Dáil Éireann Debate, Thursday - 16 April 2026
256. Deputy George Lawlor asked the Minister for Social Protection if he will review the disallowance of an illness benefit claim of a person (details supplied); and if he will make a statement on the matter. [27725/26]
Amharc ar fhreagraThe person concerned made a claim for Illness Benefit on the 2nd of March 2026. Unfortunately, they did not qualify for payment of Illness Benefit as they do not satisfy the contribution conditions.
A letter was sent on the 23rd of March 2026 providing them the full details of this decision including the options to Review/Appeal this decision. My department has since received a request to review this decision which will be undertaken as soon as possible.
Illness Benefit is paid from the Social Insurance Fund and entitlement is based on contributions made via PRSI paid. While recognising the person concerned has some history of contributions, a tenet of the social insurance system is the requirement to maintain a balance between coverage for various contingencies, such as Illness Benefit, with the sustainability of the Social Insurance Fund. This is to recognise a previous attachment to the labour market that is relatively recent and is achieved by requiring both a certain minimum of total contributions to have been made, and also by having a certain number of contributions in the relevant tax year, which in this case is 2024.
Qualifying for Illness Benefit
In order to qualify for Illness Benefit, you must meet conditions listed below:
You must have at least 104 class A, E, H or P social insurance (PRSI) contributions paid since first starting work. Only PRSI contributions paid at these classes are reckonable for Illness Benefit.
You must also meet either Condition 1 or Condition 2 below:
Condition 1
You must have 39 weeks of PRSI contributions paid or credited in the relevant tax year, of which 13 must be paid contributions.
If you do not have 13 paid contributions in the relevant tax year, then 13 paid contributions in one of the following tax years can be used instead:
• either of the two tax years before the relevant tax year
• the last complete tax year (before the year in which your claim for Illness Benefit begins)
• the current tax year
• OR
• Condition 2
• You must have 26 weeks of PRSI contributions paid in the relevant tax year, and 26 weeks of PRSI contributions paid in the tax year immediately before the relevant tax year.
• The relevant tax year is the second-last complete tax year before the year in which your claim for Illness Benefit begins.
• Example: If you make a claim in 2026, the relevant tax year is 2024.
• While the person concerned does have the minimum number of total contributions required, they only had 16 A contributions for the relevant year (2024) and as such does not qualify for payment of Illness Benefit.
• The person concerned should continue to submit medical certificates for as long as they are incapable of work in order to receive PRSI credited contributions and, if they are in urgent need of financial assistance, they can contact the Community Welfare Officer in her local Intreo office to enquire about assistance under the means-tested Supplementary Welfare Allowance scheme.
• I hope this clarifies the position for the Deputy.
