Jersey R & O 6083
Social Security (Jersey) Law, 1974.
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SOCIAL SECURITY (DETERMINATION OF CLAIMS AND QUESTIONS) (JERSEY)
ORDER, 1974.
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THE SOCIAL SECURITY COMMITTEE, in
pursuance of Articles 29 and 33 of the Social Security (Jersey) Law, 1974, hereby orders as follows: -
PART I
DETERMINATION OF CLAIMS AND
QUESTIONS BY DETERMINING OFFICER
SUBMISSION OF CLAIMS AND QUESTIONS TO DETERMINING OFFICER
1. Any
question arising under or in connexion with the Law, including any claim for
benefit, shall be submitted forthwith to the determining officer who shall take
the question into consideration and so far as is practicable, dispose of the
question within fourteen days of the question being submitted to him.
DECISIONS TO BE CONCLUSIVE FOR PURPOSES OF PROCEEDINGS UNDER THE
LAW, ETC
2.-(1) Where in any proceedings –
(a) for an offence under
the Law; or
(b) involving any question
as to the payment of contributions under the Law; or
(c) for the recovery of any
sums due to the Social Security Fund;
any question arises which under Article 1 of this Order is to be
determined by the determining officer, the decision of the determining officer
shall, unless an appeal against that determination is pending or the time for
so appealing has not expired, be conclusive for the purpose of those
proceedings.
(2) In
any such proceedings as aforesaid –
(a) where any question
arises which under paragraph (3) of Article 33 of the Law is
required to be determined in like manner as a corresponding question arising
under the Family Allowances Law, the
decision of that question by the determining officer shall, unless the question
has been referred to the Family Allowances Tribunal in accordance with
paragraph (2) of Article 12 of that Law, or the
time for applying for such a reference has not expired, be conclusive for the
purpose of those proceedings; and
(b) where the question has
been so referred, the decision of the Family Allowances Tribunal shall be
conclusive as aforesaid.
(3) If
any such decision as is mentioned in paragraph (1) or (2) of this Article has
not been obtained and the decision of the question is necessary for the
determination of the proceedings, the question shall be referred to the
determining officer for decision in accordance with the procedure (subject to
the necessary modifications) prescribed in this Part of this Order or under the
Family Allowances Law,3 as the case may be.
(4) Where
any such appeal as is mentioned in paragraph (1) of this Article is pending or
the time for appealing has not expired or where any question has been referred
to the determining officer in accordance with paragraph (3) of this Article,
the court dealing with the case shall adjourn the proceedings until such time
as a final decision upon the question has been obtained.
PART II
APPEALS AND REFERENCES
APPEALS TO THE SOCIAL SECURITY TRIBUNAL
3. Where
the determining officer has decided any question adversely to the claimant, he
shall notify the claimant in writing of the decision and the reasons therefor and
of his right of appeal to the Tribunal, and the claimant may appeal to the
Tribunal:
Provided that –
(a) where one of the
questions mentioned in paragraph (2) of Article 33 of the Law2 has risen in
connexion with the decision of the determining officer, and has been
determined, and the determining officer certifies that the decision on that
question is the sole ground of his decision, no appeal shall lie without leave
of the Committee; and
(b) no appeal shall lie
from a decision of the determining officer on any question mentioned in
paragraph (5) of the said Article 33.
APPOINTMENT OF REGISTRAR AND DEPUTY REGISTRARS
4. The
Committee shall appoint a Registrar of Appeals and one or more deputy
Registrars of Appeals from among the officers of the Committee who shall
perform such duties in connexion with appeals under the Law as the Committee
may direct subject to the provisions of this Order.
APPLICATION FOR APPEAL
5.-(1) An application for an appeal under
Article 3 of this Order by any person who is aggrieved by an award of the
determining officer shall be in writing in the form set out in the Schedule to
this Order and shall contain a statement of the facts and contentions on which
the applicant relies in support of his application.
(2) The
application shall be sent to the Registrar within twenty-eight days after the
date of the notice of the award, but an application made after the expiry of
that period may, with the consent of the Chairman of the Tribunal, be accepted.
(3) An
application may be withdrawn at any time by sending to the Registrar a notice
of withdrawal in writing, and the Registrar shall thereupon send notice thereof
to the Committee and the determining officer, as the case may require.
CONVENING OF TRIBUNAL
6. Where
an application has been made for an appeal to the Tribunal, the Registrar shall
notify the Committee in order that the Committee may give such directions as to
the composition of the Tribunal as may be required and, as soon as may be after
such directions have been given, shall convene the Tribunal.
