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27 1993

SOCIAL WELFARE (CONSOLIDATION) ACT, 1993

CHAPTER 7

Disability Benefit

Entitlement to benefit.

[1981, s. 18(1)]

31.—(1) Subject to this Act, a person shall be entitled to disability benefit in respect of any day of incapacity for work (in this Act referred to as “a day of incapacity for work”) which forms part of a period of interruption of employment, if—

(a) he is under pensionable age on the day for which the benefit is claimed, and

(b) he satisfies the contribution conditions in section 32.

[1981, s. 18(2)]

(2) A person shall not be entitled to disability benefit for the first 3 days of any period of incapacity for work.

[1981, s. 18(4); 1986, s. 10; 1987 (No. 2), s. 16(1)(a)]

(3) For the purposes of any provision of this Act relating to disability benefit—

(a) a day shall not be treated in relation to an insured person as a day of incapacity for work unless on that day he is incapable of work,

(b) “day of interruption of employment” means a day which is a day of incapacity for work or of unemployment,

(c) any 3 days of interruption of employment, whether consecutive or not, within a period of 6 consecutive days shall be treated as a period of interruption of employment and any two such periods not separated by a period of more than 13 weeks shall be treated as one period of interruption of employment,

(d) any 3 days of incapacity for work, whether consecutive or not, within a period of 6 consecutive days shall be treated as a period of incapacity for work and any two such periods not separated by more than 3 days shall be treated as one period of incapacity for work:

Provided that a period of incapacity for work shall be deemed to include any day or days of unemployment in the period of 3 consecutive days preceding the 1st day of incapacity for work, but any such day of unemployment shall not be a day of incapacity for work to which section 81(2) applies,

(e) Sunday or such other day in each week as may be prescribed shall not be treated as a day of incapacity for work or of unemployment and shall be disregarded in computing any period of consecutive days,

(f) a day shall not be treated in relation to an insured person as a day of incapacity for work if, in respect of that day, the insured person is being paid by his employer in respect of holiday leave,

(g) any two periods of incapacity for work separated by a period in respect of which an insured person is being paid by his employer in respect of holiday leave shall be treated as one period of incapacity for work.

[1981, s. 18(5)]

(4) Regulations may make provision (subject to subsection (3)) as to the days which are or are not to be treated for the purposes of disability benefit as days of incapacity for work or of unemployment.

[1981, s. 18(6); 1987, s. 9(1)]

(5) The amount payable by way of benefit for any day of incapacity for work shall be one-sixth of the appropriate weekly rate, subject to the total amount being paid at any time by virtue of this subsection being rounded up to the nearest 10p where it is a multiple of 5p but not also a multiple of 10p and being rounded to the nearest 10p where it is not a multiple of 5p or 10p.

[1981, s. 18(7); 1987 (No. 2), s. 16(1)(b)]

(6) A person who was in receipt of maternity benefit under section 37 on any of the 3 days prior to the day in respect of which a claim for disability benefit is made shall not be entitled to disability benefit for the first 3 days of incapacity for work in respect of such claim.

Conditions for receipt.

[1992, s. 32(4)(a)]

32.—(1) The contribution conditions for disability benefit are—

(a) that the claimant has qualifying contributions in respect of not less than 39 contribution weeks in the period between his entry into insurance and the day for which the benefit is claimed, and

(b) that the claimant has qualifying contributions or credited contributions in respect of not less than 39 contribution weeks, of which at least 13 must be qualifying contributions, in the last complete contribution year before the beginning of the benefit year which includes the day for which the benefit is claimed, and

(c) that the claimant has prescribed reckonable weekly earnings in excess of a prescribed amount in the prescribed period.

[1987, ss. 8(1), 8(6)(a)]

(2) In the case of any claim for disability benefit where the period of interruption of employment commenced before the 6th day of April, 1987, subsection (1)(a) shall be construed as if “26” were substituted for “39”.

[1992, s. 32(1)]

(3) Regulations may provide for entitling to disability benefit, subject to such conditions as may be prescribed, such class or classes of persons as would be entitled thereto but for the fact that the requirement in paragraph (b) of subsection (1) that there must be qualifying contributions in respect of at least 13 contribution weeks in the last complete contribution year before the beginning of the benefit year which includes the day for which the benefit is claimed is not satisfied.

[1981, s. 19(2)]

(4) Where a person has been entitled to payment of disability benefit in respect of any day which is on or after the 3rd day of January, 1981, or would but for the provisions of section 31(2) or 36(1) have been so entitled, then, as respects disability benefit, the benefit year which includes the 1st such day in every period of incapacity for work which is, or is deemed to be, a separate period of incapacity shall, for the purpose of the condition contained in paragraph (b) of subsection (1), be regarded as continuing for each day of incapacity for work in that period in respect of which the person's right to such benefit has not been exhausted up to and including the 312th day in that period in respect of which such benefit has been paid.

[1981, s. 19(3)]

(5) Regulations may provide for modifications of the contribution conditions set out in subsection (1).

[1992, s. 32(4)(b)]

(6) Subject to subsection (7), regulations may provide for entitling to disability benefit persons who would be entitled thereto but for the fact that the condition set out in subsection (1)(c) is not satisfied.

[1992, s. 32(4)(b)]

(7) Regulations for the purposes of subsection (6) shall provide that benefit payable by virtue thereof shall be payable at a rate less than that specified in the Second Schedule, and the rate specified by the regulations may vary with the extent to which the condition set out in subsection (1)(c) is satisfied.

