Claims and Late Claims

 

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Table of Contents

1. LEGISLATION GOVERNING CLAIMS

2. WHAT IS A CLAIM

  1. 2.1 Application forms and satisfying identity
  2. 2.2 Evidence of entitlement
  3. 2.4 Claims made in other countries
  4. 2.5 Discretion regarding what constitutes a claim
    1. Previous claim or enquiry prior to legislative change
    2. A Claim for a related Social Welfare Payment
    3. A Claim by a Qualified Adult
    4. A claim for a Child Dependant.
    5. Previous contact with the Department

3. CLAIMING WITHIN THE PRESCRIBED TIME

  1. 3.1 Date of claim
  2. 3.2 Disqualification for late claim
  3. 3.3 Claiming In Advance
  4. 3.4 Table of prescribed time and disqualification

4. BACKDATING LATE CLAIMS:

  1. 4.1 Good cause:
    1. Lack of Knowledge, incorrect advice from others
    2. Limitation on payment
  2. 4.2 Information given by Department
  3. 4.3 Repayment of amounts due arising from false or misleading statements or wilful concealment of facts.
  4. 4.4 Incapacity to make claim
  5. 4.5 Claims received on or after 5 April 2012 or 6 April 2012
  6. 4.6 Claims received between 1 January 1997 and 5 or 6 April 2012
  7. 4.7 Date of Effect for all other Schemes
  8. 4.8 Scaled payment claims on or after 1 January 1997 and before 5 or 6 April 2012
  9. 4.9 Scaled payment claims pre 1 January 1997

5. PAYMENT FOR LOSS OF PURCHASING POWER:

  1. 5.1 New claims
  2. 5.2 Revised decisions
  3. 5.3 Department's Responsibility
  4. 5.4 Period of calculation
  5. 5.5 Incidental Expenses
  6. 5.6 Basis of Calculation
  7. 5.7 Steps in calculation
  8. 5.8 Calculation where arrears already paid

APPENDIX 1 Consumer Price Index 1976 - 1996

APPENDIX 2 Examples of how payment for loss of purchasing power is calculated


1. LEGISLATION GOVERNING CLAIMS

The primary legislative provisions governing claims and late claims are set out in Sections 241, 342 and 342A of the Social Welfare Consolidation Act 2005, as amended. See also Part 9, Chapter 1 of Social Welfare Consolidation Act 2005.

The main regulatory provisions with regard to claims are Legislation contained in Chapter 1 of Part 7 of the Social Welfare (Consolidated Claims, Payments and Control) Regulations (S.I. No. 142 of 2007) as amended – Articles 179 to 191 and SI 695 of 2006.

Previously - SI 55 of 1998, SI 159 of 2000 and SI 160 of 2000.

Note: See also references to claims and late claims within separate guidelines dealing with the individual schemes.


2. WHAT IS A CLAIM

2.1 Application forms and satisfying identity

Section 241 of SWCA, 2005, as amended, refers.

It is a condition of a person's right to any payment that he or she makes a claim for the specific payment in the manner set out in regulations (Article 179 of SI 142 of 2007) and satisfies the Department of his or her identity.

The usual requirement is that the claimant must complete and sign the appropriate application form and ensure that it is submitted to the relevant section of the Department of Social Protection (DSP) within a specified period of becoming entitled to the payment.

This period is usually referred to as 'the prescribed time' - see paragraph 3.4 below.

For the purposes of satisfying identity, the Claimant may be asked to:

  • Attend at an Office of the Department or such other place as designated as appropriate;
  • Produce any document that authenticates his or her identity;
  • Allow a picture or other record of an image to be taken for the purposes of authenticating his or her identity;
  • To provide a sample of his or her signature in electronic form for the purposes of authentication, at any time, of his or her identity.

The Department reserves the right to retain any photograph (or other record of an image) and electronic signature.

NOTE: Reduced Price Certificates
Where a claimant for any Social Welfare Benefit or Assistance (excluding Supplementary Welfare Allowance) is required to produce Birth, Marriage or Death certificates, these may be purchased for a reduced fee (currently €1.00) from the General Register Office or Superintendent Registrar's Office (one located in each county).
In the case of certificates required for the purpose of obtaining Supplementary Welfare Allowance, no fee is payable.

Where certificates have been obtained for a reduced fee, they are retained by the Department of Social Protection.

2.2 Evidence of entitlement

Article 181 of S.I. No. 142 of 2007, as amended, refers.

In addition to making a formal claim, the person is also required to provide all relevant information and to furnish any relevant documents which are requested to substantiate the claim. He or she may also be interviewed at home or be required to attend at a local office of the Department for interview.

2.3 Claims made in other countries

Under EU Regulations and bilateral agreement legislation governing social welfare payments, a claim made in any State covered by the legislation (a relevant State) may be regarded as a claim for a similar type of payment in Ireland. When a claim for social welfare is made by a person in a relevant State, there is a legal onus on that State to take liaison action. This involves initiating a claim on the person's behalf in Ireland, where relevant.

Instances arise where liaison action is not initiated by the relevant State. In such instances, if the person later applies for a social welfare payment in Ireland, it may be possible under EU Regulations or Bilateral Agreement legislation to accept the claim in the other relevant State as a claim for a similar type of payment in Ireland. This will allow, where appropriate, backdating of the claim to the date of the earlier claim in the relevant State.

2.4 Discretion regarding what constitutes a claim

While the legislation is specific in relation to the requirement that a claim be made, article 179 of SI 142 of 2007 (as amended)allows the Minister discretion in regard to what may be accepted as constituting a valid claim. The Minister may accept a letter or other suitable form of notification, as satisfying the requirement of making a claim within the prescribed time.

