Submission 2003

Review of Income Maintenance Payments for People who are Ill and People with Disabilities

Introduction

Comhairle is responsible for the provision of information, advice and advocacy on social and civil services. Comhairle's brief includes the provision of information to people with disabilities. Comhairle provides comprehensive information on rights and entitlements through a number of routes but primarily through the OASIS and CID databases. Comhairle supports the network of Citizen's Information Centres and the Citizen's Information Call Centre as public access points to information.

Comhairle contributes to the development of social policy by using feedback from the users and providers of information and advice services to highlight issues that are of concern to users of social and civil services.

Preliminary reports show that during 2002 the 85 CICs countrywide dealt with over 468,000 queries from the general public. Queries relate mainly to the following areas:

• Social Welfare 43%
• Employment 16%
• Health 11%
• Nationality related issues 11%

Of the social welfare queries, 12% were related to disability payments. Just half of all health queries were concerned with medical cards and almost half of the employment related queries involved employment rights or redundancy.

The National Anti-Poverty Strategy sets out a long term strategy for social welfare payments. Comhairle believes that a long term social welfare strategy should also be set out to deal with issues relating to the structure of the social welfare system rather than the level of existing payments. Such issues include the absence of a cost of disability payment, the disincentives to work inherent in the operation of various payments for training for people with disabilities and disincentives to continuing education. This was addressed in detail in Comhairle's Pre-Budget Submission 2002.

Income Support

Cost of Disability Payment

A recent study in the UK by Zaidi and Burchardt 2003, concludes that “the extra costs of disability are substantial, especially for disabled people living alone and these extra costs rise with severity of disability” It also states that “These are important findings since they have implications for the adequacy of disability related state benefits and for devising poverty thresholds when comparing poverty across people with varying severity of disability”.

Disability payments at present make no provision for aids and appliances, extra medical costs or transport and travel even though people with significant disabilities may incur higher costs and expenses in all of these areas. Most Social Welfare payments and concessions cease when a person gets a full-time job, yet people with significant disabilities may have extra costs even if they succeed in finding employment. Disability allowances at present are set at levels similar to UA taking no account of the extra costs of disability, which a person on UA does not incur. In the UK there is a Disability Living Allowance and an Attendance Allowance. The only concessions here are the Households Benefits Package and transport schemes, although the latter are restrictive. All groups dealing with disability concur with the view that a cost of disabilities payment is essential for promoting independent living. A long-term plan could be put in place to introduce such a payment.

Transport /Mobility Payments

In Comhairle's submission to the Inter-Departmental Review Group, on the Disabled Drivers' and Disabled Passengers' (Tax Concessions) Scheme, we argued that the scheme should not be viewed in isolation from other transport/mobility schemes for people with disabilities and should also be reviewed in the context of a possible Costs of Disability payment. The initial outlay required to purchase a vehicle (even without tax) means that this scheme does not benefit disabled people at the greatest disadvantage. The medical conditions are very restrictive. We consider that there should be a transport/mobility subsidy available to a much wider group of people with disabilities.

The Motorised Transport grant is currently available mainly to employed people with disabilities. The qualifying criteria for this grant should be clarified for people who are undertaking training and for people living in isolated areas.

The Mobility Allowance is low relative to current taxi charges and the means test criterion is not totally clear. People over 66 may not apply for it although they may retain it if they have been awarded it earlier. This is unfair as many over 66 are likely to need it. This condition arbitrarily discriminates on the basis of age.

Medical card income guidelines and Social Welfare Payments

The social welfare increases over the past two years in particular have resulted in many people whose only income is a social welfare payment having an income in excess of the relevant medical card income guideline. Medical card income guidelines have not kept pace with social welfare increases.

Earlier in 2002, the Minister for Health and Children said that nobody should lose a medical card because of the increase in social welfare payments. However, evidence from CICs suggests that the Minister's corrective action in relation to social welfare recipients was not actually implemented by the Health Boards in a number of cases. This situation is clearly inequitable.

Sickness Allowance

Currently there is no short-term sickness/disability payment for people who do not qualify for Disability Benefit. The only option for them is to apply for Supplementary Welfare Allowance. Comhairle recommends that a short-term sickness / disability allowance be put in place as provided for in the 1997 Social Welfare Act.

Simplification

Short term and long term benefits

We accept that there is logic to the general distinction between long term and short-term benefits and that the extra benefits attached to long-term beneficiary status are appropriate. However, a small number of people are still treated as short-term beneficiaries (due to the number of PRSI payments made prior to making claim) even though they are long term beneficiaries in terms of length of time on benefits – these are people on Disability Benefit for a year or more who do not qualify for Invalidity Pension. They should be reclassified as long term beneficiaries and qualify for the related benefits.

