Thematic Note G0140: Carer’s Benefit

Years: 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022

Types of Social Welfare: Carer’s Allowance, Child Benefit

Theme: Carer’s Benefit

Period of Analysis: SWAO Annual Reports 2009-2022

Keywords: Carer’s Benefit; Maternity Benefit; Concurrent Payments; Duration of Benefit; Eligibility; Overpayment; Full-time Care; Social Welfare Consolidation Act 2005

Casebase No. Case G0140

Summary of the relevant law:

What is the relevant legislation?

The Social Welfare Consolidation Act 2005 (as amended) (the “Act”) caters for various types of benefits, to include but not limited to, (i) illness benefit, (ii) disability allowance , (iii) child benefit, (iv) maternity benefit, (v) jobseeker’s benefit/allowance, (vi) state pension and early retirement, (vii) widow’s, widower’s or surviving civil partner’s pension and (vii) carer’s allowance/benefit.  Chapter 14 of the Act deals with carer’s benefit which this note will focus on.  

What is carer’s benefit?

This benefit is paid to people who leave work or reduce their hours to care for another person.

Who does the law consider to be a ‘carer’ for the purpose of receiving carer’s benefit?

A “carer” is a person aged 16 or over who resides with or, subject to certain conditions does not reside with, and provides full-time care and attention to a “relevant person”.  A “relevant person” is a person who has such a disability that he/she requires full-time care and attention.  A person is considered to require “full-time care and attention” if that person has such a disability that he/she requires from another person either (a) continuous supervision and frequent help throughout the day in relation to normal bodily functions, or (b) continuous supervision to avoid danger to themselves.

When is a carer entitled to carer’s benefit?

In addition to the above, a carer is entitled to carer’s benefit if he/she meets three criteria:

  1. The carer has worked in paid full-time employment for a minimum of 16 hours per week for any eight weeks, whether consecutive or not, in the 26 week period immediately before commencing carer’s leave or 32 hours a fortnight; 
  2. The carer is not employed, self-employed, or attending any course of education or training for more than 18.5 hours a week; and
  3. The carer satisfies certain PRSI contribution conditions. For a first claim the carer must have 156 PRSI contributions paid since starting work and either (i) 39 contributions paid in the second last complete tax year before the beginning of the benefit year (for example, for claims made in 2024, the relevant tax year is 2022); (ii) 39 contributions paid in the 12 months immediately before the start of the carer’s benefit claim; or (iii) 26 contributions paid in the second and third last complete tax year before the beginning of the benefit year (for example, for claims made in 2024, the relevant tax years are 2021 and 2022).

The maximum period in which a carer is entitled to carer’s benefit is 104 weeks, whether consecutive or not, in respect of full-time care and attention to the same relevant person.

What type of decisions relating to carer’s benefit have been challenged in recent years?

The Annual Reports of the Social Welfare Appeals Office (the “SWAO”) during the period of 2009 to 2022 highlight ten appeals in respect of carer’s benefit:

  • one appeal related to concurrent benefit payments;
  • one appeal related to the duration of the payment of carer’s benefit;
  • two appeals related to employment in the 26 week period before commencing carer’s leave; and
  • the remaining appeals related to whether the relevant person met the care required criteria.

These are a sample of the types of appeals the SWAO receives, which are hereinafter referred to as the “Case Studies”.

Key grounds of appeals by appellants:

Receipt of 2 payments and overpayment of benefit

In 2015 an appeal came before the SWAO in circumstances where a Deciding Officer held that the appellant was not entitled to carer’s benefit with effect from the date on which maternity benefit had been paid.  There was therefore an overpayment.  The appeal failed and it was found that the appellant was not entitled to receive carer’s benefit for the period that she had been paid maternity benefit.

The solicitors for the appellant sought a review of the Appeals Officer’s decision and two arguments were put forward (i) maternity benefit was not included in the Department of Social Protection’s (the “Department’s”) list of matters that would affect her entitlement to carer’s benefit and (ii) in her application for maternity benefit the appellant provided details of the carer’s benefit payment and therefore discharged any duty she had to notify the Department of her carer’s benefit payment.  