In practice this discretion is applied administratively by officers within each scheme. It may also be applied where one of the following conditions applies, subject to the circumstances of the case. Such decisions are not subject to the Social Welfare Appeals provisions because it is a Ministerial discretion. A dissatisfied claimant may however request the decision to be reviewed, and the review should be carried out by an officer of higher rank than the person who made the decision.

A. Previous claim or enquiry prior to legislative change

If a legislative change gives entitlement on a previously refused claim, or where a previous enquiry elicited the information that there was then no entitlement, the earlier claim or enquiry may be accepted in lieu of a repeat claim from the date of implementation of the legislative change.

Similarly, if the change in legislation results in an increase in the existing rate of payment, the existing claim will be accepted as constituting a claim for an increase.

Factors to be considered in this context:

  • the timelag between the previous claim or enquiry and date of the legislative change;
  • the timelag between the date of the legislative change and the date the late claim is made;
  • the nature of the legislative change, how it relates to the reason for the previous disallowance, and the manner in which it was publicised by the Department;
  • whether in the light of the above it is reasonable to believe that the person was not aware of the change or of its application to his/her entitlement;
  • whether it can be established that all of the scheme conditions were satisfied during the relevant period.

In general it is usually easier to establish entitlement in the case of contributory and long-term schemes than in the case of non-contributory and short-term schemes.

B. A claim for a related Social Welfare Payment

Where a late claim is made by a person who is in receipt of a related Social Welfare Benefit/Allowance, the claim in payment may be accepted as a claim for the later social welfare payment. Similarly, a claim for a particular non-contributory payment is normally treated as a claim for an equivalent contributory payment if it transpires subsequently that there was a contributory entitlement.

In all such cases, the Officer must be satisfied that all other conditions governing the particular scheme were fulfilled.

Again, this is more easily established in contributory schemes where entitlement is mainly dependent on social insurance contributions and other verifiable conditions.

Example: Existing claims for:

  • Carer's Allowance,
  • Carer's Benefit
  • Disability Allowance,
  • Illness Benefit,
  • Invalidity Pension,
  • Pre-Retirement Allowance,
  • One-Parent Family Payment,
  • Jobseeker's Benefit or Allowance,
  • Widow's Widower's or Surviving Civil Partner's Contributory Pension,

may be accepted in lieu of a claim for:

  • State Pension (Contributory),
  • State Pension (Non-Contributory) Scheme or
  • State Pension (Transition **),
  • Widow's Widower's or Surviving Civil Partner's Contributory or Non-Contributory Pension.

** The Social Welfare and Pensions Act 2011 discontinues the State Pension (Transition) for new claimants with effect from 1 January 2014. This standardises the State Pension age at 66 years for all applicants.

In such cases the latter claim would be paid from the date of first entitlement to it, or from the date of the earlier claim, whichever date was later.

Reason for late claim

The officer should also consider the reason for the delay in claiming. In the above context, the possibility must always be considered that the delay was due to an undisclosed disqualification, or a means factor that no longer exists, or a condition of entitlement that was not fulfilled at the time.

However, where a reasonable explanation has been advanced as to why there was a delay in claiming, and there is no reason to believe that entitlement did not exist, the discretion to accept the other claim in lieu of the relevant claim should be applied.

If, however, the person was invited by the Department to claim the relevant payment at the correct time and did not do so, exercise of this discretion would not normally be warranted.

C. A Claim by a Qualified Adult

Where a Qualified Adult on a spouse's social welfare payment subsequently claims an entitlement in his/her own right for the same period, the discretion may be used to accept the claim for Increase for Qualified Adult (IQA) in lieu of the later claim.

The Officer must again be satisfied (with a reasonable level of certainty) that all other conditions governing the particular scheme were fulfilled.

Examples of situations where entitlement can usually be proven:

  • Where a spouse/partner on any social welfare payment is over the age 65/66 and submits a late claim to an age related contributory payment in his/her own right e.g. State Pension (Contributory) or State Pension (Transition).
  • Where a couple are over 66 and one has been in receipt of an State Pension (Non-Contributory) Scheme (SPNC) with an increase in respect of the other person. As means have been established for the existing claim, a late claim by the spouse for an SPNC in his/her own right would normally be accepted.

More difficult cases:

For instance, a late claim for Carer's Allowance would require clear and convincing evidence regarding means, that full-time care and attention was necessary and that the claimant was providing that full-time care and attention. The reason given for the claim not being made at the right time would also be examined in this context (see comments at B above).

D. A claim for a Child Dependant.

A claim to Child Benefit may be accepted as a claim for a Child Dependant Increase or an Guardian's Payment (Contributory) or Guardian's Payment (Non-Contributory) , provided no doubt exists as to entitlement to the payment for the period in question and a reasonable explanation is given for the delay in claiming.

In the case of Guardian's payment (contributory) and Guardian's payment (non-contributory), a previous claim for the orphan as a qualified child on another social welfare payment may be accepted where the scheme conditions are fully satisfied.

E. Previous contact with the Department

Where it is established that an earlier interview with the person should have brought to notice the fact that entitlement to a personal rate payment (or Increase for Qualified Adult, Child Dependant Increase, Living Alone Allowance, etc.) existed, because the necessary information was then made available, and the Department did not act on it, the claim may be deemed to have been made at the time of that interview.

Similarly, where information was supplied on a claim form for a particular scheme that should have alerted the Department to the fact that the person was entitled to another DSP scheme (e.g., where a claim for State Pension (Contributory), which is refused, provides information that the person may be entitled to Widow's Contributory Pension), the date of the earlier claim may be accepted as the date of claim for the appropriate entitlement.


3. CLAIMING WITHIN THE PRESCRIBED TIME:

Article 182 of S.I. 142 of 2007, as amended, refers

There is a requirement under the legislation that persons must claim their entitlements within a specific period from the date their entitlement arises. This period is referred to as the 'prescribed time'.