Comprehensiveness and Consistency

Disability Allowance for people in long stay care

A number of people with disabilities who have been in long stay care for some time are still not eligible for Disability Allowance. This constitutes a severe injustice in that they have no income and they are being treated unequally relative to people who came into long stay care later. The continuing injustice of certain people in long stay care being excluded from the Disability Allowance should be rectified.

For those in long stay care who are in receipt of a Disability Allowance the amount of the allowance that is contributed towards the cost of care and the portion that is retained for personal expenses should be clearly stated. However, Comhairle does acknowledge the attention currently being paid to this matter by the DSFA.

Support to Work

Disincentives to Work

There is a basic contradiction between the conditions for getting a disability payment and “the official encouragement” to such people to return to the workforce. The basic condition for all disability payments is that the person is unable to work – for Invalidity Pension that they have to be ‘permanently unable to work' yet Back to Work schemes target people on Disability Benefit, Disability Allowance, and Invalidity Pension.

If the either/or nature of the inability to work condition was amended it might be possible for people to access a half rate disability payment and make up the rest themselves from employment, without any cap or conditions as to the “therapeutic nature” of the work. A model exists in the Occupational Injuries Disablement Benefit. Any work a person can undertake is likely to be therapeutic. Many people with mental health problems and debilitating illnesses such as multiple sclerosis are able to work, but only on a part-time basis, or they may have periodic absences. In the absence of a Costs of Disability payment a long-term partial disability payment might give them security without taking away their incentive to work. The cap on therapeutic earnings also leads to anomalies and inequities in sheltered employment situations where an enterprise can be profitable but cannot afford to offer increased wages in case workers lose their allowances.

Community Employment schemes have been an important source of income and inclusion for people with disabilities and the places available to them on such schemes should be safeguarded. Also the employment support services currently operated by FÁS should be more actively promoted

Many people with learning disabilities or mental health problems are unwilling to try working full time because they fear not being able to return to Disability Allowance if the job does not work out for them. Assurances in relation to being able to return to Disability Allowance need to be more clear-cut.

Lack of accessible transport is a considerable disincentive to return to work and restricts employment opportunities for people with disabilities.

Loss of Secondary benefits a disincentive

The possible loss of secondary benefits is also a considerable work disincentive to people on disability payments. The rent supplement and medical card are the chief benefits which people with disabilities fear losing. Rent supplement is particularly problematic if a person needs special accommodation. If a person has suitable accommodation funded by a Rent Supplement, it may be uneconomic for him/her to accept any but a well-paid job.

People with disabilities who have substantial medical costs should be able to retain their medical card for a longer period after returning to work. The Cost of Disability Payment previously mentioned would alleviate many of the disincentives to work inherent in the present system.

Training

People with disabilities should be encouraged to work in the same way as all other groups. At present, there are disincentives inherent in the disability payments systems.

People who go onto training courses are treated differently depending on whether they are getting Disability Benefit (DB) or Disability Allowance (DA). People on DA lose their DA and get a training allowance and training bonus while DB people get a training allowance plus their DB. People on DA need an incentive to go on training courses, at present the training bonus just about covers the extra costs involved.

Conditions for people in supported employment should be clarified. In all cases people with disabilities should be afforded the same employment rights as other workers.

Supplementary Welfare Allowance

Supplementary Welfare Allowance (SWA) and Exceptional Needs Payments are not available to people who work more than 30 hours. There should be an income limit rather than an hours worked limit for entitlement to SWA and Exceptional Needs Payments, as low paid workers with disabilities may require additional supports. Again the Cost of Disability Payment would eliminate the need for change here. The report of the review group on the SWA scheme should be published.

Poverty and Social Exclusion

Independent Living Services / Personal Assistance

In the absence of adequately resourced Independent Living and Personal Assistance services the home help service is being used inappropriately, often as an ineffective stop gap or in the management of crisis situations. Better-resourced Independent Living Services need to be put in place if disabled people are to have equal access to education, training and employment. In some areas there is insufficient funding for even the basic home-help service.

Disabled Person's Housing Grant

CIC feedback reports that a number of clients with varying disabilities living in privately owned accommodation are requesting information about changing their current heating systems to a more fuel efficient system. In a number of cases these clients are receiving assistance from the Society of Saint Vincent De Paul to meet their current heating expenses. The Disabled Person's Housing Grant should be extended to cover installation of fuel efficient heating systems. A new scheme such as the Home Energy Efficiency Scheme in the UK could be examined. This scheme is designed to provide grants to people who have a particular requirement for heat – for example, the chronically ill or people with specific disabilities.