The Chief Appeals Officer was satisfied that the appellant provided the Department with full details of her carer’s benefit payment when she applied for the maternity benefit.  The Chief Appeals Officer concluded that in doing so, the appellant had fully discharged her duty to notify the Department of a change in circumstances that might affect her entitlement to carer’s benefit and it was noted that such information had been submitted to the Department in plenty of time to allow for the concurrent payment of carer’s benefit and maternity benefit to be avoided.  The Chief Appeals Officer revised the decision of the Appeals Officer and no overpayment was due.

Duration of payment of carer’s benefit

In Case Study 2017/33, the appellant’s application for carer’s benefit was rejected on the basis that she had previously received carer’s benefit for a period of 64 weeks and 40 weeks respectively (104 weeks in total) and had therefore already claimed her full entitlement and not entitled to claim for any further periods.  The appellant argued that she had worked for three years since she last applied for carer’s benefit and should therefore be allowed to re-qualify.  The appeal did not succeed on the basis that she had been in receipt of carer’s benefit for 104 weeks, whether consecutive or not, in respect of full-time care and attention to the same relevant person.

Paid Full-Time Employment

In Case Study 2017/32, the appellant had reduced her hours to 15 hours per week and was therefore unsuccessful in her appeal as she did not satisfy the requirement to work a minimum of 16 hours per week for any eight weeks of the 26 week period before the start of the carer’s leave.

In Case Study 2020/28, the appellant could not provide sufficient detail in order to satisfy the required minimum number of hours for any eight weeks of the 26 week period before the start of the carer’s leave.

Eligibility – Relevant Person Requiring Full-Time Care and Attention

Of the seven Case Studies dealing with whether or not a person classified as a ‘relevant person’ and indeed required full-time care and attention, all but one of the appeals were allowed.  In each case, the Appeals Officer considered both the appellant’s report on the level of care required, and the medical evidence put before the SWAO evidencing the level of care required.  In all cases, whether the appeal was allowed or not boiled down to whether the evidence satisfied the legislative criteria (i.e. whether: (a) the person has such a disability that he/she requires from another person (i) continual supervision and frequent assistance throughout the day in connection with normal bodily functions, or (ii) continual supervision in order to avoid danger to himself or herself; and (b) the nature and extent of his/her disability has been certified in the prescribed manner by a medical practitioner.)

Observations on appeal outcomes:

Each Case Study demonstrates the SWAO’s adherence to the criteria set out in the Act in respect of carer’s benefit.  The SWAO will look at the factual information (i.e. hours worked in the 26 weeks prior to the start of carer’s leave, PRSI contributions etc) and medical reports (where applicable).

As discussed above in relation to concurrent payment of maternity benefit and carer’s benefit, there may be circumstances where other social welfare payments may affect the entitlement to carer’s benefit.  It is therefore important to carefully review the carer’s benefit application for any such restrictions or obligations to notify the Department of circumstances that might affect entitlement to carer’s benefit payment. 

The Case Studies demonstrate that the SWAO’s approach to matters concerning carer’s benefit are consistent with the requirements of the Act taking into account the specific circumstances of each appeal. 

Relevant Case Studies of the SWAO Annual Reports 2009-2022

A.2009 
 N/A 
 2010 
 N/A 
 2011 
 N/A 
 2012 
 N/A 
 2013 
 N/A 
 2014 
 N/A 
 2015 
1.2015/15 Carer’s Benefit & Maternity BenefitQuestion at issue: Concurrent Payments
 2016 
 N/A 
 2017 
1.2017/32 Carer’s BenefitQuestion at issue: Employment in the 26 weeks prior to commencement of benefit
2.2017/33 Carer’s BenefitQuestion at issue: Duration of Payment
 2018 
1.2018/30 Carer’s BenefitQuestion at issue: Eligibility (Care Required)
 2019 
1.2019/32 Carer’s BenefitQuestion at issue: Eligibility (Care Required)
 2020 
1.2020/28 Carer’s BenefitQuestion at issue: Eligibility (Employment Condition)
2.2020/29 Carer’s BenefitQuestion at issue: Eligibility (Care Required)
 2021 
 N/A 
 2022 
1.2022/32 Carer’s BenefitQuestion at issue: Eligibility
2.2022/33 Carer’s BenefitQuestion at issue: Eligibility (Care Required)
3.2022/34 Carer’s BenefitQuestion at issue: Eligibility (Care Required & Care Provided)

