Domiciliary care allowance (DCA) cases, processed by the Department since April 2009, have a review date entered when initially awarded. This date is based on the recommendation of one of the Department's medical advisors having considered the child's medical prognosis. Review periods range from 12 months to a recommendation that they not be reviewed again. Customers who currently receive DCA will continue to receive the allowance unless there is a change in the medical condition of their child or another change of circumstances that means they no longer satisfy the qualifying conditions for the scheme. Customers are required to notify the Department of any change in their circumstances which may affect their eligibility.
The total number of scheduled reviews undertaken in 2010 and 2011, based on recommendations from medical advisors are set out in the table below. As the shortest review period is 12 months, the first review was not carried out until mid 2010.
Year
|
Reviews
|
Still Eligible
|
Not Eligible
|
Pending
|
2010
|
134
|
80
|
54
|
0
|
2011
|
403
|
164
|
187
|
52
|
Customers who are reviewed are asked to provide relevant up-to-date medical evidence and details of the extra care needs of their child. This information is assessed by a medical advisor and a decision is made based on their medical opinion.
Where payment is stopped as a result of a review, the customer is invited to submit any further information they may wish to have considered and that information will be further examined and/or they may appeal the decision to the Social Welfare Appeals office. Appeals resulting from scheduled reviews in the period 2010-2011 are set out below:
Year
|
Appeals
|
Eligible 2nd Review
|
Not Eligible 2nd Review
|
Pending 2nd Review
|
Allowed on Appeal
|
Disallowed on Appeal
|
Appeal Pending
|
2010
|
15
|
9
|
6
|
0
|
3
|
2
|
1
|
2011
|
21
|
4
|
14
|
3
|
0
|
2
|
12
|
On occasion, customers are reviewed for reasons other than scheduled medical reviews. For example, a review is carried out when information is received that another benefit claim in respect of a child for whom DCA is also being paid has stopped or when information is received that a family may have left the State.