The Social Security (Industrial Injuries and Adjudication) Regulations 1993

• Citation: S.I. 1993/861
• Sections: 25

Section 1 Citation, commencement and interpretation

(1) These Regulations may be cited as the Social Security (Industrial Injuries and Adjudication) Regulations 1993 and shall come into force on 19th April 1993.

(2) In these Regulations, except where the context otherwise requires—

“the Adjudication Regulations ” means the Social Security (Adjudication) Regulations 1986 ;

“the Prescribed Diseases Regulations ” means the Social Security (Industrial Injuries) (Prescribed Diseases) Regulations 1985

Section 2 Amendment of the Adjudication Regulations

The Adjudication Regulations shall be amended in accordance with this Part of these Regulations and in this Part a reference to a numbered regulation is to the regulation in the Adjudication Regulations which bears that number.

Section 3 Amendment of regulation 1

In regulation 1(2) (interpretation)—

(a) after the definition of “the 1991 Act” there shall be inserted the following definition—

“the Administration Act ” means the Social Security Administration Act 1992;

(b) for the definition of “specially qualified adjudicating medical practitioner” there shall be substituted the following definition—

“specially qualified adjudicating medical practitioner” means a specially qualified adjudicating medical practitioner appointed by virtue of section 62 of the Administration Act;

Section 4 Amendment of regulation 29

(1) Regulation 29 (determination of medical questions) shall be amended in accordance with the following provisions of this regulation.

(2) In paragraph (1)—

(a) for sub-paragraph (a) there shall be substituted the following sub-paragraph—

(a) any question arising on an application for the review of a decision under—

(i) section 47(1) of the Administration Act (decision given in ignorance of, or based on a mistake as to, a material fact); or

(ii) section 47(2) of the Administration Act (error of law);

(b) sub-paragraph (b) shall be omitted.

(3) In paragraph (2)—

(a) for “,D9 or D10” there shall be substituted “,D9, D10 or D11 ”; and

(b) for the words “a special medical board” there shall be substituted the words “a specially qualified adjudicating medical practitioner except where a question mentioned in paragraph (1) arises, in which case it shall be referred to and determined by a special medical board”.

Section 5 Amendment of regulation 33

(1) Regulation 33 (disqualification from acting as an adjudicating medical authority or as a member thereof or as a member of a medical appeal tribunal) shall be amended in accordance with the following provisions of this regulation.

(2) In paragraph (1) at the beginning there shall be inserted the words—

“Subject to paragraphs (1A) and (2) below,”.

(3) After paragraph (1) there shall be inserted the following paragraph—

(1A) A medical practitioner to whom a question has been referred under regulation 42(1) (reference of diagnosis and recrudescence questions for medical report) shall not be precluded from acting as an adjudicating medical practitioner or a specially qualified adjudicating medical practitioner solely by reason of his having prepared, under that regulation, a report on the case of the claimant (whether in relation to the question for determination or otherwise) if he proposes to determine the question in favour of the claimant.

(4) In paragraph (2)—

(a) the words “Notwithstanding the provisions of paragraph (1),” shall be omitted; and

(b) for “, D9 or D10” there shall be substituted “, D9, D10 or D11”.

Section 6 Amendment of regulation 41

In regulation 41(2)(b) (application of Part III of the 1975 Act and of the Adjudication Regulations) for “, D9 and D10” there shall be substituted “, D9, D10 and D11”.

Section 7 Amendment of regulation 42

(1) Regulation 42 (reference of diagnosis and recrudescence questions for medical report) shall be amended in accordance with the following provisions of this regulation.

(2) In paragraph (1) for “, D9 and D10” there shall be substituted “, D9, D10 and D11”.

(3) In paragraph (3) after the words “a special medical board” there shall be inserted the words “or a specially qualified adjudicating medical practitioner”.

(4) In paragraphs (5) and (6) for the words “a medical board” in each place where they occur there shall be substituted the words “an adjudicating medical authority”.

Section 8 Amendment of regulation 43

In regulation 43(2) (procedure on receipt of a medical report) for the words “a medical board for their decision” there shall be substituted the words “an adjudicating medical authority for decision”.

Section 9 Amendment of regulation 44

In regulation 44 (restriction of adjudication officer’s power to determine diagnosis and recrudescence questions) for the words “a medical board”, in each place where they occur, there shall be substituted the words “an adjudicating medical authority” and for the words “the medical board” in paragraph (2) of that regulation there shall be substituted the words “the adjudicating medical authority”.

Section 10 Amendment of regulation 45

In regulation 45 (appeal against decision of adjudication officer) for the words “a medical board”, in each place where they occur, there shall be substituted “an adjudicating medical authority” and for the words “the medical board”, in each place where they occur, there shall be substituted the words “the adjudicating medical authority”.

Section 11 Amendment of regulation 46

In regulation 46 (appeal or reference to a medical appeal tribunal) for the words “a medical board”, in each place where they occur, there shall be substituted the words “an adjudicating medical authority”.

Section 12 Amendment of regulation 47

In regulation 47 (powers of medical appeal tribunal upon determining the question referred) for the words “a medical board”, in each place where they occur, there shall be substituted the words “an adjudicating medical authority”.

Section 13 Amendment of regulation 48

In regulation 48 (review of previous assessment following recrudescence decision) for the words “the medical board” there shall be substituted the words “the adjudicating medical authority”.