2015:

2015/15 Carer’s Benefit & Maternity Benefit

Question at issue: Concurrent payment of benefits

Background: The appellant had been in full-time employment prior to the birth of her first child. When her child was diagnosed as having a disability, she made a claim for Carer’s Benefit and returned to work on a part-time basis. The claim was awarded with effect from a date in 2012 for the maximum period (104 weeks) for which Carer’s Benefit may be paid. The appellant applied for and was awarded Maternity Benefit in 2013. In connection with that claim, she had provided details of her Carer’s Benefit payment. Subsequently, however, she was advised that Carer’s Benefit is not payable with other social welfare payments such as Maternity Benefit and a Deciding Officer held that she was not entitled to Carer’s Benefit with effect from the date on which Maternity Benefit had been paid. The effect of the decision was to create an overpayment of some €5,000.

Oral hearing: The appellant outlined the background to her claim for Carer’s Benefit and her decision to make the claim. She stated that, on the application form, there had been a list of circumstances outlined that may affect Carer’s Benefit and a statement indicating that there was a requirement to notify the Department in the event of such circumstances occurring. She pointed out that payment of Maternity Benefits was not included on the list. In addition, she stated that when she completed the application form for Maternity Benefit she had declared that she was in receipt of Carer’s Benefit. She said that she did not consider that she was liable for the overpayment which had been assessed.

The appellant acknowledged that she had signed a declaration on the Carer’s Benefit claim form, indicating that she would notify the Department of any change in income or circumstances. She advised that she had been aware that her combined income was quite high but that she had considered that this was something to which she had an entitlement in view of her circumstances. She advised that her second child had also been diagnosed with the same disability and that she was in receipt of Carer’s Allowance and Domiciliary Care Allowance in respect of both children.

Consideration: Having regard to the provisions of the legislation, the Appeals Officer concluded that the appellant was not entitled to receive Carer’s Benefit for the period that she had paid been Maternity Benefit. Accordingly, the appeal was held not to succeed. Following further submissions, the Appeals Officer revised his decision and determined that it should take effect from a specified date only, with the effect that the amount of the overpayment was reduced.

Request for review: Solicitors acting for the appellant sought a review of the Appeals Officer’s decision in accordance with Section 318 of the Social Welfare Consolidation Act, 2005. The Chief Appeals Officer carried out a review, advising that her role under the terms of the legislation was a revising one rather than another avenue of appeal.

Grounds for Review: In support of the request, two points were put forward: that when the Department notified the appellant of the award of Carer’s Benefit, the receipt of Maternity Benefit was not listed as one of the circumstances that would affect her entitlement, and in her application for Maternity Benefit she had provided details of the Carer’s Benefit payment. It was asserted that the Appeals Officer did not exercise his discretion properly in relation to the reduction in the overpayment assessed against the appellant.

The Chief Appeals Officer examined the background to the case and the details of the appellant’s claim. She noted that the appellant’s attention had been drawn to the circumstances and events which might affect her Carer’s Benefit and of the necessity to notify the Department if any of these occurred. She observed that only one of the twelve events related to receipt of a payment (Domiciliary Care Allowance) and that the others related to circumstances such as change in care arrangements, change of address, bank details or marital status. Maternity Benefit was not mentioned.

Having reviewed all the material that was before the Appeals Officer, the Chief Appeals Officer was satisfied that the appellant had provided full details of her Carer’s Benefit payment when she applied for Maternity Benefit. She concluded that, in doing so, she had fully discharged her obligation to notify the Department of a change of circumstances that might affect her entitlement to Carer’s Benefit – albeit that the payment of Maternity Benefit was not listed as a payment that might affect her continued entitlement to Carer’s Benefit. She noted that the information had been submitted to the Department in ample time to allow payment of Carer’s Benefit to be discontinued and to avoid the concurrent payment of Carer’s Benefit and Maternity Benefit. She concluded, therefore, that the decision of the Appeals Officer was erroneous in that appropriate consideration was not given to all the facts of the case and that discretion had not been appropriately applied by the Appeals Officer. In the circumstances, the Chief Appeals Officer determined that the revised decision should have taken effect from a current date and no overpayment raised.

Outcome: Appeal allowed.

