asked the Minister for Social Welfare if he is aware of reports that medical certificates are available in the surgery of some doctors on a pre-signed basis for collection without a thorough examination of the patient; if such reports are correct; and if he proposes to take action to stop this practice.
Written Answers. - Issue of Medical Certificates.
360.
I am aware that allegations of this nature are made from time to time. Under the terms of their agreement with my Department medical certifiers are obliged to examine insured persons who are ill and who apply for a medical certificate. A full medical examination may not be necessary on each occasion on which an insured person visits his doctor. It is a matter for the medical certifier, having regard to his knowledge of the history of the case to decide when a further examination is necessary before the issue of a certificate.
I am, of course, very concerned at the possibility of irregular practices developing and if the Deputy is aware of any case in which he considers that a medical certifier appears to be acting irregularly in relation to the issue of medical certificates, I will arrange to have the matter investigated as a matter of urgency if he will supply me with details on a confidential basis.
361.
asked the Minister for Social Welfare if his attention has been drawn to a report (details supplied) to the effect that a person can organise himself to get a medical certificate when a strike is imminent in order to be in a position to draw disability benefit for the duration of the strike; if there is any foundation to this report; and, if so, the action he proposes to take in the matter.
Because of the nature of the scheme the control of disability benefit expenditure is essentially a medical matter. A person claiming disability benefit is required to furnish medical evidence of incapacity for work from a medical practitioner before payment is allowed. If such evidence is submitted the only way to challenge the certification is to have a second medical opinion on the claimant. It is for this purpose that my Department have a team of Medical Referees to carry out such examinations.
As part of the overall control of disability benefit claims the number of medical referees employed by my Department will shortly be increased by four, bringing the total number to 19. This will have the effect of ensuring that a second medical opinion will be obtained as early as possible in all cases where this is considered desirable.
In relation to strike situations, it is the practice of my Department to monitor claims from persons employed in firms where such a situation exists and to refer all such claims for early medical referee examination.
362.
asked the Minister for Social Welfare if his attention has been drawn to a report (details supplied) to the effect that it is possible for an employee to obtain a certificate of illness while at work and draw wages and social welfare benefits at the same time because of the inadequacies of the P.60 recording system in regard to the number of weeks actually worked; if this report is correct; and the action he proposes to take in the matter.
The P.60 is the certificate of pay, tax, PRSI contributions, number of weeks of insurable employment, etc. which an employer is required to give to each employee at the end of the tax year. Similar data is furnished by the employer to the Office of the Revenue Commissioners in respect of each employee and the relevant portion of such data is subsequently transmitted to my Department.
Under the PRSI system a contribution is payable, subject to the earnings limit, on all wages paid, including wages paid in respect of periods of incapacity for work even though the person may have been in receipt of disability benefit. In recording weeks of insurable employment on the P.60 all periods, including periods of incapacity for which wages are paid under an occupational sick pay scheme or otherwise, are regarded as weeks of insurable employment. In this way a person can be in receipt of wages and disability benefit at the same time but this does not involve any irregularity or abuse of the disability benefit system. The establishing of an entitlement to disability benefit rests primarily on the medical certification provided by doctors. I have no reason to doubt that medical certifiers as a whole act in the best traditions of their profession.
In those cases where the system is abused fraudulent claiming comes to light in a number of ways. Procedures are in operation for test visits to claimants by sickness visitors and local inspectors and agents. Where there are doubts as to whether an illness is genuine the claimant is referred to a medical referee for a second opinion. Also information is obtained as a result of inquiries made locally by social welfare and other officers of the Department. All cases of irregularity are investigated and legal proceedings are taken where the evidence is sufficient to justify a prosecution. Control procedures are regularly reviewed and every effort is made to improve them.