Departments Directions Social Fund Guide Part 6 - Reviews
8000The law provides one review model for all discretionary social fund determinations. However, there are two procedural routes within the review model. One route relates to the review of Community Care Grant (CCG) and Crisis Loan (CL) determinations and the other relates to the review of Budgeting Loan (BL) determinations. The two procedural routes are clearly distinguished and set out in Directions 32 and 39.
8001The Social Fund Guide contains the Directions in a decision making sequence, each followed by the relevant guidance. When reviewing a determination, it is important that the correct sequence of actions is followed.
8002You must ensure that you have properly carried out all the necessary steps in the correct order when considering any application for review. Failure to do so will mean that the review has not been conducted correctly and a social fund inspector (SFI) is unlikely to feel able to confirm a review decision where the process has not been correctly followed.
Power under which reviews are conducted General
8003There are four separate powers of review to be found in or under Article 38(1)(a) and (c) of the Social Security (Northern Ireland) Order 1998, two of which are mandatory and two of which are discretionary.
8004You must conduct a review if:
- an application for review is properly made - section 38(1)(a)
- one of the circumstances in direction 31 appear to be the case - section 38(10)(a)
8005You have the discretion to review in:
- cases of misrepresentation or failure to disclose a material fact to determine that an overpayment is recoverable - section 38(1)(b)
- Such other circumstances as the Decision Maker (DM) thinks fit - section 38(1)(c)
Reviewing a determination
8006In reviewing a determination under Article 38(1)(a) or (c) of the Social Security (Northern Ireland) Order 1998, the Decision Maker must, under Article 38(7) of that Order:
- in the case of CCG and CL determinations, have regard to all the circumstances of the case, in particular those matters specified as those which the Decision Maker should take into account when making the original determination, (see section 136(1)(a) - (e) of the Social Security Contributions and Benefits (Northern Ireland) Act 1992);and act in accordance with any general directions issued by the Department under article 38(7) and (10) of the Social Security (Northern Ireland) Order 1998 and take account of guidance issued by the Department under Section136 and take account of guidance issued by the the Area Decision Maker (ADM) under section 36 of the Social Security Act and any general guidance the Department may issue with regard to reviews and
- in the case of Budgeting Loan (BL) determinations, have regard to such of the applicant's personal circumstances as may be specified in directions issued by the Department, see section 136(1A) of the Social Security Contributions and Benefits (Northern Ireland) Act 1992 (as amended by Article 67(2) of the Social Security (Northern Ireland) Order 1998), together with those matters specified in section 136(1)(b) - (e) of the Social Security Contributions and Benefits (Northern Ireland) Act 1992 and any general guidance the Department may issue with regard to reviews and
- act in accordance with general directions under sections 38(7) and (10) of the Social Security Act 1998 issued by the Department about reviews, including:
-the circumstances in which a determination is to be reviewed
-the manner in which a review is to be conducted
8007In reviewng the determination , the Reviewing Officer (RO):
- need not consider any issue that is not raised by the application for review under section 38(1)(a)
- need not consider any issue that did not cause the DM to review the original determination under section 38(1)(c)
8008Directions made under section 38(10)(b) set out the manner in which reviews are conducted
Decisions that can and cannot be reviewed8009Decisions which can be reviewed are:
- the amount of an award
- the refusal of an award
- if an award should be paid to a third party
- if payment should be by instalments
- refusal to determine a repeat application
- overpayments in consequence of a misrepresentation or failure to disclose material facts.
8010Reviews of overpayment questions are dealt with separately
Effect on repayments or payments by instalments8011A review application may be received from an applicant who is either repaying a Social Fund (SF) award, or being paid a SF award by instalments. The repayment or payments will continue until the review has been resolved.
Determinations outside the remit of reviews8012This review process does not apply to:
- decisions about the rate of repayment, this should be dealt with as a complaint
- SF maternity, funeral, cold weather and winter fuel payment decisions, which are:
-based on regulations
-determined by officers who are authorised to make such decisions on behalf of the Department
8013Dissatisfied customers can ask for their decision on the regulated scheme to be reconsidered or they can appeal against the decision.
Summary of review process 8014An applicant who is dissatisfied with a decision about a Community Care Grant (CCG), Budgeting Loan (BL) or Crisis Loan (CL) may apply for it to be reviewed.
8015There are two stages to the review process.
8016First
- the application for review is considered by a Reviewing Officer (RO) authorised to review such determinations See Directions - 32 and -39 then
- if the reviewing officer (RO) is not minded to change the original determination in relation to a CCG or CL wholly in the applicant's favour,and the RO rejects the applicant’s own evidence or bases the decision on evidence provided by a third party, the applicant should be given the opportunity of taking part in a telephone interview. See Direction 33(2), 34 and 35. It will be appropriate to offer face to face interview in the circumstances detailed at paragraph 8453 below.
- A formal review interview is not required in relation to a BL application (Direction 33(4) refers), although the applicant should be provided with an explanation of the decision and an opportunity to comment/ask questions where the dispute relates to their personal circumstances or receipt of a qualifying benefit. This explanation should usually be provide by telephone, but must be in writing if the applicant:
- cannot be contacted and is difficult to reach by telephone
- is disadvantaged by using the telephone due to communication or other problems, or
- has requested a written explanation.
- after the review, the case is determined and a decision issued with a letter telling the applicant of their right to apply for a further review by the SFI. See Direction 36.
8017Second, if the applicant is dissatisfied with the review decision from the District, they may apply for a review by the SFI.
8018It is possible that, at any stage of the review process, the applicant may decide to withdraw the application for review. See Direction 37.
8019-8069
Time limits and manner of applying for a review 8070Regulations under Article 38(1)(a) of the Social Security (Northern Ireland) Order 1998 prescribe the time, form and manner for applying for a review. Under the Social Fund (Applications for Review) Regulations (Northern Ireland) 1988, applications:
- must be made within 28 days of the date of issue of the decision, although this period may be extended by the Reviewing Officer(RO) if there were special reasons
- must be in writing and contain reasons for the application
- if made on behalf of the applicant, unless they are the appointee, must have the applicant's consent, as signified in writing, to the application being made on their behalf
- must be signed by the person making the application
8071A properly made application for review must satisfy all the above conditions. Use part 1 of form SF 602 to show if they are satisfied.
8072-8089
Application outside time limits 8090The Reviewing Officer (RO) should extend the time limit so that the review can take place if:
- there is a special reason to do so or
8091If the RO decides that there are no special reasons, they must consider whether a review under Direction 31 is appropriate..
8092-8109
Application does not contain reasons8110The RO:
- is required to decide whether or not the application does contain reasons and therefore is or is not made in accordance with the regulations
- records on form SF 602 the decision and the reasons for it.
8111If the RO decides that the application satisfies the regulations, process the review application.
8112If the RO decides that the application does not satisfy the regulations, the RO will send letter SF 225 to the applicant, requesting reasons for the review
8113-8159
Application made by a third party8160Regulation 2 of the Social Fund (Miscellaneous Amendments) Regulations (NI) 1990 (SI 1990 No 132), states that where an application for review is made on behalf of the applicant, that person should signify in writing his consent to the application being made on his behalf.
8161The RO:
- considers if the application has been made in accordance with the regulations
- record on form SF 602 the decision and the reasons for it, see Direction 37
8162If the RO decides that the application does not satisfy the regulations, the RO will send letter SF 228 to the applicant.
8163-8179
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