Social Security Act (Cap. 318), article 106

106. Subject to the provisions of ar ticle 97, ever y claim for benefit, pension, allowance or a ssistance shall be considered b y the Director who may - (a) allow the claim; or (b) disallow the claim; or (c) after giving notice to the claimant, refer the claim to the Umpire appointed under article 107: Provided that - (a) if the claim is for Injury Grant, Injury Pension, Medical Assistance, or Social Assistance payable under the provisions of article 30(4), a Carer’s Allowance, Increased Carer’s Allowance, or a Disabled Child Allowance, the Director shall, before giving his decision, unless the claim falls on other statutory conditions, consult on the m edical aspects of the claim one or more persons holding the warrant to practise the medical profession drawn from a panel of persons appointed by the Minister for the purpose of advising on such cases, as the nature of the claim may require; (b) if the claim is for Injury Benefit and the resultant period of incapacity for work exceeds ten benefit days the provisions of paragraph (a) of this proviso shall apply and where the resulta nt period of incapacity of work does not exceed ten benefit days the provisions of paragraph (c) of this proviso shall apply; (c) if the claim is for Maternity Benefit, the Director may, if he so deems fit, before giving his decisions, unless the claim falls on other statutory conditions, consult on the medical aspects of the claim one or more persons holding the warrant to pract ise the medical profession, appointed by the Minister for this purpose; (d) if the claim is for Sickne ss Benefit, with effect from the day as the Minister may determine by notice in the Gazette, the Director sha ll not accept any such claim in respect of the fourth and subsequent day of each spell of incapacity for work unless the medical certificate confirming the p erson’s incapacity for work is drawn and signed by a person holding the warrant to practise the medical profession appointed by the Minister for this purpose; sohowever that, where the Director is satisfied that the person making a claim for such benefit is ordinarily resident in Malta but is, on the date of such claim, temporarily abroad, the Director may, notwithstandi ng the aforesaid provisions of this paragraph, accept such a claim as valid for the purposes of this Act as long as it is supported by a medical certificate in such form and manner as the Director may deem fit in the circumstances of the case and provided the person concerned proves to the satisfaction of the Director that he is not entitled to any form of benefits as may be payable by any SOCIAL SECURITY [CAP. 318. 107 authority that is responsible for the payment of social security benefits in the country where that person is temporarily living during the period of such incapacity for work; and (e) if the claim is for a pension in respect of invalidity, the Director shall, before giving his decision and unless the claim falls under other statutory conditions, consult on the medical aspects of the claim, one or more persons holding the warrant to practise the medical profession appointed by the Minister for the purpose of advising on such cases; (f) the Minister shall appoint a multi-disciplinary panel for the purpose of advising the Director on the psycho- socio aspect of cases in which a claim for a pension in respect of invalidity or a claim for Social Assistance has not led to the conclusive determination of the work capacity of the applicant, or in claims for a Carer’s Allowance and an Increased Carer’s Allowance, according to the provisions of article 68 or in claims for an Increased Severe Disab ility Assistance according to the provisions of article 27 as provided in the preceding paragraphs of this provis. The multi-disciplinary panel shall be made up of the following members: (i) a psychiatrist or a geriatrician; (ii) a psychologist; (iii) an occupational therapist; and (iv) a social worker; (g) the Minister in conjunction with the Minister responsible for persons with disability shall appoint one (1) or more interprofessional panels for the purpose of advising the Director on the evaluation based on the model of the World Health Organisation International Classification of Functioning, Disability, and Health (ICF), in claims further to the provisions of article 27 that make reference to this panel. Every interprofessional panel shall be made up of the following members, and applications shall be assigned to the various panels on a rotation basis: (i) a medical doctor to confirm a diagnosis; (ii) a professional with knowledge on the assessment of the components of the ICF; (iii) a social worker; (iv) an occupational therapist; (v) an expert from the Department responsible for the payment of Disability Assistance; and S.L. 595.18. (vi) a person with disability, on the advice of the Chief Executive Officer of Aġenzija SAPPORT appointed in accordance with Aġenzija SAPPORT (Establishment as an Agency) Order : Provided that every applicant who appeared before the interprofessional panel may app eal from that panel’s decision t o the 108 CAP. 318.] SOCIAL SECURITY Director, in accordance with the p rovisions of article 108, wit hin twenty (20) days from the date on which said decision would hav e been communicated to the said applicant. Further appeal from th is decision shall lie to the Court of Appeal (Inferior Jurisdictio n), at the request of the applicant or of the Director, following the same procedure envisaged in article109: Provided further that, in any claim for Sickness Benefit, the Director may, if he so deems fit, consult on the medical aspect s of the claim one or more persons holding the warrant to practise t he medical profession, appointed by the Minister for this purpose, and on the psycho-socio aspects of t he case the multi-disciplinary panel provided for in paragraph ( f) of the previous proviso. (h) the Minister in conjunction with the Minister responsible for persons with disability shall appoint one (1) or more interprofessional panels, for the purpose of advising the Director on the evaluation based on the model of the World Health Organisation International Classification of Functioning, Disability, and Health (ICF for Children and Youths), in claims further to the provisions of article 77 that make reference to this panel. Every interprofessional panel shall consist of the following members, and the applications shall be assigned to the various panels on a rotation basis: (i) consultant paediatrician to confirm a diagnosis; (ii) a professional with knowledge on the assessment of the components of the ICF; (iii) a social worker; (iv) an occupational therapist. Appointment of Umpires. Re-numbered by: XXIV . 1993.2. Amended by: III. 2005.12; XII. 2014.37.