John Kelly (Labour)
Link to this: Individually | In context

I thank the Minister of State for coming to the House to deal with this important issue, about which I have been very concerned for the past two years. It concerns how medical referees in the Department of Social Protection seem to be dealing with applications for disability allowance, invalidity pension and carer's allowance, in particular. There seems to be an unwritten rule that they refuse almost every application and send applicants along the appeals route which takes between nine and 12 months to complete for persons who are hard-pressed and want answers. They are put on a merry-go-round, which is unfair.

Let me give some examples. A constituent of mine was looking after his wife who had Parkinson's disease. He took two years off work and received carer's benefit. At the end of the two year benefit period he applied for carer's allowance. Even though his wife's condition was deteriorating, the medical profession deemed that she was not unfit for work and the application for carer's allowance was refused. Another man who suffers from severe depression, has restricted mobility in his left leg, to a level of 5%, and is incontinent has been told he does not need a full-time carer, even though he actually has one. In another case a man from the Czech Republic here on a special visa to work as a specialist butcher in a local factory, in which a crate of meat fell on top of him, seriously damaging his spinal cord and hip, which means he walks in a way that indicates he is severely disabled, has been told he might be fit to do light work and thus will not receive disability allowance, despite the fact he does not have three words of English.

I am well aware that in the good times, when there was plenty of money available, disability allowance, invalidity pension and carer's allowance was paid to people who perhaps did not fully deserve it. I have often cited the example of a man I know who receives blind pension, yet goes into town every day to buy the Daily Star. That happened in the past and I certainly disagreed with it. However, the wheel has now turned full circle and what is being done is totally unfair. If Christy Brown was to apply for disability allowance now, he would be told he was not eligible because he would be able to type with his big toe. It is becoming ridiculous and somebody has to take the issue by the scruff of the neck. Somebody has to tell departmental officials to tell medical referees that what they are doing to people is unfair. They have no idea how they are being affected.

When appeals are heard, it turns out that 50% of decisions made are overturned. If that is the case, it means the medical referees have made a mistake in 50% of cases. Either they are able to do their job, or they are not. Otherwise, it must be the case that they are being told to do it in a particular way. I want to know what has changed in the past two years and what the Minister will do to rectify the matter.

Shane McEntee (Meath East, Fine Gael)
Link to this: Individually | In context

I thank the Senator for raising this issue. There is frustration among members of all parties. I have no doubt, however, that the Minister will strive to improve the position, particularly as the number of decisions overturned on appeal does not make sense. We must work hard to deal with the matter.

I am replying on behalf of the Minister for Social Protection. With regard to the medical criteria used in qualifying for disability allowance, a person must be suffering from a medical condition which has continued or may reasonably be expected to continue for a period of at least one year and, as a result of the condition, the person must be substantially restricted in undertaking work which would otherwise be suitable, having regard to the person's age, experience and qualifications. In the case of invalidity pension, a person must have been incapable of work for at least 12 months and be likely to be incapable of work for at least a further 12 months, or permanently incapable of work. In the case of carer's allowance, the person receiving care must require full-time care and attention. The person receiving care is regarded as requiring full-time care and attention where he or she is so incapacitated as to require continuous supervision in order to avoid danger to himself or herself or continual supervision and frequent assistance throughout the day in connection with normal bodily functions, and is so incapacitated as to be likely to require full-time care and attention for a period of at least 12 months.

The medical assessment of eligibility for illness and disability-related schemes is determined by the Department's medical assessors. These are fully qualified medical practitioners who have experience and training in the field of disability and occupational medicine. Medical assessments are made in accordance with the Department's evidence-based medical guidelines and protocols.

Applicants for illness and disability-related schemes are afforded every opportunity and encouraged to furnish all medical evidence available to them in support of their claims at the time of claim. In the case of disability allowance and carer's allowance, the applicant's or caree's GP or consultant is required to certify the nature of the illness as part of the application process. In the case of invalidity pension, most claimants transfer from illness benefit where medical records will already be available to the Department.

All medical evidence furnished by the applicant is considered during the assessment, but, in some cases, despite the Department's advice to claimants that they submit all medical evidence at claim stage, complete medical evidence is furnished only at appeal stage. As an indication of the level of appeals, in 2011 in the case of disability allowance, there was an appeals rate of some 23%, while in the case of invalidity pension and carer's allowance, there were appeals rate of some 13%.

John Kelly (Labour)
Link to this: Individually | In context

Yet again I could have written the response myself, having been a community welfare officer for 28 years. I do not need to be told by a civil servant who qualifies for what payment. The issue is that despite the fact medical referees have sufficient experience and training in the field of disability and occupational medicine, 50% of their decisions have been reversed by somebody at a higher level.

Another gripe of mine is that if somebody is unhappy about a decision made by a medical referee in regard to a caree, that is, somebody who needs full-time care and attention, that he or she does not need somebody to care for him or her, and the caree seeks an oral hearing, the only person from whom the Department will hear is the applicant. It is not the applicant the Department should be dealing with but the caree. Departmental officials should have the person who needs care and attention sitting in front of them to assess whether he or she actually needs care and attention. Instead, it is the applicant who is hauled before them. They cannot make a determination in that way.

While there is a notion that the transition is smooth where a person moves from illness benefit to invalidity pension, it is not. I am aware of any amount of cases in which people have been in receipt of disability benefit for a long period, but, of late, when they apply for invalidity pension, they are told they are fit for work.

I would appreciate it if the Minister of State sent a strong message to the appropriate Minister in order that we can have these problems rectified.

Shane McEntee (Meath East, Fine Gael)
Link to this: Individually | In context

As someone who learned the hard way, I can see that the Senator seems to know what he is talking about. Putting pen to paper is often a help. A Minister sometimes needs guidance. I, therefore, propose that the Senator put pen to paper and make, say, six points on how the criteria could be met. This does work. Lobbying in a constructive manner cannot be beaten. The Senator should, therefore, put pen to paper and explain what is going wrong. We are all dealing with the same problem, day in and day out. Changes are slow in coming and appeals take a long time. The Minister needs people like the Senator who knows the system inside out to explain what changes are needed. The Senator should consider doing what I have suggested.

John Kelly (Labour)
Link to this: Individually | In context

I agree with the Minister of State that it is possible as long as the Minister deals with the issue, not the civil servants.