Decisions in relation to entitlement to social welfare payments are bound by the relevant provisions of the Social Welfare Consolidation Act, 2005 (as amended) and associated regulations. The legislation provides for an equitable, fair and transparent decision-making process in conjunction with the control of social welfare schemes. Every claimant is entitled to have their claim considered in accordance with the principles of natural justice and in the context of determinations of entitlement under social welfare legislation. A number of conditions must be satisfied in order to qualify for any payment – these vary according to the payment.
In the case of illness benefit, customers must provide a Certificate of Incapacity for Work in addition to having the required social insurance contributions. If people continue to be ill beyond their entitlement to illness benefit, they can apply for Disability Allowance or Invalidity Pension. Disability Allowance is subject to means testing and the habitual residence condition in addition to meeting the medical criteria for the payment. In the case of Invalidity Pension, customers must meet the medical criteria and the social insurance requirements for the scheme.
Any unfavourable decision of a Deciding Officer must be communicated in writing to the claimant setting out the reasons for the decision. It is open to any person to request a review of any statutory decision made by the Department and any new evidence or information provided to the Department will be considered as part of this review. It is important to note that any decision of a deciding officer can be revised in light of additional evidence without it ever being in the appeal process.
Under the provisions of Section 311 of the Social Welfare Consolidation Act 2005, if a person is dissatisfied with a statutory decision of the Department including the outcome of a review, they can submit a request for an independent appeal of the decision to the Social Welfare Appeals Office.
I trust this clarifies the matter.
