As the Deputy is aware, domiciliary care allowance (DCA) can be paid in respect of children under 16 years of age who have a disability so severe that it requires the child needing care and attention and/or supervision substantially in excess of another child of the same age. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required.
Each application is assessed on an individual basis taking account of the evidence submitted.
A review policy in an integral part of all social welfare schemes and is necessary to ensure that payments continue to be made only to those customers who meet the qualifying conditions.
DCA cases are routinely reviewed to ensure that all the conditions for receipt of the payment continue to be met. Cases are reviewed based on either a scheduled review on the recommendation of the medical assessor when the claim is initially processed or on information received about a change of circumstances which potentially affects the continued entitlement of a case already in payment. Where a child's condition is not expected to improve, their claim is noted accordingly and the eligibility to DCA is not reviewed again.
Scheduled reviews, on the recommendation of a medical assessor, are based on the prognosis of the child's disability and how their care needs may change over time. Customers who are reviewed are asked to provide relevant up-to-date medical evidence and details of the additional care needs of their child versus a child of the same age who doesn't have their disability. This information is assessed by a medical adviser and a decision is made based on the medical opinion they provide. Payment of DCA continues to be made until the review process has been completed. Where payment is stopped as a result of a review, the customer can submit any new information or medical evidence they may wish to have considered and that information will be further examined by a medical assessor, and/or they may appeal the decision directly to the Social Welfare Appeals Office.
I have recently announced that a policy review of the operation of the scheme will be carried out over the coming months. This will look, amongst other things, at the current application and assessment process with a view to identifying any potential improvements to the delivery of service to customers that can be implemented while retaining an efficient and effective operational model.
