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Internal Guidelines used in processing claims Table of contents: Description of scheme Information Leaflet Legislation Administration Qualifying Conditions Medical Conditions Habitual Residency Condition Rates of payment Method of payment Duration of payment Half rate payment Hospital stays Absences from state Respite payment How to apply Late claims Where to apply The Application Process Decisions/Review and the right of appeal Description of Scheme: Domiciliary Care Allowance (DCA) is a monthly payment for a child, aged under 16 with a severe* disability who requires ongoing (continual or continuous) care and attention, substantially* over and above the care and attention usually required (in excess of that required) by a child of the same age. The child is likely to require full-time care and attention for at least 12 months. There are no PRSI conditions and it is not means tested. *The definitions used for terms such as severe or substantial in this qualifying condition are detailed in the DCA Medical Guidelines used by the Department in assessing applications for DCA. These can be found on www.welfare.ie Information Leaflet: Domiciliary Care Allowance - SW127 available from Intreo Centres, Citizens Information Centres, on www.welfare.ie or from DCA Section Sligo. Legislation The DCA scheme is a statutory scheme with the primary legislation provided for in the Social Welfare and Pensions Act 2008. The medical criteria as set out in the Act require that "the child has a severe disability requiring continual or continuous care and attention substantially in excess of the care and attention normally required by a child of the same age". The Department uses a set of consistent and objective guidelines** in determining the medical eligibility of children for the scheme. These guidelines were drawn up by a Group chaired by the Department’s Chief Medical Advisor comprised of senior medical personnel from the HSE as well as eminent professionals in the areas of physical disabilities which affect children, and child psychiatry/psychology. All claims are assessed by designated Departmental Medical Assessors who have received special training in Human Disability Evaluation. **These guidelines were originally published in 2009, reviewed and revised in May 2013 and operational in their revised format from date of publication. Administration: The scheme is administered from the Social Welfare Services Office, College Road, Sligo. Qualifying Conditions: You may qualify to receive the allowance for a child under 16 with a disability if: - you are providing for the care of the child, - the child meets the medical criteria, - the level of care is likely to be required for at least 12 months, - Both you and the child are ordinarily resident in the State. This means that you both live in the Republic of Ireland and only leave Ireland for holidays, - the child normally lives at home with you for at least 5 or more days a week, and - the child is not detained in a children's detention school, in residential care or other placement. - Payment is not made for a child who lives full time in residential care or in other placements. However, a half rate payment can be made for a child in residential care, who goes home for two or more days a week. For example, a child who attends residential services from Monday to Friday and goes home at weekends. Medical Criteria In order to qualify for DCA a child must have a disability so severe that it requires the child needing care and attention and / or supervision substantially in excess of another child of the same age. This care and attention must be given by another person, almost all of the time, so that the child can deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months. Eligibility for DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. As such it is not possible to say if a particular child or any particular condition/disability will qualify for a payment under the scheme. Each application is assessed on an individual basis taking account of the evidence submitted. The Department's Medical Assessor will take the following into account before giving his/her opinion on whether the child meets the medical criteria: - Review the history of the case - Consider all medical reports received - Have regard to the description of the care and attention required by the child given by the parent/guardian. Habitual Residency Condition In addition, the person claiming