Written answers

Tuesday, 18 September 2012

Department of Social Protection

Illness Benefit Reform

Photo of Paschal DonohoePaschal Donohoe (Dublin Central, Fine Gael)
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To ask the Minister for Social Protection her plans in order to reform the sick certificate system and cut out the amount of defrauding of the system; and if she will make a statement on the matter. [39171/12]

Photo of Joan BurtonJoan Burton (Dublin West, Labour)
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The illness benefit system involves Medical Certifiers who are responsible for the certification of illness in relation to customers. Medical certifiers, who are in the main general practitioners or hospital doctors, enter into a contract with the Department that requires them to medically examine persons claiming illness or injury benefit and to certify as accurately as possible the specific disease or ailment that renders a person incapable of work. The contract requires them to refuse to issue a medical certificate if the person’s condition does not justify it. The terms of the GPs’ contract with the Department specifies that if a medical certifier fails to abide by the terms of the agreement, financial penalties may be applied, including termination of contract.

Medical evidence submitted in support of a claim, based on GP certification, is systematically reviewed by medical assessors within the Department. In all cases of incapacity, there is scope for individual medical interpretation based on the certifier's perception of the nature of the incapacity and the type of work the person is involved in. Thus, when a case is reviewed by the Department’s medical assessors, who are independent and impartial in their assessments, they may express a different opinion to that of the certifier. When conducting an assessment, the Medical Assessor does not dispute the existence of the certified cause of incapacity but rather s/he assesses the degree to which the loss of function in work-related activities resulting from the disease or injury, affects the person’s ability to perform either their own job or alternative types of work.

However, if it were to emerge that a disproportionate number of customers certified by any particular certifier were found capable of work by Medical Assessors, this would be investigated. No such unusual pattern of certification has come to attention to date.

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