3.1 Date of claim

For the purposes of these provisions, a claim is deemed to have been made on the date on which it is received in the Department.

3.2 Disqualification for late claim

Where a claim is made after the prescribed time, a statutory disqualification is incurred, and payment cannot be made for the period of disqualification. (But see Section 4 hereunder which lists circumstances in which this disqualification will not apply) .

The period of disqualification is prescribed in Section 241 of the Social Welfare Consolidation Act 2005, and is set out in a table at 3.5 hereunder.

The following schemes have particular conditions attached:

In the case of Maternity Benefit the prescribed time is the date on which entitlement arises. However where the claim is made before the end of the week of confinement, the disqualification applies in respect of any period before the beginning of the week in which the claim is made. Where the claim is made after the end of the week of confinement, the person will be disqualified for payment for any period prior to the beginning of the week of confinement, and for any period before the beginning of the 7th week before the week in which the claim is made.

Article 183 of S.I. 142 of 2007, as amended, refers

In the case of a Home Maker, where a person has commenced as a homemaker on or after 6 April, 1994 and not later than 31 December 2013, an application to be regarded as a homemaker shall be made not later than 31 December 2014.

(Note - A person who is in receipt of Carer's Allowance or Child Benefit in his/her own right is not required to make an application to be regarded as a homemaker.)

Article 182(ba) of S.I. 142 of 2007, as amended and Section 186(d) of the Social Welfare Consolidation Act 2005, as amended, refers

In the case of Domiciliary Care Allowance (DCA) the day on which, apart from satisfying the condition of making a claim, the claimant becomes a qualified person.

A person is a qualified person for the purpose of receiving DCA in respect of a qualified child if –

  1. The child normally resides with the person;
  2. The person provides for the care of the child, and
  3. At the date of making the application for DCA –
    1. That person is habitually resident in the State or
    2. While the qualified person or that person's spouse civil partner or co-habitant is in recognised service outside the State as provided for by Section 219(2)of the main Act.

3.3 Claiming In Advance

Claimants for State Pension (Non-Contributory) Scheme, State Pension (Contributory) ( SPC) and State Pension (transition) ( SPT) may apply up to 3 months in advance of pension age. Claimants for SPC or SPT, whose claim will depend on employment contributions from other countries under EU legislation or Bi-Lateral agreements, are encouraged to claim 6 months in advance.

Similarly, an Invalidity Pension may be claimed up to 3 months in advance of the date on which the person will first become entitled to it.

3.4 Table showing the prescribed time for making a claim and the late claim disqualification for each scheme:

(Article 182 of SI 142 of 2007, as amended. Please see Article Legislative References on left for each scheme below

Leg Ref Type of claim Prescribed time for making claim Disqualification for periods prior to ....
182(f) Adoptive Benefit First date of entitlement Date of Claim
182(g) Bereavement Grant Within 3 months of death of deceased Date of Claim
182(b) Blind Pension First date of entitlement Date of Claim
182(b) Carer's Allowance First date of entitlement Date of Claim
182(i) Carer's Benefit 8 weeks before first day of entitlement Date of Claim
182(k) Child Benefit Within 12 months of first date of entitlement Date of Claim
182(h) Continued Payment For Qualified Children Within 13 weeks of commencing employment Date of Claim
182(e) Disability Allowance Within 7 days of first entitlement 7 days before date of claim
182(ba) Domiciliary Care Allowance First date of entitlement               Date of Claim
182(d) Illness Benefit Within 7 days of becoming unable to work 7 days before date of claim
182(c) Family Income Supplement Within 3 months of first date of entitlement Date of Claim
182(b) Farm Assist First date of entitlement Date of Claim
182(f) Health And Safety Benefit First date of entitlement Date of Claim
182(a) Invalidity Pension Within 3 months of first entitlement 6 months before date of claim
182(i) Respite Care Grant 8 weeks before the date grant payable ending on 31 Dec.of the year immediately following the year in which the grant is payable 8 weeks before date of claim
182(a) State Pension (Contributory) Within 3 months of first date of entitlement 6 months before date of claim
182(b) State Pension (Non-Contributory) First date of entitlement Date of claim
182(c) One Parent Family Payment Within 3 months of first date of entitlement Date of claim
182(c) Guardian's Payment (Contributory) Within 3 months of first entitlement 6 months before date of claim
182(c) Guardian's Payment (Non-Contributory) Within 3 months of first entitlement Date of Claim
182(b) Pre-Retirement Allowance First date of entitlement Date of Claim
182(a) State Pension(Transition **) Within 3 months of first entitlement 6 months before date of claim
182(b) Jobseeker's Allowance First date of entitlement Date of Claim
182(b) Jobseeker's Benefit First date of entitlement Date of Claim
182(c) Widow's Widower's or Surviving Civil Partner's (Contributory) Pension Within 3 months of first entitlement 6 months before date of claim
182(f) Maternity First date of entitlement Date of claim

 

SI 102 of 2007 refers to the following. Article Legislative References are shown on left
Leg Ref Type of claim Prescribed time for making claim Disqualification for periods prior to ....
43(c) Constant Attendance Allowance (OIB) Within 3 months of first date of entitlement 3 months before date of claim
43(d) Death Benefit (OIB) Within 3 months of death of deceased 3 months before date of claim
43(b) Disablement Benefit (OIB) Within 3 months of first date of entitlement 3 months before date of claim
43(a) Occupational Injury Benefit (OIB) Within 21 days of first date of entitlement Date of claim
43(c) Incapacity Supplement (OIB) Within 3 months of first date of entitlement 3 months before date of claim
43(e) Medical Care Within 6 wks of commencement of such care 6 wks before date of claim

4. BACKDATING LATE CLAIMS

The following provisions may override or reduce the period of disqualification for a late claim. All decisions with regard to entitlement under these provisions are made by deciding officers, and can therefore be appealed to the Social Welfare Appeals Office (SWAO).

