[2005] UKSSCSC CG_2973_2004 (02 February 2005)

Factual and Procedural Background

This opinion concerns an appeal brought by the Claimant against a decision of the Fox Court Appeal Tribunal dated 2 December 2003. The Tribunal had dismissed the Claimant's appeal against a decision by the Secretary of State dated 6 November 2001, which held that the Claimant was entitled to widows benefit only from 29 July 2001, rather than from the date of her husband's death on 23 May 2000. This was on the basis that no claim form had been received until 29 October 2001, with benefits backdated automatically for three months from the date of claim receipt.

The Claimant contended that she had posted an original claim form on 4 July 2000, but the Benefits Agency only received a photocopy of this form on 29 October 2001, followed by the original form on 14 December 2001 after a request from the Agency. The Tribunal hearing was adjourned and rescheduled for 2 December 2003, with directions limiting postponements due to the Claimant's ill-health unless supported by medical evidence. The Claimant, suffering from a serious lung disease, requested a postponement supported by a medical letter dated 28 November 2003, which the Tribunal chairman did not receive before the hearing and refused the postponement. The Tribunal then decided against the Claimant on the basis that no original claim form had been found in the Department’s records.

Following this, the Claimant sought to set aside the Tribunal's decision on grounds of natural justice, arguing that the Tribunal chairman had not seen the medical evidence supporting her inability to attend. The Commissioner found that the failure to consider the medical letter resulted in an inadvertent breach of natural justice and set aside the Tribunal's decision. The Commissioner then exercised power under s.14(8)(a)(ii) of the Social Security Act 1998 to make findings of fact and substitute a decision dismissing the Claimant's appeal.

Legal Issues Presented

1. Whether the Claimant had made a valid claim for widows benefit by posting the original claim form on 4 July 2000.
2. Whether the original claim form was received by an appropriate office of the Department for Work and Pensions within the meaning of the Social Security (Claims and Payments) Regulations 1987.
3. Whether the Tribunal's refusal to postpone the hearing in the absence of medical evidence breached the rules of natural justice.
4. The proper allocation of the burden of proof concerning receipt of the claim form, including the applicability of s.7 of the Interpretation Act 1978.

Arguments of the Parties

Claimant's Arguments

• The Claimant asserted that she posted the original claim form on 4 July 2000 and provided a photocopy as evidence.
• She contended that the refusal to postpone the Tribunal hearing was unfair because the Tribunal chairman did not have the medical evidence she faxed requesting postponement.
• The Claimant argued that the Tribunal's finding that no original claim form was received was incorrect and that the claim should be backdated accordingly.

Secretary of State's Arguments

• The Secretary of State maintained that no original claim form had been received until the photocopy on 29 October 2001, and thus the claim date should be that date.
• He argued that the Benefits Agency conducted a thorough search and found no evidence of an earlier claim.
• The Secretary of State submitted that the refusal to postpone the hearing was justified due to lack of medical evidence.
• He relied on the Department’s procedures and the role of Royal Mail as agent for receipt of claims, arguing that if the original claim had been received at the appropriate office, it would have been recorded on the computer system, which it was not.
• In relation to burden of proof, the Secretary of State accepted an evidential burden to show non-receipt but did not concede that posting alone conclusively established receipt.

Table of Precedents Cited

Court's Reasoning and Analysis

The Commissioner first identified an inadvertent breach of natural justice arising from the Tribunal chairman’s failure to consider the Claimant’s medical evidence supporting a request for postponement. The Claimant's oral evidence and supporting testimony were accepted as truthful, establishing that the letter dated 28 November 2003 was posted but not received by the Tribunal. This breach required setting aside the Tribunal's decision.

On the substantive issue of when the claim was first made, the Commissioner accepted the Claimant’s evidence that she posted the original claim form on 4 July 2000, based on the genuineness of the photocopy, corroborating witness evidence, and the Claimant’s credible testimony despite the delay in follow-up due to her serious illness.

The Commissioner examined the Secretary of State’s evidence regarding receipt of the claim form. Although the Benefits Agency found no record of the original form, the Commissioner accepted that Royal Mail acts as an agent for the Department for Work and Pensions in receiving mail and that the date stamp by Royal Mail on 29 October 2001 indicates receipt at an appropriate office. However, the original claim form might have been lost before reaching the Benefits Agency office, or the recording procedures may have failed.

Considering the burden of proof, the Commissioner analysed s.7 of the Interpretation Act 1978 and concluded it did not apply to social security claim forms due to the clear requirement in Regulation 6(1)(a) that a claim is not made until received. Therefore, the legal burden remained on the Claimant to prove receipt, but the Secretary of State bore an evidential burden to produce evidence of non-receipt once posting was established.

On balance of probabilities, the Commissioner found it more likely that the original claim form was lost before reaching the appropriate office rather than after receipt, but this did not establish that the claim was received. Consequently, the Commissioner upheld the Secretary of State’s decision that the Claimant’s entitlement to widows benefit commenced from 29 July 2001, based on the date of receipt of the photocopy and subsequent claim form.

Holding and Implications

The Commissioner set aside the decision of the Fox Court Appeal Tribunal dated 2 December 2003 on the grounds of breach of natural justice but dismissed the Claimant’s appeal against the Secretary of State’s decision of 6 November 2001. The Commissioner substituted the Tribunal’s decision with one confirming that the Claimant’s entitlement to widows benefit commenced from 29 July 2001, not from the date of death in May 2000.

The direct effect is that the Claimant’s benefit claim is limited to the date the Department effectively received a claim form, with no backdating to the date she initially posted the original form. No new legal precedent was established beyond the application of existing principles concerning natural justice, burden of proof, and interpretation of claim form receipt under the relevant statutory framework.