Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694252868690.pdf (Guyana)
Published on the 22nd day of September, 1969 155 No.

26 of 1969 THE NATIONAL INSURANCE AND SOCIAL SECURITY ACT, 1969.

THE NATIONAL INSURANCE AND SOCIAL SECURITY (DETERMINATION OF CLAIMS AND QUESTIONS)REGULATIONS, 1969 of the powers conferred In exercise 20, 38, 39 and 51 of the National Act, 1969, and by virtue and in exercise upon the Minister and Social Insurance hy of all other powers Regulations are hereby in that bthalf the following sections Security enabling him made - 1.
These Regulations Security (Determination 1969, and shall come into operation may be cited as the National � tion of Claims and Questions) on the appointed Regu-menc��;t. day.

lnsurance and Social lations, PART I 2.

( 1) In these Regulations, unless the context otherwise f::for::e­ - requires "tbe Act'' means the National Security "claimant" Act, 1969; me-a:ns a person who has claimed Insurance for the purposes benefit under of Part II of these and Social ,No.
ts ot 1969• the Ac:t and includes, Regulations liability in question; a persons to pay or to be credited with from whose right to be excepted is a contribution ",the Commissioner" missioner "grant" means any payment appointed means the National under regulation 14; Insurance Com­ ment made by way of old age ben_efit, invalidity survivor's disablement and includes not being a periodical benefit, benefit or death benefit, funeral benefit; benefit, pay­ "pension" age benefit, ment benefit means periodical benefit, invalidiiy or d.!ath benefit; payments made by way of old survivor's benefit, disable­ "question" includes, for the purposes of Part III of these Regulations a claim under the Act; "registered practitioner meclical regjsrered as a medical • ,., means a person duly under the laws for practitioner 156 the time being in force relating to the registration of medical practitioners; "reserved question'' means any question s~t out in regul ation 3.
( 2) Any notice or other document required or authorised to be given or sent to any person under the provisions of these Regula tions shall be deemed to have been given or sent if it was sent by post to that person ait hir.

ordinary or last known address.


( 3) Any po~r conferred by these Regulations to extend the period during which anything is required to be done under these Regulations or to dispense with any of the requirements thereof may be exercised in any case, notwithstanding that the period during which the thing is requited to be done has expired.

PART II Determination of Quetstions by Board Question, for de:er• mination by Iha Board .. 3.
Subject to the provisions of these Regulations, the follow- ing reesn'\!d questions arising under or in connection with the Act shall be determined by the Board on application made to it in accord ance with regulation 4, and the deci1;1ion of the Board shall be final- (a) whether a person is or was an insured person; (b) whether a person is or was an e,mployed person or a self-employed person; (c) as to the class or category of insured persons in which a person is to be included; (d) whether the contribution conditions for any benefit are satisfied, or any question otherwise relating to a person's contribntions; or ( e ) who is or was liable for payment of contributions as the employer of any insured person.
Proc:t'durc for deter· mination of questiom by the Board.

4.

( 1) Any person desiring to obtain the decision of the Board on any question mentioned in regulation 3 shall deliver or send to the Board an application for the purpose in writing in a form approwd by the Board and shall furnish such particulars as the Board may require for the purpose of the consideration and determination of any such question.
(2) The Board shaU take steps to bring any such application and any such particulars to the notice of any person appearing to it to be interested therein and to obtain from such person such particulars within such time and in such form as it considers necessary for the proper determination of the question.
(3) The Board may, if it thinks fit, before determining any 157 question, appoint a person to hold an inquiry into the question or any matters arising in connection therewith and to report to it thereon aJnd the person so appointed may by summons require persons to attend at any such inquiry to give evidence or to produce documents reason ably required for the purpose of the inquiry and may take evidence on oath and for that purpose administer oaths.
(4) Reasonable notice of the date and place of the holding of such an inquiry shall be given to the applicant and any persons notifi_ed of the application in accordance with paragraph (2) of this regulation.
(5) The applicant and any person appearing to the Board or to the person appointed to hold the inquiry to be interested in the application shall be entitled to attend and be heard at the inquiry, and to be represented by any other person, and the procedure thereat shall, · subject to this regulation, be such as the person appointed to hold the inquiry shall determine.
(6) The Board shall give notice in writing of its decision to the applicant and to any persons appearing to it to be interested therein and may pubiilsh its decision in such manner as it thinks fit.

f .

