the Secretary of State requires information or evidence for a determination whether a decision awarding a relevant benefit should be—

• (a) revised under section 9; or

• (b) superseded under section 10.

• (2) For the purposes of paragraph (1), the following persons must satisfy the requirements of paragraph (4)—

• (a) a person in respect of whom payment of a benefit has been suspended in the circumstances prescribed in regulation 16(3)(a);

• (b) a person who has made an application for a decision of the Secretary of State to be revised or superseded;

• (c) a person from whom the Secretary of State requires information or evidence under regulation 32(1) of the Claims and Payments Regulations;

• (ca) a person from whom the Secretary of State requires documents, certificates or other evidence under regulation 24(5) or (5A) of the Jobseeker’s Allowance Regulations;

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

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

• (f) a person whose entitlement to an employment and support allowance is conditional on his having, or being treated as having, limited capability for work.

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

• (4) A person to whom paragraph (2) refers must either—

• (a) supply the information or evidence within—

• (i) a period of 14 days beginning with the date on which the notification under paragraph (3) was sent to him or such longer period as the Secretary of State allows in that notification; or

• (ii) such longer period as he satisfies the Secretary of State is necessary in order to enable him to comply with the requirement; or

• (b) satisfy the Secretary of State within the period applicable under sub-paragraph (a)(i) that either—

• (i) the information or evidence required of him does not exist; or

• (ii) that it is not possible for him to obtain it.

• (4A) In relation to a person to whom paragraph (2)(ca) refers, paragraph (4)(a)(i) has effect as if for “14 days” there were substituted “7 days”.

• (5) The Secretary of State may suspend the payment of a relevant benefit, in whole or in part, to any person to whom paragraph (2)(b) to (f) applies who fails to satisfy the requirements of paragraph (4).

• (6) In this regulation, “evidence” includes evidence which a person is required to provide in accordance with regulation 2 of the Social Security (Medical Evidence) Regulations 1976 .

Termination in cases of failure to furnish information or evidence

18

• (1) Subject to paragraphs (2), (3) and (4), the Secretary of State shall decide that where a person—

• (a) whose benefit has been suspended in accordance with regulation 16 and who subsequently fails to comply with an information requirement made in pursuance of regulation 17; or

• (b) whose benefit has been suspended in accordance with regulation 17(5),

that person shall cease to be entitled to that benefit from the date on which payment was suspended except where entitlement to benefit ceases on an earlier date other than under this regulation.

• (2) Paragraph (1)(a) shall not apply where not more than one month has elapsed since the information requirement was made in pursuance of regulation 17.

• (3) Paragraph (1)(b) shall not apply where not more than one month has elapsed since the first payment was suspended in accordance with regulation 17.

• (4) Paragraph (1) shall not apply where benefit has been suspended in part under regulation 16 or, as the case may be, regulation 17.

Suspension and termination for failure to submit to medical examination

19

• (1) Except where regulation 8 of the Social Security (Incapacity for Work) (General) Regulations 1995 ... (where a question arises as to whether a person is capable of work) or regulation 23 of the Employment and Support Allowance Regulations (where a question arises whether a person has limited capability for work) applies, the Secretary of State or the Board may require a person to submit to a medical examination by a health care professional approved by the Secretary of State where that person is in receipt of a relevant benefit, and either—

• (a) the Secretary of State considers or the Board consider it necessary to satisfy himself or themselves as to the correctness of the award of the benefit, or of the rate at which it was awarded; or

• (b) that person applies for a revision or supersession of the award and the Secretary of State considers or the Board consider that the examination is necessary for the purpose of making his or their decision.

• (2) The Secretary of State or the Board may suspend payment of a relevant benefit in whole or in part, to a person who fails, without good cause, on two consecutive occasions to submit to a medical examination in accordance with requirements under paragraph (1) except where entitlement to benefit is suspended on an earlier date other than under this regulation.

• (3) Subject to paragraph (4), the Secretary of State or the Board may determine that the entitlement to a relevant benefit of a person, in respect of whom payment of such a benefit has been suspended under paragraph (2), shall cease from a date not earlier than the date on which payment was suspended except where entitlement to benefit ceases on an earlier date other than under this regulation.

• (4) Paragraph (3) shall not apply where not more than one month has elapsed since the first payment was suspended under paragraph (2).

