The Social Security (Medical Evidence) Regulations 1976

These regulations may be cited as the Social Security (Medical Evidence) Regulations 1976, and shall come into operation on 4th October 1976.

In these regulations, unless the context otherwise requires—

• “the Act” means the Social Security Act 1975;

• F1“the Contributions and Benefits Act” means the Social Security Contributions and Benefits Act 1992;

• “doctor” means a registered medical practitioner;

• F2“healthcare professional” means a person, not being the patient, who is—

  1. (a)

     a registered medical practitioner;

  2. (b)

     a registered nurse;

  3. (c)

     a registered occupational therapist or registered physiotherapist;

  4. (d)

     a registered pharmacist within the meaning of article 3 of the Pharmacy Order 2010;

• F3“the Employment and Support Allowance Regulations” means the Employment and Support Allowance Regulations 2008;

• F4“limited capability for work” has the meaning—

  1. (a)

     for the purposes of employment and support allowance, given in section 1(4) of the Welfare Reform Act 2007; and

  2. (b)

     for the purposes of universal credit, given in section 37 of the Welfare Reform Act 2012;

• F5“limited capability for work assessment” means the assessment of whether a person has limited capability for work—

  1. (a)

     for the purposes of old style ESA, under Part 5 of the Employment and Support Allowance Regulations;

  2. (b)

     for the purposes of new style ESA, under Part 4 of the Employment and Support Allowance Regulations 2013;

  3. (c)

     for the purposes of universal credit, under Part 5 of the Universal Credit Regulations 2013;

• F6“personal capability assessment” means the assessment provided for in section 171C of the Contributions and Benefits Act;

• F7...

• F8“registered midwife” means a midwife who is registered as a midwife with the Nursing and Midwifery Council under the Nursing and Midwifery Order 2001;

• “signature” means, in relation to any statement or certificate given in accordance with these regulations, the name by which the person giving that statement or certificate, as the case may be, is usually known (any name other than the surname being either in full or otherwise indicated) written by that person in his own handwriting; and “signed” shall be construed accordingly.

Any reference in these regulations to any provisions made by or contained in any enactment or instrument shall, except in so far as the context otherwise requires, be construed as a reference to that provision as amended or extended by any enactment or instrument and as including a reference to any provision which it re-enacts or replaces, or which may re-enact or replace it, with or without modification.

The rules for the construction of Acts of Parliament contained in the Interpretation Act 1889 shall apply in relation to this instrument and in relation to the revocation effected by it as if this instrument, the regulations revoked by it and regulations revoked by the regulations so revoked were Acts of Parliament, and as if each revocation were a repeal.

For the purposes of the definition of “limited capability for work assessment” in paragraph (2)—

Subject to regulation 5 and paragraph (1A) below, where a person claims to be entitled to any benefit, allowance or advantage (other than industrial injuries benefit or statutory sick pay) and entitlement to that benefit, allowance or advantage depends on that person being incapable of work or having limited capability for work, then in respect of each day until that person has been assessed for the purposes of the personal capability assessment or the limited capability for work assessment they shall provide evidence of such incapacity or limited capability by means of a statement given by a F2healthcare professional in accordance with the rules set out in Part 1 of Schedule 1 to these Regulations.

Where it would be unreasonable to require a person to provide a statement in accordance with paragraph (1) above that person shall provide such other evidence as may be sufficient to show that they are incapable of work or have limited capability for work so that they should refrain (or should have refrained) from work by reason of some specific disease or bodily or mental disability.

Every person to whom paragraph (1) applies F3who has not been assessed for the purposes of the F4personal capability assessment F5or the limited capability for work assessment shall, before he returns to work, furnish evidence of the date on which he will become fit to resume work either in accordance with rule 10 of Part I of Schedule 1 to these regulations, or by such other means as may be sufficient in the circumstances of the case.

Every woman who claims maternity benefit shall furnish evidence—

and shall furnish such evidence F6by means of a maternity certificate given by a doctor or by a registered midwife F7not earlier than the beginning of the 20th week before the week in which she is expected to be confined, in accordance with the rules set out in Part I of Schedule 2 to these regulations in the appropriate form as set out in Part II of that Schedule or by such other means as may be sufficient in the circumstances of any particular case.

F3The evidence of incapacity F4or limited capability for work required for the purposes of determining entitlement to a benefit, allowance or advantage referred to in regulation 2(1)–

• may consist of a self certificate instead of a certificate in the form of a statement in writing given by a F7healthcare professional in accordance with regulation 2(1).

For the purpose of this regulation-

• F8“self-certificate” means either—

  1. (i)

     a declaration made by the claimant in writing, on a form approved for the purpose by the Secretary of State; or

  2. (ii)

     where the claimant has made a claim for employment and support allowance in accordance with regulation 4G of the Social Security (Claims and Payments) Regulations 1987, an oral declaration by the claimant,

  that the claimant has been unfit for work from a date or for a period specified in the declaration and may include a statement that the claimant expects to continue to be unfit for work on days subsequent to the date on which it is made;.

• F9“spell of incapacity” has the meaning given to it by section 171B(3) of the Contributions and Benefits Act.

the patient’s name;

the date of the assessment (whether by consultation or consideration of a report as the case may be) on which the healthcare professional’s statement is based;

the condition in respect of which the F4healthcare professional advises the patient they are not fit for work;

a statement, where the healthcare professional considers it appropriate, that the patient may be fit for work;

a statement that the healthcare professional will or, as the case may be will not, need to assess the patient’s fitness for work again;

the date on which the healthcare professional’s statement is given;

the address of the healthcare professional F5; F6and

F7the name of the healthcare professional (whether in the form of a signature or F8otherwise); and

the profession of the healthcare professional

the healthcare professional’s name shall, irrespective of their profession, be recorded next to the words “doctor’s signature”;

the healthcare professional’s address shall, irrespective of their profession, be recorded next to the words “doctor’s address”; and

the healthcare professional shall record their profession within the statement in such place as appears to them to be appropriate.

the patient has been advised by a F2healthcare professional that they are not fit for work and, in consequence, has refrained from work for at least 6 months immediately preceding the date of the assessment on which the F3healthcare professional’s statement is based; and

in the healthcare professional’s opinion, the patient will not be fit for work for the foreseeable future,

the woman’s name;

the week in which the woman is expected to be confined or, if the maternity certificate is given after confinement, the date of that confinement and the date the confinement was expected to take place F3...;

the date of the examination on which the maternity certificate is based;

the date on which the maternity certificate is signed; and

F4the address of the doctor or, where the maternity certificate is signed by a registered midwife, the personal identification number given to her by the Nursing and Midwifery Council (“NMC”) on her registration in the register maintained under article 5 of the Nursing and Midwifery Order 2001 and the expiry date of that registration