Having noted an article which appeared in the Irish Examiner on 10 February 2014, the Ombudsman, Mr Peter Tyndall, has decided to issue this statement.
The article was about Domiciliary Care Allowance (DCA) (see Note 1) payments and difficulties being experienced by some applicants in their dealings with the Department of Social Protection. The article highlighted the fact that more families are bringing court challenges against the Department over its refusal to grant them DCA and in many cases are bypassing the Department's appeals system altogether.
The Ombudsman is keen for applicants to be aware that he can examine complaints about this issue. He can examine complaints about the actions of a range of public bodies, including the Department of Social Protection and the Social Welfare Appeals Office. All complaints, including those relating to undue delay in arranging appeal hearings and decisions of Appeals Officers, are dealt with independently and impartially when judging whether the application was dealt with in a fair and reasonable manner. The Ombudsman stressed that complaints should be made to his Office within 12 months of the decision being made. Normally the Ombudsman cannot examine cases that are due before the courts or have been decided upon by the courts. The Ombudsman provides a free service to complainants.
The Ombudsman's Office dealt with 17 DCA complaints in 2013 and is at present dealing with a number of on-going complaints. An example of a complaint which was completed by the then Ombudsman, Emily O'Reilly in 2012 and published in her Annual Report is attached.
Note 1 :
DCA is a monthly payment to the carer of a child under 16 with a severe disability that is likely to last for at least 1 year. It is not means tested. The guidelines for DCA state that the payment is not based on the type of disability but on the resulting physical or mental impairment which means that the child requires substantially more care and attention than another child of the same age. This care and attention must be required to allow the child to deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months.
For further information contact:
Tom Morgan
Senior Investigator
Office of the Ombudsman
01 639 5620
tom.morgan@ombudsman.gov.ie
General Media queries:
David Nutley
Communications Officer
01 639 5610
086 023 1420
david.nutley@ombudsman.gov.ie
@OfficeOmbudsman
DCA case: Department refused to award an allowance from the date of application
Background
My complainant’s son had been diagnosed with autistic spectrum disorder when he was two years old. She had applied to the Department of Social Protection for a Domiciliary Care Allowance (DCA) in respect of her son. The DCA application was initially refused. However, following the presentation of additional medical evidence at an oral hearing, the Appeals Officer approved the application but considered that the child needed substantial care from the time of the appeal decision only. My complainant contended that payment should have applied from the date of application, 17 months earlier, rather than from the date of the oral hearing.
Examination
I examined why the Appeals Officer considered that the child required substantial additional care and attention from the date of the oral hearing and not from the date of the DCA application.
Medical and occupational therapy reports showed that the child had received extensive input from several services including medical, care and treatment professionals, and from his parents, since he was two years old.
The Appeals Officer considered that all children require full-time care and attention up to a certain age and that it is difficult to discriminate among babies/toddlers. I accepted that it may sometimes be difficult to distinguish between the level of care among very young children. I drew the Department’s attention to Appendix 6 of the Department’s Expert Medical Group Report. The appendix outlines the “normal age of attainment- age by which 90% of children can perform the activity”. It appeared from the medical evidence on file and the ongoing supporting correspondence from care workers and social workers that the child - by reference to the normal age of attainment as outlined at Appendix 6 - was receiving substantial additional care and attention from a very early stage to allow him to deal with the normal activities of daily living which a typical child of the same age would normally be able to perform without assistance.
I also drew the Department’s attention to its ‘Guidelines for DCA’, which deal with the ‘Date of Award’. The Guidelines provide that:
“As a general rule the date of the award should be the date of application...”
In addition Appendix 8 of the ‘Medical Eligibility Guidelines for DCA’ outline the guidelines to desk assessment of DCA. It provides that autism is a condition which is more likely to result in a disability so severe that DCA is appropriate.
Outcome
Following my request, the Appeals Officer reviewed the case and taking all the above points into consideration, revised his decision. My complainant was awarded DCA for her child from the date of her original application and was awarded payment of arrears of €8,400.