Making of payments which have been suspended

20

• (1) Subject to paragraphs (2) and (3), payment of a benefit suspended in accordance with regulation 16 or 17 shall be made where—

• (a) in a case to which regulation 16(2) or (3)(a)(i) to (iii) applies, the Secretary of State is satisfied or the Board are satisfied that the benefit suspended is properly payable and no outstanding issues remain to be resolved;

• (b) in a case to which regulation 16(3)(a)(iv) applies, the Secretary of State is satisfied or the Board are satisfied that he has or they have been notified of the address at which the person is residing;

• (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (d) in a case to which regulation 17(5) applies, the Secretary of State is satisfied that the benefit suspended is properly payable and the requirements of regulation 17(4) have been satisfied. in a case to which regulation 18(1) applies, the Board are satisfied that the benefit suspended is properly payable and the requirements of regulation 17(2), (4), (5) or (7) have been satisfied.

• (2) Where regulation 16(3)(b)(i) applies, payment of a benefit suspended shall be made if the Secretary of State—

• (a) does not, in the case of a decision of the First-tier Tribunal, apply for a statement of the reasons for that decision within the period specified under Tribunal Procedure Rules;

• (b) does not, in the case of a decision of the First-tier Tribunal, the Upper Tribunal or a court, make an application for permission to appeal and (where permission to appeal is granted) make the appeal within the time prescribed for the making of such applications and appeals;

• (c) withdraws an application for permission to appeal or the appeal; or

• (d) is refused permission to appeal, in circumstances where it is not open to him to renew the application for permission or to make a further application for permission to appeal.

• (3) Where regulation 16(3)(b)(ii) applies, payment of a benefit suspended shall be made if the Secretary of State, in relation to the decision of the Upper Tribunal or the court in a different case—

• (a) does not make an application for permission to appeal and (where permission to appeal is granted) make the appeal within the time prescribed for the making of such applications and appeals;

• (b) withdraws an application for permission to appeal or the appeal; or

• (c) is refused permission to appeal, in circumstances where it is not open to him to renew the application for permission or to make a further application for permission to appeal.

• (4) Payment of benefit which has been suspended in accordance with regulation 19 for failure to submit to a medical examination shall be made where the Secretary of State is satisfied or the Board are satisfied that it is no longer necessary for the person referred to in that regulation to submit to a medical examination.

CHAPTER II — OTHER MATTERS

Decisions involving issues that arise on appeal in other cases

21

• (1) For the purposes of section 25(3)(b) (prescribed cases and circumstances in which a decision may be made on a prescribed basis) a case which satisfies the condition in paragraph (2) is a prescribed case.

• (2) The condition is that the claimant would be entitled to the benefit to which the decision which falls to be made relates, even if the appeal in the other case referred to in section 25(1)(b) were decided in a way which is the most unfavourable to him.

• (3) For the purposes of section 25(3)(b), the prescribed basis on which the Secretary of State or the Board may make the decision is as if—

• (a) the appeal in the other case which is referred to in section 25(1)(b) had already been determined; and

• (b) that appeal had been decided in a way which is the most unfavourable to the claimant.

• (4) The circumstance prescribed under section 25(5)(c), where an appeal is pending against a decision for the purposes of that section, even though an appeal against the decision has not been brought (or, as the case may be, an application for permission to appeal against the decision has not been made) but the time for doing so has not yet expired, is where the Secretary of State or the Board—

• (a) certifies in writing that he is , or certify in writing that they are, considering appealing against that decision; and

• (b) considers , or consider, that, if such an appeal were to be determined in a particular way—

• (i) there would be no entitlement to benefit in a case to which section 25(1)(a) refers; or

• (ii) the appeal would affect the decision in that case in some other way.

Appeals involving issues that arise in other cases

22

The circumstance prescribed under section 26(6)(c), where an appeal is pending against a decision in the case described in section 26(1)(b) even though an appeal against the decision has not been brought (or, as the case may be, an application for permission to appeal against the decision has not been made) but the time for doing so has not yet expired, is where the Secretary of State or the Board—

• (a) certifies in writing that he is , or certify in writing that they are, considering appealing against that decision; and

• (b) considers , or consider, that, if such an appeal were already determined, it would affect the determination of the appeal described in section 26(1)(a).

