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The role of the Social Welfare Appeals Office

The main role of the Social Welfare Appeals Office is to provide a fair and independent appeals procedure where a person is dissatisfied with a decision given under the Social Welfare Acts by a Deciding Officer or a Designated Person about their entitlement to social welfare payments or the insurability of their employment.

The Appeals Office operates independently of the Department of Social Protection and is headed by a Chief Appeals Officer and has its own Appeals Officers who are themselves independent in their decision-making role.

While the issues that are dealt with on appeal are in the main based on legal provisions set out in the Social Welfare Consolidation Act 2005 and in the Social Welfare (Appeals) Regulations (S.I. No. 108 of 1998) the Social Welfare Appeals Office (SWAO) aims to deal with those issues in an informal manner. Therefore, while the issues that arise on appeal are of a quasi-judicial nature, the Social Welfare Appeals Office is not a court, but of course must, like all administrative bodies, observe the principles of natural justice and fair procedure. The Social Welfare Appeals Office aims to deliver the appeals service in a prompt, fair and courteous manner.

It should be noted that some decisions taken by officers of the Department of Social Protection are administrative in nature and are not open to appeal to the SWAO. Some examples of these include – Back to Education Allowance, Back to School Clothing and Footwear, Free Electricity Allowance, Free Travel, Free TV Licence and Exceptional/Urgent Needs Payments under the Supplementary Allowance scheme (a list is available on the Appeals website at www.socialwelfareappeals.ie).

In  2015 Annual Report, the Chief Appeals Officer provided a brief outline of the journey of an appeal once it is registered in the SWAO. In the course of the past year the CAO noticed that, despite the availability of information on our website and through information leaflets, many questions arose from people who had submitted an appeal or who were considering making an appeal in relation to other aspects of the appeals procedure. For this reason, it was decided to set out in summary form the answers to some of those questions that arose most frequently in the course of the year.

How to make an appeal

A person can make an appeal within 21 working days of receiving the decision of the Deciding Officer (about a payment of social welfare benefit or assistance, or insurability of employment) or the determination of the Designated Person (about a payment under the Supplementary Welfare Allowance scheme). The notification of the decision/determination on their entitlement will also advise of a right to appeal the decision.

A person can make an appeal by completing Form SWAO 1 which is available from local Intreo Centres or by downloading the form from the ‘Your Appeal’ area on this website: www.socialwelfareappeals.ie.

Alternatively, the grounds of an appeal may be set out in a letter or by email to: swappeals@welfare.ie.

The important thing is that the grounds of appeal are set out in full. An appeal may be sent directly to the Chief Appeals Officer at the address below or through any local Intreo Centre.

Chief Appeals Officer

Social Welfare Appeals Office

D’Olier House

D’Olier Street

Dublin 2.

Appellants should state their name, address and Personal Public Service (PPS) number and enclose:

• a copy of the decision/determination which is being appealed,

• a statement of the reasons why they are dissatisfied with the Department’s decision, and

• any relevant evidence that they think may support the appeal.

If any information or copies of documents that the Department used in making the decision is needed, the relevant scheme area of the Department of Social Protection should be contacted as early as possible to request a copy of the file (or relevant documents from the file) for the purposes of preparing the appeal.

Appellants should ensure that appeals are submitted within the 21 working day statutory timeframe – even if they are awaiting some supporting evidence (e.g. medical reports from a doctor) at that stage. They may indicate, in doing so, that they intend to send further supporting evidence when it becomes available.

The timeframe for submitting an appeal is within 21 working days from the date of the decision of the Deciding Officer or Designated Person. Failure to appeal within this timeframe may result in your appeal not being accepted. For this reason you should register your appeal as quickly as possible and at a minimum within the 21 day timeframe – even if you need to take some additional time to gather your supporting evidence or to seek advice from an advocate in finalising your appeal contentions. You can indicate in submitting your appeal that you intend to send further evidence in support of your appeal in the near future.

Can the period of 21 days be extended?

Clearly the legislature envisaged a short time-frame for submitting an appeal and this is for a very good reason – the experience of the Chief Appeals Officer is that issues under appeal become more complicated with the passage of time.

While the time-frame is short, the Chief Appeals Officer has discretion to accept an appeal after the expiration of the 21 working days provided for in legislation. The Chief Appeals Officer is not in favour of denying a person a right of appeal but  must also respect that the legislature set down a specific time-frame within which to make an appeal. There are no criteria set down in the legislation as to how that . Discretion can be applied and the decision to accept or reject an appeal will largely depend on the circumstances of each individual case. In order for the Chief Appeals Officer to accept an appeal outside that time-frame, the Chief Appeals Officer needs to know why an appeal was not submitted within the 21 working days. While it is easier to accept an appeal within a short period of time after the expiration of the 21 days provided for in legislation, it becomes more difficult to do so when a long period of time has elapsed.

Next Steps

When an appeal is registered in the Appeals Office, the appellant will receive an acknowledgement. The appeal must then be sent by the Social Welfare Appeals Office to the Department fof Social Protection or comment in accordance with the appeals legislation. The Deciding Officer or Designated Officer may change the decision/determination in the appellant’s favour at this stage, for example, in light of new evidence provided since the original decision was made. If the decision is not changed, the appeal will be returned to the Appeals Office for consideration by an Appeals Officer.

The Appeals Officer will make a decision based on the evidence available and taking account of the relevant scheme qualifying conditions which are set out in legislation.