Section 14 Amendment of regulation 50

In regulation 50(1) (review of decision on diagnosis or recrudescence question) for the words “medical board” where they first occur, there shall be substituted the words “adjudicating medical authority”.

Section 15 Amendment of regulation 51

For regulation 51 (additional provisions relating to the powers and decisions of special medical boards) there shall be substituted the following regulation—

Additional provisions relating to the powers and decisions of specially qualified adjudicating medical practitioners and special medical boards

(51)

(1) Specially qualified adjudicating medical practitioners and special medical boards shall have power to make or cause to be made a radiological examination of the lungs of the claimant and to obtain the report of a radiologist on the case, and to make or cause to be made serological, lung function and such other tests as they consider necessary and to obtain reports upon the results of such tests.

(2) Where in respect of a claim for disablement benefit by reason of prescribed disease D1 (pneumoconiosis) or D2 (byssinosis) a specially qualified adjudicating medical practitioner, special medical board or a medical appeal tribunal gives a decision under the foregoing provisions of these Regulations that the claimant is or was suffering from one or other of those diseases—

(a) that practitioner, board or tribunal may on the evidence before him or it at the time of that decision, determine also the date from which the claimant has or had suffered from that disease; and

(b) notwithstanding the provisions of section 60(1) of the Administration Act (finality of decisions) in making that determination, the practitioner, board or tribunal shall not be bound by any previous decision of an adjudication officer, specially qualified adjudicating medical practitioner or special medical board that the claimant was not suffering from that disease; and

(c) any such previous decision, in so far as it is inconsistent with the said determination, shall cease to have effect.

Section 16 Amendment of the Prescribed Diseases Regulations

The Prescribed Diseases Regulations shall be amended in accordance with this Part of these Regulations and in this Part a reference to a numbered regulation is to the regulation in the Prescribed Diseases Regulations which bears that number.

Section 17 Amendment of regulation 1

(1) Regulation 1(2) (interpretation) shall be amended in accordance with the following provisions of this regulation.

(2) After the definition of “the Claims and Payments Regulations” there shall be inserted the following definition—

“adjudicating medical authority” means, as the case may be, an adjudicating medical practitioner, a specially qualified adjudicating medical practitioner, a medical board or a special medical board;

(3) After the definition of “special medical board” there shall be inserted the following definition—

“specially qualified adjudicating medical practitioner” means a specially qualified adjudicating medical practitioner appointed by virtue of section 62 of the Social Security Administration Act 1992 ;

Section 18 Amendment of regulation 9

(1) Regulation 9 (re-employment of pneumoconiotics and special provisions for benefit (workmen’s compensation cases)) shall be amended in accordance with the following provisions of this regulation.

(2) In paragraph (1) at the end there shall be inserted the words “or a specially qualified adjudicating medical practitioner”.

(3) In sub-paragraph (a) of paragraph (2)—

(a) after the words “special medical board”, in each place where they occur, there shall be inserted “or the specially qualified adjudicating medical practitioner”; and

(b) after the words “to them” there shall be inserted the words “or him”.

(4) In sub-paragraph (b) of paragraph (2) after the words “foregoing sub-paragraph by” there shall be inserted the words “a specially qualified adjudicating medical practitioner,”.

(5) In sub-paragraph (c) of paragraph (2) after the words “the decision of” there shall be inserted the words “the specially qualified adjudicating medical practitioner,”.

Section 19 Amendment of regulation 22

(1) Paragraph (2) of regulation 22 (pneumoconiosis-effects of emphysema and chronic bronchitis) shall be amended in accordance with the following provisions of this regulation.

(2) In sub-paragraph (a) for the words “a medical board” there shall be substituted the words “an adjudicating medical authority”.

(3) In sub-paragraph (b) for the words “the medical board” there shall be substituted the words “the adjudicating medical authority”.

Section 20 Amendment of regulation 23

In regulation 23 (reduced earnings allowance-special provision for pneumoconiosis cases) after the words “advice from a special medical board” there shall be inserted the words “or a specially qualified adjudicating medical practitioner”.

Section 21 Amendment of regulation 27

In regulation 27 (further claims in respect of occupational deafness) for the words “a medical board”, in each place where they occur, there shall be substituted the words “an adjudicating medical authority”.

Section 22 Amendment of regulation 31

In regulation 31 (review of assessment for unforeseen aggravation in respect of occupational deafness) for the words “a medical board” there shall be substituted the words “an adjudicating medical authority”.

Section 23 Amendment of regulation 38

(1) Regulation 38 (periodical examinations) shall be amended in accordance with the following provisions of this regulation.

(2) After the words “special medical board”, in each place where they occur, there shall be inserted the words “or a specially qualified adjudicating medical practitioner”.

(3) After the words “such a board” there shall be inserted the words “or practitioner”.

Section 24 Amendment of regulation 40

In paragraph (2) of regulation 40 (conditions of suspension) after the words “special medical board” there shall be inserted the words “or specially qualified adjudicating medical practitioner”.

Section 25 Transitional provision

Nothing in these Regulations shall be taken to affect the validity of any reference to, or any proceedings of or any decision of, a medical board if the reference was made, or the proceedings were begun, before the date upon which these Regulations come into force.