Dáil Éireann Debate, Tuesday - 22 March 2016
10. Deputy Clare Daly asked the Tánaiste and Minister for Social Protection the number of medical assessments which were modified downwards by the deciding officer in contradiction to the original medical assessor for awards for social protection payments; and if she will make a statement on the matter. [4730/16]
Amharc ar fhreagra11. Deputy Clare Daly asked the Tánaiste and Minister for Social Protection why medical eligibility criteria in calculating the fixed percentage of social protection awards is not published; if she will rectify this situation; and if she will make a statement on the matter. [4731/16]
Amharc ar fhreagra12. Deputy Clare Daly asked the Tánaiste and Minister for Social Protection her views on the application of medical eligibility criteria in determining social protection payments, with particular reference to the discretion exercised with regard to loss of faculty; if the system is sufficiently consistent; and if she will make a statement on the matter. [4732/16]
Amharc ar fhreagraI propose to take Questions Nos. 10 to 12, inclusive, together.
The Department of Social Protection (DSP) has a cadre of medical assessors in the Medical Review and Assessment Service (MRAS) which currently comprises a Chief Medical Officer (CMO), a Deputy Chief Medical Officer (DCMO) and 25 Medical Assessors. The function involves the provision of impartial medical opinion for the guidance of Deciding Officers in determining entitlements to the various medical related schemes operated by the DSP.
Medical eligibility is a critical condition of certain DSP schemes. The Medical Assessors work in a collegiate way to ensure that best practice and professional expertise is shared and applied across all of the cases that are reviewed by them. This includes daily case conference meetings and a medical research unit to actively engage in the update of the body of medical knowledge and evidence based practice.
When conducting an assessment, the Medical Assessor does not dispute the existence of the certified cause of incapacity but rather he/she assesses the degree to which the loss of function in work-related activities, resulting from disease, mental health disorder or injury, affects the person’s ability to perform either their own job or alternative types of work. In carrying out assessments the Medical Assessor reviews any medical evidence available, e.g. GP/Specialist reports, results of investigations, X rays, MRIs, etc. and expresses an opinion based on findings. All assessments are carried out in accordance with agreed and accepted guidelines.
The medical protocols used by Medical Assessors are published on the Department’s website in the Operational Guidelines section. In addition a Statistical Report on all claim numbers is published annually and available on the Department's website.
In relation to the numbers of medical assessor opinions where the Deciding Officer took an opposite view, the following are the statistics in relation to the major schemes (for 2015):
|
New applications |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Carer’s Allowance |
8,413 |
918 |
11% |
|
Appeal/FME Reviews |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Carer's Allowance |
1,908 |
372 |
20% |
|
New applications |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Illness Benefit |
1,028 |
78 |
7.6% |
|
New applications |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Disability Allowance |
15323 |
1741 |
11.4% |
|
Appeal/FME Reviews |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Disability Allowance |
4947 |
1272 |
25.7% |
|
New applications |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Invalidity Pension |
4036 |
491 |
12.17% |
|
Appeal/FME Reviews |
Ineligible at MA stage |
Eligible by DO |
% Eligible by DO |
|
Invalidity Pension |
2481 |
589 |
23.74% |
In addition, the deciding officer awarded 40 DCA claims where the Medical Assessor opining was negative, representing 2% of all negative opinions.
