Appealing Medical Card Application decision?

ivorystraws

Hi,

I had a traumatic Brain Injury in April 2009. I applied for a medical card on the 14th of April 2011. I thought I had supplied all the relevant documentation when they kept getting back to me asking for things which weren't initially requested such as house valuation etc. So after I have provided them with all that, which includes;

1. Evidence of wages: I don't receive wages but an insurance payout which is processed through my employers Permanent Health Insurance scheme which is less than one fifth of what I was on.
2. Evidence of Savings and Investments: I do not have any shares or investments.
3. Evidence of fire and contents insurance premia
4. Evidence of Mortgage Protection Payments
5. Evidence of expenses incurred in respect of rent: I currently rent in Dublin as all my treatments are ongoing in Dublin.
6. Evidence of Mortgage Payments
7. Evidence of my rental income: I am not in receipt of any rental income whatsoever.
8. Valuation of second property or land: Provided documentary evidence of the valuation of the property I co-own with my brother
9. Summary details of management of Traumatic Brain Injury: I have provided them with a detailed summary of the majority of my medical appointments and treatments since my accident happened. This also provides details on the prescribed medicines I am on, the ongoing symptoms I am experiencing and the long-term illness medication I have been prescribed.

Now despite the Medical Card office confirming that they had finally received all required documentation on the 22nd of November (via me calling them), I only received confirmation via letter that my application was unsuccessful on the 16th of January i.e. almost two months later despite them guaranteeing that applications done online would be processed within 15 days!! Aren't they breaching some law there?

I was declined a medical card for financial reasons despite their calculations being totally incorrect i.e.

• they had a number down for Investment income even though I stated I don't receive any!?
• The amount they have for my employment (insurance) amount is incorrect as the revenue state I have a 2k+ tax liability since I am in receipt of invalidity pension!?
• I don't see where they took my home and contents insurance into account? Shouldn't that be included with Mortgage/Rent?
• My rent/Mortgage calculation is now incorrect
• They haven't taken into account my loan repayments via MABS!?

Why didn't they take my MABS loan repayments into account? Is this correct?

The financial burden of me having to pay for further treatment to aid my Traumatic Brain Injury rehabilitation would certainly cause me undue hardship. Why didn't they take that into account?

I am appealing the decision but I'm awaiting my P60 and newest payslip plus I'd appreciate some feedback from anyone on this forum, thanks.

ivorystraws

Are the medical card income guidelines €184 for a single person? It states on the letter I received that the Basic Allowance is €164... is that just another mistake the medical card department "apparently" made?

Balagan

Its Euro 184 for a single person living alone and Euro 164 for a single person living with family.

http://www.citizensinformation.ie/en/health/entitlement_to_health_services/medical_card.html

ivorystraws

Balagan wrote: »

Its Euro 184 for a single person living alone and Euro 164 for a single person living with family.

http://www.citizensinformation.ie/en/health/entitlement_to_health_services/medical_card.html

Thanks for clarifying that... it's yet just another thing the medical card department got wrong!

Looking forward to someone being able to help answer my other queries.

Balagan

Everything you mentioned should have been taken into account (see below). As you know, this forum is for info on State Benefits, not criticism of departments, and, under the heading of info, it is true that extensive media reports (you could listen back to Liveline, RTE Radio One http://www.rte.ie/radio1/liveline from Friday, 20th January as an example) have made it clear that there are very long delays in issuing and renewing medical cards and many people are spotting obvious errors in the decisions when they finally arrive. From what I have heard and read, your appeal should include all your documentation again, from scratch, and it would be recommended that you keep copies and when mailing it, send it by Registered Post.


Outgoings - evidence to be provided
Rent / Mortgage
Home Improvement Loans
Mortgage Protection
House Insurance
Childcare/Child Minder
Travel to Work Costs
Maintenance payments to another person
If your income is above the income guidelines, you may still be granted a Medical Card or GP Visit Card if you have exceptional circumstances that cause you undue fi nancial hardship.
Please provide details and evidence of any other issues which you wish to have considered.
Examples would include:
• Health Expenses including
professional fees
• Prescribed Medicines or Appliances
• Hospital Charges
• Travel, Accommodation or
Childcare costs related to
attending clinics or hospitals
• Loans or other money
management issue
http://www.hse.ie/eng/services/Find_a_Service/entitlements/Medical_Card_GP_Visit_Card_Application_Form.pdf
From Part 4, details of outgoings and expenses

ivorystraws

Balagan wrote: »

Everything you mentioned should have been taken into account (see below). As you know, this forum is for info on State Benefits, not criticism of departments, and, under the heading of info, it is true that extensive media reports (you could listen back to Liveline, RTE Radio One http://www.rte.ie/radio1/liveline from Friday, 20th January as an example) have made it clear that there are very long delays in issuing and renewing medical cards and many people are spotting obvious errors in the decisions when they finally arrive. From what I have heard and read, your appeal should include all your documentation again, from scratch, and it would be recommended that you keep copies and when mailing it, send it by Registered Post.


Outgoings - evidence to be provided
Rent / Mortgage
Home Improvement Loans
Mortgage Protection
House Insurance
Childcare/Child Minder
Travel to Work Costs
Maintenance payments to another person
If your income is above the income guidelines, you may still be granted a Medical Card or GP Visit Card if you have exceptional circumstances that cause you undue fi nancial hardship.
Please provide details and evidence of any other issues which you wish to have considered.
Examples would include:
• Health Expenses including
professional fees
• Prescribed Medicines or Appliances
• Hospital Charges
• Travel, Accommodation or
Childcare costs related to
attending clinics or hospitals
• Loans or other money
management issue
http://www.hse.ie/eng/services/Find_a_Service/entitlements/Medical_Card_GP_Visit_Card_Application_Form.pdf
From Part 4, details of outgoings and expenses

Thanks for the response.

It would seem to me that not everything I've mentioned would have been taken into account and hence the reason they have made so many mistakes.
I do know that this forum is for information on State Benefits and that's exactly what I'm asking about. The criticism of Social Protection departments is very obvious in most threads on this forum and totally understandable so I don't want to waste time on that.

I've heard many reports about the long delays being incurred in issuing and renewing medical cards and I know that many people are spotting obvious errors in the decisions when they finally arrive but I'm asking what formal route, apart from the appeals procedure is available to me and others like me... or is there any at all?

I'm not sure if my appeal should include all the relevant documentation again since they have it on their system (so a representative told me on the phone) but knowing the way they work, I feel I will have to provide all relevant documentation again, unfortunately.
I already quickly learnt, from my dealings with anything to do with the HSE to keep copies, records of everything I fax, email and send all applications/submissions by Registered Post. I also record some calls so it's easy to note who said what and when the said it.
The items you have outlined, I have already sent them, which is why I ask:

• They had a number down for Investment income even though I stated I don't receive any - is this something to do with the house valuation?
• I can see that they have a figure down for "Fire and Contents insurance premia" but I don't see where they took my mortgage protection into account? Shouldn't that be included with Mortgage/Rent?
• I know they don't take loans into account so in my appeal, I will be including a report from MABS.

Everything else, I've already provided to them but will probably have to do so again.

LegacyUser

only home improvement loans are taken into consideration and these must be verified as a home improvement loan by your financial institution.