Annex D
Decisions and determinations that are appealableBenefit decisions
1. All decisions, other than those in Annex E, made on a claim for or award of a
relevant benefit (1), including whether there has been a valid claim (2) or if the claim
is defective.
1 SS Act 98, s 12(1)(a); 2 UC, PIP, JSA & ESA (C&P) Regs, regs 8, 11, 13, 15, 19, 21 & 23
2. Entitlement to and amount of a benefit for which no claim is required (1).
1 UC, PIP, JSA & ESA (C&P) Regs, regs 6 , 7, 9(6) & 9(7); SS Act 98, Sch 3, paras 1-2
3. Whether benefit to which a claimant is entitled is not payable because (1)
3.1 the claimant is disqualified for receiving benefit (2)
3.3 the claimant is in hospital (3)
3.4 a sanction has been imposed (4)
3.5 a PIP claimant is in a care home, hospital or in prison (5)
1 SS Act 98, Sch 3, para 3; 2 SS Act 98, Sch 3, para 3(a) WR Act 07, s 18;3 SS CB Act s 113(2);
4 SS Act 98, Sch 3, para 3(f); WR Act 12, s 26-28 & s 46; ESA Regs 13, reg 50-61;
5 SS Act 98, Sch 3 para 3 (h &i)
4. Payments to third parties (1) (but see Annex E for exceptions).
1 SS Act 98, Sch 3 para 4
5. Whether an overpayment of benefit is recoverable, and if so, the amount (1).
1 SS A Act, s 71,71A, 71ZB, 71ZG & 71ZH
6. Decisions about a proposal to make or vary a claimant committment (1).
1 SS Act 98, para 8; JS Act 95, s 9 & 10
7. A decision as to the amount of a relevant benefit that is payable under
prescribed legislation (1).
1 SS Fraud Act 01, s 6B, 7, 8 &9; SS Act 98, Sch 3, para 3A
Contributions decisions
1. Whether a person was precluded from regular employment by home
responsibilities (1).
1 SS Act 98, Sch 3 para 16
2. Whether a person should be credited with earnings or contributions (1).
1 SS Act 98, para 17; SS CB Act 92, s 22(5)