Social Welfare Appeal G0134: Carer’s Allowance – Overpayment

Title of Payment: Carer’s Allowance

Date of Final Decision: 29 August 2022

Keywords: Overpayment – Carer’s Allowance – Reduction of Overpayment

Organisation who represented the Claimant: Community Law & Mediation

Casebase No. G0134

Case Summary:

This case relates to an appeal of the decision of the Deciding Officer of the Department of Social Protection (DSP) that there was an overpayment of the Carer’s Allowance to the appellant. 

Carer’s Allowance is a means-tested social assistance payment available to people on low incomes who are full-time carers of another person.  The person being cared for may need support due to disability, illness or age and they must require full-time care.  There is a number of criteria which needs to be fulfilled in order for a carer to be found entitled and granted payment.  In accordance with social welfare legislation, the carer is under a legal obligation to inform the DSP of any change in circumstances after they have been granted payment.

One of the qualifying conditions for this payment is that the person being cared for must not be living in a hospital, convalescent home or other similar institution.

The appellant in this case had been receiving Carer’s Allowance since having been found eligible for the payment in March 2011.  However, in June 2015, the DSP was notified that the person being cared for had been in long-term residential care since May 2013.  Following this, the Directing Officer of the DSP notified the appellant that they were not entitled to receive payment for the period of 6 May 2013 to 17 June 2015.  This gave rise to an overpayment of €25,037 and this would have to be recovered.

As the appellant genuinely believed that they were entitled to the payment during this period, and had not lied nor hidden information, this was found not to be fraud.  If it was fraud, the appellant may have been criminally prosecuted and a reduction in the sum of the overpayment recoverable would not be available.  However, regardless of the fact that this was not fraud, there was still deemed to have been an overpayment.

The Social Welfare Appeals Process in accordance with the Social Welfare (consolidation) Act 2005 as amended is as follows:

s. 300 – Deciding Officer makes decision on social welfare application.

s. 301 – Applicant can request that a Deciding Officer reviews a refusal.

s. 311 – Applicant can appeal to the Social Welfare Appeals Office (SWAO) and an Appeals Officer makes a decision.

s. 317 – Appellant can request a review of the Appeals Officer’s decision.

s. 318 – Appellant can request a review by the Chief Appeals Officer.

s. 327 – Appellant can make a statutory appeal to the High Court.

The appellant took the following actions to challenge the Deciding Officer’s decision.

On 1 July 2015, the client initially responded to the Deciding Officer of the DSP stating that they genuinely believed they were entitled to the payment during this period as they were still providing care.  They also explained that they were already in a difficult financial situation.

On 19 April 2021, Money Advice and Budgeting Service (MABS) sent a letter on behalf of the appellant

submitting that there had been no offset and that the appellant would have been entitled to Supplementary Welfare Allowance (SWA) during that period.  This was an unsuccessful argument for the following reasons. 

Firstly, the Carer’s Allowance overpayment could not be offset as  the SWA was an allowance or social assistance payment. An overpayment can only be offset if the payment the appellant would have been eligible for was a benefit or social insurance payment.  The difference being that an allowance is means tested whereas a benefit is a PRSI benefit from having worked previously.

Secondly, the appellant could only be held eligible if they had applied for SWA.  They could then apply in 2021, however it could only be backdated by six months and so this would not apply to the period of concern.  The Social Welfare Services Office decided to not revise the Deciding Officer’s decision.

The appellant then appealed the decision to the Social Welfare Appeals Office (SWAO).  The SWAO upheld the decision, dismissing the appeal, and held that discussion concerning the recovery of overpayment should be with the Debt Recovery Unit of the DSP.  The SWAO also held that only the issue of the entitlement of the appellant to Carer’s Allowance was under review.  Issues such as other potential entitles, off sets and the appellant’s financial situation was held to be outside the scope of the SWAO.

Therefore, on the 29 August 2022, the final decision was made by the SWAO that the appeal remained disallowed.

Social Welfare Appeal G0091

The Appellant had been in receipt of One Parent Family Payment and half rate Carer’s Allowance (CA) in respect of her son, for whom Domiciliary Care Allowance (DCA) was in payment.

On 7 January 2016, the Department of Social Protection (the Department) commenced a review of the Appellant’s entitlement to Carer’s Allowance in respect of the full time care needs of her son, the Caree.  The Appellant submitted, as requested, a completed Medical Report (CR1) on which the Caree’s GP certified that he was moderately affected in relation to his mental health and behaviour.  The Appellant also submitted a school report and further medical evidence, including a medical report from a Consultant Child and Adolescent Consultant.

Following receipt of the papers the Department issued multiple decisions whereby it was asserted that the Caree did not require full time care and attention within the meaning of section 179(4) of the Social Welfare Consolidation Act 2005 (as amended) (the 2005 Act).  Despite decisions having been made that the Caree did not require full time care and attention the Department did not revoke the Appellant’s claim.

In April 2016, the Appellant’s son reached age 16 and therefore entitlement to DCA ceased.  By letter, dated 15 June 2016, the Deciding Officer stopped the Appellant’s Carer’s Allowance with effect from 30 June 2016.