2017:

2017/32 Carer’s Benefit

Question at issue:

Employment in the 26 weeks prior to the commencement of benefit

Background: The appellant applied for Carer’s Benefit in July 2016 in respect of her mother. Her application was refused as she did not satisfy the employment conditions for the 26 week period immediately prior to the date of her application. The evidence was that from February 2016 the appellant had reduced the number of hours she worked to 15 hours per week. In her letter of appeal the appellant referred to the Carer’s Leave Act 2001 and the condition that you must not work outside of the home for more than 15 hours per week while on carer’s leave. She also stated that if she had the information regarding having to work a minimum of 16 hours per week for any eight weeks of the 26 week period immediately prior to the date that carer’s leave would commence, she could have arranged with her boss to work 16 hours per week.

Consideration: Section 100 of the Social Welfare Consolidation Act 2005 states that it is a condition for eligibility for Carer’s Benefit that a person must work a minimum of 16 hours per week for any eight weeks in the 26 week period immediately prior to the date that carer’s leave would commence. The Appeals Officer concluded that the statutory conditions were not fulfilled in this case; the appellant had not established that she worked a minimum of 16 hours per week for at least eight weeks in the 26 week period immediately prior to her application, and regrettably the appeal could not succeed. The appellant was advised that it was open to her to apply for a means tested Carer’s Allowance instead of Carer’s Benefit, where this work condition rule did not apply.

Outcome: Appeal disallowed.

2017/33 Carer’s Benefit

Question at issue: Duration of Payment

Background: The appellant applied for Carer’s Benefit In August 2016 in respect of care provided to her son. This application was disallowed as she had previously received Carer’s Benefit for a period of 64 weeks in 2010/2011 and for 40 weeks in 2012/2013, a total of 104 weeks. The Department pointed out in the decision letter that she had already claimed her full entitlement to Carer’s Benefit in respect of her son and consequently she was not eligible to claim Carer’s Benefit for any further periods. The appellant contended that as she had worked for three years since she last applied for Carer’s Benefit, she should be allowed to re-qualify.

Consideration: The Appeals Officer referred to Section 103 of the Social Welfare Consolidation Act 2005 which states that “a carer who has been in receipt of carer’s benefit for 104 weeks, whether consecutive or not, in respect of full-time care and attention being provided to a relevant person, shall not thereafter be entitled to that benefit in respect of full-time care and attention being provided to the same relevant person”. The Appeals Officer concluded the appeal could not succeed.

Outcome: Appeal disallowed.

2018:

2018/30 Carer’s Benefit

Question at issue: Eligibility (medical-care required)

Background: The appellant applied for Carer’s Benefit in respect of the care provided to his mother who was 80 years of age and had a diagnosis of back pain. His claim was disallowed on the grounds that the care recipient was not so invalided or disabled as to require full time care and attention as laid down in Section 99 of the Social Welfare Consolidation Act 2005. The ability/disability profile indicated that the care recipient’s ability was affected in the following areas: severe in relation to lifting/carrying; moderate in relation to bending/ kneeling/squatting and climbing stairs and mild in relation to reaching, manual dexterity, sitting/rising, standing and walking. The letter of appeal outlined that the care recipient required care in all areas of daily living including getting up, showering, getting dressed and being helped to the bathroom. The care recipient had a bell beside her bed to call the appellant during the night if she needed assistance. The appellant stated that on several occasions he had found his mother on the floor where she had fallen and could not get up.

Consideration: The Appeals Officer noting the care recipient’s age, diagnosis, the medical report and the appellant’s evidence concluded that the care recipient required full-time care and attention as laid down in the governing legislation.

Outcome: Appeal allowed.

2019:

2019/32 Carer’s Benefit

Question under appeal: Eligibility (care required)

Background: The appellant applied for Carer’s Benefit in respect of care provided to her father. The application was refused on the grounds that the caree did not require continual supervision and frequent assistance throughout the day with normal bodily functions or continual supervision in order to avoid danger to himself. The caree was diagnosed with paranoid schizophrenia, deafness and psycho-organic syndrome. The GP stated in the application form that the conditions were expected to last indefinitely. In the ability/disability profile, the caree was deemed to be affected to a profound degree in most categories, moderately affected in one and severely affected in three. The appellant stated that her father was confined to bed for the past four years, used incontinence pads, could not eat or drink independently, could not walk or sit, had problems sleeping and could spend nights  shouting. Her mother was elderly and could no longer take care of her husband.

