Sandra McLellan (Cork East, Sinn Fein)
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Question 260: To ask the Minister for Social Protection the realistic alternatives available to persons when their illness benefit runs out and who are refused Invalidity pension as the Department deem them suitable for work even though their doctors do not (details supplied); and if she will make a statement on the matter. [35553/11]

Joan Burton (Dublin West, Labour)
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Illness Benefit is an income support payment for people of working age who are unable to work due to illness and who satisfy certain social insurance conditions. The scheme is intended to provide income replacement for insured persons during short spells of incapacity or illness, while other payments are available to people who are unable to work long-term because of a disability or a medical condition.

Prior to the introduction of changes provided for in the Social Welfare (Miscellaneous Provisions) Act 2008, there was no limit on the amount of time for which Illness Benefit could be paid to people who had more than 260 social insurance contributions. An OECD review entitled "Sickness, Disability and Work: breaking the Barriers" noted that paying illness or sickness benefit without a time limitation was very unusual across the OECD, and pointed to the risk that people in such circumstances will never return to the labour market. Against that background, the legislation now provides that entitlement to Illness Benefit is limited to two years (or 624 days) duration for claims arising after the 5th January, 2009.

Where a person's eligibility for Illness Benefit ceases on the expiry of this two year time limit they can apply for entry to one of the long-term illness/disability schemes, namely Invalidity Pension (social insurance contribution based) or Disability Allowance (means based) and their claim will be considered by the Department taking advice from its own medical assessors.

The Department's medical assessors are fully qualified and experienced practitioners who provide a second opinion to that of the person's own doctor for the guidance of deciding officers. Their assessments conform to the ethical conduct and behavioural guidelines of the Medical Council. Medical assessors are required to be medical practitioners who are on the general register of medical practitioners while holding an appointment. They must have at least six years' satisfactory experience in the practice of medicine since registration. Many of the medical assessors have specialist post-graduate qualifications. They also have special training in eligibility assessment and disability evaluation.

Every effort is made to ensure that the interests of persons called for assessment are fully safeguarded. Their own certifiers are advised of the scheduled assessments and invited to submit any appropriate medical reports including references to any recent assessments by consultants. In addition it is open to a certifier to attend an assessment if he or she so wishes. A Nurse Attendant is always present during assessments. In carrying out assessments the Medical Assessor considers all medical evidence presented and expresses an opinion based on findings. All assessments are carried out in accordance with the accepted guidelines of the Irish Medical Council.

The Medical Assessor does not dispute the existence of the certified cause of incapacity but rather assesses the degree to which the loss of function in work-related activities, resulting from disease or injury, affects the person's ability to perform either their own job or alternative types of work. Assessments are conducted in a fair, equitable, impartial and independent manner to the highest standards in accordance with accepted medical practice and ethics.

If a decision, based on the opinion of a Medical Advisor, is unfavourable to a customer, the customer has a right of appeal to the independent Social Welfare Appeals Office. Before an appeal is heard by an Appeals Officer, the customer is afforded a second medical assessment by a different Medical Assessor to the one who gave the original unfavourable opinion.

Where a claimant fails to qualify for Invalidity Pension or Disability Allowance, either on first application or appeal, and if they are unable to secure suitable employment, taking account of their medical condition, they can seek recourse to Jobseeker Allowance payments or to the Supplementary Welfare Allowance Scheme.