Medical referees now a thing of the past?

Archbishop Desmond Tutu

Do medical referee clinics still exist? Does the department still send people to see a department doctor when reviewing illness benefit etc?

Or is it all done on papers now with no examinations at all?

Balagan

Medical Review and Assessment
http://www.welfare.ie/en/Pages/Medical-Review-and-Assessment.aspx

Fred Swanson

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hawthorne

Wrong.
Most IB/DA cases are constantly reviewed and people are still called for medical examinations by SW doctors.
The frequency and volume of the assessments were increased over the last number of years to combat fraud and to safe money that way.
The department has now a very large turnover of reassessment per year.
Pure desk exams are very rare.

Fred Swanson

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steveone

I was told by a doctor in oisin house some time ago that despite his medical opinion the SW officer has the final say on my claim. I'm just wondering here, what happens if a disability claim is supported by medical opinion/evidence but overturned by SW officer- and the claimant is forced to return to work, and suffers an injury related to their condition?

Fred Swanson

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steveone

thanks for that FS, by putting a person on JSA are the department not returning them to work? since JSA is not a fixed payment (ie pension)-and the objective is return to work. I'm surprised, given the legal pitfalls alone, that officials can over rule medical opinion. but sone will argue that it seldom happens i suppose.

d9oiu2wk07blr5

steveone wrote: »

I was told by a doctor in oisin house some time ago that despite his medical opinion the SW officer has the final say on my claim. I'm just wondering here, what happens if a disability claim is supported by medical opinion/evidence but overturned by SW officer- and the claimant is forced to return to work, and suffers an injury related to their condition?

The medical referee in Oisin Hse was spinning you a line! It's a similar story with ATOS in the UK where their doctors and disability analysts try to distance themselves professionally and legally from the final decision on whether the claimant meets the medical criteria for eligibility to benefits.

When the medical referee completes their medical review, that report is then forwarded on to the chief medical advisor who signs off on the medical decision of the medical referee on whether the claimant meets the criteria for being unfit for f/t work. That document is then forwarded on to the relevant departmental section, and the DO takes on board 100% the decision of the medical referee regarding a persons fitness for work, and whether a claimant meets the medical criteria for eligibility. DO's are not medically qualified which is why the MRA section exists in the first place.

It's a similar story with the whole appeals process. None of the persons in the Appeals Office are medically qualified, and yet they are adjudicating over a persons medical fitness for work. In that situation, the appeals officers takes on board the opinion of the second referee who conducted the second medical or desk review. So there's a question about the whole independence of the appeals process and whether it constitutes natural justice to be having officers with zero relevant qualifications adjudicating over an appeal where there are questions about whether the claimant meets the medical criteria for eligibility. Why this hasn't been legally challenged before the courts or by the Office of the Ombudsman before now, I don't know.

The legal issues potentially arise where the medical referee says one thing, and the claimants own certifier who can be a gp or consultant says another. Theoretically, you could have a situation arise where a claimant decides to take on board the opinion of the medical referee regarding their fitness to work under the belief that they are medics, so they know what they're talking about, and if they subsequently suffer an injury because the medical referee made an erroneous decision, then it opens a whole can of worms where both DSP and the individual medical referee can be held professionally and legally liable. That's why claimants should always get access to their records including the medical report which clearly documents the opinion of the medical referee on a persons fitness for work and what type of functional activities, if any, that they may need to avoid.

One can also argue that under H&S laws there is a professional and legal onus on the medical referee to verbally advise the claimant regarding any functional impairments noted during the course of the examination on their fitness for work, and what type of workplace activities that they may need to avoid to avoid further injury or an aggrevation of their condition. If a person is claiming a means based payment, DO's would normally decide on whether the claimant falls within the means threshold for eligility following a means assessment.

foggy_lad

steveone wrote: »

thanks for that FS, by putting a person on JSA are the department not returning them to work? since JSA is not a fixed payment (ie pension)-and the objective is return to work. I'm surprised, given the legal pitfalls alone, that officials can over rule medical opinion. but some will argue that it seldom happens i suppose.

Afaik the claimant would be eligible for supplementary welfare allowance from their local community welfare office rather than Job-seekers allowance.

Fred Swanson

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Fred Swanson

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d9oiu2wk07blr5

Fred Swanson wrote: »

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Good luck getting an answer from the Appeals Officers. I agree with you about desk reviews and it's become a major issue with DCA. I do think there's a case for judicial review on certani points of law, and I don't think that you would even need to go to the appeals office for that to happen. There's also a provision where the chief appeals officer can revert matters for clarity on points of law for judicial review. Don't know if that ever happened in practice though. Even if the case does go to a full medical review, the next hurdle is ensuring that the medical asessor holds the necessary expertise and experience in the specialist division. Unfortunately, that's not always the case.

Did you read the report from FLAC last year on the appeals process. It highlighted several issues from the requirement of the appellant to get the prior approval from the appeals office before they can have someone accompany them to the oral hearing, which they believe is a violation of their constitutional rights. One also has to question the legality of the way in which appellants must notify the appeals office if they wish to bring witnesses along to the hearing whereas there's no corresponding obligation on the DSP or the appeals office to notify the appellant of the witnesses who will be in attendance on behalf of the DSP. My own belief is that there should be a requirement on the DO and the medical assessor to attend an appeal hearing so that the appellant and/or their legal representative/advocate can cross-examine them.

I also think that when claims are disallowed that appellants should be automatically issued with their file so that they have some grasp on the reasons for the disallowance. I also think that the full report of the appeals officer should be issued to the appellant. I am also surprised there hasn't been a judicial review proceedings brought yet on the independence of the whole process given the second medical review is carried out by the same MRA section who made the original decision. FLAC also found that the appeals office also defer to the MRA section for advice, so the two offices are intertwined.

http://www.flac.ie/download/pdf/not_fair_enough_final.pdf

Fred Swanson

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cee_jay

I have closed this thread as it has veered off into a discussion on SW policy. This forum is not for discussions & criticisms of govt. depts. so if you would like to continue, perhaps try a forum such as politics or Irish economy where the discussion would be more suited.