Case Studies » Sickness » Illness Benefit - Case from 2015 Annual Report (ref: 2015/07)

Background: The appellant, a woman in her 50’s, had a diagnosis of Multilevel Degenerative Disc Disease and had been in receipt of Illness Benefit since 1990.  Following a review, which included an assessment by a Medical Assessor for the Department of Social Protection, her claim was disallowed on grounds that she was no longer deemed to be incapable of work and not entitled to Illness Benefit under the provisions of the governing legislation (Section 40 (3) (a) of the Social Welfare (Consolidation) Act, 2005). 

Oral hearing: The appellant attended alone.  She reported that she had had a good job that she enjoyed, prospects of progressing in her role and an expectation of a good pension in retirement.  However, in view of her medical condition, she was required to retire on grounds of ill health.

The appellant stated that, at times, she is unable to do anything for herself, and that she has to take periods of rest throughout the day to get some relief from pain.  She advised that she had no recollection of hurting her back but that the problem got worse after childbirth.  She said that she tries to swim but cannot afford it at the moment.  She advised that her husband and children help with household tasks.  Her husband is farming and this helps as he is in and out during the day.  She said that when she cooks, she prepares something that will do dinner for a few days.

The appellant stated that she had to have a pain relief injection in the previous month and that she had had another one about six months before that.  She said that when the pain is bad, she is unable to dress herself and that using the bathroom presents difficulty.  She reported that she has also developed neck pain over the last number of years and that she gets bad pins and needles in her right arm and elbow so that it can take her an hour in the morning before she can move her arm comfortably.  She went on to provide an account of the extent to which she felt she was compromised in the activities of daily living as a result of her diagnosis, and she provided details of an appointment with a Consultant Neurophysiologist which had been scheduled for a date in the following month.

The appellant advised that it had taken her two years to complete an ECDL (computer training) course because she was unable to sit for long periods.  She provided details of the medication she has been prescribed. 

Consideration: Having examined all the evidence available, including that adduced at oral hearing, the Appeals Officer concluded that it had been established that the appellant was incapable of work, in line with the qualifying conditions for receipt of Illness Benefit. 

Outcome: Appeal allowed.