[1992, s. 32(3)]

(8) The requirement contained in subsection (1)(b) that there must be qualifying contributions in respect of at least 13 contribution weeks in the relevant contribution year shall not apply to any period of incapacity for work commencing before the 1st day of July, 1992.

Rate of benefit.

[1981, s. 20]

33.— Subject to this Act, the weekly rate of disability benefit shall be as set out in column (2) of Part I of the second Schedule .

Increases for adult and child dependants.

[1981, s. 21(1)]

34.—(1) The weekly rate of disability benefit shall be increased by the amount set out in column (3) of Part I of the second Schedule for any period during which the beneficiary has an adult dependant, subject to the restriction that a beneficiary shall not be entitled for the same period to an increase of benefit under this subsection in respect of more than one person.

[1982, s. 2(2)]

(2) The weekly rate of disability benefit shall be increased by the appropriate amount set out in column (4) or (5) of Part I of the second Schedule in respect of each qualified child who normally resides with the beneficiary.

[1985 (No.2), s. 4(1)]

(3) Any increase of disability benefit payable pursuant to subsection (2) in respect of a qualified child who normally resides with a beneficiary and with the spouse of a beneficiary shall be payable at the rate of one-half of the appropriate amount in any case where the spouse of the beneficiary is not an adult dependant, and subsection (2) shall be construed and have effect accordingly.

Duration of payment.

[1991, s. 55(1); 1993, s. 12(1)]

35.—(1) Where a person—

(a) has qualifying contributions in respect of less than 260 contribution weeks in the period between his entry into insurance and any day of incapacity for work, and

(b) before that day has been entitled, in respect of any period of interruption of employment (whether including that day or not) during the period beginning on the date 1 year immediately prior to that day, to disability benefit for 312 days,

he shall not be entitled to disability benefit for that day unless since the last of the said 312 days and before that day he has requalified for benefit.

[1993, s. 12(2)]

(2) In the case of any claim for disability benefit which was made before the 5th day of April, 1993 subsection (1)(b) shall be construed as if “3 years” were substituted for “1 year”.

[1991, s. 55(1A)]

(3) Notwithstanding subsection (1), where in any period a person has exhausted his entitlement to disability benefit he shall not requalify therefor unless he satisfies the conditions set out in subsection (4).

[1981, s. 22(2)]

(4) Where a person has exhausted his right to disability benefit—

(a) he shall requalify therefor when he has qualifying contributions in respect of 13 contribution weeks begun or ended since the last day for which he was entitled to benefit, and

(b) on his requalifying therefor, subsection (1) shall again apply to him but, in a case where the period of interruption of employment in which he exhausted his right to benefit continues after his requalification, as if the part before and the part after his requalification were distinct periods of interruption of employment.

[1992, s. 33]

(5) For the purposes of this section, any period in respect of which a person is disqualified for receiving disability benefit by virtue of subsection (1) of section 36 shall be treated as though it were a period in respect of which disability benefit was paid.

[1981, s. 22(3)]

(6) Regulations may provide for treating a person for the purposes of this section as having been entitled to benefit for any day if he would have been so entitled but for any delay or failure on his part to make or prosecute a claim:

Provided that a person shall not be so treated where he shows that he did not intend, by failing to acquire or establish a right to benefit for that day, to avoid the necessity of requalifying for benefit under this section.

[1990, s. 32]

(7) Where a person has qualifying contributions in respect of not less than 260 contribution weeks on the 312th day on which benefit is paid in respect of a period of incapacity for work, and he would be entitled to disability benefit but for the fact that the contribution condition set out in subsection (1)(b) of section 32 is not satisfied, he shall be deemed to satisfy that contribution condition in respect of every subsequent day of incapacity in that period of incapacity for work.

[1987, ss. 8(2), 8(6)(b); 1993, s. 35(1)]

(8) In the case of any claim for disability benefit where the period of interruption of employment in respect of incapacity for work beyond 312 days commenced before the 6th day of April, 1987, subsection (1)(a) shall be construed as if “156” were substituted for “260”.

[1987 (No. 2), ss. 8(1), 8(2); 1993, s. 35(2)]

(9) In the case of any claim for disability benefit where the period of interruption of employment in respect of incapacity for work beyond 312 days commenced on or after the 6th day of April, 1987 and before the 4th day of January, 1988, subsection (1)(a) shall be construed as if “208” were substituted for “260”.

[1987 (No. 2), s. 8(3)]

(10) Subsections (8) and (9) shall not apply to any claim for disability benefit where the period of incapacity for work commenced on or after the 4th day of July, 1988.

Disqualifications.

[1981, s. 23(1); 1986, s. 9(1)]

36.—(1) Regulations may provide for disqualifying a person for receiving disability benefit for such period not exceeding 9 weeks as may be determined under the provisions of this Part if—

(a) he has become incapable of work through his own misconduct, or

(b) he fails without good cause to attend for or to submit himself to such medical or other examination or treatment as may be required in accordance with the regulations, or to observe any prescribed rules of behaviour.

[1981, s. 23(2)]

(2) Regulations may also provide for imposing in the case of any class of persons additional conditions in relation to the receipt of disability benefit and restrictions on the rate and duration thereof if, having regard to special circumstances, it appears to the Minister necessary so to do for the purpose of preventing inequalities or preventing injustice.

[1981, s. 23(3)]

(3) Regulations may also provide for disqualifying a person for the receipt of disability benefit if he fails, on becoming or again becoming incapable of work, to make a claim within the prescribed time, but any such regulations may provide for extending, subject to any prescribed conditions, the time within which the claim may be made.