PROCEDURE ON APPLICATION FOR APPEAL
7. The
Registrar shall furnish a copy of an application for an appeal to the
determining officer and within twenty-one days thereafter the determining
officer shall send to the Registrar a statement setting out the facts and
grounds on which he relies in support of the adverse decision, and a copy of
such statement shall be sent by the Registrar to the applicant:
Provided that in any case in which it appears to the determining
officer that the facts and contentions as set out by the applicant in –
(a) the claim; and
(b) the application for
appeal;
clearly establish that the applicant’s claim must fail, he
may, in lieu of submitting the statement mentioned in this Article, give notice
to the Registrar within the said period of twenty-one days that he does not
propose to submit a statement, and thereupon the Tribunal may, if it is
satisfied that the claim fails, dismiss the appeal forthwith, but if it is not
so satisfied, the Registrar shall inform the determining officer to that
effect, and the determining officer shall, within twenty-one days of being so
informed, forward to the Registrar shall furnish the applicant with a copy of
that statement.
FURTHER PARTICULARS
8. The
Tribunal may at any time require the applicant or the determining officer to
furnish it with further particulars in writing and within such time as it may
direct with regard to any appeal, and may at any stage of the proceedings allow
the amendment of any application for appeal or any statement or particulars and
extend the time for furnishing any statement or particulars.
DECISION WITHOUT A HEARING
9. If
the Tribunal is of opinion that the case can properly be determined on the
particulars supplied by the applicant and the determining officer without a
hearing, it may dispense with a hearing and determine the reference on the
particulars so supplied.
NOTICE OF HEARING
10. If
in the opinion of the Tribunal a hearing is required, the Tribunal shall as
soon as may be practicable fix a date and place for the hearing, and the
Registrar shall give not less than seven days’ notice thereof to the
applicant and to the determining officer.
PROCEDURE AT HEARING
11.-(1) The applicant may appear at the hearing
in person, or be represented by any member of his family or by an advocate or
solicitor or, with the consent of the Tribunal, by any other person, and in the
case of a woman may be accompanied by another person.
(2) Notwithstanding
the provisions of paragraph (1) of this Article, no person other than the
Registrar shall be present while the Tribunal is considering its decision or
discussing any question as to procedure.
(3) The
Tribunal may adjourn the hearing from time to time as it thinks fit.
(4) The
Tribunal may, if it thinks fit, admit any duly authenticated written statement
or other material as prima facie evidence of any fact or facts in any case in
which it thinks it just and proper to do so.
(5) The
Tribunal may, if it thinks fit, call for such documents and examine such
witnesses as appear to it likely to afford evidence relevant and material to
the issue, although not tendered by either the applicant or the determining
officer.
(6) If,
after notice of the hearing has been duly given, the applicant or the
determining officer fails to appear at the hearing, the Tribunal may proceed to
determine the appeal notwithstanding the absence of both or either of them, or
may give such directions with a view to the determination of the appeal as the
Tribunal thinks just and proper.
(7) Any
person authorized by the Committee to represent it shall be entitled to be
heard at the hearing.
(8) The
Tribunal may require any party to proceedings before the Tribunal under this
Order or any witness in the proceedings to give evidence on oath and, for that
purpose, the person presiding over the Tribunal shall have power to administer
an oath.
(9) Where
in connexion with the determination of any claim or question there is before
the Tribunal medical advice or medical evidence relating to the claimant which
has not been disclosed to him and, in the opinion of the Chairman of the
Tribunal, the disclosure to the claimant of that advice or evidence would be
harmful to the claimant’s health, such advice or evidence shall not be
required to be disclosed to the claimant, but the Tribunal shall not by reason
of such non-disclosure be precluded from taking it into account for the purpose
of the said determination.
DECISION OF TRIBUNAL
12.-(1) The decision on any matter of the
majority of the Tribunal shall be the decision of the Tribunal, and the
decision of the Tribunal shall be in writing and signed by the Chairman or
Deputy Chairman of the Tribunal, who may correct in any decision any clerical
mistake or error.
(2) A
copy of the decision, signed as aforesaid, shall be sent by the Registrar, as
soon as may be practicable, to the applicant, to the determining officer and to
the Committee.
GENERAL PROVISION AS TO PROCEDURE
13. Save
as otherwise expressly provided by this Order, the procedure at any hearing
before the Tribunal shall be such as the Tribunal may determine.
