The statutory procedures in processing an appeal are set out in the Social Welfare Consolidation Act 2005 and the Social Welfare (Appeals) Regulations, 1998 and 2011.
When a decision is made by a Deciding Officer/Designated Person of the department, a person is entitled to know full the basis on which the initial claim was disallowed. This should be set out in the decision letter you received.
Any person who is dissatisfied with a decision may submit an appeal within 21 days of the date of the letter giving the decision you wish to appeal.
There is no charge for making an appeal.
The completed appeal form must include the facts and reasons for the appeal. The appeal must also include whatever documents the appellant wants to have considered in support of the appeal. When submitting your appeal, you can advise if you intend to send further evidence in support of your appeal. You must do this as soon as possible
You will receive an acknowledgement letter once your appeal has been registered.
A person may withdraw the appeal at any stage by by advising the Appeals Office. An appeal will be deemed to be withdrawn where the indications are that the appellant is no longer pursuing the appeal.
The Chief Appeals Officer must notify the relevant scheme area of an appeal received as it is a statutory requirement of the appeals process that the relevant departmental papers and comments by the Deciding Officer on the grounds of appeal be sought.
The scheme area will review the decision and may undertake further investigation of any new facts or evidence in the appeal, for instance by a Social Welfare Inspector. In the case of a claim to a sickness or disability related payment, they may arrange a further examination by a Medical Assessor.
It is open to the Deciding Officer/Designated Person of the department at this stage to make a revised decision on the question at issue but only if such a revised decision would be in favour of the appellant. Where a revised decision is made at this stage, effect is given to it by the relevant scheme area and so the appeal is thereby resolved and withdrawn.
If the decision of the Deciding Officer/Designated Person is not revised, they must then give the Chief Appeals Officer a statement, by or on behalf of the Deciding Officer/Designated Person, on the facts and contentions in the appeal. Any information, document or item in the power or control of the Deciding Officer/Designated Person that is relevant to the appeal must also be provided.
An appellant will be advised of any additional evidence against his or her case which comes out of such further investigation and will be given an opportunity to comment on it.
All this activity takes time, but it also affords the appellant many opportunities to strengthen their case along the way. In a significant number of cases it saves time as the appeal can be resolved without the need for it to be considered by an Appeals Officer.
Notice that an appeal has been submitted is issued to any other party who appears to be concerned, that is a person with a material interest in the case. An Appeals Officer may call witnesses who might be in a position to furnish evidence in relation to the appeal.
On receipt of a relevant documents from the scheme area, the appeal is referred to an Appeals Officer.
Given the volume of appeals and in order to be fair to all appellants, the assignment of appeals is generally dealt with in chronological order.
The Chief Appeals Officer may, where she considers it appropriate, refer any question which has been referred to an Appeals Officer to the High Court for decision. This is only where complex points of law are involved.
The Chief Appeals Officer may certify that the ordinary appeals procedures are inadequate to secure the effective processing of an appeal and can direct that the appellant submit the appeal to the Circuit Court for determination. If the appeal relates to a decision made by an officer of the Criminal Assets Bureau, the Chief Appeals Officer must direct that the appeal be submitted to the Circuit Court.
An Appeals Officer may ask any relevant person to provide further information on the appeal and may allow amendment of the notice of appeal and of any statements made.
Where the Appeals Officer is of the opinion that the appeal can be determined on the basis of the documents available and without the need for an oral hearing, she or he may determine the appeal summarily.
Where the Appeals Officer considers that an oral hearing is required to determine the question at issue, she or he will arrange for an oral hearing of the appeal.
There is no absolute right to an oral hearing and a request for an oral hearing will not be given in all cases.
Where an oral hearing of the case is required, it is estimated that the logistics involved can add another 6 weeks to the process as the hearing venue must be scheduled and the appellant is generally given 2-3 weeks’ advance notice.
In practice, in forming an opinion as to whether an appeal can properly be determined without an oral hearing an Appeals Officer will have regard to:
As an Appeals Officer may determine an appeal on a summary basis it is important that all the documentary evidence and grounds relied on are submitted with the notice of appeal.
At any time during this process, up to and including the oral hearing, if applicable, an appellant can submit additional information, which affords them the opportunity to strengthen their case.
An oral hearing may be held virtually (by video call online), in person or by phone. An in-person hearing will be held in a location deemed suitable by the Appeals Officer.
A notice of an oral hearing is sent to all parties concerned.
The appellant will normally attend the oral hearing and may be accompanied by a member of his or her family or, by any other person if the Appeals Officer consents..
An appellant may also be represented at the hearing by a member of his or her family or by any other person with the consent of the Appeals Officer.
Appellants should make any arrangements considered necessary in preparation for the oral hearing. as scheduled hearings will only be re-arranged in exceptional circumstances. It is also important that appellants provide all evidence considered relevant to the appeal in a timely manner.