Child support decisions involving issues that arise on appeal in other cases

23

• (1) For the purposes of section 28ZA(2)(b) of the Child Support Act (prescribed cases and circumstances in which a decision may be made on a prescribed basis), a case which satisfies either of the conditions in paragraph (2) is a prescribed case.

• (2) The conditions referred to in paragraph (1) are that—

• (a) if a decision were not made on the basis prescribed in paragraph (3), the parent with care would become entitled to income support if a claim were made, or to an increased amount of that benefit;

• (b) the non-resident parent is an employed earner or a self-employed earner.

• (3) For the purposes of section 28ZA(2)(b) of the Child Support Act, the prescribed basis on which the Secretary of State may make the decision is as if—

• (a) the appeal in relation to the different maintenance calculation, which is referred to in section 28ZA(1)(b) of that Act had already been determined; and

• (b) that appeal had been decided in a way that was the most unfavourable to the applicant for the decision mentioned in section 28ZA(1)(a) of that Act.

• (4) The circumstances prescribed under section 28ZA(4)(c) of the Child Support Act (where an appeal is pending against a decision for the purposes of that section, even though an appeal against the decision has not been brought or, as the case may be, an application for permission to appeal against the decision has not been made but the time for doing so has not expired), are that the Secretary of State—

• (a) certifies in writing that the Secretary of State is considering appealing against that decision; and

• (b) the Secretary of State considers that, if such an appeal were to be determined in a particular way—

• (i) there would be no liability for child support maintenance, or

• (ii) such liability would be less than would be the case were an appeal not made.

• (5) In this regulation—

• “non-resident parent” and “parent with care” have the same meaning as in section 54 of the Child Support Act;

• “employed earner” and “self-employed earner” have the same meaning as in section 2(1) of the Contributions and Benefits Act.

Child support appeals involving issues that arise in other cases

24

The circumstances prescribed under section 28ZB(6)(c) of the Child Support Act , where an appeal is pending against a decision in the case described in section 28ZB(1)(b) even though an appeal against the decision has not been brought (or, as the case may be, an application for permission to appeal against the decision has not been made), is where the Secretary of State —

• (a) certifies in writing that the Secretary of State is considering appealing against that decision, and

• (b) considers that, if such an appeal were already determined, it would affect the determination of the appeal described in section 28ZB(1)(a).

PART IV — RIGHTS OF APPEAL AND PROCEDURE FOR BRINGING APPEALS

CHAPTER I — GENERAL

GENERAL APPEALS MATTERS NOT INCLUDING CHILD SUPPORT APPEALS

Other persons with a right of appeal

25

For the purposes of section 12(2), but subject to regulation 3ZA, the following other persons have a right to appeal to the First-tier Tribunal—

• (ai) any person who has been appointed by the Secretary of State or the Board under regulation 30(1) of the Claims and Payments Regulations (payments on death) to proceed with the claim of a person who has made a claim for benefit and subsequently died;

• (aii) any person who is appointed by the Secretary of State to claim benefit on behalf of a deceased person and who claims the benefit under regulation 30(5) and (6) of the Claims and Payments Regulations;

• (aiii) any person who is appointed by the Secretary of State to make a claim for reduced earnings allowance or disablement benefit in the name of a person who has died and who claims under regulation 30(6A) and (6B) of the Claims and Payments Regulations;

• (a) any person appointed by the Secretary of State or the Board under regulation 33(1) of the Claims and Payments Regulations (persons unable to act) to act on behalf of another;

• (b) any person claiming attendance allowance or disability living allowance on behalf of another under section 66(2)(b) of the Contriburions and Benefits Act or, as the case may be, section 76(3) of that Act (claims on behalf of terminally ill persons);

• (c) in relation to a pension scheme, any person who, for the purposes of Part X of the Pension Schemes Act 1993 , is an employer, member, trustee or manager by virtue of section 146(8) of that Act.