the allowance for the child must provide for the care of the child and also be habitually resident in the State. The term "habitually resident" is not defined in either Irish or EC law, but it is intended to convey a degree of permanence evidenced by a regular physical presence enduring for some time, beginning at a date usually in the past and intended to continue for a period into the foreseeable future. It implies a close association between the applicant and the country from which payment is claimed and relies heavily on fact. The following are the five factors taken into consideration in relation to Habitual Residency: - Length and Continuity of residence in Ireland or in any other particular country - Length and purpose of any absence from Ireland - Nature and pattern of employment - Applicant's main centre of interest - Future intentions of applicant as they appear from all the circumstances. Rates of payment: The DCA rate is €309.50 per month (2010). There is no restriction on the number of children in respect of whom DCA can be claimed. Method of Payment: Payment is made on the third Tuesday of every month for the current month. Payment maybe made through a Post Office of the applicant’s choice by Social Welfare swipe card (E.I.T.), alternatively, the allowance may be paid by electronic fund transfer (E.F.T.) into his/her account in a financial institution. Any arrears of payment due may be included in the normal method of payment or paid by cheque. Duration of Payment DCA and increases for qualified child/ren are payable as long as all the qualifying conditions are satisfied and the person is not disqualified from receipt of the Allowance e.g. ceases to provide full-time care and attention, the child reached age 16, or leaves the State. Half rate payment Children who are being cared for on a full time basis in residential homes or other institutions are not eligible for the allowance. However, children in residential care who go home may receive a half rate payment if they are at home for 2 days or more a week, for example, a child who attends residential services from Monday to Friday and goes home at weekends. Hospital stays Payment may continue for up to 13 weeks if the child is getting medical or other treatment in hospital. 13 Absences from the state: The allowance is not payable in respect of any perios that the child is living outside the state. Respite Payment You will also qualify for a Respite Care Grant; this is an annual payment to persons who provide full-time care and attention to others and is paid in June of each year. You do not have to apply for this grant but will receive it automatically if in receipt of DCA in June. This grant is paid at a fixed amount per eligible child. How to apply To apply, fill in a Dom Care 1 form which can be downloaded from www.welfare.ie or text "FORM DCA" followed by your name and address to 51909 (from the Republic of Ireland only). Standard text rates apply. Application forms are available in Intreo Centres or Citizens Information Centres. You should complete Parts 1 to 5 of the application form and have your child’s G.P./Specialist complete parts 6 and 7 (the medical section). Please ensure that you attach any reports or assessments relevant to your child’s disability and the impact it has on their care needs. If your child has a pervasive development disorder (PDD) (see below), you are advised to have the medical professional/specialist dealing with your child complete an additional medical form Dom Care 3 available on www.welfare.ie. The completed form will detail your child’s conditions, any specific care needs your child might have as a result of their disability and will assist the Department’s medical assessor in forming an opinion on eligibility. Pervasive Development disorder (PDD) refers to a group of disorders characterized by delays in the development of socialization and communication skills. Autism, Asperger’s Syndrome, Childhood Disintegrative Disorder and Rett’s Syndrome are generally referred to under this category. Late Claims - You should apply as soon as you consider that you and your child satisfy the qualifying conditions Office. Note: If you delay in applying, you will, subject to satisfying the qualifying conditions for the scheme, usually get Domiciliary Care Allowance from the month after we get your application. If some circumstances the payment can be back-dated for 6 month if good cause for the delay in applying can be shown. Where to apply Application