.

d h th B 5.

(1) Any question of law arising in connection with the deter- R~fcrcncc 10 • 1 High Court bJ .

.

b mmatton y e oar o any sue question as 1s ment10ne m regu a- Board of ques.

tion 3 may, if the Board thinks fit, be referred for decision to the High ~;;::llsof law; Court.
- ac:iin£t dcci- sions of Board (2) In the event of the Board derennining in accordance with ~ qu~stioos 1 aw.

paragraph ( 1) of this regulation to refer any question of law to the O High Court, it shall send notice in writing of its intention so to do to the applicant and to any other person ap~aring to it to be interested therein.

d .

.
(3) Any person aggrieved by the decision of the Board on any question of law such as is mentioned in paragraph ( 1) of this regulation which is not referred in accordance with that paragraph, may in accordance with rules of court made pursuant to section 38 of the Act, appeal from that decision to the High Court and the appli cant and any other person appearing to the Board to be interested shall, on request, be furnished with such a statement of the grounds of the Board's decision ais will enable them to determine whether any question of law has arisen upon which they may wish to appeal.
( 4) Without prejudice to the rights of any other person, the Board shall be entitled to appear and be heard on any such reference or appeal.

6.
6.

(1) The Board may, on new facts being brought to its notice ~e~iew or de or if it is satisfied that the decision was given in ignorance of, or was ~:°':io:d. based on e mistake as to, ,some material fact, review a dech,ion given by lit in accordance with this Part of these Regulations: Provided that any sucb decision ~hall not be reviewed while an appeal is pending against the decision of the Board on a question of law arising in connection therewith, or before the time for so appeal ing has expired.
(2) The provisions of regulation 5 shall appiy in relation to a decision on review as they apply to the original determination or decision.

PART Ill Determination of Claims and Qu~ons by tbe Director.

Appeal Tribunal O.l' Commi~sioner SubmlHion of que.

;tlcns tu Director.

7.

( 1) The foTiowing questiions.


thr.t is to say- (a) any question as to the right to benefit; and (h) anv other question arising under or in conn~tion with the Act, not being a reserved question, shalt be submitted to the Director, who shalt consic'loer the question, and.

so far as practicable dispose of it in accordance with these Rernlations within fourteen days after the date when it was submitted.
(2) If on consideration of a question the Director is of opinion that no reserved que9tion arises then - (a) if he is satisfied that the question ought to be deter mined wholly in favour of the claimant, he may deter mine the question accordingly; (b) in so far as he is not so satisfied, he may either- (i) refer the question (so far as is practicable with in fourteen days after the dare on which iit was submitted to him ) to an appeal tribunal consti tuted in accordance with the provision~ of the Schedule to these Regulations for its decision; or (ii) himself determine the question in whole or in part adversely to the claimant.
( 3) Where the Director refers a question to an appeal tribunal in accordance with paragraph (2) , of this regulation, notice in writing of such reference sha11 be given to the claimant.

l\ppeals 10 '!Pr>eal tribunal.

8.

( 1 ) If the Director has determined a question in whole or in part adversely to the ciaimant, the ciaimant shall, subject to the provisions of this regulation.
have a right of appeal in respect of t,he decision to the appeal tribunial and sha11 be notified in writing of the decision and the reasons therefor and his right of appeal therefrom: 159 Provided that where a reserved question has arisen in connection with the decision of tht= Director and has been determined by the pro per authority, and the Director certifies that the decision on 'llhat ques tion is the sole grc>und of his decision, no appeal shall lie without the ]eave of the chairman of the appeal tlribunal.
(2) An appeal against a decision of the Director must be brought by giving notice of appeal at the office of Ube Board within two months after the date of that decision or within such further time, not exceeding four months, as .the chairman of the appeal tribunal may aJJow.

(3) A notice of appeai shall be in writing and shall contain a statement of the grounds upon which the appeal is made.