Decisions against which an appeal lies

26

Subject to regulation 3ZA, an appeal shall lie to the First-tier Tribunal against a decision made by the Secretary of State or an officer of the Board—

• (a) as to whether a person is entitled to a relevant benefit for which no claim is required by virtue of regulation 3 of the Claims and Payments Regulations ; or

• (b) as to whether a payment be made out of the social fund to a person to meet expenses for heating by virtue of regulations made under section 138(2) of the Contributions and Benefits Act (payments out of the social fund); or

• (c) under Schedule 6 to the Contributions and Benefits Act (assessment of extent of disablement) in relation to sections 103 (disablement benefit) and 108 (prescribed diseases) of that Act for the purposes of industrial injuries benefit under Part V of that Act;or

• (d) under section 59 of, and Schedule 7 to, the Welfare Reform and Pensions Act 1999 (couples to make joint-claim for jobseeker’s allowance) where one member of the couple is working and the Secretary of State has decided that both members of the couple are not engaged in remunerative work; or

• (e) under, or by virtue of regulations made under, section 23A (contributions credits for relevant parents and carers) of the Contributions and Benefits Act.

Decisions against which no appeal lies

27

• (1) No appeal lies to the First-tier Tribunal against a decision set out in Schedule 2.

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

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

Notice of decision against which appeal lies

28

• (1) A person with a right of appeal under the Act or these Regulations against any decision of the Secretary of State or the Board or an officer of the Board shall—

• (a) be given written notice of the decision against which the appeal lies;

• (b) be informed that, in a case where that written notice does not include a statement of the reasons for that decision, he may, within one month of the date of notification of that decision, request that the Secretary of State or the Board or an officer of the Board provide him with a written statement of the reasons for that decision; and

• (c) be given written notice of his right of appeal against that decision.

• (2) Where a written statement of the reasons for the decision is not included in the written notice of the decision and is requested under paragraph (1)(b), the Secretary of State or the Board or an officer of the Board shall provide that statement within 14 days of receipt of the request or as soon as practicable afterwards.

Further particulars required relating to certificate of recoverable benefits appeals or applications

29

• (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (3) Where it appears to the Secretary of State that a notice of appeal in respect of an appeal under the 1997 Act relating to a certificate of recoverable benefits or, as the case may be, recoverable lump sum payments does not contain the particulars required, the Secretary of State may direct the appellant to provide such particulars.

• (4) Where paragraph (3) applies, the time specified for making the appeal ... may be extended by such period, not exceeding 14 days from the date of the Secretary of State’s direction under paragraph (3), as the Secretary of State may determine.

• (5) Where further particulars ... are required under paragraph (3) they shall be sent to or delivered to the Compensation Recovery Unit of the Department for Work and Pensions at Durham House, Washington, Tyne and Wear, NE38 7SF within such period as the Secretary of State may direct.

• (6) The Secretary of State may treat any—

• (a) purported appeal (where, as the result of regulation 9ZB(2) (consideration of review before appeal), there is no right of appeal);

• (b) appeal relating to the certificate of recoverable benefits; or

• (c) appeal relating to the certificate of recoverable lump sum payments,

as an application for review under section 10 of the 1997 Act.

GENERAL APPEALS MATTERS INCLUDING CHILD SUPPORT APPEALS

Appeal against a decision which has been replaced or revised

30

• (1) An appeal against a decision of the Secretary of State ... or the Board or an officer of the Board shall not lapse where the decision is treated as replaced by a decision under section 11 of the Child Support Act by section 28F(5) of that Act, or is revised under section 16 of that Act or section 9 before the appeal is determined and the decision as replaced or revised is not more advantageous to the appellant than the decision before it was replaced or revised.

An appeal against a decision of the Secretary of State or the Board or an officer of the Board shall not lapse where—

• (a) the decision is revised under section 9 before the appeal is determined; and

• (b) the decision as revised is not more advantageous to the appellant than the decision before it was revised.

• (2) Decisions which are more advantageous for the purposes of this regulation include decisions where—

• (a) any relevant benefit paid to the appellant is greater or is awarded for a longer period in consequence of the decision made under section 9;

• (b) it would have resulted in the amount of relevant benefit in payment being greater but for the operation of any provision of the Administration Act or the Contributions and Benefits Act restricting or suspending the payment of, or disqualifying a claimant from receiving, some or all of the benefit;

• (c) as a result of the decision, a denial or disqualification for the receiving of any relevant benefit, is lifted, wholly or in part;

• (d) it reverses a decision to pay benefit to a third party;

• (dd) it reverses a decision under section 29(2) that an accident is not an industrial accident;

• (e) in consequence of the revised decision, benefit paid is not recoverable under section 71, 71A or 74 of the Administration Act or regulations made under any of those sections, or the amount so recoverable is reduced; or

• (f) a financial gain accrued or will accrue to the appellant in consequence of the decision.