4.1 Good cause

Provision is made in the legislation to allow payment within certain limits where there was 'good cause' for the late claim.

Schemes to which this provision applies:

Adoptive Benefit
Bereavement Grant
Blind Pension
Carer's Allowance
Carer's Benefit
Child Benefit (See Note1)
Constant Attendance Allowance (OIB)
Death Benefit under the Occupational Injuries Scheme (OIB)
Disability Allowance
Disablement Benefit (OIB)
Domiciliary Care Allowance
Family Income Supplement
Farm Assist
Guardian's Payment (Non-Contributory)
Health And Safety Benefit
Illness Benefit
Incapacity Supplement(OIB)
Injury Benefit(OIB)
Jobseeker's Allowance
Jobseeker's Benefit
Maternity Benefit
One-Parent Family Payment
Pre-Retirement Allowance
State Pension (Non-Contributory) Scheme
Widow's Widower's or Surviving Civil Partner's (Non-Contributory) Pension
Widowed or Surviving Civil Partner Grant

[Note: The following schemes allow backdates of payment for the same or greater periods without any necessity to show 'good cause' for late claim: Invalidity Pension (6 months), State Pension (Contributory), Guardian's Payment (Contributory), State Pension (Transition), Widow's, Widower's or Surviving Civil Partner's Contributory Pension (6 months), Medical Care (12 months). See table at 3.4 above.]

'Good cause' is not generally defined in the legislation, and must be assessed by Deciding Officers by the application of common sense principles to the contentions put forward by the person concerned and by the evaluation of the evidence available to support those contentions.

Lack of Knowledge, incorrect advice from others

Lack of knowledge by itself is not regarded as a sufficient reason for not claiming in time. The Department publishes information leaflets as widely as possible and advertises changes of legislation in the National Press. Information Offices are available throughout the country for people to make enquiries as to their entitlements.

The Deciding Officer must consider what is a reasonable level of knowledge to be expected in the particular case. If, for example, legislation extends entitlement to a particular scheme a plea of ignorance of the change may be reasonable.

Similarly particular circumstances may arise where the Deciding Officer is satisfied that it was reasonable for the person to believe that s/he had no entitlement, or that there was nothing to enquire about.

The receipt of incorrect advice or information from any person other than a person employed by the Department of Social Protection is not normally regarded as good cause for failure to claim at the correct time. (See paragraph 4.2 below regarding information given by the Department.)

However consideration should include whether the person believed that the source of advice was authorised by the Department and therefore whether it was reasonable for the person to rely on this advice rather than make further enquiries with the Department. This may apply in relation to state or semi-state offices where claim forms and information leaflets are officially made available to the public on behalf of the Department.

Where a claimant requests an agent (professional or otherwise) to act on his or her behalf in making a claim, and the agent fails to forward the claim within the prescribed time, good cause for the delay depends upon the claimant having been given sufficient reason to believe that the claim had been made.

Similarly where the agent has acted on behalf of the claimant in seeking information and conveyed incorrect information to the claimant, good cause depends on whether there is sufficient reason in the opinion of the Deciding Officer for the claimant to have relied on the agent instead of making personal enquiries, and for the claimant to have believed the information obtained was correct.

Limitation on payment

The legislation limits to 6 months (the last 6 months prior to the date the claim is actually made), the period for which payments may be backdated under this clause. Entitlement throughout the period must also be proven to the satisfaction of the deciding or appeals officer.

NOTE 1: This limitation does not apply in the case of Child Benefit. Where a late claim for Child Benefit is accepted under the heading of "good cause" for late claim, payment will be made from the date entitlement would have first existed if the claim had been made at the correct time.

NOTE 2: The 6 month limitation is related to payment only. Where a claim is accepted under this clause with respect to a period greater than 6 months, a decision to award the claim from date of first entitlement will have implications (depending on the circumstances and type of claim) for entitlement to credits, for linking to previous claims, and for determination of the appropriate governing contribution year, etc.

4.2 Information given by Department

This provision applies to all statutory schemes except Jobseeker's Allowance, Jobseeker's Benefit, Farm Assist and Supplementary Welfare Allowance.

Where the failure to claim within the prescribed time arose as a result of information supplied by staff of the Department to the person concerned or to his/her appointed agent, the claim may be backdated to

  • the date of commencement of entitlement if subsequent to the date the information was given or
  • (if entitlement already existed) the date on which that information was given plus any period in respect of which a disqualification would not have been imposed if the claim had been made on that date.

If the information was supplied in writing, verification should be sought by obtaining (if possible) a copy from the claimant or from the Department's records.

Many of the claims arising under this heading however will not be easily substantiated (particularly if the person who is alleged to have given the information has died, retired or left the Department) and the evidence will need to be considered along the following lines:

  • How clear is the claimant as to what information was given? Is the claimant's memory clear enough to establish what was said (rather than what was heard)?
  • Can the claimant identify the person who gave this information?
  • Was the point at issue an unusual point that was not commonly addressed by Department staff and on which there may have been confusion?
  • Is it reasonable to believe that the person so identified might have given the information as reported?
  • Was the information the main reason for the failure to make the claim at the correct time?
  • Where it appears that the information given was correct but was misunderstood by the person, was the misunderstanding reasonable in the light of the complexity of the issue, the level of knowledge of the claimant, etc.?

