Reviews and appeals
10 Review of certificates of recoverable benefits.
F1(1)
Any certificate of recoverable benefits may be reviewed by the Secretary of State—
(a)
either within the prescribed period or in prescribed cases or circumstances; and
(b)
either on an application made for the purpose or on his own initiative.
(2)
On a review under this section the Secretary of State may either—
(a)
confirm the certificate, or
(b)
(subject to subsection (3)) issue a fresh certificate containing such variations as he considers appropriate F2or.
(c)
revoke the certificate.
(3)
The Secretary of State may not vary the certificate so as to increase the total amount of the recoverable benefits unless it appears to him that the variation is required as a result of the person who applied for the certificate supplying him with incorrect or insufficient information.
11 Appeals against certificates of recoverable benefits.
(1)
An appeal against a certificate of recoverable benefits may be made on the ground—
(a)
that any amount, rate or period specified in the certificate is incorrect, or
(b)
that listed benefits which have been, or are likely to be, paid otherwise than in respect of the accident, injury or disease in question have been brought into account F3or.
(c)
that listed benefits which have not been, and are not likely to be, paid to the injured person during the relevant period have been brought into account, or
(d)
that the payment on the basis of which the certificate was issued is not a payment within section 1(1)(a)
(2)
An appeal under this section may be made by—
(a)
the person who applied for the certificate of recoverable benefits, or
F4(aa)
(in a case where that certificate was issued under section 7(2)(a)) the person to whom it was so issued, or
(b)
(in a case where the amount of the compensation payment has been calculated under section 8) the injured person or other person to whom the payment is made.
(3)
No appeal may be made under this section until—
(a)
the claim giving rise to the compensation payment has been finally disposed of, and
(b)
the liability under section 6 has been discharged.
(4)
For the purposes of subsection (3)(a), if an award of damages in respect of a claim has been made under or by virtue of—
(a)
section 32A(2)(a) of the M1Supreme Court Act 1981,
(b)
section 12(2)(a) of the M2Administration of Justice Act 1982, or
(c)
section 51(2)(a) of the M3County Courts Act 1984,
(orders for provisional damages in personal injury cases), the claim is to be treated as having been finally disposed of.
(5)
Regulations may make provision—
(a)
as to the manner in which, and the time within which, appeals under this section may be made,
(b)
as to the procedure to be followed where such an appeal is made, and
(c)
for the purpose of enabling any such appeal to be treated as an application for review under section 10.
F5(6)
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12 Reference of questions to medical appeal tribunal.
F6(1)
The Secretary of State must refer an appeal under section 11 to an appeal tribunal.
(3)
In determining F7any appeal under section 11, the tribunal must take into account any decision of a court relating to the same, or any similar, issue arising in connection with the accident, injury or disease in question.
(4)
On F8an appeal under section 11 an appeal tribunal may either—
(a)
confirm the amounts, rates and periods specified in the certificate of recoverable benefits, or
(b)
specify any variations which are to be made on the issue of a fresh certificate under subsection (5) F9or.
(c)
declare that the certificate of recoverable benefits is to be revoked.
(5)
When the Secretary of State has received F10the decision of the tribunal on the appeal under section 11, he must in accordance with that decision either—
(a)
confirm the certificate against which the appeal was brought, or
(b)
issue a fresh certificate F11or.
(c)
revoke the certificate.
F12(6)
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(7)
Regulations F13. . . may (among other things) provide for the non-disclosure of medical advice or medical evidence given or submitted following a reference under subsection (1).
F14(8)
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13 Appeal to Social Security Commissioner.
(1)
An appeal may be made to a Commissioner against any decision of F15 an appeal tribunal under section 12 on the ground that the decision was erroneous in point of law.
(2)
An appeal under this section may be made by—
(a)
the Secretary of State,
(b)
the person who applied for the certificate of recoverable benefits, F16. . .
F17(bb)
(in a case where that certificate was issued under section 7(2)(a)) the person to whom it was so issued, or
(c)
(in a case where the amount of the compensation payment has been calculated in accordance with section 8) the injured person or other person to whom the payment is made.
(3)
F18Subsections (7) to (12) of section 14 of the Social Security Act 1998 apply to appeals under this section as they apply to appeals under that section.
F19(4)
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14 Reviews and appeals: supplementary.
(1)
This section applies in cases where a fresh certificate of recoverable benefits is issued as a result of a review under section 10 or an appeal under section 11.
(2)
If—
(a)
a person has made one or more payments to the Secretary of State under section 6, and
(b)
in consequence of the review or appeal, it appears that the total amount paid is more than the amount that ought to have been paid,
regulations may provide for the Secretary of State to pay the difference to that person, or to the person to whom the compensation payment is made, or partly to one and partly to the other.
(3)
If—
(a)
a person has made one or more payments to the Secretary of State under section 6, and
(b)
in consequence of the review or appeal, it appears that the total amount paid is less than the amount that ought to have been paid,
regulations may provide for that person to pay the difference to the Secretary of State.
(4)
Regulations under this section may provide—
(a)
for the re-calculation in accordance with section 8 of the amount of any compensation payment,
(b)
for giving credit for amounts already paid, and
(c)
for the payment by any person of any balance or the recovery from any person of any excess,
and may provide for any matter by modifying this Act.