• (3) Where a decision as replaced under section 28F(5) of the Child Support Act or revised under section 16 of that Act or under section 9 is not more advantageous to the appellant than the decision before it was replaced or revised, the appeal shall be treated as though it had been brought against the decision as replaced or revised.

Where a decision as revised under section 9 is not more advantageous to the appellant than the decision before it was revised, the appeal shall be treated as though it had been brought against the decision as revised.

• (4) The appellant shall have a period of one month from the date of notification of the decision as replaced or revised to make further representations as to the appeal.

• (5) After the expiration of the period specified in paragraph (4), or within that period if the appellant consents in writing, the appeal to the First-tier Tribunal shall proceed except where, in the light of the further representations from the appellant, the Secretary of State ... or the Board or an officer of the Board further revises his, or revise their, decision and that decision is more advantageous to the appellant than the decision before it was replaced or revised.

Time within which an appeal is to be brought

31

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Late appeals

32

• (1) Where a dispute arises as to whether an appeal was brought within the time specified under Tribunal Procedure Rules the dispute shall be referred to, and determined by, the First-tier Tribunal.

• (2) The Secretary of State ... or the Board, as the case may be, may treat a late appeal as made in time in accordance with Tribunal Procedure Rules if the conditions in paragraphs (4) to (8) are satisfied.

• (4) An appeal may be treated as made in time if the Secretary of State... or the Board, as the case may be, is satisfied that it is in the interests of justice.

• (5) For the purposes of paragraph (4) it is not in the interests of justice to treat the appeal as made in time unless, the Secretary of State or the Board, as the case may be, is satisfied that—

• (a) the special circumstances specified in paragraph (6) are relevant ...; or

• (b) some other special circumstances exist which are wholly exceptional and relevant ...,

and as a result of those special circumstances, it was not practicable for the appeal to be made within the time limit specified in Tribunal Procedure Rules.

• (6) For the purposes of paragraph (5)(a), the special circumstances are that—

• (a) the appellant or a partner or dependant of the appellant has died or suffered serious illness;

• (b) the appellant is not resident in the United Kingdom; or

• (c) normal postal services were disrupted.

• (7) In determining whether it is in the interests of justice to treat the appeal as made in time, regard shall be had to the principle that the greater the amount of time that has elapsed between the expiration of the time limit under Tribunal Procedure Rules and the submission of the notice of appeal, the more compelling should be the special circumstances.

• (8) In determining whether it is in the interests of justice to treat the appeal as made in time, no account shall be taken of the following—

• (a) that the applicant or any person acting for him was unaware of or misunderstood the law applicable to his case (including ignorance or misunderstanding of the time limits imposed by Tribunal Procedure Rules); or

• (b) that the Upper Tribunal or a court has taken a different view of the law from that previously understood and applied.

• (9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Making of appeals and applications

33

• (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (2) A notice of appeal made in accordance with Tribunal Procedure Rules and on a form approved by the Secretary of State ... or the Board, as the case may be, or in such other format as the Secretary of State ... or the Board, as the case may be, accepts, is to be sent or delivered to the following appropriate office —

• (a) in the case of an appeal under the 1997 Act against a certificate of recoverable benefits or, as the case maybe, recoverable lump sum payments, the Compensation Recovery Unit of the Department for Work and Pensions at Durham House, Washington, Tyne and Wear, NE38 7SF;

• (b) in the case of an appeal against a decision relating to a jobseeker’s allowance, an office of the Department for Work and Pensions the address of which was indicated on the notification of the decision which is subject to appeal;

• (c) in the case of a contributions decision which falls within Part II of Schedule 3 to the Act, any National Insurance Contributions office of the Board, or any office of the Department for Work and Pensions;

• (cc) in the case of a decision made under the Pension Schemes Act 1993 by virtue of section 170(2) of that Act, any National Insurance Contributions office of the Board;

• (d) in the case of an appeal under section 20 of the Child Support Act ..., an office of the Child Support Agency; and