4.3 Repayment of amounts due arising from false or misleading statements or wilful concealment of facts – Section 342A of SWCA 2005, as amended

Section 342A of the SWCA 2005, as amended,provides that where a fraudulent social welfare overpayment occurs, any other social welfare benefits to which that person may have qualified for during the period in which that overpayment occurred, will not be offset against the amount of the overpayment to be recovered in relation to overpayments that arise for periods after 29 June 2011.

Overpayments that span previous periods before and after this date may be split and the provisions of Section 342A of SWCA, 2005, as amended, applied to overpayments after 29 June 2011.

The following payments under the Social Welfare Consolidation Act, 2005 as amended, apply:

  • Illness Benefit
  • Partial Capacity Benefit
  • Maternity Benefit
  • Health and Safety Benefit
  • Adoptive Benefit
  • Jobseeker’s Benefit
  • Occupational Injuries Benefit comprising injury benefit, disablement benefit and death benefit
  • Carer’s Benefit
  • State Pension (Contributory)
  • State Pension (Transition)
  • Invalidity Pension
  • Widow’s (Contributory) Pension
  • Widower’s (Contributory) Pension
  • Surviving Civil Partner’s (Contributory) Pension
  • Guardian’s Payment (Contributory)
  • Bereavement Grant
  • Widowed or Surviving Civil Partner Grant (paid by virtue of receipt of a benefit under Part 2)
  • Jobseeker’s Allowance
  • Pre-Retirement Allowance
  • State Pension (Non-Contributory)
  • Blind Pension
  • Widow’s Non-Contributory Pension
  • Widower’s Non-Contributory Pension
  • Surviving Civil Partner’s (Non-Contributory) Pension
  • Guardian’s Payment (Non-Contributory)
  • Widowed or Surviving Civil Partner Grant (paid by virtue of One-Parent Family Payment or State Pension (Non-Contributory) under this Part)
  • One-Parent Family Payment
  • Carer’s Allowance
  • Domiciliary Care Allowance
  • Supplementary Welfare Allowance
  • Disability Allowance
  • Farm Assist
  • Child Benefit
  • Respite Care grant
  • Family Income Supplement
  • Continued Payment for a Qualified Child and a
  • Payment pursuant to Section 239

Where the claimant was in receipt of a payment after 29 June 2011 to which they were not entitled under a revised decision under section 301(a), 319(a) or 325(a), any other social welfare benefits to which that person may have qualified for during the period of the overpayment will not be offset against the amount of the overpayment to be recovered.

Note: Section 342A of SWCA 2005, as amended  does not apply in respect of another claimant’s entitlement to IQA.

4.4 Incapacity to make claim

This provision applies to all statutory schemes except Jobseeker's Allowance, Jobseeker's Benefit, Farm Assist and Supplementary Welfare Allowance.

Where the delay arose because the person was incapacitated by illness or infirmity between the date of initial entitlement and the date of claim, a back date may be considered. The nature of the illness or incapacity must be such that the claimant could not have been expected to make a claim or appoint an agent to act on his/her behalf. An illness, though disabling, which by its nature would not cause the claimant's mental faculties to diminish significantly will not be regarded as sufficient reason for the failure to make a timely claim.

It should be noted that an illness which did not exist at the date of initial entitlement or a relevant subsequent period would not be regarded as justifying a back date.

However, where a person recovers from such an incapacity to the extent that it would then be possible for the person to make a claim or appoint an agent for that purpose, the claim must then be made before the disqualification for late claim would come into effect (see third column of table at 3.5 above).

In these circumstances, the claim may be backdated for any period of entitlement,

  1. to the date of initial entitlement where such incapacity existed at that time, or
  2. in other cases, to the date the person became so incapacitated, plus any period in respect of which a disqualification would not have been imposed if the claim had been made on that date.

[Note: Under (b), exceptional circumstances may arise where a delay in making a claim occurs both before and after the period of incapacity. In such cases, the sum of the periods prior to the incapacity and of the later delay must not exceed the maximum period allowed under Section 241 of the Social Welfare Consolidation Act 2005,as amended, including the provision for good cause.] Where medical evidence is submitted as justification for claiming late, this should be considered on its merits in the light of all the available evidence. For example, intermittent employment within the late claim period would probably indicate that the incapacity did not preclude the ability to claim throughout that period.

It may be necessary in some cases to seek comment by the Department's Medical Adviser with regard to the impact of the particular illness. However, the decision must be made by a Deciding Officer, or an Appeals Officer

4.5 Claims received on or after 5 April 2012 or 6 April 2012.

This provision is contained in Statutory Instrument (S.I. No 102 of 2012) and applies to claims for:

State Pension Transition** made on or after 5 April 2012 and

State Pension (Contributory)
Guardian's Payment (Contributory)
Widow(er)'s and Surviving Civil Partner's Contributory Pension made on or after 6 April 2012.

Late claims for the above schemes may be backdated for a maximum period of 6 months from date of receipt of claim provided the relevant qualifying conditions are fulfilled.

Backdating of a late claim beyond 6 months can be considered only in circumstances where the failure to claim arose as the result of :

  • Incorrect information being supplied by the Department or
  • The claimant's incapacity by illness or infirmity

4.6 Claims received between 1 January 1997 and 5 or 6 April 2012

Section 32 of the Social Welfare Act 1997 extended the period for which Retirement, Old Age and Survivor's Contributory Pensions could be backdated from 6 months to 12 months in respect of claims made on or after 1 January 1997. This was later contained in Section 241 (2) of the SW Consolidation Act, 2005.

This provision applies to claims for:

State Pension Transition** made on or after 5 April 2012 and

State Pension (Contributory)
Guardian's Payment (Contributory)
Widow(er)'s and Surviving Civil Partner's Contributory Pension made on or after 6 April 2012.

Where a claim to pension is made late i.e. after the qualifying age, payment can be backdated up to 12 months from date of receipt of claim, provided the relevant qualifying conditions are fulfilled.

