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Invalidity Pension Appeals

Dáil Éireann Debate, Tuesday - 4 November 2014

Tuesday, 4 November 2014

Ceisteanna (96)

Tom Fleming


96. Deputy Tom Fleming asked the Tánaiste and Minister for Social Protection if she will review the existing processing and the adjudication of invalidity pension applicants due to the high percentage of initial refusal decisions being reversed following reviews and appeals; and if she will make a statement on the matter. [41748/14]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte) (Ceist ar Social)

I ask the Minister if she will review the existing processing and adjudication of invalidity pension applicants due to the high percentage of initial refusal decisions being reversed following reviews and appeals. There is an increasing trend towards obstacles and barriers in initial stages, although decisions may be subsequently reversed. Will the Minister intervene and use her good office to resolve this problem?

One of the main reasons there is a high disallowance rate of invalidity pension applications is that, in common with all the illness and disability schemes, claimants and their doctors often do not provide full and comprehensive details of their condition or disability until they receive notification of a disallowance. In this regard, it should be noted that invalidity pension is a long-term payment for insured people who are permanently incapable of work due to illness or incapacity. Accordingly, it is vital that comprehensive medical data is provided at the claim stage in order to facilitate a fully informed decision. I urge Members of the House to use every opportunity to get the message out that there is a need for comprehensive medical information from the individual and the medical advisers in order to have a reasonable chance of a claim being allowed.

As Members will be aware, the Department has a series of stakeholder forums with disability organisations and representative groups and the Department, in this context, takes every opportunity to emphasise the importance of providing full information at initial claim stage. With the recent improvements in information technology and other changes, I am happy to say we have now introduced a review process whereby illness benefit recipients are identified as potentially having an underlying entitlement to invalidity pension. This process utilises the medical and contribution information already available to the Department. The customers concerned are only required to complete a short supplementary application form. These claims are processed promptly, ensuring an improved and streamlined customer service.

I welcome the Minister's statement about the review group being set up and I hope this will be a workable and efficient process that will expedite the work. The statistics for 2013 speak for themselves. There were 6,958 appeals for invalidity pensions.

Overall, some 80.04% of appeals by applicants were successful, with 32% of decisions being reversed in the initial stages by deciding officers. There was a huge about-turn when matters went before an independent appeals officer at an oral hearing, when decisions in some 50% of cases that had initially been refused were reversed. This is disastrous as people are in dire straits. I believe some medical professionals are making a full diagnosis in the early stages and there are unnecessary barriers and obstacles, with people being made to jump through hoops for no reason.

The new system will identify people who can be transferred based on information the Department has on file. This information will include a description of the illness or disability and the period for which it may be endured. Improved information technology, IT, has made this possible. When I became Minister, I inherited an enormous backlog in this area and there were many discussions in this House on the issue. The problem remains, however, that when people submit applications, they are often inadequate initially - this may be because applicants lack the knowledge of the Deputy and others. It is up to applicants and their medical advisers to submit information needed to support a claim. That is why applications are refused. When people appeal a decision, they tend to produce more detailed and substantial information in support of a claim, which is why awards are often made on appeal.

People feel strongly that genuine applications are deliberately delayed and refused initially as part of wider efforts by the Department of Social Protection to crack down on fraud. They believe they are the victims of such an approach and I have anecdotal evidence of similar cases. An independent oral hearing can take from 12 to 18 months and many of those involved suffer from cancer, terminal and psychiatric illnesses. It has happened that appellants had died by the time an oral hearing was held. I commend the Minister for the review process which I hope she will police effectively. I hope the process is expedited and that those involved see justice in their applications. What is happening is not good enough.

In 2013 there were 9,640 applications, while this year 6,933 applications were received by the end of September. Some 9,494 claims were awarded in 2013, while this year 5,373 claims were awarded by the end of September.

Obviously, they are not the same people because there is a considerable period during which claims are processed. With the new information technology, I can put it absolutely to the Deputy that if a person has the support of a medical adviser or advisers and this is clearly indicated in the documentation, it will vastly improve his or her opportunity to receive a favourable decision. That is really what it hinges on.