This may be done on the basis of the written evidence only, or the appellant may be invited to attend an oral hearing. It is open to appellants to request an oral hearing when submitting an appeal. Such requests will usually be granted, unless it is clear that there is nothing to be gained from such a hearing.

Will there be an Oral hearing?

The Appeals Officer may decide to hold an oral appeal hearing to obtain more details about a case or to clarify points which are at issue in relation to the decision/determination which is under appeal. The appellant may wish to request an oral hearing because they wish to elaborate on some aspect of the evidence or they consider that they can better make their case if they have an opportunity to meet with the Appeals Officer in person. Appeals Officers make every effort to keep oral hearings as informal as possible. Should an oral hearing be required, the hearing will be held at a location as near as possible to where the appellant lives.

In what circumstances would a request for an oral hearing not be granted?

A request for an oral hearing will not be granted where there is no prospect that additional information could be provided that would affect the outcome of the appeal.

Examples of such types of appeal include the following:

• Appeals against assessment of means where the grounds of the appeal are that the assessment did not take into account certain specified expenses. If, in these cases, the scheme legislation does not allow for such expenses to be taken into account then an appeal on this basis would have no chance of success, regardless of whether or not an oral hearing was convened.

• Appeals relating to PRSI conditionality where a minimum number of contributions are required to qualify for a particular social welfare payment. If a person does not have sufficient contributions there would be nothing to be gained from an oral hearing.

Is there a charge for making an appeal?

There is no charge for making an appeal. If an appellant has to travel to attend an oral hearing, the Appeals Office will make a payment for reasonable travel expenses incurred. An appellant can also request compensation for any loss of earnings if they have to take time off work to attend the hearing.

Can an appellant be accompanied at the oral hearing?

Yes – an appellant may be accompanied or represented at the hearing.

An appellant may be accompanied by any member of their family, or, with the consent of the Appeals Officer, by any other person. However, the accompanying person must remember that it is the appellant’s appeal and the Appeals Officer will want to hear from the appellant personally.

Alternatively, an appellant may, with the prior consent of the Appeals Officer, be represented at the oral hearing by an advocate, public representative or any other person. The representative may, by agreement, give evidence at the hearing on the appellant’s behalf but again, the Appeals Officer will want to hear directly from the appellant, primarily.

Do appellants need to be legally represented?

There is no need for appellants to be legally represented to make an appeal or to attend an oral hearing, but it is of course open to them to be represented by a solicitor or another person. The Appeals Officer may make an award to any such representative towards the cost of their expenses. Any such award is limited to expenses incurred for actually attending the hearing. Any legal costs must be paid by the appellant.

What is the procedure at the hearing?

In general terms, the Appeals Officer is in charge of the oral hearing and will therefore determine the procedure. An appellant can expect that the Appeals Officer will have invited a person from the Department to attend the hearing along with any other person considered by the Appeals Officer to be concerned with the outcome of the appeal e.g. an employer where the issue relates to the insurability of employment.

An Appeals Officer may postpone or adjourn a hearing if he/she considers it necessary to do so.

 Is the Appeals Officer’s decision final?

The Appeals Officer’s decision is normally final and conclusive but may be appealed to the High Court on any question of law. However, it may be subject to review under specific provisions of the Social Welfare Consolidation Act 2005 in the following circumstances:

• under Section 317, by an Appeals Officer where new facts or evidence which are relevant to the original decision are brought to notice since the appeal decision was given, or

• under Section 318, by the Chief Appeals Officer where it is considered that the decision was wrong by reason of a mistake in relation to the law or the facts.

In making a request for a Section 317 review of an appeal decision, new evidence must be enclosed, or, if a Section 318 review by the Chief Appeals Officer is being sought, the appellant must give specific reasons why they believe a mistake has been made regarding the law or the facts.

Is an appellant entitled to claim Supplementary Welfare Allowance pending the outcome of their appeal?

If an appellant’s means are insufficient to meet his/her needs pending the outcome of the appeals process, the appellant should contact his/her local Intreo Centre to explore possible entitlement to Supplementary Welfare Allowance. This is a means tested payment and the appellant will be required to complete a separate claim form and provide evidence about means in order that a decision in relation to entitlement can be made. If the decision is not in the appellant’s favour, that decision can also be appealed to the Appeals Office. Supplementary Welfare Allowance appeals are prioritised for attention at all stages of the appeals process.

Even if the appellant does not qualify for a weekly Supplementary Welfare Allowance payment, he/she may wish to explore possible entitlement to an exceptional needs payment under the Supplementary Welfare Allowance scheme pending the outcome of the appeals process. Information in this regard is available at local Intreo Centres. There is no right of appeal to the Appeals Office if an appellant is refused an exceptional needs payment but an appellant can request that the refusal be reviewed within the Department.

Office of the Ombudsman

The Ombudsman can examine complaints about the everyday administrative activities carried out by the Appeals Office.

Office of the Ombudsman

18 Lower Leeson Street

Dublin 2

Telephone: 01 639 5600

LoCall: 1890 22 30 30

Website: www.ombudsman.gov.ie

Further Information

Further information can be accessed on our website: www.socialwelfareappeals.ie

or by email at swappeals@welfare.ie or by phone at LoCall: 1890 74 74 34. Persons can also call to our Office in D’Olier House, D’Olier St., Dublin 2.