Wednesday, 25 April 2012
Social Welfare Benefits
Question 3: To ask the Minister for Social Protection in relation to applications for disability allowance if she will clarify when an application has been assessed by the appointed medical assessor and has been deemed not to qualify for the allowance, the way the medical evidence provided by the applicant's medical practitioner in support of their application can be dismissed without a face to face assessment with an independent medical practitioner appointed by her Department in view of circumstances (details supplied); and if she will make a statement on the matter. [20881/12]
Disability allowance is a means tested weekly payment made to people aged between 16 and 66 years who have an injury, disease, physical or mental disability that has continued or may be expected to continue for at least one year and as a result of which the person is substantially restricted in undertaking work that would otherwise be suitable for a person of similar age, experience and qualifications.
Applications for disability allowance are assessed "at desk" on a case by case basis by the Department's medical assessors, all of whom are fully qualified medical practitioners who have training-experience in human disability evaluation. The medical assessor's opinion is based on the medical information furnished as part of the application process. It is important to note that when conducting an assessment, the medical assessor does not dispute the diagnosis of the person's doctor but, rather, taking the viewpoint of an occupational physician, considers the adverse effects that the person's condition has on the person's daily activities and capacity for work. Not alone does the medical assessor have regard to the person's medical condition, but he-she also considers the person's medical history, treatment regime, medication and personal ability-disability profile. Medical assessors also employ evidence based protocols to assist them with their desk assessments. The desk assessment process is much less time consuming than an "in person" process and as medical assessors do not diagnose, treat or give advice, the desk assessment process is considered to be a more efficient use of resources.
Additional information not given on the floor of the House.
In cases where applicants are notified that they have not satisfied the medical conditions of the scheme, they are advised to submit any further medical evidence relevant to the case which is then reviewed by a medical assessor. In addition, applicants are advised regarding the option of appealing their case to the independent Social Welfare Appeals Office. In cases of appeal the medical evidence is reviewed by a different medical assessor.
In certain circumstances a medical assessor may decide to call an applicant for an in-person assessment. However, in most cases the medical evidence furnished in support of the application is such that an in-person assessment is not required.
As a long-standing politician, the Minister, and many Members, will be aware that many people who present with illness to a medical practitioner are often diagnosed with a serious illness and subsequently deemed incapable of working. This diagnosis is then sent with their application form for disability or invalidity allowance. In many cases, these diagnoses are rejected.
I would like to read a small piece of correspondence into the record, following which I will have a question for the Minister. The following is relevant to many cases with which Members deal:
X has a medical diagnosis of ischio-vertebral dysplasia resulting in significant deterioration and orthopaedic problems, has a rod inserted in her spine to attempt to support her trunk due to deterioration of bones in the spine. The use of powered mobility for medium to long distances and her ability to propel herself or mobilise on foot for long periods cannot be done. Uses a wheelchair.
I received the following reply from the Department of Social Protection:
I wish to refer to your correspondence regarding case X. The case was assessed by a medical assessor for the social welfare services who was of the opinion that X was not medically suitable for disability allowance.
This was in spite of a letter from the Central Remedial Clinic, a doctor and a specialist. Many doctors and specialists, having assessed and deemed a person physically or mentally unable to work, believe they are being undermined by unseen doctors from the social services, whom the Minister says are qualified. Why is it necessary for people who have doctor and specialist certification to support that they are incapable of working re-assessed? These people need disability and invalidity allowances. Would we not be better off abolishing this assessment and allowing the qualified doctors and specialists - in this case it is the Central Remedial Clinic - to make that decision, thus saving a substantial amount of money?
I thank the Deputy for his question. The number of people in receipt of the disability allowance has continued to increase significantly. In 2005, some 79,000 people were in receipt of disability allowance as compared with 102,000 in 2011, an increase of 1.7%. The number of awards has continued to rise. Medical evidence and diagnosis presented by a person's medical advisers and experts, be it a GP, consultant or specialist, is reviewed by the departmental medical assessors, who are qualified medical doctors. The test is in relation to the person's capacity to participate in work or some work.
I do not wish to comment on the particular case instanced by Deputy Halligan.
People often do not understand that the diagnosis of the person's medical advisers, doctors and experts is examined by medical assessors who are trained in occupational medicine. This is about whether a person can participate in some work. International information in this area indicates that enabling people to do some work is extremely good for their health-----
An alternative approach would be to set up an independent agency. The Deputy should remember that the claims on the Department in this respect are very large. The number of people has reached 102,000. The adviser who is the expert is the person's own doctor. The Department of Social Protection is not a medical service. We are asking medical experts to examine what the person's own doctor or medical adviser has said. In many cases, there is probably some work to be done in that regard. It is a question of whether the person can do some work. It is not possible for everyone to be taken in for a detailed medical assessment by the Department.
Quite frankly, the Department would not have the resources to examine more than 100,000 people. Approximately 25,000 apply for this benefit each year. We simply would not have the resources. We would also be duplicating the work of the person's own medical advisers. If the Deputy is suggesting there should be a separate medical expert system, perhaps that can be examined. The Department's resources would not stretch to examining everybody. One would be talking about over 100,000 people, or approximately 25,000 new people each year. We have to rely on the person's own medical experts. It is then a question of the presentation of the evidence and the decisions that are reached. The administrative assistants who administer the payments base their decisions on what the medical experts and assessors have to say.