REFERENCES AND APPEALS TO THE ROYAL COURT
14.-(1) Any question of law arising in connexion
with the determination by the determining officer or the Tribunal of any
question under this Order may be referred for decision to the Royal Court.
(2) In
the event of any question of law being so referred to the Royal Court, notice
in writing to that effect shall be sent to the applicant or claimant, as the
case may be, and to any other person appearing to be interested therein.
(3) Any
person aggrieved by a decision of the determining officer, other than a
decision on a question mentioned in paragraph (5) of Article 33 of the Law, or of the Tribunal, on any question of law which is
not referred in accordance with paragraph (1) of this Article, may appeal from
that decision to the Royal Court, and the applicant or claimant, as the case
may be, and any other person appearing to the determining officer or the
Tribunal to be interested shall, on request, be furnished with such a statement
of the grounds of the decision as will enable him to determine whether any
question of law has arisen on which he may wish to appeal.
PART III
REVIEW OF DECISIONS
REVIEW OF DECISIONS OF DETERMINING OFFICER AND THE TRIBUNAL
15.-(1) Any decision of the determining officer
of the Tribunal may be reviewed at any time by the determining officer or, on a
reference from him, by the Tribunal, if –
(a) the determining officer
or the Tribunal is satisfied that the decision was given in ignorance of, or
was based on a mistake as to, some material fact; or
(b) there has been any
relevant change of circumstances since the decision was given; or
(c) the decision was based
on the decision of any question to which paragraph (5) of Article 33 of the Law5 applies, and
the decision of that question is revised.
(2) A
question may be raised with a view to such a review as aforesaid by means of an
application in writing to the determining officer, stating the grounds of the
application.
(3) On
receipt of any such application, the determining officer shall proceed to deal
with or refer any question arising thereon in accordance with the provisions of
this Order.
(4) Any
decision given on a review under this Article, and any refusal to review a
decision under this Article, shall be subject to appeal in like manner as an
original decision, and the provisions of this Order shall, subject to the
necessary modifications, apply in relation to any decision given on such a
review as they apply to the original decision of a question.
REVIEW OF DECISIONS OF THE ROYAL COURT
16. If,
in any case in which a decision has been given by the Royal Court with respect
to a matter which has formed the subject of an appeal to the Court under
Article 14 of this Order, it appears to the Committee that the decision might
properly be reconsidered in view of further information which has been brought
to its notice since the date on which the decision was given as to the
circumstances existing at the time by reference to which it was given, the
Committee may cause the decision to be referred to the Royal Court for
reconsideration, and the Court may revise the decision.
REVIEW OF DECISION INVOLVING PAYMENT OR INCREASE OF BENEFIT
17.-(1) Where, on review, a decision is revised
so as to make benefit payable or to increase the rate of benefit, the decision
given on the review shall have effect as follows –
(a) in the case of
maternity allowance, as from the date of application for the review;
(b) in the case of
incapacity benefit or accident benefit, as from the date ten days before the
date of the application for the review; or
(c) in the case of
widow’s benefit or an old age pension, as from the date three months
before the date of the application for the review:
Provided that, subject to the provisions of paragraph (2) of this
Article, if in any case the claimant proves –
(i) that
on a date earlier than the date on which the application for the review was
made, he was (apart from satisfying the condition of making a claim therefor)
entitled to benefit; and
(ii) that
throughout the period between the earlier date and the date on which the
application for review was made, there was good cause for delay in making the
application;
he shall not be disqualified by virtue of the foregoing provisions
of this paragraph for receiving any benefit to which he would have been
entitled in respect of the said period.
(2) Notwithstanding
anything contained in this Article, the following provisions shall have effect
–
(a) the proviso to paragraph
(1) of this Article shall apply in any case subject to the condition that no
sum on account of benefit shall be paid to any person in respect of any part of
the period referred to in that proviso earlier than six months before the date
on which the application for the review was made;
(b) the decision on review
shall not in any event have effect for any period before the date on which the
original decision took effect or would have taken effect if an award had been
made;
(c) if the said decision on
review was based on a material change of circumstances subsequent to the date
from which the original decision took effect, it shall not have effect for any
period before the date declared by the determining officer or the Tribunal, as
the case may be, to be the date on which such material change of circumstances
took place.
(3) For
the purposes of this Article, where a decision is reviewed at the instance of
the determining officer under paragraph (1) of Article 15 of this Order, the
date on which it was first decided by the determining officer that the decision
should be reviewed shall be deemed to be the date of the application for the
review.
