Social Security Appeal System
Updated 18 December 2018
Assistance with appeals
There are various appeal procedures in place to enable you to have decisions of Customer and Local Services adjudicated by independent tribunals. The procedures differ according to the benefit in question. Also see the booklet "If you think our decision is wrong" available from Customer and Local Services.
|Client receives decision on benefit/pension, and finds it unsatisfactory,
or Customer and Local Services wants to have decision reviewed:
|An application to appeal must be lodged in the form of a written letter within the
prescribed time (normally 21 days). Statements as evidence to support the
appeal must be submitted.
|The case is reviewed by a Determining Officer first. If the client is still dissatisfied
the case is passed to the Social Security Tribunal.
WHAT TYPE OF BENEFIT IS IN QUESTION
Where the benefit in question is dependent upon a contribution record, e.g. old age pension, decisions are based on the client's contributions paid over a period of time. For some benefits, e.g. Maternity Benefit, there is a relevant period of time specified during which a sufficient level of contributions must have been made. The record of such contributions is a matter of fact for which there is no right of appeal. Although the recording of payments may extend back over a long time, and payments may have been made during work in another country e.g. the UK, it is up to Customer and Local Services with the assistance of the claimant to research such records and assess whether contribution conditions have been satisfied.
Reasons for possible appeal
Benefits must be claimed within prescribed times set out in law for claims to be accepted outside these times good cause must be demonstrated for late application, however application made more than six months after the start of the prescribed time cannot be considered by the Determining Officer. An appeal could be lodged regarding the Determining Officer's decision relating to good cause not being present.
There may be medical reasons for a benefit being refused or limited. Benefits such as Long Term Incapacity Allowance are decided on evidence assessed by a Medical Board of two medical practitioners or medical specialists. If a client is unhappy with the benefit offered, or if benefit is refused, a client should contact the Department immediately for advice because there is no appeal available in the case of some awards of Long Term Incapacity Allowance.
In some cases where the percentage of incapacity is disputed, a Medical Tribunal can be convened to hear medical evidence provided by the applicant's GP or specialist. The Medical Tribunal consists of the Chairman (an advocate) and two medical practitioners. The rules governing Long Term Incapacity Allowance appeals are complex and therefore people wishing to question an award should contact the Department for guidance.
Where the benefit being applied for is based on medical circumstances, e.g. Personal Care Component of Income Support, any dispute would be considered by a Medical Tribunal but in these cases the Board consists of three medical practitioners.
Legal aspects of a decision on a non-contributory benefit may be looked into by the Social Security Tribunal.
The Operation of Tribunals
Applicants would normally appear before the tribunal, and may be represented and supported by a lawyer, a friend or a treating doctor.
Oaths are administered to those giving evidence to tribunals, and the Chairman has the discretion to admit written evidence where appropriate.
The tribunal hears evidence from the Determining Officer, for Customer and Local Services, and also from the applicant and their representatives. The Tribunal has the right to request additional information if necessary to help it reach a decision.
The tribunal members must then make a judgement on the case, which is binding on both parties.