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Illness Benefit - Case 2

Question At Issue:

Late claim and backdating to late 2004/early 2005.

Background:

The appellant came to Ireland from his native Lithuania in April 2004. He was a victim of an assault on the October Bank Holiday 2004 and suffered a knee injury which occasioned two disability benefit claims. The claims were submitted late and his application for retrospective payment was disallowed.

Oral Hearing:

The appellant attended alone. The question at issue was explained and the Appeals Officer also explained the circumstances in which retrospection of claims could be allowed.

The appellant stated that at the time when he should have submitted his disability benefit claims his English was poor and he may have misunderstood instructions given to him by staff of the Department. He said that his English had improved since.

The appellant went on to give details of the assault during which he sustained a knee injury. He said that the assault had been reported to the Gardai. Immediately after this incident he had grave difficulty in walking and was unable to continue with his work. He attended his doctor and was told that he needed keyhole surgery to repair the damage to his knee. It would have taken several months for this surgery to be carried out in Ireland, so after a short holiday which had been booked and paid for before the assault, he returned to Lithuania where the keyhole surgery was done immediately and he was able to return to Ireland in early December 2004. He resumed work in January 2005. While off work between the date of the assault in October 2004 and his resumption in January 2005 he was paid by his employers.

Consideration of the Appeals Officer:

The appellant was convincing in his presentation of his evidence and there seemed to be no doubt that his knee injury was caused in the mugging incident. The Appeals Officer considered that this incident constituted force majeure particularly for somebody who had poor English and was not in their native country at the time the assault took place. In the circumstances, the Appeals Officer was prepared to allow retrospection of the claim.

Outcome:

Appeal allowed.

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