The Deciding Officer/Designated Person who made the decision may attend or they may be represented by another officer of the Minister. Any other person whom the Appeals Officer considers should be heard may also attend . Every effort is made to keep the hearing as informal as possible.
If a person has to travel to attend the hearing, the Appeals Officer will arrange reimbursement for reasonable travel and subsistence expenses and compensation for any loss of earnings.
The costs of professional representation at an oral hearing are not paid. However, the Appeals Officer may make an award in regard to such representation but only in respect of the representative's actual attendance at the oral hearing.
Oral hearings are held in private, and the aim is to keep the proceedings as informal as possible. However, the Appeals Officer may, if she or he thinks it appropriate, take evidence on oath and administer oaths to persons attending as witnesses at the hearing (Section 313). The recording of an oral hearing is not permitted.
The Appeals Officer will introduce him/herself and all other persons present. She or he will also say if there are other people he or she intends to call to give evidence during the hearing. The Appeals Officer will outline the decision against which the appeal is being made, the grounds of the appeal and the scheme area's response to these grounds. Evidence will be taken from any witnesses.
At the hearing the appellant is given every opportunity to set out his or her case and to question any evidence offered by witnesses. Alternatively, if applicable, his or her representative, may do this on their behalf.
In a small minority of cases the Appeals Officer may be compelled to postpone or adjourn the hearing. This might be necessary if, for example, a crucial witness is not available or some additional evidence requiring further investigation is introduced at the hearing. The Appeals Officer may agree to defer consideration of the appeal to give the appellant the opportunity of obtaining some further evidence in support of his or her case, for example a Medical Consultant's report. However, every effort should be made to have all relevant evidence in support of the appellant’s case in advance of the hearing.
Where a person fails to attend an oral hearing, the Appeals Officer may take such steps as she or he considers appropriate to determine the appeal.
An Appeals Officer may, by giving notice in writing, require a person to attend an oral hearing and to produce any relevant documents. A person failing to comply with such a notice is guilty of an offence and, on summary conviction, may be fined up to €1,500.
Following his or her consideration of the appeal, including evidence given at the oral hearing, if applicable, the Appeals Officer will then make a determination in relation to the appeal.
The decision of the Appeals Officer will be in writing and, where the decision is not in favour of the appellant, will explain the reasons for the decision.
The decision outcome will be sent to the appellant and any other person concerned. The decision is also sent to the relevant scheme area at that stage for any necessary action.
The question before the Appeals Officer for decision is the same question as was before the Deciding Officer/Designated Person who made the initial decision. The Appeals Officer is not confined to the grounds on which the initial decision was based, and she or he may consider the question as if it were being determined for the first time.
In considering the appeal, the Appeals Officer will have regard to all relevant evidence including the supporting material. This material may include reports of departmental Investigating Officers and Medical Assessors, the grounds of appeal including any documentation submitted with it and the submission by or on behalf of the officer who made the decision. Other documentary evidence could consist of correspondence from an employer as to the occurrence of an occupational accident or in regard to how a person's employment terminated. The Appeals Officer will also have regard to any facts emerging from the presentation of evidence at the oral hearing.
The conditions underlying entitlement to benefit are contained in provisions of social welfare legislation [the Social Welfare Acts and Regulations made thereunder] and the Appeals Officer must apply this legislation to his or her findings of the facts in determining the question under appeal. Some issues may involve the application of other legislation or case law.
Case law used consists of Irish Courts judgements and of decisions by other courts acknowledged in Irish courts judgements.
Some appeals may involve issues which had not arisen previously and the decisions of Appeals Officers in those cases may provide guidance were the same issues to arise again, subject, of course, to the merits of individual cases.
The (published) annual report of the Chief Appeals Officer to the Minister contains summaries of cases determined by Appeals Officers and reviews of decisions of Appeals Officer carried out by the Chief Appeals Officer, which the Chief Appeals Officer considers would be helpful in construing particular aspects of legislation or in making findings of facts based on particular circumstances.
A decision of an Appeals Officer may be revised by an Appeals Officer in the light of new facts or new evidence brought to attention or if there has been a relevant change of circumstances since the decision was given (Section 317).
A decision of an Appeals Officer may also be revised by the Chief Appeals Officer if it appears to her that the decision was erroneous by reason of a mistake as to the facts or the law (Section 318).
In either case, the person concerned should submit a written statement of the grounds on which a review of the decision is sought and include any new evidence that was not previously considered.
In all procedures, principles of natural justice are fully adhered to and, if such a review would have a material interest for some other person concerned, such other person will be afforded an opportunity to comment.
The decision of an Appeals Officer is in general final and conclusive (Section 320). However, this is subject to appeal to the High Court on a point of law (Section 327), review in light of new facts or evidence (Section 317), or by reason of a mistake in relation to the law or the facts (Section 318).
It is also open to any appellant to seek a judicial review of a decision in the Courts if she or he feels that a decision is deficient for want of fairness of procedure.