It was proposed in A Strategy for Equality, it’s been widely researched and implemented elsewhere—Why not here? asks Dr Pauline Conroy, Ralaheen Ltd.


A cost of disability payment is a cash amount paid to individuals with disabilities, in addition to their existing income or welfare payments, to enable them to meet the extra costs connected with their disability. A cost of disability payment is one of the supports to equalise opportunities between people with, and people without, disabilities. It recognises the extra, recurring and unavoidable expenditure associated with participating in everyday life.

The Commission on the Status of People with Disabilities recommended the introduction of a cost of disability payment in its report to government in 1996. That recommendation (no.53) was rejected in the government’s 1999 progress report on the implementation of the Commission’s Report. Following extensive lobbying, and mention of such a payment in the Programme for Prosperity and Fairness, discussion on a cost of disability payment was revived again. A working group on the feasibility of a cost of disability payment was formed in 2000, chaired by the Department of Health and Children. The Forum of People with Disabilities commissioned a study on how a cost of disability payment could be introduced in Ireland. Ralaheen Ltd completed that study in June 2001 and it was submitted to the Department of Health and Children working group. The working group agreed to commission its own research on the subject and asked the National Disability Authority to assist in organising such a study. Discussion, from the point of view of the public, is at a standstill.

So what are extra, unavoidable and recurring costs which might be addressed by a cost of disability payment? People with disabilities face a range of additional costs in everyday life which are not provided for by free services or by tax allowances—for example, extra heating, taxis where there is no accessible public transport, purchase and repair of assistive devices and equipment, purchase of quality nappies, home help and personal assistance, computerised learning equipment, Braille notes and the services of sign language interpreters, special shoes or clothing. While individual circumstances vary, what all these costs have in common is that they are extra, recur all the time and are essential for participation in everyday life in society.

What is special about a costs of disability payment is that all persons with a disability could be eligible to apply whether they worked or not, whether they lived in residential care or not, whether they claimed disability payments or not. A costs of disability payment is a top-up payment, in addition to existing welfare payments, income, salary or allowance. Given the European single market, such a payment should have a portable dimension so that Irish claimants could travel with their payment.

The amount of the cost of a payment should be based on the severity of impediments to be overcome for participation in everyday life. A person with an intellectual disability might have extra recurring costs, essential in their everyday life, which would increase with age. An individual moving from residential to semi-independent living might encounter additional and essential costs to live in an apartment. An individual returning to work after an occupational injury might have additional costs, for a limited period. The key issues are what is essential, what is recurring and what is additional. These are the three features of the payment, which distinguish the costs of disability from other payments.

To ease administration of such a payment, the model of ‘self-assessment’, already widely used by the Revenue Commissioners, could be followed. The claim for a costs of disability payment could be completed by an individual, carer, parent, advocate, intermediary advisor or professional. Systems of detecting abuse, fraud or irregularity have already been established within the tax and social welfare systems. The Central Statistics Office and Census 2001 will soon provide information about the percentage of the Irish population experiencing some limitations in their everyday life.

The ideal social partner to a costs of disability payment is a system of disability tax credits for workers with disabilities, who at present pay taxes while absorbing their own additional and recurring costs through earned income. In such a scenario, individuals would opt either for a costs of disability payment or a disability tax credit.

A costs of disability payment is not a health or medical payment. It is one of the methods of equalising opportunities between individuals with, and individuals without, disabilities to participate and enjoy to the maximum their potential. The 1970 Health Act provides a legal basis for this type of payment. Before he left office, President Bill Clinton signed into law The US Ticket to Work and Work Incentive Improvement Act (1999) which is a recognition of the additional health costs of working Americans with disabilities. The UK has integrated some costs of disability into their welfare and tax systems. It is not a choice between Boston and Berlin—Europe and the USA are recognising the monetary costs of equalisation of opportunities. For Ireland, it is a question of when?