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Tuesday 16 September 2014

Thousands on sick benefit ‘fit to work’ after medical checks

GPs admit problems with medical certs

Michael Brennan Deputy Political Editor

Published 29/08/2011 | 05:00

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MORE than 11,000 people had state illness benefits stopped last year after medical checks found they were fit to work, an Irish Independent investigation has found.

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The revelation came as a doctors' body admitted last night that there were major problems with the ease with which workers were able to get medical certificates from their GPs.

On the strength of these certificates, claimants were able to get payments of €188 a week and upwards, depending on family circumstances. But they subsequently lost the benefits after doctors working for the Department of Social Protection reassessed them.

The department's doctors examined 40,000 illness-related benefit claimants last year and found 11,600 -- almost one in three -- were capable of work.

They included those who claimed to be unfit for work due to back or neck problems, depression, stress, post-surgical complications and arthritis. All benefits were immediately cut off. However, very few were later prosecuted for fraud.

As well as the 40,000 claimants, a further 13,000 people were called for check-ups with department doctors, but did not show up. They also had their illness benefits cut off.

The Irish College of General Practitioners (ICGP) last night accepted the revelations raised questions over the professional standards of some doctors.

Spokesman Dr John Ball said: "Not every GP is doing this correctly. To be blunt, those figures are disappointing. They are not very good."

Dr Ball accepted that in some cases it was possible doctors were giving the illness certificates due to the long relationships built up with patients.

The 40,000 people were examined by the department's doctors to determine if they were entitled to stay on the three different state sick pay schemes -- illness benefits, invalidity pensions and incapacity supplements.

Around €1.6bn is paid out annually from the three schemes, with 133,000 claiming benefits last year.

Those who were found to be capable of work when checked were not automatically forced to pay the money back.

The department said not everybody whose benefits were stopped had committed a fraud because they may have genuinely believed they were ill in line with the advice from their own doctor. The assessments of the department doctors are also open to challenge, with 2,000 of those whose benefits were cut successfully appealing.

Last year, just four people were fined in court for illness benefit fraud and one offender was given the Probation Act.

Six further prosecutions have taken place so far this year, with two people being fined, two receiving suspended sentences and the other two being struck out. The revelations will raise questions over the way the system for sickness benefits works.

The system is designed to ensure that people who have made PRSI contributions and are too ill or sick to work are not left without any income.

Benefits can be claimed on the basis of a GP medical certificate and an application form.

It is only afterwards the department chooses people to summon for medical assessment, and even then not all are called for checks.

The disclosures will also focus attention on the role of GPs, who earn substantial income from the state sick pay schemes.

Value

Last year, GPs were paid €28.7m by the department for providing 3.1 million medical certificates and 65,500 medical reports, primarily in connection with illness benefits, invalidity pensions and incapacity supplements.

Social Protection Minister Joan Burton recently put the spotlight on GPs by highlighting their role in granting illness benefit payments.

But Ms Burton's department insisted it was getting value for money from GPs. "The department is quite satisfied with the service provided by medical certifiers," a spokesman said.

The department said there was scope for the GPs to have a different medical opinion to its own "specially trained" doctors.

It added that some claimants might have genuinely believed they were ill.

ICGP spokesman Dr John Ball said it was difficult for doctors to access the necessary diagnostic services for illness benefit claims -- with an MRI scan to prove a patient's back complaint taking several months to secure in a public hospital.

"To a large extent, we have to go on what the patient tells us," he added.

Irish Independent

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