PART IV
PROVISIONS RELATING TO BENEFIT
FOLLOWING DECISIONS ON REVIEW OR APPEAL
ADJUSTMENT OF BENEFIT
18.-(1) Where, by a decision on review or
appeal, a person entitled to benefit is awarded some other benefit in lieu
thereof, the decision on the review or appeal shall direct that any payments
already made on account of the benefit originally awarded in respect of any
period covered by the decision on review or appeal shall be treated as having
been made on account of the benefit awarded by that decision.
(2) Where,
by virtue of an award, an increase of benefit has been paid for any period to
one person in respect of another as being the wife or husband, or an adult
dependant, of the first-mentioned person, and by reason of a subsequent
decision either –
(a) the said other person
is himself entitled to benefit for that period; or
(b) a third person is
entitled to benefit for that period in respect of the said other person in
priority to the first-mentioned person;
then, notwithstanding that under any order relating to overlapping
benefits made under Article 28 of the Law such
increase of benefit is not payable, the subsequent decision shall direct that
it shall be treated as having been properly paid for that period and that any
arrears of benefit for that period payable by reason of the subsequent decision
shall be reduced to the extent to which the increase of benefit is so directed
to be treated as having been properly paid.
REVISION ETC. OF DECISIONS INVOLVING NON-PAYMENT OR REDUCTION OF
BENEFIT
19. Where,
on review or appeal, a decision is revised or is reversed or varied so as to
make benefit not payable or to reduce benefit, the decision given on the review
or appeal shall require repayment to the Social Security Fund of any benefit
paid in pursuance of the original decision to the extent to which it –
(a) would not have been
payable if the decision on the review or appeal had been given in the first
instance; and
(b) is not directed to be
treated as paid on account of the benefit awarded by the decision on review or
appeal:
Provided that, subject as aforesaid, repayment shall not be
required in any case where the person concerned is shown to the satisfaction of
the determining officer or the Tribunal, as the case may be, to have acted in
good faith in all respects as to the obtaining and receipt of the benefit.
PART V
GENERAL
INTERPRETATION
20.-(1) In this Order, unless the context
otherwise requires –
“applicant” means a person who has made an application
under the Law for the determination of any such question as is mentioned in
Article 1 of this Order;
“claimant” means a person who has claimed benefit under
the Law;
“determining officer” means an officer appointed by the
Committee in pursuance of Article 33 of the Law;
“the Family Allowances Law” means the Family Allowances
(Jersey) Law, 1972;
“the Law” means the Social Security (Jersey) Law, 1974;
“question” includes a claim under the Law, but excludes
any such question as is referred to in paragraph (2) of Article 33 of the Law;7
“the Registrar” means the Registrar of Appeals or a
deputy Registrar of Appeals appointed in accordance with this Order;
“the Royal Court” means the Inferior Number of the
Royal Court;
“the Tribunal” means the Social Security Tribunal
constituted under the Fourth Schedule to the Law.
(2) Any
notice or other document required or authorized to be given to any person under
the provisions of this Order shall be deemed to have been given or sent if it
was sent by post to that person at his ordinary or last known address.
(3) References
in this Order to any enactment shall, unless the context otherwise requires, be
construed as references to that enactment as amended by any subsequent
enactment or to any other enactment repealing and re-enacting that enactment
with or without further amendment.
CITATION AND COMMENCEMENT
21. This
Order may be cited as the Social Security (Determination of Claims and
Questions) (Jersey) Order, 1974. and shall come into force on the first day of
January, 1975.
By Order of the Social Security Committee,
E.J.M. POTTER,
Greffier of the States.
27th November, 1974.
SCHEDULE
Social Security (Jersey) Law, 1974
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APPLICATION FOR
APPEAL.
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To
the Registrar of Appeals
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I
………………...…………………………….........………………….
of …..………………………………………………………….....………...
being dissatisfied by the award or decision of the determining officer given
on the
……………………………….....................................…day
of ……………………..
19……....., under the Social Security (Jersey) Law, 1974, hereby
apply for the question to be determined by the Social Security Tribunal on
appeal.
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The facts and
contentions on which I rely in support of my application are set forth in the
particulars hereto attached.
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In support of
this application the following documents are sent herewith: -
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Insert list of all documents sent with
application.
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Dated this
………………......……… day of
……………........………….
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…................……..........……………….
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(Signature).
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N.B. – The particulars furnished
by the applicant and all documents and other information which may be sent to
the Tribunal by or on behalf of the applicant in connexion with his or her
application will be disclosed to the determining officer. A copy of the
officer’s award or decision must be furnished
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