Bernard Durkan (Kildare North, Fine Gael)
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131. To ask the Minister for Employment Affairs and Social Protection the steps taken by her Department to ensure equity and fairness for all social welfare applicants with particular reference to applications for illness-related payments; if account is taken of the fact that whilst rules and regulations are important in creating fairness, that they should not be applied in such a strict and inflexible manner so as to create inequity to social welfare applicants; the steps taken by her Department to address any unfairness in this regard with particular reference to illness-related payments; and if she will make a statement on the matter. [15387/22]

Heather Humphreys (Cavan-Monaghan, Fine Gael)
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Decisions in relation to entitlement to social welfare payments are bound by the relevant provisions of the Social Welfare Consolidation Act, 2005 (as amended) and associated regulations. The legislation provides for an equitable, fair and transparent decision-making process in conjunction with the control of social welfare schemes. Every claimant is entitled to have their claim considered in accordance with the principles of natural justice and in the context of determinations of entitlement under social welfare legislation. A number of conditions must be satisfied in order to qualify for any payment – these vary according to the payment.

In the case of illness benefit, customers must provide a Certificate of Incapacity for Work in addition to having the required social insurance contributions. If people continue to be ill beyond their entitlement to illness benefit, they can apply for Disability Allowance or Invalidity Pension. Disability Allowance is subject to means testing and the habitual residence condition in addition to meeting the medical criteria for the payment. In the case of Invalidity Pension, customers must meet the medical criteria and the social insurance requirements for the scheme.

Any unfavourable decision of a Deciding Officer must be communicated in writing to the claimant setting out the reasons for the decision. It is open to any person to request a review of any statutory decision made by the Department and any new evidence or information provided to the Department will be considered as part of this review. It is important to note that any decision of a deciding officer can be revised in light of additional evidence without it ever being in the appeal process.

Under the provisions of Section 311 of the Social Welfare Consolidation Act 2005, if a person is dissatisfied with a statutory decision of the Department including the outcome of a review, they can submit a request for an independent appeal of the decision to the Social Welfare Appeals Office.

I trust this clarifies the matter.

Bernard Durkan (Kildare North, Fine Gael)
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132. To ask the Minister for Employment Affairs and Social Protection the standard procedure, regulations and guidance followed by deciding officers and appeals officers when ensuring full disclosure of the reasons and justification for refusal of an application for illness-related payments is communicated to the applicants to enable due process including preparation for any further appeal may take place; if an internal Departmental guidance exists as to the level of detail required in such disclosures with particular reference to medical evidence; and if she will make a statement on the matter. [15388/22]

Heather Humphreys (Cavan-Monaghan, Fine Gael)
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Deciding officers and appeals officers are independent in their decision making and are required to apply the law on a case-by-case basis. All statutory decisions are bound by the relevant provisions of the Social Welfare Consolidation Act 2005 and associated regulations. The legislation provides for a transparent and fair decision-making process in conjunction with the control of social welfare schemes. Every claimant is entitled to have their claim considered in the context of determinations of entitlement under the relevant social welfare legislation and in accordance with the principles of natural justice.

A deciding officer may at any time revise any decision of a deciding officer by reason of an error having been made in relation to the law or facts or in light of new evidence or facts brought to his or her attention since the date on which the original decision was made. The Social Welfare Appeals Office functions independently of the Department and is responsible for determining appeals against decisions in relation to social welfare entitlements.

The legislation provides that any unfavourable statutory decision made by a deciding officer or an appeals officer must be communicated in writing to the claimant outlining the reasons for the decision. The Department’s Decisions Advisory Office has published guidelines for Deciding Officers and Designated Persons on the legal requirements for reasoned statutory decisions. The guidelines include ‘Decision Making and Natural Justice’; Reasons for Decisions’ and ‘Revised Decisions and their Date of Effect’.

The natural justice principle of ensuring that the reasoning underpinning a decision is clearly set out is included as standard in all guidelines and applies to decisions made on all schemes including illness-related schemes. The guidelines are updated continuously and concurrently with any relevant legislative changes or principles emerging from relevant case law of the Courts. The guidelines were recently reviewed and will be re-issued to all staff of my Department in the coming days and will be re-published on the Department’s website.

Training is provided to all decision makers and emphasises the importance of ensuring that the grounds, reasons and rationale for an unfavourable decision are clearly communicated to the customer. My Department and the Social Welfare Appeals Office consult with each other on issues related to decision letters to ensure consistency of decisions made by both deciding officers and appeals officers.

I trust this clarifies the matter for the Deputy.