Further backdating of payment may be made on a proportional or scaled basis as at 4.8 below.

4.7 Date of Effect for all other Schemes

For Schemes not listed in S.I. 102 of 2012 (i.e. all other Schemes bar those listed in Paragraphs 4.5 and 4.6 above) the date of effect is the date of enactment of S.I. 102 of 2012 which is the 2nd of April 2012.

4.8 Scaled payment - claims on or after 1 January 1997 and before 5 or 6 April 2012.

This provision applies only to claims made on or after 1 January, 1997 in respect of the same schemes as 4.6 above:

Section 32 of the Social Welfare Act 1997 provided for further backdating in prescribed circumstances. The Regulations made under these provisions (S.I. No 55 of 1998) put on a statutory basis the extra-statutory arrangements sanctioned by the Department of Finance for back-dating late claims.

This follows on from 4.6. In order to calculate the extent of the backdate in addition to 12 months as at 4.6 and the arrears entitlement under the legislation, it is necessary to establish a new award date; referred to as the 'derived award date'. This date is established by using the Reckoner below as follows:

  1. Establish the period in years between the date entitlement first arose and the date the late claim was made. When this period has been established, identify the relevant line under column A below - (Lines 1 to 5).
  2. Move directly across to column B and calculate the number of weeks by which the claim should be backdated from the date the claim was made. This is the 'derived award date'.

    Please note that any fraction of a week which is 0.5 or more is rounded up to the next whole number.

  3. The arrears are then calculated by totalling the appropriate rates of payment for each week during the period from the 'derived award date' to 12 months before the date the claim was made. This allows for the fact that full arrears have already been provided for in section 241 of the Social Welfare Consolidation Act 2005 for the 12 month period before the date the claim was made (see paragraph 3.3).
Reckoner:
Period from date of establishment of entitlement to the date the claim was made.
(A)
Period by which payment shall be extended beyond the date the claim was made.
(B)
1. Exceeding 1 year but not 2 years 50% of the number of weeks exceeding 1 year from the date claim was made
2. Exceeding 2 years but not 3 years 40% of the number of weeks exceeding 2 years from the date claim was made plus 26 weeks
3. Exceeding 3 years but not 4 years 30% of the number of weeks exceeding 3 years from the date claim was made plus 47 weeks
4. Exceeding 4 years but not 5 years 20% of the number of weeks exceeding 4 years from the date claim was made plus 63 weeks
5. Exceeding 5 years 10% of the number of weeks exceeding 5 years from the date claim was made plus 73 weeks

4.9 Scaled payment - claims pre 1 January 97.

Proportionate arrears of pension are made under this heading and under extra statutory provisions to those who made late claims before 1 January 1997 in respect of the following schemes:

State Pension (Contributory)
Guardian's Payment (Contributory)
State Pension (Transition)
Widow's, Widower's or Surviving Civil Partner's Contributory Pension

In order to calculate the extent of the backdate and the arrears entitlement under the legislation, it is necessary to establish a new award date; referred to as the 'derived award date'. This date is established by using the Reckoner below as follows:

  1. Establish the period in years between the date entitlement first arose and the date the late claim was made. When this period has been established, identify the relevant line under column A below - (Lines 1 to 5).
  2. Move directly across to column B and calculate the number of weeks by which the claim should be backdated from the date the claim was made. This is the 'derived award date'.
    Please note that any fraction of a week which is 0.5 or more is rounded up to the next whole number.
  3. The arrears are then calculated by totalling the appropriate rates of payment for each week during the period from the 'derived award date' to 6 months before the date the claim was made. This allows for the fact that full arrears have already been provided for in section 241 of the Social Welfare Consolidation Act 2005, as amended, for the 6 month period before the date the claim was made (see paragraphs 3.3 and 4.1).
Reckoner
Period from date of establishment of entitlement to the date the claim was made.
(A)
Period by which payment shall be extended beyond the date the claim was made.
(B)
1. Exceeding 0.5 years but not 1.5 years 25% of the period exceeding 0.5 years plus 26 weeks.
2. Exceeding 1.5 years but not 2.5 years 20% of the period exceeding 1.5 years plus 39 weeks
3. Exceeding 2.5 years but not 3.5 years 15% of the period exceeding 2.5 years plus 49 weeks
4. Exceeding 3.5 years but not 4.5 years 10% of the period exceeding 3.5 years plus 57 weeks
5. Exceeding 4.5 years 5% of the period exceeding 4.5 years plus 62 weeks.

5. PAYMENT FOR LOSS OF PURCHASING POWER

Section 243 of SWCA, 2005, as amended and
Articles 211 – 216 of S.I. 142 of 2007, as amended, refers.

This provision applies to all statutory schemes except Supplementary Welfare Allowance and Medical Care under the Occupational Injuries Benefits Scheme.

5.1 New Claims

Payment in respect of loss of purchasing power must be made in accordance with the following guidelines where there has been a delay by the Department of more than 12 months in dealing with a claim, including a claim for an increase.

5.2 Revised Decisions

Similarly, where a Deciding Officer or an Appeals Officer's decision increases retrospectively the rate of pension payable or awards a previously refused claim, compensation may be paid in the following circumstances provided no significant new facts or evidence were made available at that stage.

5.3 Department's Responsibility

The responsibility for the loss must lie clearly with the Department. Payments should be made in cases where the Department is solely or significantly at fault and, in the case of the latter, where any culpability on the part of the claimant is not a significant factor in the delay. Payment may be made for a part of such a period where the Deciding Officer or Appeals Officer decides that the Department was solely responsible for a portion (exceeding 12 months) of the time, but not for all the period of delay.

