Social Security (Incapacity for Work) (General) Regulations 1995
1995 No. 311
SOCIAL SECURITY
The Social Security (Incapacity for Work) (General) Regulations 1995
Made 10th February 1995
Coming into force 13th April 1995
Whereas a draft of this instrument was laid before Parliament in accordance with section 6(3) of the Social Security (Incapacity for Work) Act 19941and approved by resolution of each House of Parliament.
Now, therefore, the Secretary of State for Social Security, in exercise of the powers conferred by section 61A of the Social Security Administration Act 19922and sections 171A, 171B, 171C, 171D, 171E, 171G(2) and 175(2) to (4) of the Social Security Contributions and Benefits Act 19923and of all other powers enabling him in that behalf, by this instrument which contains only regulations made by virtue of section 5 and 6 of the Social Security (Incapacity for Work) Act 1994 and which is made before the end of the period of 6 months beginning with the coming into force of that Act4, after consultation with the Council on Tribunals5, hereby makes the following Regulations:
PART I
GENERAL
Citation and commencement
1. These Regulations may be cited as the Social Security (Incapacity for Work) (General) Regulations 1995 and shall come into force on 13th April 1995.
Interpretation
2.—(1) In these Regulations, unless the context otherwise requires—
“activity” means an activity specified in column (1) of Parts I and II of the Schedule;
“adjudication officer” means an officer appointed in accordance with section 38(1) of the Administration Act;
“the Administration Act” means the Social Security Administration Act 1992;
“the all work test” means the test defined in Part III of these Regulations;
“benefit” does not include statutory sick pay or industrial injuries benefit;
“confinement” has the meaning given to it by section 171(1) of the Contributions and Benefits Act;
“the Contributions and Benefits Act” means the Social Security Contributions and Benefits Act 1992;
“close relative” means a parent, parent-in-law, son, son-in-law, daughter, daughter-in-law, step-parent, step-son, step-daughter, brother, sister, or the spouse of any of the preceding persons or, if that person is one of an unmarried couple, the other member of that couple;
“descriptor” means, in relation to an activity, the descriptor in column (2) of the Schedule which describes a person’s ability to perform that activity;
“disability appeal tribunal” means a tribunal constituted under section 43 of the Administration Act;
“the Disability Living Allowance Advisory Board” means the board referred to in section 175(1) of the Administration Act;
“doctor” means a registered medical practitioner;
“the own occupation test” means the test defined in section 171B of the Contributions and Benefits Act;
“the President” means the President of the social security appeal tribunals, disability appeal tribunals and medical appeal tribunals;
“social security appeal tribunal” means a tribunal constituted under section 41 of the Administration Act;
“spell or incapacity” has the meaning given to it by section 171B(3) of the Contributions and Benefits Act;
“voluntary organisation” means a body, other than a public or local authority, the activities of which are carried on otherwise than for profit;
“volunteer” means a person who is engaged in voluntary work with a charity or voluntary organisation, or who is engaged in voluntary work otherwise than for a close relative, where the only payment received by him or due to be paid to him by virtue of being so engaged in respect of any expenses reasonably incurred by him in connection with that work;
“week” means any period of 7 days.
(2) In these Regulations, unless the context otherwise requires, any reference—
(a)
(a) to a numbered regulation is to the regulation in these Regulations bearing that number;
(b)
(b) to the Schedule is to the Schedule to these Regulations.
Application
3. These Regulations do not apply for the purposes of Part V (benefit for industrial injuries) or Part XI (statutory sick pay) of the Contributions and Benefits Act.
PART II
GENERAL PROVISIONS RELATING TO INCAPACITY FOR WORK
CHAPTER I
OWN OCCUPATION TEST
Definition of “remunerative work”
4.—(1) For the purposes of section 171B of the Contributions and Benefits Act (the own occupation test) “remunerative work” in relation to the period of 21 weeks referred to in that section means work—
(a)
(a) in one occupation in which a person was engaged for 16 or more hours a week for more than 8 weeks; and
(b)
(b) for which payment was made or which was done in expectation of payment.
