Written Answers. - Disability Benefit Claimants.
Séamus Hughes
Question:
141
Mr. Hughes
asked the
Minister for Social Welfare
his views on the number of claimants for disability benefit who failed to turn up when called for medical assessment, which amount to nearly 40 per cent of those who claim in the first instance, and the fact that, of the remainder, approximately 20 per cent are deemed fit to work; and the plans, if any, he has to encourage good practice amongst general practitioners in view of the serious impact that the temporary absence of certain employees can have, particularly on small businesses.
[14397/95]
The medical referee system is the principal control mechanism for the sickness payment schemes administered by the Department of Social Welfare.
A new focus on the referral of clients for medical referee examination was introduced in May 1993 to ensure more effective targeting of short term disability benefit cases and to reduce the time period in which new claims are referred for examination. In order to achieve these objectives, priority was given to the referral of disability benefit claims of less than one year's duration.
One of the results of this new focus has been the increase in the number of final certificates submitted by clients following notification to attend for medical referee examination.
In 1994 some 59,274 disability benefit and invalidity pension customers were called for examination by the Department's medical referees. Some 41,294 were examined and 7,995 such persons were found to be capable of work and had their payments withdrawn. However, the majority, 33,299 — over 80 per cent, were found to be still incapable of work and entitled to benefit.
Final certificates in respect of 8,756 cases were received and these people were not examined.
A person who is disallowed following a medical referee's examination, has the right to appeal his-her case to the Social Welfare Appeals Office. Many, in fact, do. Of the 3,241 disability benefit appeals submitted last year some 2,000 had their benefit restored mainly on the basis of a second medical referee examination and as a result of further medical evidence or other relevant information being provided in support of the appeal.
The Department requires a doctor to personally complete and issue medical certificates to persons claiming disability benefit where she or he is satisfied, after medical examination, that the persons in question are incapable of work due to illness.
The vast majority of doctors operate the certification system correctly and conscientiously. Many avail of a confidential report system that alerts the Department of the desirability of getting a second medical opinion in a particular case. In addition, they co-operate satisfactorily with the Department in its operation of the medical review system.
When a person is called for a medical referee examination his/her doctor is invited to attend the examination and to furnish a report of the medical condition of the person to assist the medical referee in considering the case. All such reports are carefully considered. These liaison arrangements have proved to be very worthwhile.
Having regard to the large volume of certificates received each week, some 28,000 very few are found to have been issued irregularly. A serious view is taken of any doctor found to have issued certificates irregularly and under the terms of his/her agreement, the doctor may be reported to the Medical Council or fined or have his/her contract terminated, depending on the seriousness of the case.
To promote a better understanding and co-operation between the Department of Social Welfare and medical certifiers a seminar on the medical review system was held on Friday, 6 October 1995. The seminar was facilitated by the Irish Society of Occupational Medicine. It proved to be very useful and further seminars may be organised as the need arises.
