More refusals to grant domiciliary care allowance (DCA) were overturned last year than the total amount of appeals lodged, prompting calls for a change in how the process is handled.
More than 70% of families denied their initial application for the monthly DCA for their child had the decision overturned on appeal, with 811 of the 1,142 DCA appeals decided by an appeals officer allowed.
However, in another 517 cases that did not go to appeal, the initial refusal was also reversed — almost one-in-five of the 2,875 applications that were originally turned down.
DCA is paid for a child aged under 16 with a severe disability and who requires ongoing care and attention. A total of 8,719 DCA applications were received by the Department of Employment Affairs and Social Protection (DEASP) last year, with 5,886, or 67%, awarded.
However, while it typically takes less than 10 weeks for an initial decision, the appeals process takes between 27 weeks for a summary decision and more than 30 weeks for an oral hearing.
Solicitor Gareth Noble of KOD Lyons, which has brought a large number of DCA cases to court, said the huge number of rejected applications overturned on appeal was cause for concern.
“The number of appeals that are successful is extraordinarily high,” he said.
I would be concerned about what it tells us about the quality of the initial decision-making process. A lot of it could be avoided if people had a right to an oral hearing in the first instance.
Currently, there is no provision for an oral hearing at the initial application stage.
Mr Noble said in his review of numerous files on behalf of his clients it was apparent that many of the assessors involved refer to how specialist reports, such as reports by occupational or speech and language therapists, would be of assistance in making a decision as to the application, but this is never communicated to the family.
“They just get a refusal,” he said.
Mr Noble also said that while the vast majority of those who appeal are successful, many do not appeal or fail to do so within the 21-day window, often because they feel “burnt out”.
He said an extension of the three-week window to two months would allow more families to lodge an appeal.
Mr Noble also raised the “huge inconsistency” in some cases where a child has a special needs assistant (SNA) allocated in their school, but are still refused DCA even though, in his words, “the criteria is the same”.
“These decisions are irrational,” he said, adding that a school principal, who sees a child on a daily basis, can decide on the allocation of SNAs, yet a deciding officer in the department who never sees the children can decide against allocating DCA.
A DEASP spokesperson said that in any year about 85% of all social welfare claims are awarded and approximately 1% of claims that are not awarded are appealed to the Social Welfare Appeals Office.
“There are a number of reasons why a decision which was refused at first instance might be successful on appeal and it is not necessarily the case that the first decision was incorrect,” said the spokesperson, adding that new or further evidence is provided and the appeals officer may gain “further insights during their discussions with the appellant at the oral hearing”.