(2) For the purposes of this regulation and regulation 5—
(a)
(a) one occupation comprises either—
(i) all work of the same kind, whether or not it is for the same employer and whether a person is employed or self-employed; or
(ii) all work for the same employer; and
(b)
(b) a person who was normally engaged in one occupation for 16 or more hours a week shall be treated as if he had been engaged in that occupation in relation to any week when he was on paid or unpaid leave from that occupation.
Person with more than one occupation
5. Where a person was engaged in more than one occupation which qualified as remunerative work in the period of 21 weeks referred to in regulation 4, his occupation for the purposes of the own occupation test is the last such occupation in which he was engaged during that period; but if, during his last week of remunerative work in that period, he was engaged in more than one such occupation he must satisfy the own occupation test in respect of each.
CHAPTER II
INFORMATION AND EVIDENCE
Information required for determining capacity for work
6.—(1) Subject to paragraph (2) the information or evidence required for the purposes of determining whether a person is capable or incapable of work is—
(a)
(a) where the own occupation test or the all work test applies, evidence of his incapacity for work in accordance with the Social Security (Medical Evidence) Regulations 19766(which prescribe the form of doctor’s statement or other evidence required in each case);
(b)
(b) where the all work test applies, such information as the Secretary of State may request in the form of a questionnaire relating to a person’s ability to perform the activities referred to in the Schedule;
(c)
(c) such additional information relating to the relevant test as the Secretary of State may request.
(2) Where the Secretary of State is satisfied that he has sufficient information for a determination whether a person is capable or incapable of work without the information specified in paragraph (1)(b), that information shall not be required for the purposes of that determination.
(3) Where it has been determined that a person is to be treated as incapable of work under regulations 10 to 14 the information referred to in paragraph (1) shall not be required.
Failure to provide information
7.—(1) Where a person fails without good cause to comply with a request of the Secretary of State to provide the information referred to in regulation 6(1)(b) (all work test questionnaire) he shall, subject to paragraph (2), be treated as capable of work.
(2) A person shall not be treated as capable of work under paragraph (1) unless—
(a)
(a) at least 6 weeks have elapsed since the Secretary of State sent that person the first request for that information; and
(b)
(b) the Secretary of State has sent that person a further request at least 4 weeks after the first, and at least 2 weeks have elapsed since that further request was sent.
Person may be called for a medical examination
8.—(1) Where a question arises as to whether a person is capable of work, he may be called by or on behalf of a doctor approved by the Secretary of State to attend for a medical examination.
(2) Subject to paragraph (3) where a person fails without good cause to attend for or submit himself to such an examination, he shall be treated as capable of work.
(3) A person shall not be treated as capable of work under paragraph (2) unless written notice of the time and place for the examination was sent to him at least 7 days beforehand, or unless he agreed to accept a shorter period of notice.
Matters to be taken into account in determining good cause
9. The matters which are to be taken into account in determining whether a person has good cause under regulation 7 or 8 (failure to provide information or attend a medical examination) shall include—
(a) whether he was outside Great Britain at the relevant time;
(b) his state of health at the relevant time; and
(c) the nature of any disability from which he suffers.
CHAPTER III
PERSONS TREATED AS INCAPABLE
Certain persons with a severe condition to be treated as incapable of work
10.—(1) A person shall be treated as incapable of work on any day on which any of the circumstances set out in paragraph (2) apply to him.
(2) The circumstances are—
(a)
(a) that he is in receipt of the highest rate care component of disability living allowance;
(b)
(b) that he is suffering from a progressive disease and his death in consequence of that disease can reasonably be expected within 6 months;
(c)
(c) that he is a blind person whose name is on a register compiled and maintained by a local authority under section 29 of the National Assistance Act 19487(welfare services) or, in Scotland, has been certified as blind and in consequence is registered as blind in a register maintained by or on behalf of a regional or islands council;
(d)
(d) that he is suffering...
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