Consideration: The relevant legislation in this case is Section 99(2) of the 2005 Act which provides that a person shall not be regarded as requiring full-time care and attention unless the person has such a disability that he or she requires from another person –

a. continual supervision and frequent assistance throughout the day in connection with

normal bodily functions , or

b. continual supervision in order to avoid danger to himself or herself.

From the evidence presented, the Appeals Officer was satisfied that the appellant had established that the caree required full-time care as defined in the relevant legislation.

Outcome: Appeal allowed

2020:

2020/28 Carer’s Benefit

Question at issue: Eligibility (employment condition)

Background: The appellant’s application for Carer’s Benefit was initially refused by the Department on two grounds: (i) that she was not providing full-time care and attention, and (ii) that she had not been working for the required minimum number of hours for at least eight weeks within a 26 week period prior to her application for Carer’s Benefit. Following a review by the Department it was decided that the appellant was providing full-time care and attention but the disallowance on the grounds of not meeting the required number of hours over eight weeks within a 26 week period remained unchanged.

Consideration: The Appeals Officer outlined that in accordance with Section 100 of the 2005 Act in order to be entitled to Carer’s Benefit a person must, among other things, have been working for at least 16 hours per week for not less than eight weeks within a 26 week period prior to the date of application for Carer’s Benefit.

The evidence originally provided at the time of application showed that the applicant did not meet this requirement. The appellant provided additional general information in relation to her employment but did not provide specific details in relation to the period in question.

The Appeals Officer concluded that it had not been established that the appellant had been working for the required minimum number of hours for at least eight weeks within a 26 week period prior to her application for Carer’s Benefit.

Outcome: Appeal disallowed

2020/29 Carer’s Benefit

Question at issue: Eligibility (care required)

Background: The appellant was in receipt of Carer’s Benefit from December 2018 to March 2019. She was re-awarded from March 2019 to September 2019. She subsequently applied for another extension up until March 2020. By decision dated in November 2019, the Department stated that following medical review, the appellant was not entitled to any further period of Carer’s Benefit beyond September 2019 on the grounds that the care recipient did not require full-time care and attention as laid down in the governing legislation.

Oral Hearing: At the time of appeal, the care recipient was two-years-old. The appellant explained that when the care recipient was born in October 2017 she was diagnosed with extreme prematurity and chronic lung disease. She said this is a lifelong disease and can lead to serious complications. The care recipient was treated in the maternity hospital from birth. For the first two winters of her life, the care recipient received immunotherapy to protect her against viruses. She was then discharged into community care. By the time of the oral hearing, she had been commenced on an inhaler. The care recipient had been admitted to hospital in December 2019 with suspected pneumonia.

The appellant said as the main carer, she was required to restrict all outdoor activities and avoid crowded areas in an effort to prevent further trauma and damage to the care recipient’s lungs. Even a simple head cold massively impacted the care recipient and her ability to breathe. The appellant had to limit the care recipient’s interactions with everyone, even close family. She said they could not have a childminder as this would put her at risk. She said placing the care recipient in the care of others would have put her in danger of picking up harmful viruses, damaging her lungs further and suppressing her already weakened immune system. The appellant said due to her occupation in the medical profession she recognised the early signs of any respiratory illnesses and acted immediately by performing nasal flushes and aspirations and also steamed her in the shower a few times a day. She said it was these actions that prevented the care recipient being admitted to hospital regularly. Subsequent to the oral hearing, the appellant provided a letter of support from the consultant neonatologist in the maternity hospital.

Consideration: Section 99 (2) of the 2005 Act provides that a person shall not be regarded as requiring full-time care and attention unless the person has such a disability that he or she requires from another person continual supervision and frequent assistance throughout the day in connection with normal bodily functions or continual supervision in order to avoid danger to himself or herself.

Having examined the medical evidence, and having had regard to the appellant’s grounds of appeal and information adduced at oral hearing which served to clarify the support required by the care recipient in the context of her diagnosis, the Appeals Officer concluded that the care recipient required full-time care and attention in line with the provisions of the governing legislation.

