Secretary of State for Work and Pensions v Whalley

A decision finally determining that a claimant did not suffer from a prescribed disease binds later decision-making on another industrial-injuries benefit claim involving the same disease. This applies to the diagnosis question, not merely to a specified onset date. A later tribunal cannot fix onset during a period already covered by the negative finding. For reduced earnings allowance, the statutory scheme preserves a procedural link with disablement benefit. A claimant must make a disablement benefit claim to obtain the necessary disablement assessment; reduced earnings allowance cannot be established independently.

The Secretary of State appealed from a ruling by a Social Security Commissioner concerning the effect of an earlier disablement benefit decision on a later reduced earnings allowance claim. An Adjudicating Medical Authority had decided on 6 September 1991 that the respondent did not suffer from prescribed disease A11 and had not suffered from it since 1985. A later Medical Appeal Tribunal made an inconsistent finding, but its decision was set aside for procedural error and remitted.

The Commissioner held that the earlier finding bound later disablement benefit claims but was merely factual for a reduced earnings allowance claim, and that reduced earnings allowance could be claimed without a disablement benefit claim. The central issues were the finality of the diagnosis decision and the statutory relationship between the two benefits.

1. Finality. The appeal was allowed. The court held that section 60(1) of the Social Security Administration Act 1992 made final the decision that the claimant did not suffer from the prescribed disease. The result was the same whether the question arose in a disablement benefit claim or a reduced earnings allowance claim. The distinction drawn by the Commissioner between successive claims for the same benefit and claims for different benefits had no logical or statutory basis.
2. Effect on onset. Section 60(2) did not prevent finality attaching to the diagnosis question itself. A later tribunal could not decide that the claimant first suffered the relevant loss of faculty during a period in which it had already been finally decided that he did not suffer from the prescribed disease. The first finding, dated 6 September 1991, was therefore final and binding for both claims. The date of onset could not be determined as earlier than that date. Since reduced earnings allowance was unavailable for onset after 1 October 1990, the claim could not succeed.
3. Claim requirement for reduced earnings allowance. The court also accepted that the Commissioner erred in holding that reduced earnings allowance could be obtained without a disablement benefit claim. The statutory meaning of entitlement required a claim for benefit. Paragraph 11(1)(a) of Schedule 7 to the Social Security Contributions and Benefits Act 1992 linked reduced earnings allowance to entitlement to disablement benefit, or what would have been entitlement if disablement were assessed at 1 per cent. Schedule 6 provided no separate assessment route for a reduced earnings allowance claim. The disablement questions therefore had to be determined through a disablement benefit claim.
4. Order. The court declared that the respondent had suffered from prescribed disease A11, or a sequela of it, since 7 September 1991. The cross-appeal was dismissed. There was no order as to costs, save for a detailed Community Legal Service assessment of the respondent’s costs.

• Court of Appeal (Civil Division): Allowed the Secretary of State’s appeal, dismissed the cross-appeal and issued a declaration concerning the date from which the prescribed disease or its sequela was suffered.
• Social Security Commissioner: Allowed the appeal from the Medical Appeal Tribunal on procedural grounds and remitted the disablement benefit matter to a new tribunal. The Commissioner ruled that the earlier negative finding was not binding for the reduced earnings allowance claim and that reduced earnings allowance could be claimed without a disablement benefit claim.
• Medical Appeal Tribunal: Made a later finding that the respondent had suffered from the prescribed disease since 1 January 1986. The decision was subsequently set aside because its date had been impermissibly corrected.
• Adjudicating Medical Authority: On 6 September 1991 found that the respondent did not suffer from prescribed disease A11 and had not suffered from it since 1985.