forms and supporting documentation should be sent to: Domiciliary Care Allowance Department of Social Protection College Road Sligo The Application Process - Departments Website, www.welfare.ie, any SWLO, Citizens Information Centre, DCA Section in Sligo or by texting 51909. - Complete the application form Dom Care 1, and have your GP/Specialist fill in the medical section of the form, include medical reports or other supporting documentation that you think helps explain your child’s care needs. - Please note that as your child will not be physically examined by the medical assessor (MA) (they assess your child’s care needs based on the medical and other information you provide), it is IMPORTANT that you detail your child’s care needs in a comprehensive but concise manner. This will ensure the MA will have all the necessary information available to them. - If you child has a pervasive developmental disorder (PDD), e.g. Autism Spectrum Disorder, you are advised to complete an additional medical form, Dom Care 3, which is available on www.welfare.ie or from DCA Section Sligo. This form should to be completed by a medical professional/specialist dealing with your child. It will detail the child’s condition(s) and any specific care needs the child might have as a result of their disability and will assist the Department’s MA in forming their opinion. - If you give us a mobile phone number, we will send you a text message to confirm receipt of your application by the Department. - Your application, including any additional information you provide, will then be examined by one of the Department’s medical assessors, who will provide an opinion to the deciding officer as to whether your child meets the medical criteria for the scheme. - If the additional form “Dom Care 3” is not received and is considered desirable/necessary by the MA, a decision will not be made until we contact you to see if you want to submit this form. If a completed form has not been provided in a reasonable time frame the MA will proceed to make a decision. - The deciding officer having received the opinion of the medical assessor will consider the application in its entirety and make a decision on whether you qualify for DCA or not. You will receive notification of the Deciding Officer’s decision in writing. (We will write to inform you of the decision.) - In the notification you receive, you will be advised of the Deciding Officer’s decision. If the application is allowed you will be advised when and how payment will be made and when your entitlement may be reviewed. If the decision is to disallow your application, you will be told the reason for the disallowance and given the right to have the decision reviewed and/or you can appeal the decision directly to the Social Welfare Appeals Office (SWAO). - In the case of PDDs - Where the decision of the deciding officer is that you do not qualify for DCA, a detailed assessment form can be provided to document the areas that were considered by the MA in forming their opinion. - Should you request a review of or appeal a disallow decision, your application will be sent for a review opinion by another medical assessor, together with any new or additional medical or other information received. - When the medical assessor’s opinion is known, a revised decision will be considered by the deciding officer if necessary. - If you appeal the case, the appeals officer in reaching their decision will provide a reason for their decision in each case, for your information and that of the deciding officer. Decisions/Reviews and the right to Appeal Claims are decided by Deciding Officers appointed by the Minister under Section 299 of the Social Welfare (Consolidation) Act 2005. They are independent in the exercise of their function in deciding on entitlement to DCA. A written notification of the decision is issued to the claimant. Claimants are also advised of their right of appeal against a Deciding Officer's decision. Any decision of a Deciding Officer may be subsequently revised by a Deciding Officer in the light of new information or evidence. This could arise where new information is made available as part of an appeal by the claimant. In such circumstances, a Deciding Officer may revise a decision on entitlement, if it is to the advantage of the claimant. There is also a right of appeal against a revised decision. In the case of an application which is refused on medical grounds, the applicant may submit additional information and/or ask for