Social Welfare - Case Study 2017

By nclcadmin, Wednesday, 10th April 2019 | 0 comments
Filed under: Social Welfare, Case Studies 2017.

Social Welfare - Successful appeal of decision made to terminate entitlement to Carer's Allowance

Background

CLM represented a client in her appeal of a decision by the Department of Employment Affairs and Social Protection (DEASP) to terminate her entitlement to a half rate Carer’s Allowance in respect of her son, for whom Domiciliary Care Allowance was being paid. In January 2016, DEASP commenced a review of our client’s entitlement to Carer’s Allowance in respect of the full time care needs of her son, the Caree. Our client submitted a school report and a number of medical reports, including a report from a Child and Adolescent Consultant. In April 2016, the client’s son reached age 16 and therefore entitlement to Domiciliary Care Allowance ceased. By letter dated June 2016, the Deciding Officer stopped the client’s Carer’s Allowance with effect from 30 June 2016. The decision was based on the fact that the Deciding Officer had determined that our client was no longer entitled to Carer’s Allowance as the relevant person being cared for, her son , no longer met the full time care and attention requirements as set out in section 197(4) of the Social Welfare (Consolidation) Act 2005, as amended. CLM submitted a Notice of Appeal in July 2016 on the basis that our client’s son had significant difficulties and had been diagnosed as having clinically significant scores in the areas of opposition, cognitive problems, hyperactivity, inattention and restlessness.

CLM Northside’s Input

CLM sought additional medical evidence and evidence from the Caree’s school showing the need for full time care and attention. The medical evidence highlighted the fact that the Caree’s diagnosis was more complex than when reviewed by the Department as, in addition to various learning difficulties, he had also been diagnosed with depression and was threatening self-harm. Due to the risk of self-harm, the Caree required continual supervision. CLM lodged a written submission with the Social Welfare Appeals Office in April 2017. The submission included various key arguments in addition to evidence demonstrating the need for full-time continual care and attention. CLM represented the client at an oral hearing where she gave an account of her son’s daily life and confirmed that he was no longer attending school. She explained that he attends a high support special needs school. She stated that she was required to supervise her son at all times and that he rarely leaves the house. She further stated that she is reluctant to leave her son alone in the house due to the risk of self-harm. When she does leave, she asks a family member to be present. CLM submitted at the hearing that the medical evidence coupled with the oral testimony of the client in relation to the extent of the Caree’s needs show that the Caree does meet the requirement to provide full time care and attention as set out under the legislation. The Appeals Officer issued a decision allowing the appeal on the grounds that the new medical evidence confirmed that the client’s son required full time care and attention as set out in the 2005 Act. The client was also awarded significant arrears of payment backdated to the date her Carer’s Allowance was first terminated.

Impact

On the basis of the written and oral submissions made by CLM, the appeal was successful. Our client was paid half rate Carer’s Allowance again and substantial arrears of payment were granted. The case highlights the limited medical information relied upon by the Deciding Officer and the limitations of the medical questionnaire form used by as part of the medical review process in determining that our client’s son did not satisfy the full time care and attention requirement as set out under the legislation. Our client had experienced a particularly stressful period in her life given the mental health and behavioural difficulties of her son. This stress was exacerbated by the decision of DEASP to terminate her entitlement to her Carer’s Allowance payment. The case highlights the importance of appealing decisions of DEASP and in obtaining legal advice.

 

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