Departments Directions Social Fund GuidePart 7 - Reviews by Social Fund Inspectors
SFI Direction 5 - Social Fund Inspector (SFI) overpayment review, first stage SFI - Direction 5
SFI overpayment review - first stage
10500The first stage of the Social Fund Inspector's (SFI's) review is to consider if the decision under review was reached correctly. The factors set out in Direction 5 will help the SFI to decide if the overpayment determination was both legally sustainable and made in accordance with the correct procedure. The second stage of the SFI's review should look at the circumstances of the misrepresentation or failure to disclose any material facts.
10501It does not matter whether the misrepresentation or failure to disclose was fraudulent or otherwise.
10502-10549
SFI Direction 6 - Social Fund Inspector (SFI) overpayment review, second stage SFI - Direction 6
SFI overpayment review - second stage
10550If the Social Fund Inspector (SFI) is satisfied that the overpayment determination was both legally sustainable and made in accordance with the correct procedure, they should continue with the review, having full regard to the factors set out in Direction 6.
10551The SFI should consider if, in taking account all the factors in Direction 6, the Review Officer's (RO's) determination is one they agree with. This does not mean that the SFI should reject a determination because it is not exactly the one they would have made. The SFI should, however, before confirming the overpayment determination, be satisfied that it is a determination which can be considered to be legally correct, having regard to all the relevant factors.
10552If the SFI is unable to confirm the RO's determination because it falls at Direction 5 or 6 they will need to decide whether the matter should be dealt with by substituting their own determination or referring the case back to the RO to be determined afresh.
10553-10559
SFI substitutes a determination 10560If the SFI decides to substitute his own determination, they should first ensure that all the relevant papers surrounding the misrepresentation or failure to disclose material facts are available to enable a determination to be given.
10561The SFI might decide to substitute a determination for that of the RO if:
- the SFI finds that the determination was not impartial, or that there was prejudice or bias
- the required procedural steps were not followed in the determination under review
- the case has been referred to the SFI a second time, the SFI is unable to confirm the RO's redetermination, and considers it expedient that a final decision is given
There may be other reasons for the SFI to substitute a determination.
10562If the SFI determines the application, they will do so in accordance with the general directions and guidance issued under section 38(8) of the Social Security (Northern Ireland) Order 1998. The SFI in making the determination, should have regard to all the facts relating to the misrepresentation or failure to disclose, including any revealed by new evidence.
10563-10579
Cases referred back for determination 10580If the SFI decides to refer the case back for redetermination, he should give detailed reasons for the decision, identify defects in the Decision Maker's (DM's) decision process and give clear reasons for referring the case.
10581In referring the case back for redetermination, the SFI might give one or more reasons, e.g.:
- the evidence in the case does not support the decision given
- the decision is based on irrelevant facts
- the law and directions have been interpreted or applied incorrectly
- insufficient weight has been given to relevant facts
- the determination is unreasonable or irrational
The SFI may give other reasons for referring the case back.
10582If the applicant remains dissatisfied, they may again apply to have the determination reviewed by a SFI.
10583-10999
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