the case to be reviewed by a different Medical Assessor specially designated for this task. Where a person is not satisfied with the decision of a Deciding Officer they may appeal the decision to the Social Welfare Appeals Office. The appeal should be made by writing to the Chief Appeals Officer, Social Welfare Appeals Office, D'Olier House, D’Olier Street, Dublin 2, within 21 days of notification of the Deciding Officer's decision, stating the grounds of appeal. The Appeals Officer can decide the matter summarily or may deal with the case by way of an oral hearing. A statement is prepared on the facts relied on by the Deciding Officer in the making of a decision on entitlement to DCA and on the extent to which the facts and contentions advanced by the appellant are admitted or disputed. This statement is put before the Chief Appeals Officer.
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Eolas Íocaíocht mhíosúil is ea an Liúntas Cúram Baile a dhéantar le cúramóir linbh a bhfuil míchumas trom air a chiallaíonn go bhfuil i bhfad níos mó cúraim agus aire agus/nó maoirseachta de dhíth air ná leanbh eile den aois chéanna. Caithfear an cúram agus aire seo a sholáthar le cur ar chumas an linbh déileáil le gníomhaíochtaí laethúla. Caithfidh sé a bheith dealraitheach go mbeidh an leibhéal cúraim agus aire seo de dhíth ar an leanbh ar feadh 12 mhí ar a laghad. Is féidir leat na sainmhínithe ar théarmaí amhail trom nó go substaintiúil a fháil i dTreoirlínte Míochaine an Liúntais Chúram Baile (DCA) (pdf). Bíonn siad sin in úsáid ag an Roinn Coimirce Sóisialaí agus iarratais ar DCA á measúnú aici. Sonraítear sna treoirlínte nach bhfuil an íocaíocht bunaithe ar an gcineál míchumais ach go bhfuil sí bunaithe ar an lagú iarmhartach fisiciúil nó meabhrach a fhágann go dteastaíonn cúram agus aire ón leanbh atá ar mhéid atá níos mó go substaintiúil ná leanbh eile den aois chéanna. Bhí an Liúntas Cúram Baile á riar ag Feidhmeannacht na Seirbhíse Sláinte sular aistríodh chuig an Roinn Coimirce Sóisialaí é. Is féidir leat freisin an bhileog faisnéise le haghaidh DCA (SW127) a léamh. Tá an bhileog faisnéise ar fáil ó ionad Intreo nó ó Sheirbhís um Fhaisnéis do Shaoránaigh. Rialacha Le go mbeidh sé incháilithe, ní mór míchumas trom a bheith ar an leanbh is dócha a mhairfidh bliain ar a laghad agus: - Ní mór dó a bheith faoi bhun 16 bliana d’aois, (in aois a 16, féadfaidh an leanbh cur isteach ar Liúntas Míchumais) - A bheith ina chónaí sa bhaile leis an duine a bhfuil an liúntas á éileamh aige ar feadh 5 lá nó níos mó in aghaidh na seachtaine - féach ‘Íocaíocht ar leathráta’ thíos - Na critéir liachta a chomhlíonadh - féach thíos - A bheith ina ghnáthchónaí sa Stát. Lena chois sin, caithfidh an duine a bhfuil an liúntas á éileamh don leanbh aige: - Socruithe a dhéanamh le haghaidh cúram an linbh - A bheith ina ghnáthchónaí sa Stát. Critéir Liachta Sonraítear sa reachtaíocht nach mór do leanbh bheith faoi “mhíchumas trom a éilíonn cúram agus aire leantach nó leanúnach is mó go substaintiúil ná an cúram agus an t-aire a theastaíonn ó leanbh den aois chéanna” chun cáiliú le haghaidh Liúntas Cúram Baile. Ciallaíonn sé sin nach bhfuil incháilitheacht le haghaidh Liúntas Cúram Baile bunaithe ar an gcineál lagaithe nó galair. Ina ionad sin, tá sí bunaithe ar easpa feidhme iarmhartach an choirp nó na meabhrach a fhágann go dteastaíonn cúram breise agus aire bhreise ón leanbh. Caithfidh an cúram agus an t-aire sin bheith ag teastáil chun ligean don leanbh déileáil le gníomhaíochtaí na maireachtála laethúla. Caithfidh gur dócha go dteastóidh an leibhéal sin cúraim agus aire ón leanbh ar feadh 12 mhí ar a laghad. Cuirfidh Measúnóir Liachta na Roinne an méid seo a leanas san áireamh sula dtabharfaidh sé/sí a thuairim nó a tuairim maidir le cibé an gcomhlíonann an leanbh na critéir liachta: - Athbhreithniú ar stair an cháis - Gach tuairisc liachta a fhaightear a bhreithniú - Aird a thabhairt ar an gcur síos ar an gcúram agus ar an aire a bhíonn ag teastáil ón leanbh agus a thugann an tuismitheoir/caomhnóir. Íocaíocht ar Leathráta Níl leanaí atá atá ag fáil cúraim ar bhonn lánaimseartha in ionaid chónaithe nó in institiúidí eile incháilithe don liúntas. Féadfaidh leanaí in ionaid chúraim chónaithe a théann abhaile íocaíocht ar leathráta a fháil áfach má bhíonn siad sa bhaile ar feadh 2 lá nó níos mó in aghaidh na seachtaine, mar shampla, leanaí a théann abhaile ag an deireadh seachtaine. Athbhreithnithe agus achomhairc Má dhiúltaítear do d’iarratas, féadfaidh tú faisnéis