Outcome: Appeal allowed

2022:

2022/32 Carer’s Benefit

Question at Issue: Eligibility – care required

Background: The appellant was disallowed Carer’s Benefit on the ground that the care recipient, her spouse, did not require full-time care and attention for the purposes of the legislation.

The medical report stated that the care recipient had generalised anxiety disorder, depression, hypertension and morbid obesity. The report indicated that mental health/behaviour was affected to a “severe” degree and four physical abilities were affected to a severe, moderate or mild degree.

A letter from the GP reported that the care recipient had been medically unwell for years and developed severe phobic anxiety and depression several years ago. She was fully dependant on her husband for her likely long-term care. A letter from the consultant psychiatrist reported that at one point the care recipient did not leave her house for several months. The appellant reported that his wife dealt with severe anxiety and depression. She could not leave the house alone and needed constant help in the house, for example using the stairs. He had to physically get her up most days and put her in the shower.

Consideration: The Appeals Officer noted the appellant’s report of the assistance required with showering and mobility and his specific concerns for his wife’s mental health. She also noted that the GP reported that the care recipient was “fully dependant on her husband for her likely long-term care”. On balance, the Appeals Officer was satisfied that the particular combination of the care recipient’s conditions meant that she required full-time care and attention for the purposes of the legislation.

Outcome: Appeal allowed

2022/33 Carer’s Benefit

Question at Issue: Eligibility – care required

Background: The appellant was refused an extension of his Carer’s Benefit for 2022 on the ground that the care recipient did not require full-time care and attention for the purposes of the legislation.

The medical evidence comprised a medical report, two letters of support from the GP and a letter of support from the psychiatrist. The medical report indicated that the care recipient’s mental health was affected to a “severe” degree (the 2020 report indicated a “moderate” effect) and six physical abilities were affected to a “moderate – severe” degree.

The GP reported that the care recipient was in remission from Lymphoma, was in constant pain and needed help washing, walking and with housework. The psychiatrist reported that the care recipient had a longstanding history of anxiety and depression and remained very anxious despite her medications. The appellant reported that his partner needed help getting out of bed and showering and forgot things constantly, for example locking doors and putting up the fire guard.

Consideration: Section 99(2) of the 2005 Act provides that a person shall not be regarded as requiring full-time care and attention unless the person has such a disability that he or she requires from another person continual supervision and frequent assistance throughout the day in connection with normal bodily functions, or continual supervision in order to avoid danger to himself or herself.

The Appeals Officer found that the medical evidence in 2022 did not indicate an improvement in the care recipient’s needs and if anything disclosed more complex needs as a result of both her physical and mental health. She was satisfied that the care recipient continued to require full-time care and attention for the purpose of the legislation.

Outcome: Appeal allowed

2022/34 Carer’s Benefit

Question at issue: Eligibility – care required and care provided

Background: The appellant’s application for a Carer’s Benefit in respect of the provision of care and attention to their father, aged 81, was disallowed on the grounds that the care recipient did not require full-time care and attention as required by the governing legislation. When completing the medical report the caree’s GP stated that the caree was normal in terms of nine abilities of daily living but was impaired in terms of lifting/carrying, mental health/behaviour, continence, bending/kneeling/squatting, sitting/rising, climbing stairs/ladders. In the appeal submission, the appellant elaborated on the supports and care which included managing medication, making and attending medical appointments, support with finances, household duties and strenuous work, and ensuring self-care with diet and checks for diabetes. The Department was not satisfied that full-time care and attention was required.

Consideration: The Appeals Officer outlined that Section 99 of the 2005 Act provides that in order to be considered a carer for the purposes of Carer’s Benefit the person must be providing full-time care and attention to a person who requires continual supervision and frequent assistance throughout the day in connection with normal bodily functions, or continual supervision in order to avoid danger to himself or herself.

The evidence submitted indicated that the appellant did not need continual supervision and frequent assistance with normal bodily functions throughout the day or that he was danger to himself. While the GP stated that the caree attends a cardiologist, no reports or additional information was submitted to substantiate a related care requirement. The Appeals Officer concluded, that while the care recipient required a level of care and support which the appellant provided, it had not been established that the caree required full-time care and attention within the meaning of the governing legislation.

Outcome: Appeal disallowed

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