Examples:

  • a valid claim is disallowed or underpaid due to miscalculation by the deciding officer, or error in the Department's records for which the Department was responsible;
  • a valid claim is disallowed or underpaid due to a wrong interpretation of the law;
  • clear evidence on the file shows that although not entitled to the benefit/pension claimed, an alternative related entitlement existed and should have been examined;
  • cases of oversight (e.g. an investigation or review of entitlement by the Department overlooks clear evidence from the information supplied that there was entitlement to a related pension/benefit);
  • serious unjustified delay by the Department in dealing with the investigation or processing of a claim.

5.4 Period of Calculation

Payments for loss of purchasing power are made from a date one year after the correct entitlement date. This allows a period of one year in which to process a claim, including the appeal process. This period is sometimes referred to as the 'fallow period'. Payment for loss of purchasing power is calculated by reference to the rate of inflation during the relevant period.

5.5 Incidental Expenses

Payment may also be made to offset out of pocket incidental expenses necessarily incurred by the claimant as a result of delay in making benefit payments. There will be an onus on the claimant to provide satisfactory proof of expenditure in this regard. The claimant will also bear the first €12.70 of such costs and total payment by the Department is subject to an upper limit of €63.49 per individual case in respect of such costs.

5.6 Basis of Calculation

The Consumer Price Index (CPI) produced by the Central Statistics Office (CSO) provides data on inflation which is used to calculate payments in respect of loss of purchasing power.

The indices are calculated by the CSO on a quarterly basis up to and including the last quarter of 1996. Thereafter, they are calculated on a monthly basis. A number of Consumer Price Indices are available, covering the period from 1968 to the present. These indices are based on the purchasing power of £100 in a series of base years; viz., 1968, 1975, 1982, 1989, 1996. A new base year is established every 7 years. For the purpose of examples illustrated in this guideline, the Consumer Price Index in the series to base November 1975 = 100, is used. See Appendix 2, Example 1.

See Appendix 1 for further information on CPI.

5.7 Steps in calculation

Note: in calculating arrears, deductions are made in respect of any social welfare payments already made during the relevant period. This could arise where the claimant was in receipt of a lower rate of his/her current payment or in receipt of another social welfare payment during the relevant periods.

  1. The period over which arrears of benefit are due is established; normally from the date of entitlement to the date the arrears of benefit are actually paid.
  2. The arrears of benefit are calculated for the period of one year after date of entitlement - i.e., the 'fallow period'(see Para 5.4 above).
  3. The arrears of benefit are then calculated on a quarterly basis for each subsequent quarterly period, up to and including the last quarter of 1996. This facilitates the use of quarterly Consumer Price Indices.
  4. The arrears of benefit are then calculated on a monthly basis for the remaining arrears period, to coincide with the availability of monthly Consumer Price Indices from January of 1997.
  5. The payment for loss of purchasing power for the benefit arrears appropriate to the 'fallow period' and each subsequent quarterly and monthly period is then calculated as follows.
    • The Consumer Price Index (CPI) appropriate to the month in which the arrears of benefit are to issue is identified by reference to the Consumer Price Index. This is referred to as the 'Present Index'. The indices are normally available from the CSO, by the middle of each month. However, the monthly index available in any month will refer to the previous month's inflation. In order that the calculation and issuing of the payment for loss of purchasing power can be carried out promptly, the most up to date CPI is used.
    • CPIs are then identified for each of the relevant periods (end of the 'fallow period', subsequent quarters up the last quarter of 1996 and each subsequent monthly period. These indices are referred as the 'Previous indices'.
    • An 'Inflation factor' is then calculated for each relevant period according to the following formula;
      (Present Index/Previous Index) minus 1 = Inflation Factor
    • The Inflation Factors for the relevant periods are then multiplied by the appropriate net arrears of benefit for each period. The product is the inflation arrears due for that period.
    • The inflation arrears are then totalled.
    • The total inflation arrears are rounded up or down to the nearest 10p.

See Example 1 in Appendix 2.

5.8 Calculation where Arrears Already Paid

Instances may occasionally arise where benefit arrears have issued for a significant period in advance of the date of the issuing of payments for loss of purchasing power. Where this occurs, it will be necessary to adjust for inflation losses in the interval between payment of the benefit arrears and the making of the payment for the loss of purchasing power.

This is calculated as follows:

  • The payment for loss of purchasing power is calculated to the date of issuing of the benefit arrears, as already outlined.
  • The most recently available CPI (at the date of the issuing of the payment for loss of purchasing power) is identified. This becomes the 'Present Index'. The relevant CPI at the date of issue of the benefit arrears is identified; i.e., 'the Previous Index'. The standard formula is then applied as follows:
    Present Index/Previous Index - 1 = Inflation Factor
  • The basic payment for loss of purchasing power at the date of the issuing of the benefit arrears is then multiplied by the inflation factor. The resulting sum is added to the basic payment for loss of purchasing power.

See Example 2 in Appendix 2.


Appendix 1 - Consumer Price Index

CONSUMER PRICE INDEX 1976 - 1996
(Base November 1975 = 100)
Year Mid Feb Mid May Mid Aug Mid Nov Av.Annual Index
1975
 
 
 
 
 
 
100
-
1976
107.3
114.0
115.7
120.6
114.4
1977
125.2
129.9
131.3
133.6
130.0
1978
135.5
137.9
142.1
144.2
139.9
1979
150.2
155.0
161.4
167.2
158.4
1980
173.5
186.3
191.8
197.7
187.3
1981
209.9
218.1
230.4
243.8
225.6
1982
249.5
263.9
269.5
273.8
264.2
1983
280.6
288.3
296.5
302.0
291.8
1984
309.1
316.2
320.1
322.3
316.9
1985
328.3
332.7
337.6
338.1
334.2
1986
343.3
347.5
348.0
348.8
346.9
1987
355.1
357.3
359.2
359.5
357.8
1988
362.0
363.9
366.9
369.1
365.5
1989
374.0
377.8
383.3
386.3
380.4
1990
389.8
391.0
394.4
396.8
393.0
1991
399.9
402.9
408.4
411.1
405.6
1992
414.5
417.6
419.9
420.7
418.2
1993
422.3
421.5
425.7
426.9
424.1
1994
429.6
433.1
436.6
436.9
434.1
1995
440.4
445.1
447.0
447.4
445.0
1996
449.3
451.2
453.6
455.9
452.5

