Case Studies » Sickness » Disability Allowance - Case from 2016 Annual Report (ref: 2016/16)

2016/16 Disability Allowance

Oral hearing

Question at issue: Eligibility (medical)

Background: The appellant, in her mid-40s, has a diagnosis of intellectual disability, hypothyroidism and anaemia. She made claim for Disability Allowance and this was refused on medical grounds. In completing the ability/disability profile, her G.P. had assessed her abilities in the areas of ‘Mental Health/Behaviour’ and ‘Learning/Intelligence’ as affected to a mild to moderate degree by her condition. In an appeal against that decision, it was submitted that she had been in receipt of Disability Allowance previously and that her condition remained unchanged.

Oral hearing: The appellant attended with her mother who spoke on her behalf. She referred to the appellant’s learning difficulties and said that she was not capable of independent living. She advised that she had attended a special school and then a training centre for people with intellectual disabilities. Subsequently, the centre had facilitated her in gaining assisted employment and she works in a local supermarket. She advised that this had been classified as work of a rehabilitative nature for social welfare purposes.

Her mother reported that the appellant had sustained injuries following a road traffic accident in 2007 and that she had taken legal proceedings on her behalf. She advised that she had received a compensation award of some €120,000 and had been made a Ward of Court, with a committee appointed to oversee the distribution of assets. She went on to say that she had lost her Disability Allowance payment on foot of the means assessed based on the compensation.

Her mother advised that she has had to seek a payment every three months equal to the Disability Allowance payment the appellant would have received. She referred to other payments made, in relation to holidays for example, and said that the amount remaining had reduced to just over €60,000. She went on to say that the appellant needs her parents’ support, that she is unable to cook or clean and has little concept of money as is shown by her being made a Ward of Court. She said that the G.P. who filled in the claim form has very little contact with the appellant who, apart from her intellectual disability, is in good health. She went on to say that she had understood originally that the claim had been refused on means grounds and could not believe that it had actually been disallowed on medical grounds, as had the claim made in 2015.

Consideration: The Appeals Officer noted that the appellant had been in receipt of Disability Allowance all her adult life until she received a compensation award which resulted in her means being in excess of the qualifying limit. However, he observed that when she reapplied in 2013, only €90,000 of her compensation remained. This resulted in a means assessment of €110.65 weekly but the claim had been refused on medical grounds. A subsequent claim in 2015 had also been refused on medical grounds. He concluded that the evidence was sufficient to conclude that the medical qualifying criteria were met. Having regard to the circumstances of case, which included the appellant being a Ward of Court and her inability to act on her own behalf, he determined that she had established an entitlement to Disability Allowance with effect from the date of the earlier claim in 2013.

Outcome: Appeal allowed.