Dáil Question on medical professional accountability to the Department of Social Protection

-   Alan Farrell TD

To ask the Minister for Social Protection if she will outline consequences for medical professionals who are found to be providing false information to her Department in relation to disability or illness benefit claims; and if she will make a statement on the matter.
Reply from Minister for Social Protection Joan Burton T.D.
GP’s and Hospital Doctors who have successfully registered with the Department are authorised to issue medical certs to customers who present themselves as unfit for work. They also complete medical reports for customers for the various illness and disability related schemes, as required. In the case of Illness Benefit, the Department initially accepts the GP’s opinion regarding medical eligibility for the scheme. However, as part of the review process the Medical Assessors carry out desk assessments of medical evidence/reports supplied by the medical professional and where required, conduct in person assessments in order to provide a second medical opinion to that of the certifying doctor for the guidance of Deciding and Appeals Officers.
The Medical Assessors employ evidence based medical protocols in completing their medical assessments of clients. These protocols provide comprehensive guidelines on a wide range of medical conditions/disorders. When conducting an assessment, the Medical Assessor does not dispute the existence of the certified cause of incapacity but rather s/he assesses the degree to which the loss of function in work-related activities resulting from the disease or injury, affects the person’s ability to perform either their own job or alternative types of work. Therefore when a Medical Assessor presents a medical opinion that a customer is not eligible for a scheme, this does not necessarily mean that he is contradicting the medical report completed by the GP for the customer or that there is any suggestion of falsification of information by the GP.
Any instances of irregular certification that come to light pertaining to the issue of Social Welfare Medical Certificates or completion of medical reports, are investigated by this Department. Following investigation, irregular certification action may have consequences which include the imposition of monetary penalties, termination of the Certifier’s agreement, or referral to the Medical Council or relevant body.

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