 

For details on the Consumer Price Index (CPI) from 1997 to date, please go to the following link:

http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=cpm02

Here, in the left column, click on “Base November 1975 = 100”. Then in the column on right, click on Month and Year of your choice e.g. for August 2013, click on 2013M08. Then, click on “Show Table”. (e.g. CPI for August 2013 comes up as 676.4, CPI for May 2011 is 661.5)

If you have difficulty with this, a contact name for Central Statistics Office (CSO) will appear after you click on ‘Show Table' as above.


Appendix 2 - Examples of how payment for loss of purchasing power is calculated.

Example 1:

Date of entitlement to State Pension (contributory)is 20/01/95. Arrears are due from 20/1/95 to 06/08/98. Date of payment of arrears is 07/08/98. The CPI for July is the 'Present Index' used in this example, as the August CPI would not be available until mid-August.

Example of how payment for loss of purchasing power is calculated
Period of arrears No. Weeks Weekly Rate Base Arrears Inflation Factor Inflation Arrears
20/01/95-15/06/95
21
£71.00
£1,491.00
(471.4/445.1)-1=.0590
£88.10
16/06/95-18/01/96
31.7*
£72.80
£2,307.76
(471.4/447.4)-1 = .053
£123.79
19/01/96-04/04/96
11
£72.80
800.80
(471.4/449.3)-1 = .0491
£39.39
05/04/96-13/06/96
10
£72.80
£728.00 
(471.4/451.2)-1 = .0447
£32.39
14/06/96-04/07/96
3
£75.00
£225.00
(471.4/451.2)-1 = .0447
£10.07
05/07/96-03/10/96
13
£75.00
£975.00
(471.4/453.6)-1 = .0392
£38.26
04/10/96-02/01/97
13.7*
£75.00
£1,027.50
(471.4/455.9)-1 = .0339
£34.93
03/01/97-06/02/97
5
£75.00
£375.00
(471.4/453.6)-1 = .0392
£14.71
07/02/97-06/03/97
4
£75.00
£300.00
(471.4/456.4)-1 = .0328
£9.85
07/03/97-03/04/97
4
£75.00
£300.00
(471.4/456.8)-1 = .0319
£9.59
04/04/97-01/05/97
4
£75.00
£300.00
(471.4/457.3)-1 = .0308
£9.24
02/05/97-05/06/97
5
£75.00
£375.00
(471.4/458.2)-1 = .0288
£10.80
06/06/97-12/06/97
1
£75.00
 
 
   
 
13/06/97-03/07/97
3
£78.00
£309.00
(471.4/459.5)-1 = .0258
£8.00
04/07/97-31/07/97
4
£78.00
£312.00
(471.4/459.1)-1 = .0267
£8.35
01/08/97-04/09/97
5
£78.00
£390.00
(471.4/458.2)-1 = .0288
£11.23
05/09/07-02/10/97
4
£78.00
£312.00
(471.4/460.5)-1 = .0236
£7.38
03/10/97-06/11/97
5
£78.00
£390.00
(471.4/461.4)-1 = .0216
£8.45
07/11/97-13/11/97
1
£78.00
£78.00
(471.4/461.4)-1 = .0216
£1.69
05/12/97-01/01/98
4.7*
£78.00
£366.60
(471.4/464.6)-1 = .0146
£5.37
02/01/98-05/02/98
£78.00
£390.00
(471.4/461.8)-1 = .0207
£8.10
06/02/98-05/03/98
4
£78.00
£312.00
(471.4/464.1)-1 = .0157
£4.90
06/03/98-02/04/98
4
£78.00
£312.00
(471.4/466.4)-1 = .0107
£3.34
04/04/98-30/04/98
£78.00
£312.00
(471.4/468.7)-1 = .0057
£1.79
01/05/98-04/06/98
5
£78.00
£390.00 
(471.4/470.5)-1 = .0019
£0.75
05/06/98-02/07/98
4
£83.00
£332.00
(471.4/472.8)-1 = nil
nil
03/07/98-06/08/98
5
£83.00
£415.00
(471.4/471.4)-1 = nil
nil
Total     £13,825.66 (€17,558.58)   £490.67 (€623.15)

Grand Total Arrears due £14,316.33 (€18,181.74)

* Includes an increase in respect of the Christmas Bonus payable at 70% of the weekly rate.

Example 2:

Arrears of pension for the period January, 1994 to November 1995, amounting to £5,000 issued to a claimant in December of 1995.

The payment for the loss of purchasing power to the date of the issuing of the pension arrears in December of 1995, is calculated in the manner outlined above and amounts to £90.

However, payment for the loss of purchasing power did not issue until February of 1998.

The 'Present Index', appropriate to arrears issuing in February 1998 is 461.8 (This is the CPI for January, '98, as the February CPI would not be available until mid-March).

The 'Previous Index' for arrears issuing in December of 1995 is 447.4.

461.8/447.4 minus 1 = 0.032 (Inflation Factor)

The basic payment for loss of purchasing power to 1995 (£90) is then multiplied by the 'Inflation Factor' £90 X 0.032 = £2.88.

Total payment for loss of purchasing power = £92.88 (€117.93)

Last modified:29/09/2014