9.
9.

C 1) Rt:asonalJle notke of the time and place of the hearing Time aoi1 before the appeal tribunal shall be givan to the claimant, and to any ~~!~n: other person who may appear to the chairman of the tribunal to be ~~ore LppeaJ interested and, except with the coosent of tbe claimant, the appeal tn una tribunal shall not proceed with the hearing of any case unless such notice has been given.
(2) If a claimant or other person to whom notice of hearing has been duly given in accordance with these Regulations fails to appear either in person or by representative at such hearing and has not given a reasonable explanation for his absence, the tribunal may proceed to determine the case, or may give such directions with a view to the determinati0n of ithe case as it may think proper.

10.
10.

( 1 ) Every hearing by an appeal tribunal shall be in public H earings be except in so far as the chairman of the tribunal may otherwise dircct1 f~~~n!r.PeAl if he is of the opinion that intimate personal or financial circumstances may have to be disclosed or that considerations of public security are involved; and any per,;on appearing to the tribunal to be interested shall have the right to be present notwithstanding that the hearing of the case is not in public.
(2) The Director and the claimant shall be entitled to be heard at the hearing of auy case by an appeal tribunal.
(3) Any person who by virtue of the provimons of this regu lation has the right to he heard at the hearing of a case by an appea1 tribunal may be repres:ented at the hearing by some other person whetlher ·having professional qualifications or not and, for the pur poses of the hearing, any -;uch representative shall have al] the righ 1s to which the person whom he reprer,ents is entitled unckr these Regulations.
( 4) Any per~on who exercises the right conferred by this regulation to be heard at the hearing may call witnesses and shall be given an opportunity of putting questions directly to any witnesses called at the hearing.

Decisians of appeal uibuna:.


160 (5) For the pur.poses of arriving at their decision or discuss ing any questk,n of procedure, an appeal tribunal may, notwithstanding anything in this regulation, order all persons not being members of the tribunal other 1than the person acting as clerk to the tribunal.

to withdraw from t'he sitting of the tribunal.

11.
11.

( 1 ) An appeal tribunal shall - (a) record in writing in such form as may from time to time be approved by the Board all its ded,ions (whether on an appeal or on a reference from tlte Director; and (b) include in the record of every decision (which shall be signed by all members of the tribunal) a state ment of the reasons for its decision including iis findings on all questions of fact material thereto.
(2) Where the tribunal is unable to reach a unammous deci sion on any case, the decision of the majority of the members thereof shall be the decision of the tribunal.

(3) As soon as may be practicable, a copy of the record of ills decio;ion made in accord:moe with this regulation shall hi!

sent to the claimant and to the Director and 1to any other person who appears to the appeal tribunal to be interested.

to Appeal the commts- sinner.

12.


( 1) Suhjcct as hereinaftter provided, an appeal shall lie to the Commissioner appointed in accordance with regulation 14 whcise decision shall IJe final subject to the previsions of this Part of these Regulation<;, from any decision of an appeal tribunal at tlhit!

instance of - (a) the Director, (b) the claimant.
(2 ~ An appeal 1o the Commissioner must be brought within three months after the date of the decision of the appeal tribunal or such further period as the Commissioner may in any case for special reasons allow, and such an appeal shall be brought by giving notice in writing to the Commissioner in a form approved by the Board stating the grounds of the appeal, and a copy of such notice shall be given - (a) in the case of an claimnnt ~ appeal by the Director, to the (b) in the ca:-e of an appeal by the claimant, to the Director through the office of the Board.
Oral hearing of appeal.

13.

