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Dáil Éireann debate -
Thursday, 27 Nov 2003

Vol. 575 No. 5

Social Welfare Appeals.

I thank the Leas-Ceann Comhairle for allowing me to raise this issue on the Adjournment and the Minister for attending. This issue is one that would be dear to any Minister's heart. It is a case of an award made in 1976 for an occupational injury suffered in 1970. In the assessment of the award at the time, it was determined that the individual had a loss of 20% faculty of which 10% was attributable to the occupational injury. I do not know how expert the medical advice of the time was, but if diagnosis could be as accurate every day, medical science would be more outstanding than others.

The Minister and I know that the replies to these questions are written. However, I am asking that this case be re-examined and the medical evidence be tested because at an appeal to the Department in 1999 the appeals officer stated:

The appellant was awarded 10% disablement pension in respect of loss of faculty due to an occupational accident in 1970. He sought a review of this award on the basis that his condition has deteriorated since the date of the award. He was examined by a medical referee for the Department and found to have a loss of faculty amounting to 20%. However, it was considered that the increase in the loss of faculty of 10% was not attributable to the occupational accident he originally sustained but was related to the onset of osteoarthritis loss of hearing and anxiety. Having considered the evidence submitted, including that adduced at an oral hearing of the case, I do not consider that it has been clearly established that the deterioration in his condition, i.e. the increased loss of faculty was related to his occupational injury in 1970.

That is a profound judgment and I am sure the Minister recognises it as such. I challenge it because, if one has an injury to the spine or a limb, it can trigger arthritic conditions, which is the case in this instance. I do not know how it was determined that both conditions could not be related. There is no evidence that can tell with such accuracy, as in this case, that loss of faculty is not related to an accident.

Following representations I made to the Department, a further appeal was opened. The appeals officer on this occasion was nearly as good as the previous one. It was also disallowed on the basis that:

All the available evidence has been considered. It has not been established that the deterioration in the appellant's overall condition is directly related to his occupational injury in 1970.

I am not asking the Minister to carry out a medical examination. If the Ceann Comhairle were present, he could shed more light on the subject. However, the appellant has medical evidence that his current condition is directly related to the accident that took place in 1970. Will the Minister have the case tested again?

We are an amazing people.

The Minister is telling us.

We set up independent systems of appeal. We move it all at arm's length away. However, when we do not get the answer we want, we call for the Minister to intervene in the matter.

That is not an independent appeals system

I have sympathy with both the Deputy and the appellant. However, one thing I have learned in life is that if a procedure is established it must be followed. We should go through the procedure very carefully.

Let us do it.

The person claimed disability benefit in 1970 following an accident at work. Between 1970 and 1976 he received a number of provisional awards based on assessments of his loss of faculty. Following a medical examination on 2 February 1976 the person concerned was awarded a 10% life gratuity from 5 March 1976.

In February 1997, 21 years later, he sought a review of his further entitlement to disability benefit and was advised that such a decision is only reviewable in the event of deterioration in his condition arising from the accident, since the last award was made. The person submitted a new disability benefit claim in July 1998. It was referred for an examination by a medical assessor of the Department Social, Community and Family Affairs on 18 December 1998 who assessed him at 20% disablement. Are we agreed so far?

A report from his GP of 8 December 1998 stated that the person had osteoarthritis of the lower back, cervical spondylosis and was suffering from depression and increasing deafness at that stage. However, the medical assessor considered that the additional 10% loss of faculty was not attributable to the accident he had sustained at work but was related to the onset of osteoarthritis, loss of hearing and anxiety.

Here we begin to disagree.

He was the assessor; the Deputy and I are only laypersons. Accordingly, it was decided that the original 10% award should stand. The person was notified of this decision and advised of his right to appeal. The person appealed this decision on 31 March 1999. The appeals officer, having considered all the evidence including the evidence adduced at an oral hearing on 16 November 1999, disallowed the appeal.

Following representation from the Deputy a further appeal was opened on 8 July 2003 and the case was referred to a different appeals officer. This appeals officer, having considered all the available evidence, decided that a further oral hearing was not required. He disallowed the appeal on the basis that it has not been established that the deterioration in the appellant's overall condition is directly related to his occupational injury in 1970.

I understand that the Deputy subsequently requested that an oral hearing be arranged but the appeals officer held that in the circumstances no useful purpose would be served by holding such a hearing.

That is even better.

While I do not want to put words into the appeals officer's mouth, it would appear that the issue at stake was not the condition but the cause of the condition. Ultimately this is a matter of opinion. The question is whose opinion counts.

Medical science challenges that opinion.

The appeals officer does not consider that there is any new evidence that would warrant a revision of his decision of 28 July 2003. Under social welfare legislation, decisions on claims must be made by deciding officers and appeals officers. This is the nub of the matter. This is the way the Oireachtas has set it up and moved the process to arms length to stop any allegations of Ministers interfering. It is often how these things come back on us all, but we do them in the House all the time.

Some of us do not agree with them.

If I ever do something that means more power for those of us who answer directly to the people, I will be looking directly for the Deputy's support and I hope it will be forthcoming.

The Minister will get it if he is right when he makes that challenge.

These officers are statutorily appointed and I have no role in regard to making such decisions, nor does the Minister for Social and Family Affairs.

The Dáil adjourned at 8.05 p.m. until 10.30 a.m. on Friday, 28 November 2003.

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