Pauline Tully (Cavan-Monaghan, Sinn Fein)
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129. To ask the Minister for Employment Affairs and Social Protection further to Parliamentary Question No. 868 of 18 April 2023, if she will provide the specific developmental milestones which a deciding officer uses to compare and contrast an applicant for domiciliary care allowance against a child of the same age without their disability; and if she will make a statement on the matter. [21937/23]

Heather Humphreys (Cavan-Monaghan, Fine Gael)
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Domiciliary Care Allowance (DCA) is a monthly allowance payable to a parent / guardian in respect of a child aged under 16 who has a severe disability requiring continual or continuous care and attention in the home, substantially in excess of the care and attention normally required by a child of the same age without their disability and the child must be likely to require this level of care for at least 12 consecutive months.

Applications for Social Welfare schemes, including DCA, are decided by Deciding Officers appointed under Section 299 of the Social Welfare (Consolidation) Act 2005. All Deciding Officers are required to consider applications for Social Welfare schemes in a fair and impartial manner and in accordance with the legislative provisions set out in the Act.

All Deciding Officers are trained and have a full understanding of the scheme rules and relevant legislation and regulations governing the scheme they deal with. Scheme and operational guidelines set out additional information on the factors which are taken into account as part of the decision-making process. Applications for DCA, which involve medical conditionality, are referred to my Department’s Medical Assessors for consideration in the first instance. The Medical Assessor will consider the medical information, care reports and any supporting documentation submitted in support of the application. They will examine all of this information and evidence in order to form a medical opinion as to whether the applicant meets the medical conditionality for the scheme.

In general, social welfare schemes with complex qualifying conditions, such as DCA, tend to require extensive, detailed information and documentary evidence, medical or otherwise, to be provided as part of the application process, in order to make an appropriate decision on entitlement. It is important to note that eligibility for DCA is established by reference to the impact of the child’s disability or diagnosis and the degree of resulting additional care and attention required by the child. In that regard, Departmental Medical Assessors use their clinical judgement and experience to form an opinion, based on the documentary and medical evidence provided by the applicant, as to whether the child meets the medical criteria for eligibility for DCA.

The Department’s Medical Assessors are fully qualified and experienced doctors who have been specially trained. It should be noted that the role of the Medical Assessor differs fundamentally from that of the traditional treating physician, GP or Specialist. The treating physician's role is to investigate, diagnose, treat and give advice to patients regarding their medical condition. The Medical Assessor's role is to assess how the medical condition or disability adversely affects the child with reference to their daily living activities and resultant care needs. The Medical Assessor considers the severity of the condition, its expected duration and resultant care needs and gives an opinion as to whether the child satisfies the medical criteria of eligibility for DCA.

In determining the medical eligibility criteria for a scheme, a Deciding Officer will make decisions in accordance with the legislative provisions, taking account of all information and documentation provided by the applicant and having regard to the medical opinion of the Medical Assessor.

I trust that this clarifies the matter for the Deputy.