1.1) If the claimant or Director makes a request to the Com missioner for an oral hearing of the appeal, the Commissioner shaU 161 grant such request, unless after considering the record of the case and the reasC\ns put forward in the request for the hearing, he is satisfied that the appeal can properly be determined without a hearing in which event .

he shall so inform the claimant and the Director in writing and may proceed to determine the case without a hearing.
(2) If, in accordance with the provisions of paragraph (1) of this regulation a request for an oral hearing bas been granted, or if, notwith!rtanding that no request has bean made, the CommissiOtller is o1Jherwise satisfied that an oral hearing is desirable, reasoMble notice of the time and place of the hearing shall be given to the claimant and the Director, and, if he think fit, to any other person appearing to the Commissioner to be interested.
( 3) In any case in which an oral hearing of an appeal is held, such hearing shall be in public except in so far as the Commissioner may otherwise direct if he is of the opinion that mtimate personal or financial circumstances may have to be disclosed or that considerations of public security are involved.
( 4) Any person to whom notice of the hearing has been given shall be entitled to be heard at the hearing and to oo represented thereat by some other person, whether having professional qualifica tions or not, and for the purpose of the hearing such representative shall have all the rights to which that pel'Son whom he represents is entitled under these Regulations.
(5) Any person who exercises the rights conferred by this regulation to be heard at the hearing may, with the leave of the Commissioner, call witness and shall be given an opportunity of putlting que£tions directly to any witnesses called at the hearing.
( 6) If any person to whom notice of the bearing has been duly given shcmld fail to appear either in person or by renresentative at the hearing, and has not given a reasonable explanation for his absence, the Commissioner may proceed to determine the appeal or may give such directions with a view to the determination of the appeal as he thinks proper.
(7) If it appears to the Commissioner that any appeal under this regulation involves a question of law or fact of special difficulty he may direct that in dealing with the appeal or any part thereof he shall have the assistance of an assessor or assessors.

(8) The Commissioner may, if he thinks fit, refer any question arising for his decision to a registered medical practitioner for ex aminatdon and report.
(9) The decision of the Commissioner shall be in writing and signed by him, and, as soon as practicable, copies thereof shall be sent, simultaneously, one to the claimant and one to the Director.

~r~;;:f!t sioner.

14. who shall be appointed by the Governor General and shall barrister or solicitor of not less than iter.

year's standing.

There shall be a National Insurance Commissbioner e a 162 R_eyiew of de.

c1s1ons of Director and m1ss10ner under this Part ot t e-se ~~:~iii.
15. f 1) Any decision of the Director, appeal tribunal or Com- d at R , any time by the Director, or on a reference from the Director, by an appeal tribunal, if -- egu atlons may · · rev1ewe 1 · be h • , ' ( a) he is or they are ~atisfied, but not without fresh evidence in the case of a decision of the Com missioner, that the decision was given in ignorance of, or was ba-sed oo a mistake as to, some material fact; there has been any relevant change of drcumstances since the decision was given; or the decision was based on the decilsion of anv reserved question and the decision of that questri.on· ba'l been re\-ised.
(b) (c) (2) A question may be raised with a view to such a review by means of an application in writing to the Director stating the grounds of the application.

(3) On re~ipt of any such application, the Director shall proceed to deal with or refer any question arising the~on in accordance with the Act and these Regulations.
(4) Any decision given on a review under this regulation, and any refusal to review a decision under this regulation, shall be subject to appeal in like manner as an original decision and the provisions of this Part of these Regutations shall, suhject to the necessary modificiitions, apply in relation to any decisi0n given on a revi,ew as they apply to the original decision of a question.

Interim paymellts.

16.


( 1 ) Subject to the provisions of this regulation and of regula tion 19, bt:n:efit shall he payable in accordance with an award, not withstanding that an appeal against the award is pending.
(2) Where it appears to the Board that a question has arisen whether - {a) the conditions for the receipt of ben'l!fit payable under an award are or were fulfilled; or (b) an award of benefit ought to be revised in accordance with these R~gulations, it may direct that payment of the benefit shall be suspenkJed in whole or in part until that q:1estion ha~ been determif'lcd .

