Answer to a question from a reader

Can I be financially and medically assisted while waiting for the independent tribunal to decide on my compensation claim?

The short answer

You can apply for SASSA Temporary Disability Grant while you wait for the outcome of the tribunal.

The whole question

Dear Athalie

Do I have any rights to be financially and medically assisted while waiting for the independent tribunal to decide on my compensation claim for a work-related musculoskeletal disorder which was repudiated in 2013, 2017 and 2022 by Rand Mutual Assurance (RMA) after I had been medically boarded in 2012? I am a former mine employee. 

The long answer

I am presuming that you have already claimed your UIF benefits since your medical boarding in 2012. 

The only other source of financial assistance in the interim while you wait for the outcome of the tribunal might be a SASSA Temporary Disability Grant, on the basis that you are unable to work, but are still waiting for the tribunal hearing to take place.

SEESA, a legal compliance and business solutions company, says: “Employees who are temporarily or permanently medically boarded may claim UIF or a SASSA medical disability grant, depending on their circumstances and whether they meet the requirements to submit a claim. A SASSA disability grant will be awarded, according to their website, if the claimant meets the legislated requirements and is not receiving any other disability benefit, and where the medical assessment confirms that the claimant cannot work because of their condition or disability.”

The Western Cape government has the following on its website: “If you’re permanently unable to work, or if you’re temporarily unable to work for longer than 6 months due to a physical or mental disability, you’re eligible to apply for a South African Social Security Agency (SASSA) disability grant.”

The disability information NGO, Disability Info South Africa (DISA), says a person can apply for a disability grant if they are “owing to a physical or mental disability, unfit to obtain by virtue of any service, employment or profession the means needed to enable him or her to provide for his or her maintenance.”

This is the information you would need to submit to apply for a SASSA Temporary Disability Grant, according to the Western Cape government

  • Your 13-digit bar-coded identity document (ID)

  • A medical report and functional assessment report, by a medical practitioner recognised by SASSA, confirming your disability. Your medical assessment must not be older than 3 months at the date of application. (A GroundUp article expands on this: you need to undergo a medical examination where a doctor appointed by the state will assess the degree of your disability; bring along any previous medical records and reports when you make the application and have the assessment)

  • Proof of marital status (if applicable)

  • Proof of residence

  • Proof of income or dividends (if any)

  • Proof of assets, including the municipal value of your property

  • Proof of private pension (if any)

  • Your bank statements for the past three months

  • Unemployment Insurance Fund (UIF) document ("blue book") or discharge certificate from your previous employer if you were employed.

“Your application form will be completed in the presence of an officer from SASSA. If SASSA does not approve your application, you will be given valid reasons why the application has been declined in writing. You have the right to ask SASSA to reconsider your application, if you’re unhappy with their decision. You can also appeal to the Minister of Social Development in writing, explaining why you disagree. This appeal must be lodged within 90 days of you being informed of the outcome of your initial application.” (source)

You may be waiting for the outcome of the tribunal before claiming your pension or provident fund. These are the documents you would need to claim from the Mineworkers Provident Fund: 

  1. Withdrawal (Retirement, Disability & Terminally ill) claim form signed by the member and two employer authorised signatories, AND stamped by the mine;

  2. Banking details (copy of a bank statement stamped by the bank);

  3. Certified copy of Identity Document;

  4. Payslip.

For claims, you need to contact the Human Resources office at the mine.

Email: clientsservices@mineworkers.co.za

Tel: +27 (0) 10 100 3001

In terms of the tribunal being postponed, RMA says on its website that it will try to settle a complaint (i.e. your objection to the RMA rejecting your claim) within three months. Thus, it is supposed to set up a tribunal within three months.

What struck me was the possibility that the RMA may have rejected your compensation claim three times, despite you being unable to work, because your musculoskeletal disorder may have been diagnosed as fibromyalgia. Fibromyalgia is described as “medically ill-defined” and confirming a diagnosis can take up to five years. 

It is not a recognised Prescribed Medical Benefit disease in South Africa, and so disability claims are usually rejected. Instead, you have to demonstrate that the symptoms of the musculoskeletal disorder negatively impact your ability to hold down a steady job.

So, if you have been diagnosed with fibromyalgia, below are some resources for support and patient information:

If the tribunal assesses that you are between 1% and 30% disabled, you will receive a lump sum payment. If the assessment is between 31% and 100% you will be on a disability pension for life. This would be 70% of your net salary based on the salary you earned before you stopped working.

If the tribunal confirms RMA’s rejection of your claim, you could challenge it in the High Court.   

In January 2022, Groundup published an article about a mineworker who was losing his hearing after working with very noisy machinery for a long time. This worker’s claim was declined by RMA because they said the worker had not proved that his hearing loss was caused by his work. He lodged an objection to RMA’s assessment and they appointed a tribunal, which upheld RMA’s assessment. The worker then took the matter to the Gauteng High Court, where two judges found that the worker was entitled to compensation as the RMA tribunal was required to prove that the worker’s hearing loss was not caused by his work, and they failed to prove it. In other words, it was not the worker who had to prove that his hearing loss was caused by his work, but RMA who had to prove that it was not caused by his work.

The judges found that the tribunal did not properly assess the medical evidence that the worker presented, and so the court overturned the tribunal’s decision and sent the matter back to the tribunal to decide how much compensation the worker was owed.

Given that you are struggling financially, if you needed to challenge the tribunal’s decision in court, you could approach Legal Aid, which is a means-tested organisation that must assist people who can’t afford a lawyer.

These are their contact details:

Tel: 0800 110 110 (Monday to Friday 7AM - 7PM) 
079 835 7179 (Please Call Me) 
Email: communications2@legal-aid.co.za 

You can also contact SA Society Labour Law

Tel: 021 762 4498 

Email: westerncape@saslaw.org.za (other provinces have different emails)

Wishing you the best,
Athalie

Answered on July 9, 2023, 11:27 p.m.

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