Social Welfare Appeal G0086

This case relates to the decision by a Deciding Officer in November 2015 to stop payment of the Appellant’s Carer’s Allowance for the reason that he was no longer providing full time care for his wife, ‘the Caree’. The Deciding Officer’s decision was grounded in a report submitted by the Social Welfare Inspector (SWI), and a written statement submitted by the Appellant in which he advised that he was unable to care for his wife. The Appellant had been in receipt of Carers Allowance from April 2010 – November 2015.  There was no dispute with respect to the Caree’s on-going need for full time care; she was in receipt of Invalidity Pension, and suffered from multiple sclerosis and was prone to epileptic seizures.

Social Welfare Appeal G0082

This case relates to an application by the Appellant for Carer’s Allowance (half rate) in order to care for his wife. The Appellant’s wife was 57 years of age and had a diagnosis of Recurrent Psychotic Depression.

The Appellant applied for Carer’s Allowance in 2015. The Appellant’s application was refused. On Part 10 of the application form, the Doctor certified that the Appellant’s wife was moderately affected by her condition. The Deciding Officer (DO) considered that the Appellant’s wife was not so invalided or disabled as to require full time care and attention. The Appellant appealed the DO’s decision to the Social Welfare Appeals Office (SWAO). The Appeals Officer denied the appeal, following an oral hearing; on the basis that it had not been shown that the Appellant’s wife required full-time care and attention.

The Appellant sought assistance from MABS. In May/June 2016 MABS requested a review of the Appeal Officer’s decision pursuant to section 318 of the Social Welfare Consolidation Act 2005 (the 2005 Act).  In submitting grounds for review, MABS asserted that the Appeals Officer had not demonstrated that appropriate evidential weight had been attributed to the Appellant’s written and oral testimony as to facts of his wife’s care needs. As a consequence it was asserted that the Appeals Officer’s reasoning was flawed to the extent that he had erred in fact and law.

Social Welfare Appeal G0067

This case relates to the Appellant’s Carer’s Allowance (CA) claim in respect of his daughter for whom he cares.

The Appellant had been in receipt of Carer’s Allowance and Domiciliary Care Allowance (DCA) in respect of his daughter until 5 November 2013. At this time, the Appellant’s daughter reached aged 16, and therefore, the Appellant could no longer claim DCA in respect of his daughter. She subsequently applied for, and was awarded, Disability Allowance.

When the DCA payment ceased, the Appellant’s eligibility for Carer’s Allowance was reviewed.  A Deciding Officer determined that the Appellant’s daughter did not require full time care and attention and consequently the Appellant was found to be no longer entitled to Carer’s Allowance. The Appellant appealed this decision.  The Appeal was disallowed by an Appeals Officer on 20 June 2014. The decision was made on a summary basis; that is, without an oral hearing.

The Appellant subsequently sought a review of the Appeals Officer’s decision under Sections 317 and 318 of the Social Welfare (Consolidation) Act 2005 (as amended). The Appeals Officer revised his decision and the appeal was allowed on 10 April 2015.

Social Welfare Appeal G0061

This case relates to the Appellant’s Carer’s Allowance (CA) claim in respect of her son for whom she cares.

The Appellant had been in receipt of Carer’s Allowance and Domiciliary Care Allowance [DCA] in respect of her son until the 15th May 2013. At this time, the Appellant’s son reached aged 16, and therefore, in accordance with the relevant statutory provisions, the Appellant could no longer claim DCA. The Appellant’s son subsequently applied for, and was refused, Disability Allowance.  Following a successful appeal, Disability Allowance was awarded. The Disability Allowance appeal was allowed on 30th April 2014.

At the time when the DCA payment ceased, the Appellant’s eligibility for Carer’s Allowance was reviewed.  It was decided that the Appellant’s son did not require full time care and attention as set out in the relevant legislation. The Appellant appealed the decision.  The Appeal was disallowed by the Social Welfare Appeals Office on the 13th January 2014. The decision was made on a summary basis; that is, without an oral hearing.

The Appellant subsequently sought a review of the Appeals Officer’s decision under Sections 317 and 318 of the Social Welfare (Consolidation) Act 2005 (as amended). The Appeals Officer revised his decision and the appeal was allowed on the 6th August 2014.

Social Welfare Appeal G0019

The Appellant applied for Carer’s Allowance in 2008. The Appellant applied for Carer’s Allowance as he was the carer of his elderly mother, with whom he lived. The Deciding Officer refused the claim on the basis that the Appellant worked outside the home for more than 15 hours per week. The Appellant appealed the decision. He submitted that he worked outside the home for only 13 to 14 hours per week. The Appeals Officer partially allowed the appeal.

Social Welfare Appeal G0008

Carer’s Allowance claim. The Appellant (the carer) cares for his wife who is in receipt of Disability Allowance.

The Appellant applied for Carer’s Allowance in September 2005 and was refused on the grounds that the evidence did not support his claim that his wife required “continual supervision” to meet her needs. The Appellant appealed the decision. The Appeal was disallowed.

Social Welfare Appeal G0003

The applicant appealed a Deciding Officer’s decision in relation to the award of a 50% increase in her Carer’s Allowance in respect of her care for her autistic child backdated to 6 months prior to the receipt of the application. Appellant would like to have the claim backdated to at least 11 or 13 years ago on the basis that her son had been misdiagnosed at that time; Arrears were granted back to the date on which the child reached 16 years of age; consideration to further backdating was brought before the HSE.