Review of decisions inv,>Jv1rg payment or incre3se of benefir, other than gfallll, 17.
(I) Where on review a decision is revised so as to make benefit payable, or to increase the rate of benefit, the decision on review shall have effect as from the date of the application for the review: Provided that, subject to paragraph (2) of ttiis regulation, if in 163 any case the claimant proves that on a date earlier than the date on which the application for the review was made, he was ( apart from satlisfying the condition of making a claim therefor) entitled to benefit he shall not be disqualified by virtue of the foregoing provisions of this paragraph for receiving any benefit to which he would have been entitled in respect of the period between the earlier date and the date on which the application for the review was made.
( 2) Notwithstanding anything contained in this regulation, the following provisions shaJI have effect - to (a) the proviso to paragraph ( l) of this regulation shall that no sum on the conditions apply subject account of benefit shall be paid to any person in respect of any part of the period referred to in that proviso earlier than six months before the date on which the application for the review was made; (b) the diecision on review shall not in any event have effect for any period before the date on which the original decision took effect or would have taken effect if an :1ward had been made; ( c) if the said decision on review was based on a material change of circumstances subsequent to the date from which the orilrinal decision took effect, it sha11 not have effect for any period before the date declared by the Director, appeal tribuna1 or the Commissioner as the case may be, to be the date on which such material change of circumstances took place.
(3) For the purpose of this regulation, where a decision is reviewed at the instance of the Director under paragraph ( 1) of regulation 15, the date on which it was first decided by the Director that the decision should be reviewed shall be deemed to be the date of the application for the review.

( 4) In this regulation ''!Jenefit" does not include any grant.

18.

( 1 ) A decision shall not be reviewed so as to make a !
!rant Review of payable unless the claimant proves that the appli~tion for review- was ~~i!~~~ns"~~: made not later than four years from the date of the decision.

ments c,f grnms.

(2) The provisions ot paragraph (3) of regulation 17 shall apply in th" application of paragraph ( 1 ) of this regulation as they apply in the application of paragraphs (1) and (2) of that regulm:ion.

19 .. (1>.
19 .. (1>.

Where a gr~nt is awarded by a decision on review or AdJustmen1 appeal m heu of a pension previously awarded, such decision shall o!

henefit direct that any payments made on account of such pensif'n shall, in ro far as they do nnt exceed the amouht of 1lhe !

?rant be treated as being made oo account of the grant. '
- 164 (2) Where any benefit other than a grant is awarded by a decision on review or appeal in lieu of another kind of benefit pre viously awarded, that decision shall, as respects any payments made on account of the benefit previously awarded - (a) direct that in so far as the amount thereof dot:s not excieed the amount of any arrears payable by way of the bendit so awarded, such payments shall be treated as having been made on account of such arrears; and (b) to the extent by which the amount thereof exreeds the amount of tJhe said arrears, direct that such pay ments shall ( except in so far as they are required to be repaid under this regulation) be treated as having been made on account of sums becoming payable after the dare of the decision on review or appeal by way of the benefit awarded thereby.
( 3) Where on review or appeal a decision is revised, or is reversed or varied so as to make benefit not payable or to reduce benefit, the decision givf'n on the review or appeal shall require repayment to the Fund of any benefit paid in pursuance of the original decision to the extent to which it - (a) would not have been payable if the decision on tht review or appeal had been gi,-en in the first instance ; and (b) is not directed to be treated as paid on account of the benefit awardred by the decision on review or appeal.
(4) Where - (a) on appeal against an award of bentfit a decision is reversed or varied, so that such benefit is not payable or is payable at a less rate; and (b) on review, the decision on that appeal is revised so as to make such benefit payable or payable at a higher rate from a date before the decision on appeal, any benefit paid in pursuance of the award before the decision on appeal shall, to the extent to which it would not have been payable if the decision on appeal had been given in the first instance, be treated as having been paid on account of any benefit made payable for the same period by the decision on review, except in so far as it has, in pursuan~ of the decision on appeal, been repaid or, treated as paid on account of the benefit awarded by that decision.
(5) Where, in accordance with a decision given on a review or appeal, any benefit is required to be repaid to the Fund then, without prejudice to any other method of recovery, such henefit shall be re- 16S coverable by deduction from any benefit then or thereafter payable to the person by whom it is to be repaid or from any benefit payable on his death .. • 20.
(1) If on consideration o a ques 10n opinion that a reserved question arises he shall - t' f ' th D' e t rrec or ls • of the Reference of reserved questions.
(a) refer the reserved question for determination to the Board to determine the same; and (b) deal with any other questions as if the reserved question had not arisen: Provided that the Director may - (ii) (i) postpone the reference of or dealing with any question until after other questions have been determined; in cases where the determination of any question disposes of a claim or any part thereof, make an award, or decide that an award cannot be made, as to the claim or that part thereof without re ferring or dealing with, or before the determina tion of, any other question.
(2) The foregoing provisions of this regulation shall apply to the appeal tribunal or the Commissioner as they apply to the Director, except th~t an appeal tribunal or the Commissioner instead of them selves referring a question for determination in accordance with sub paragraph (a) of paragraph (1) of this regulation shall requiie it to be so refe:red by the Director.

