06 – Child’s age: 5 years

Diagnosis: Autism Spectrum Disorder, Heart Tumour, Asthma

Background: The appellant’s son, [F], was diagnosed with Autistic Spectrum Disorder and she made a claim for Domiciliary Care Allowance when he was 4 years old. The claim was refused on grounds that the medical qualifying criteria were not met.

In her appeal submission, the appellant stated that [F] is constantly falling and bumps into things; he is still in nappies and needs help with the activities of daily living; food must be prepared in a particular way for him and he eats with his hands. She referred to the Heart Tumour and Asthma and said that it is a struggle to give him his medication and to get a mask inhaler on his face. The medical evidence submitted confirmed that [F] has tantrums and that his behaviour is difficult to manage. It states that he demonstrates hand flapping, vocalises loudly and goes around in circles repeatedly. The appellant advised that there is a family history of children with special needs and [F]’s sibling attends an autism school.

Comments/Conclusions: The Appeals Officer noted that, in completing the ability/disability profile on the medical report, the family GP assessed [F] as follows:

Hearing, Sitting, Standing: Profound
Mental Health/Behaviour, Learning/Intelligence, Continence: Severe

Having considered all the evidence in the case, including the details of the appellant’s written submission and supporting medical evidence, the Appeals Officer concluded that the qualifying criteria for Domiciliary Care Allowance were met.

Decision of the Appeals Officer: The appeal is allowed.

Note on decision reason(s): Domiciliary Care Allowance may be paid where a person is providing care at home for a child who has a severe disability, and requires continuous care which is substantially in excess of that normally required by a child of the same age. The qualifying conditions are outlined in social welfare legislation.

Having examined the evidence available in this case, I have concluded that it has been established that [F] needs substantial additional care on a continuous basis, as provided for in the legislation. In the circumstances, the appeal succeeds.