Many Local Authorities have insufficient funding for the Disabled Person's Housing Grant resulting in long waits for necessary house-adaptations. In some local authorities the allocation was exhausted in the first six months of the year. More funding needs to be given to this scheme as it allows people with disabilities the opportunity to live more independent lives.

Delays in processing entitlements

Feedback from CICs provides evidence of long delays in decisions on various claims and services. There are particular delays in processing SWA claims, which in many cases constitute the only entitlement available to a person who is waiting for a long term benefit/allowance to be processed. This is obviously causing hardship and frustration among people who are entitled to payments but have to live without them for long periods of time. In the DSFA's Annual Report 2001 target and actual times for processing disability payments were as follows:

• Carer's Allowance 80% in 8 weeks 26% achieved
• Disability Benefit 90% in 1 week 74% achieved
• Disability Allowance 70% in 9 weeks 60% achieved
• Invalidity Pension 70% in 9 weeks 68% achieved.

The turnaround times shown for the Carers Allowance and for the Disability Allowance in particular suggest that a substantial number of people have to wait quite long periods for their entitlements. Comhairle recommends the introduction of an enforceable Charter of Customer Rights that would outline specific time limits for the processing of claims and appeals, as well as other basic standards of service.

Alternative Approaches

Independent Complaints and Appeals Systems

Comhairle regards statutory independent complaints and appeals machinery as an essential requirement of a customer focused public service. To enable this to work effectively there is a need for all service providers to clarify and publish the guidelines and administrative procedures to be followed.

In a recent submission to the review of the Social Welfare Appeals Office (SWAO) we reiterated our view that the SWAO provides a prototype of the independent statutory system, which we consider should be available in all areas. We recommended that the remit of that office be extended to those areas of social welfare in which it is not currently concerned such as administrative schemes – for example employment support schemes, the household benefits package, the back to work/education schemes and parts of the SWA scheme.

As well as formal appeals procedures, there is a need for complaints procedures to be available to citizens who feel they have been treated unfairly or discourteously. These procedures should be established in all state agencies dealing with a large public throughput as a matter of priority. There should be some external element to these procedures and their existence should be widely advertised.

Overall Recommendations

1. A Costs of Disability Allowance (non means tested) should be introduced to cover extra transport, heating, education and assistance costs for people with significant disabilities – to reduce disincentives to employment, training and education and to promote independent living;
2. Higher medical card thresholds should be introduced on Social Welfare Payments;
3. A short-term sickness / disability allowance should be put in place as provided for in the 1997 Social Welfare Act;
4. People on Disability Benefit for a year or more who do not qualify for Invalidity Pension should be reclassified as long term beneficiaries and qualify for related benefits;
5. The Disability Allowance should be introduced for all people in long stay residential care;
6. In the absence of a Costs of Disability payment, a long-term partial disability payment for people with disabilities who have a partial ability to work, could give security without taking away the incentive to work. Recipients would be free to work up to 19 hours a week and have earnings up to an agreed limit disregarded
7. The cap on therapeutic earnings can lead to anomalies and inequities in sheltered employment situations where an enterprise can be profitable but cannot afford to offer increased wages in case workers lose their allowances. This situation needs to be examined;
8. Specific disincentives to work for people on disability and long term illness payments need to be examined and removed;
9. In all cases people with disabilities should be afforded the same employment rights as other workers;
10. There should be an income limit rather than an hours worked limit for entitlement to SWA and Exceptional Needs Payments, as low paid workers with disabilities may require additional supports;
11. Better resourced Independent living Services along with better personal assistance and home help services should be provided for people with disabilities and long term illnesses;
12. The Disabled Person's Housing Grant needs to be more adequately funded to enable people with disabilities the opportunity to live more independent lives;
13. The long delays in processing claims is causing unnecessary hardship for many clients and additional resources should be put towards dealing with backlogs in the system;
14. Extension of the Disabled Person's Housing Grant to cover fuel efficient heating or the introduction of a scheme such as the Home Energy Efficiency Scheme in the UK should be considered. This scheme is designed to provide grants to people who have a particular requirement for heat – for example, the chronically ill or people with specific disabilities.
15. As well as formal appeals procedures, there is a need for complaints procedures to be available to citizens who feel they have been treated unfairly or discourteously. The SWAO provides a prototype of an independent statutory system, which we consider should be available in all areas.

Reference

Zaidi, Asghar and Burchardt, Tania, Comparing Incomes when Needs Differ: Equivalisation for the extra costs of disability in the UK, CASE Paper 64, February 2003