PART IV 21 .

· Miscellaneous d' (1) Wh (a) (b) ere Ill any procee mgs - Decisior1.1 to be conclusive ~~r I>~!
":~e for an offence under the Act; or involving any question as to the payment of contri~ ~ u;!~r butions under the Act; or ( c) for the recovery of any sums due to the Fund, any question arises which under the Act or the Regulations is to be determined by the Board, or by the Court in the event of an appeal on · a point of law, or the Director, appeal tribunal or Commissioner the decision by the appropriate determining authority shall, unless an appeal under these Regulations is pending or the time for so appealing has not expired, be conclusive for the purpose of those proceedings.
.

.

· · (2) Il any such decision·under paragraph (.1) of this regulation has not been obtained and the decision of the question is necessary for th~ determination of the proceedings, the question shall be referred 166 to the appropriate determining authority, as the case may require, in accordance with the procedure (modified where necessary) prescribed in these Regulations.
(3) Where any such appeal as is mentioned iJ?, paragraph (1) of this regulation is pending, or the time for so appealing has not ex pired, or where any question has been referred under parag~aph (2) of this regulation, the authority dealing wi~ the case shall adJo.um the proceedings until such time as a final dec1s1on upon the quest10n has been obtained.

1.
SCHEDULE Regulation 7 Appeal Tribunal An appeal tribunal shall consist of - (a) one person selected, in accordance with paragraph 3 of this Schedule, from a panel of persons chosen by the Board to represent employers; (b) one person selected, in accordance with paragraph 3 of this Schedule, from a panel of persons chosen by the Board to represent insured persons; and a chairman who, subject to the provisions of this Schedule, shall hold office for such period not exceed ing two years, as the Minister may determine, and shall be eligible for re-appointment.
(c) 2.

( 1) The chairman of an appeal tribunal shall be a barrisrer of at least five years' standing a_nd the Minister may appoint one or more persons to perform the functions of chairman.

(2 ) If the chairman of an appeal tribunal is by reason of ab sence or any other cause unable temporarily to perform the functions subject to the provisions of this of his office the Minister may, Schedule, appoint another person to act in his place.
(3) Where several persons are appointed to perform th_e functions of chairman of an appeal tribunal, they shall as far as practi cable be invited by the Board to preside over a tribunal in tum.

3.

As far as practicable, the members of each panel shall be summoned by the Board to serve in turn on the appeal tribunal for which the panel is established : Provided that - (a) no person shall sit on a tribunal during the considera.
tion of a case - 167 (i) in which he appears as the representative of the claimant; or (ii) by which he is or may be directly affected; '-.

in which he has taken any part as an employet or as a witness; (iii) (b) where the claimant is a woman, at least one of the members of lthe tribunal, if practicable, shall be a woman, 4.
The appeal tribunal may, with the consent of the claimant, but pot otherwise, proceed with any case in the absence of any mem ber other than the chairman, and in any such case the chairman shall, if the number of the members of the tribunal is an even number, have a second or casting vote.

5.

Members appointed to a panel pursuant to this Schedule shall, subject to the provisions of this Schedule, hold office for such term and on such conditions as may be determined by the Board.

6.
6.

The Minister may, if he considers it expedient so to do, at any time revoke the appointment of the chairman and the Board may, if it considers it expedient so to do, at any time revoke the appointment of any member of a panel.

7.

No member of the Board shall be eligible for appointment as a chairman or member of an appeal tribunal.

Made this 18th day of September, 1969.

W. CARRINGTON, Minister of Labour and Social Security.