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PART 12Determinations and appeals

CHAPTER 2Appeals to Board of Medical Referees

Reference of appeal to the board

166.—(1) On receiving a notice of appeal, the scheme manager must supply the Welsh Ministers with three copies of—

(a)the notice of appeal;

(b)the notice of the relevant determination;

(c)the opinion, response or evidence (as the case may be) supplied to the appellant (P); and

(d)every other document in its possession or under its control which appears to it to be relevant to the issue that is the subject of the appeal.

(2) The Welsh Ministers must refer an appeal to a board of medical referees (“the board”).

(3) The board is to consist of not less than three medical practitioners appointed by, or in accordance with arrangements made by, the Welsh Ministers.

(4) One member of the board must be a specialist in a medical condition relevant to the appeal.

(5) One member of the board must be appointed as chairman.

(6) Where there is an equality of votes among the members of the board, the chairman is to have a second or casting vote.

(7) As soon as reasonably practicable after referring an appeal to the board, the Welsh Ministers must supply the board’s administrator with three copies of every document supplied under paragraph (1).

(8) The board must arrange for one of their number to review those documents (‘the reviewing member’).

(9) As soon as reasonably practicable after concluding the review, the reviewing member must give written notice to the Welsh Ministers—

(a)of any other information which the reviewing member considers would be desirable so as to provide the board with sufficient information for the purpose of enabling the board to determine the appeal; and

(b)if it is the case, that it is the reviewing member’s opinion that the board may regard the appeal as frivolous, vexatious or manifestly ill-founded.

(10) On receipt of the reviewing member’s notice the Welsh Ministers must—

(a)where the reviewing member has notified the Welsh Ministers of the desirability of obtaining other information, require the scheme manager to use its best endeavours to obtain that information; and

(b)where the notice contains an opinion of the description mentioned in paragraph (9)(b), send a copy of it to the scheme manager.

(11) A scheme manager which receives a copy of a reviewing member’s opinion must, as soon as reasonably practicable—

(a)send a copy of it to P; and

(b)by written notice to P—

(i)advise P that if P’s appeal is unsuccessful, P may be required to pay the scheme manager’s costs, and

(ii)require P to notify it within 14 days of the date of the notice whether P intends to pursue or withdraw the appeal.

(12) A scheme manager which notifies P under paragraph (11)(b) must inform the Welsh Ministers of P’s response to the notice under sub-paragraph 11(b); and the Welsh Ministers must notify the board accordingly.