Northern Ireland - Social Security and Child Support Commissioners' Decisions

[1998] NISSCSC C1/98(REA) (22 February 1999)

 


Decision No: C1/98(REA)

SOCIAL SECURITY ADMINISTRATION (NORTHERN IRELAND) ACT 1992 SOCIAL SECURITY CONTRIBUTIONS AND BENEFITS (NORTHERN IRELAND) ACT 1992 SOCIAL SECURITY (CONSEQUENTIAL PROVISIONS) (NORTHERN IRELAND) ACT 1992 REDUCED EARNINGS ALLOWANCE Appeal to the Social Security Commissioner on a question of law from the decision of the Belfast Social Security Appeal Tribunal dated 20 June 1997 DECISION OF THE SOCIAL SECURITY COMMISSIONER
1. This is an appeal (leave having been granted by the chairman) against a decision dated 20 June 1997 of a Social Security Appeal Tribunal (hereinafter called "the Tribunal") sitting at Belfast. That Tribunal had unanimously decided that Mr W... was not entitled to Reduced Earnings Allowance from and including 1 January 1984 because the date of onset of the prescribed disease D1 (in respect of which Mr W... was claiming the benefit) was found by a Medical Appeal Tribunal to be 18 January 1991. In essence the Social Security Appeal Tribunal considered itself bound by the Medical Appeal Tribunal's decision as to the date of onset of the disease and in light of the provisions of Schedule 7 to the Social Security Contributions and Benefits (Northern Ireland) Act 1992 considered Mr W... was therefore not entitled to the Reduced Earnings Allowance.
2. My decision is that the Tribunal's decision is not in error of law and the appeal is therefore dismissed.
3. Mr W...'s grounds of appeal are contained in a letter dated 12 November 1997 attached to the OSSC1 form. In essence Mr W... submitted that the appeal which he had made to the Social Security Appeal Tribunal was primarily concerned with the date of onset of the above disease and that the Tribunal in considering itself bound by the Medical Appeal Tribunal as to the date of onset had not adequately dealt with the issue.
4. The appeal was opposed by Miss Griffin of Central Adjudication Services by letter of 14 August 1998.
5. Miss Griffin stated in her observations that the dispute appeared to relate to the actual date of onset of the relevant prescribed disease. She also stated this date was based on the decision of the Medical Appeal Tribunal and that Tribunal's decision is binding on the adjudication authorities and in particular in this case on the Social Security Appeal Tribunal.
6. Certain questions in connection with claims for Industrial Injuries Benefits (which include Reduced Earnings Allowance) are reserved for decision by the medical authorities. These questions are the "disablement questions". They are set out at Section 43 of the Social Security Administration (Northern Ireland) Act 1992 and in relation to prescribed diseases are whether the relevant diseases resulted in a loss of faculty and at what degree the extent of disablement resulting from that loss of faculty is to be assessed and what period is to be taken into account by the assessment. By Section 43(2) of the said Act the Adjudication Officer can refer the disablement questions to an Adjudicating Medical Practitioner or to a Medical Appeal Tribunal for determination. Once either course is followed the decision of the medical authorities is binding on the Adjudication Officer and Social Security Appeal Tribunal in relation to that disablement question.
7. As Miss Griffin submitted, Regulation 6(1) of the Social Security (Industrial Injuries) (Prescribed Diseases) Regulations (Northern Ireland) 1986 provides that once a date of onset is determined for a first claim in respect of a prescribed disease, that date is to be treated as the date of onset for the purposes of any subsequent claim in respect of the same disease.
8. The first claim in respect of PDDI in Mr W...'s case was his claim to Disablement Benefit on 6 January 1995. The date of onset was determined as 18 January 1991 and this applied to the later claim to Reduced Earnings Allowance for that disease, that later claim being received on 28 October 1996.
9. As Miss Griffin has stated there are numerous Commissioners decisions to the effect that the decisions of the medical authorities are binding on Social Security Appeal Tribunals on disablement questions. Of particular note is R(I) 16/66, which case

went beyond the Commissioners and in fact went to the House of Lords under the title R v Amalgamated Engineering Union ex parte Dowling. The House of Lords confirmed the division of responsibility for adjudication, ie the disablement questions were for determination by the medical authorities (adjudicating Medical Practitioners, Medical Boards and Medical Appeal Tribunals) and the statutory questions for the adjudicating authorities (Adjudication Officers and Social Security Appeal Tribunals).

In Great Britain Commissioners' decision CI/189/94 it was held that the determination of the date of onset involves the determination of a diagnosis question, and on a claim for disablement benefit, a disablement question. The date of onset of a prescribed disease was for determination by the Medical Authorities. Accordingly the matter fell within the jurisdiction of a Medical Appeal Tribunal rather than a Social Security Appeal Tribunal. I agree with that conclusion.

10. As the question of the date of onset of the disease involves a disablement question and as it was correctly referred to a Medical Appeal Tribunal and had been decided by it, that Medical Appeal Tribunal's decision was binding on the Social Security Appeal Tribunal. The latter Tribunal was therefore correct in its decision and the appeal is dismissed.
11. Mr W... may wish to consider appealing the Medical Appeal Tribunal decision.

(Signed): M F Brown

COMMISSIONER

22 February 1999