The Medical Review and Assessment system is the principal control mechanism for illness and disability schemes administered by the Department of Social Protection. Medical Assessors carry out desk assessments of medical evidence/ reports supplied by doctors/patients and where required, conduct in person assessments in order to provide a second medical opinion for the guidance of Deciding and Appeals Officers. All guidelines are carried out in accordance with the accepted guidelines of the Irish Medical Council.
The vast majority of illness related claims pertain to the Illness Benefit scheme for those initially presenting with a short term illness. Illness Benefit claimants are normally first assessed by a Medical Assessor at a desk assessment (without meeting the claimant) based on the perusal of a medical report from the claimant's doctor. In these desk assessments, the Medical Assessor cannot recommend refusal of Benefit, but can recommend eligibility for benefit or that the claimant should be assessed in person by a Medical assessor to ascertain eligibility for continued entitlement to Illness Benefit. At the in-person assessment, the Medical Assessor may present an opinion to a Deciding Officer in the scheme area who then makes the decision on eligibility. Applicants who wish to claim Disablement Benefit in respect of an injury obtained at work, are normally assessed by a Medical Assessor at an in-person assessment to determine the loss of function involved.
Applicants for other schemes such as Disability Allowance, Invalidity Pension, Domiciliary Care Allowance, Carers Allowance/Benefit, and Respite Care Allowance are generally assessed by a Medical Assessor at desk, based on medical reports and medical evidence submitted by the patient's doctor/specialist. The Medical Assessor presents his/her opinion from the assessment for the guidance of the Deciding Officers in the scheme areas. In certain cases if warranted, the Medical Assessor can recommend that the patient undergo an in person assessment.