bhreise a chur isteach agus a iarraidh go ndéanfar athbhreithniú ar an gcinneadh. Déanfar cinneadh athbhreithnithe más gá. Mura bhfuil tú sásta le toradh an athbhreithnithe sin nó más mian leat achomharc a dhéanamh go díreach gan athbhreithniú, féadfaidh tú achomharc a dhéanamh chuig an Oifig Achomhairc Leasa Shóisialaigh neamhspleách. Rataí Is é an ráta don Liúntas Cúram Baile ná €309.50 in aghaidh na míosa. Níl aon srian ar líon na leanaí a bhféadfar Liúntas Cúram Baile a éileamh ina leith. (Is é sin le rá, má tá tú ag tabhairt cúraim do bhreis agus leanbh amháin atá incháilithe don Liúntas Cúram Baile, féadfaidh tú an liúntas míosúil a éileamh do gach duine díobh). Déantar íocaíocht ar an tríú Máirt de gach mí don mhí reatha. Sealanna in ospidéal Féadfaidh íocaíocht leanúint ar aghaidh ar feadh tréimhse suas go dtí 13 seachtaine má bhíonn cóir leighis nó cóireáil eile á fháil ag an leanbh in ospidéal. Íocaíochtaí eile Níl aon bhaint aige seo leis an teidlíocht ar Shochar Leanaí agus féadfaidh tuismitheoir nó cúramóir eile a bheith incháilithe do Shochar Cúramóra nó do Liúntas Cúramóra freisin má chomhlíonann siad na coinníollacha eile. Féadfar Deontas Cúraim Faoisimh a éileamh freisin, rud a íoctar go huathoibríoch gach bliain i rith an Mheithimh. Conas iarratas a dhéanamh Chun iarratas a dhéanamh, comhlánaigh foirm Dom Care 1 nó téacsáil “FORM DCA” agus d’ainm agus do sheoladh ina dhiaidh chuig 51909 (bíonn rátaí caighdeánacha téacs i bhfeidhm). Is féidir leat foirm iarratais a fháil i d'Ionad Intreo ó d’Oifig Leasa Shóisialaigh áitiúil nó san Ionad Faisnéise do Shaoránaigh freisin. Ba chóir duit Codanna 1 go dtí 5 den fhoirm iarratais a chomhlánú agus iarraidh ar lia-chleachtóir ginearálta do linbh codanna 6 agus 7 a chomhlánú. Bí cinnte le do thoil go gceanglaíonn tú aon tuarascálacha nó measúnuithe a bhaineann le míchumas do linbh. Tabhair faoi deara: Má tá Neamhord Forleatach Forbraíochta (PDD) ar leanbh, moltar duit iarraidh ar an ngairmí/speisialtóir míochaine atá ag déileáil le do leanbh foirm míochaine bhreise darb ainm DomCare3 (pdf) a chomhlánú. Beidh mionsonraí san fhoirm chomhlánaithe faoi riochtaí do linbh agus faoi aon sainriachtanais chúraim a d’fhéadfadh a bheith ag do leanbh de bharr a mhíchumais/míchumais agus cabhróidh an fhoirm chomhlánaithe le measúnóir míochaine na Roinne teacht ar thuairim faoi incháilitheacht. Tagraíonn Neamhord Forleatach Forbraíochta (PDD) do ghrúpa neamhord arb iad moilleanna ar an bhforbairt scileanna sóisialaithe agus cumarsáide is tréithe dóibh. Tagraítear d’uathachas, do shiondróm Asperger, do Neamhord Dítháthaíoch sa Luath-Óige agus do Shiondróm Rett faoin gcatagóir seo go ginearálta. Cad a tharlaíonn nuair a bhaineann mo leanbh aois 16 bliana amach? Cuirtear stop leis an LCB nuair a bhaineann leanbh 16 bliana d’aois amach, mar sin, déanfar d’íocaíocht dheireanach LCB do mhí a mbreithlae 16 bliana. Scríobhfaidh an Roinn Coimirce Sóisialaí chugat 3 mhí roimh bhreithlá 16 bliana do linbh lena mheabhrú duit go gcuirfear deireadh leis an LCB sin agus cuirfear ar an eolas thú ar na roghanna atá ar fáil. Ag aois 16 bliana, féadfaidh do leanbh iarratas a dhéanamh ina gceart féin ar Liúntas Míchumais (LM). Íocaíocht ar a ndéantar tástáil mhaoine is ea an LM do dhaoine atá faoi mhíchumas, a bhfuil cosc substaintiúil orthu chun tabhairt faoi obair a bheadh oiriúnach do dhuine ar a n-aois féin, a bhfuil an taithí agus na cáilíochtaí céanna acu, mar thoradh ar a míchumas. Is éagsúil coinníollacha cáilithe don LM ó choinníollacha cáilithe don LCB, mar sin, níl do leanbh i dteideal an LM a fháil go huathoibríoch mar gheall go raibh an LCB á íoc. Ba cheart do do leanbh iarratas a dhéanamh cúpla mí sula mbaineann siad 16 bliana amach, chun roinnt ama a thabhairt go bpróiseálfar a n-iarratas. Cuirfear stop le do theidlíocht do Liúntas Cúramóra nuair a chuirfear stop leis an LCB. Féadfaidh tú athiarratas a dhéanamh ar Liúntas Cúramóra, ach déanfar measúnú nua ort. Cá háit a ndéanfaidh mé iarratas Ba chóir d’fhoirm iarratais agus doiciméid a thacaíonn léi a sheoladh chuig: Liúntas Cúram Baile Oifig na Seirbhísí Leasa Shóisialaigh Roinn Coimirce Sóisialaí Bóthar an Choláiste Sligeach Láithreán Gréasáin: http://www.welfare.ie Is féidir leat ríomhphost don Rannóg Liúntas Cúram Baile a sheoladh tríd an fhoirm fhiosraithe a úsáid. Más mian leat labhairt duine-le-duine faoi do theidlíochtaí, is féidir leat cuairt a thabhairt ar d'ionad Faisnéise do Shaoránaigh áitiúil, oifig leasa shóisialaigh áitiúil nó ionad Intreo.