# Disability allowance appeal



## Moral Ethos (22 May 2010)

My friend just had his application turned down on medical grounds. He was never called to a medical examination as part of the process. Is it common for cases to be decided without examination of the applicant?


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## Black Sheep (22 May 2010)

What has his GP said or did he give him a clearance cert to return to work


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## Moral Ethos (22 May 2010)

I have no idea what his GP said, but I do know his GP was very positive. I told him to get the file via FOI and see who said what.

I have a feeling that his GP and/or the deciding officer does not understand the full extent of his condition fully. Anyways I told him to submit an appeal. He would most likely get a medical examination that way and an oral hearing to get his side across.


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## Moral Ethos (31 May 2010)

Further to the above he has received a letter from the local CWO regarding his continuing SWA. The CWO is now looking for "medical evidence". 

Would appealing the decision not be valid grounds to continue paying SWA pending a decision of the appeals officer?


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## doubledeb (31 May 2010)

AFAIK the CWO works for the HSE, not the Dept of soc welfare.  I wouldn't think that they would be able to exchange information like that.  Maybe its the case that the CWO will pay him until a decision is reached in the DSFA and just needs the medical evidence?


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## Moral Ethos (31 May 2010)

The letter was very vague to say the least. I told him to ring the CWO and see what exactly he wants. 

Ah, I have just seen the letter, it is basically telling him to submit an appeal to SWAO with medical evidence. They want a copy of the letter for their records. 
Well his appeal is on points of law and procedure, he has told them he will produce medical records at a medical exam and/or an oral hearing.


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## ShadyBrady (31 May 2010)

He would be better off to correspond with the CWO in writing, leave a paper trail. Also there is the posibility, down the line if necessary of complaining to the ombudsman if he is not happy with the outcome.[broken link removed]

Can you say what the illness is as you say 





> I have a feeling that his GP and/or the deciding officer does not understand the full extent of his condition fully


I understand you may not want to


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## doubledeb (31 May 2010)

The problem is the system is being abused, and in the current economic climate (I hate that term) they are clamping down big time.  Unfair on those that are honestly unable to work.  The information would no doubt be passed on to someone qualified to make a decision on it.


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## Moral Ethos (31 May 2010)

But surely continuing SWA pending an appeal decision is perfectly lawful.


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## pudds (31 May 2010)

Moral Ethos said:


> Further to the above he has received a letter from the local CWO regarding his continuing SWA. *The CWO is now looking for "medical evidence". *
> 
> Would appealing the decision not be valid grounds to continue paying SWA pending a decision of the appeals officer?



Give them a report from your GP and that should suffice pending an appeal for DA.


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## Moral Ethos (31 May 2010)

It is not required. I had the situation clarified by a chief CWO. 

All he wants is proof that an appeal was lodged. That is the letter from SWAO.


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## ShadyBrady (2 Jun 2010)

Moral Ethos said:


> It is not required. I had the situation clarified by a chief CWO.
> 
> All he wants is proof that an appeal was lodged. That is the letter from SWAO.


well done glad to hear you are sorted


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## Ell69 (4 Jun 2010)

my sister got one of those letters today, and was diagnosed with MS last December. Needless to say she's appealing, but just goes to show, theyre clamping down on the ones that deserve it, they should get their facts right first.
They just dont get that just one signature on the bottom of those letters can mess up someones lives. These are real people that are applying for this financial aid.


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## annet (4 Jun 2010)

*Info*



Ell69 said:


> my sister got one of those letters today, and was diagnosed with MS last December. Needless to say she's appealing, but just goes to show, theyre clamping down on the ones that deserve it, they should get their facts right first.
> They just dont get that just one signature on the bottom of those letters can mess up someones lives. These are real people that are applying for this financial aid.


 
Good to see they are clamping down on fraudulant claimants. 

However, there has been many genuine cases who had to climb mountains to get their payments reinstated. The whole system is nonsensical and bureaucratic. 

The first thing to do is get a copy of the records of medical review and all other records that exist for her claim. The medical files should clarify the reason for the decision taken and should provide a logical process showing the processes that the doctor used to reach his/her decision. The written report now has to include the name of the examining doctor, including their medical registration number.  This is so that the doctor can be readily identifiable. 

You should contact whoever fills in your own certs ie. a GP or Consultant and ask them did the Department send them a form to fill in for you. This is important.  Sometimes, they dont send out these forms.  This can have consequences for claimants - and some would say its negligent. 

The deciding officers can find themselves caught between a rock and a hard place....they are not medically trained and they are wholly reliant on the decisions of the medical referree and those coming from the Chief Medical Advisor.

Good luck in the Appeal.


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## Odlum (10 Jun 2010)

just wondering:  i am on illness benifit for post natal depression and have since been made redundant.  i am still on medication and i have been called up for medical assessment.  what format does the assessment take and also the fact that I  no longer have a job to go to  - will i be changed to jobseekers even though i am still sending in certs


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## Moral Ethos (10 Jun 2010)

Nope. You will remain on IB for as long as you are sick.


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## annet (10 Jun 2010)

*Information*



Odlum said:


> just wondering: i am on illness benifit for post natal depression and have since been made redundant. i am still on medication and i have been called up for medical assessment. what format does the assessment take and also the fact that I no longer have a job to go to - will i be changed to jobseekers even though i am still sending in certs


 

The Operational Guidelines have information on the medical assessment and med review process

http://www.welfare.ie/EN/OperationalGuidelines/Pages/medassess.aspx

http://www.welfare.ie/EN/OperationalGuidelines/Pages/medreview.aspx

The assessment will look at your ability to perform your usual work ie. occupation.  If the doctor determines that you are fit for your usual work, you do have the right to appeal to the SWAP.  

In the meantime, you may be entitled to claim jobseekers benefit/allowance.  While jobseekers is being processed, you may be entitled to claim supplementary welfare allowance from the CWO in your local health centre which is a means tested payment.


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## Odlum (5 Jul 2010)

*medical review for post natal depression*

ihave just had my review and got a letter this morning to say that it has been rejected.  has any one appealled the assessment for depression.  so fustrating  -


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## annet (5 Jul 2010)

*Appeals Process*



Odlum said:


> ihave just had my review and got a letter this morning to say that it has been rejected. has any one appealled the assessment for depression. so fustrating -


 
I would suggest that you need to put in a Section 7 request under the FOI Act 1997 and the FOI (Amendment) Act 2003 seeking all the records relating to the medical assessment, and any other records that exist regarding your claim.

These medical assessment records will show the doctors findings on clinical review and assessment and the reason why the doctor felt you were fit for your usual work.

It would also be in your interest to ask your own medical certifier (usually your GP) whether the Department notified them of the last examination. They usually request the submission of reports and information on your medical condition when they do so.

If you decide to appeal the decision, you will have to submit a letter of appeal outlining why in your opinion you are unfit for usual work. This letter should clearly outline how your condition affects you in everyday life. If you are on medication, and it adversely affects you, explain how that affects your everyday functioning. It would be advisable to explain if you are undergoing any sort of treatment, such as counselling.

It would be helpful if you would have supporting medical evidence, which should be quite detailed, and a consultants letter would pull far more weight in terms of expertise than a GP's. 

The normal process in appeal cases is that you will be called for another medical assessment by a doctor who works in the MRA section.

You may be called for an oral hearing in respect to your appeal.  You will be given the opportunity to present your case to a panel of arbiters from the appeals office, none of whom are medically trained. 

And if you are dissatisified with the decision of the appeals process, you can alway's revert to the Office of the Ombudsman.


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