Social grants

Elma de Vries
Division of Family Medicine
What different social grants are
available in SA?
 What different social grants are
available in SA?
• Child support grant (R290pm in April and R300
in October)
• Care-dependency grant (R1260 pm)
• Foster child grant (R800 pm)
• Grant-in-aid (R 280 pm)
• Social Relief of Distress Award (temporary
payment in a crisis) – for up to 3 months
• Grant for older persons (R1260 pm)
• Disability grant (R1260 pm)
• (Updated figures for April 2013)
 Child support grant
• the primary care giver must be a South African citizen or
permanent resident; both the applicant and the child
must reside in South Africa;
• applicant must be the primary care giver of the child/
children concerned;
• the child/children must be under the age of 18 years;
• the applicant and spouse must meet the requirements of
the means test;
• Child can not be cared for in state institution.
• Need ID of the parent / primary caregiver
• Need birth certificate
• Need proof of income
 Care-dependency grant
• This grant is available to the parent or foster
parent of a child (<18 years) who has a severe
mental or physical handicap and therefore
needs full time care.
• Must submit a medical / assessment report
confirming permanent, severe disability;
• Applicant and spouse must meet the
requirements of the means test (except
for foster parents);
• The care-dependent child/children must not be
permanently cared for in a State Institution
 Foster care grant
• This grant is available to anyone who looks after a foster
child. It is supposed to help pay for the child's food,
clothes and education.
• The applicant and child must be resident in South Africa
• Need a court order indicating foster care status;
• The foster parent must be a South African citizen,
permanent resident or refugee.
• Child must remain in the care of the foster parent (s)
• The income of foster parents will not be taken into
consideration (no means test)
 Grant-in aid
• The applicant must be in receipt of a grant
for Older Persons, Disability grant, and
require full-time attendance by another
person owing to his/her physical or mental
disabilities;
• must not be cared for in an institution that
receives subsidy from the State for the
care/housing of such beneficiary
 Social Relief of Distress Award
• Social relief of distress is the temporary provision
of assistance intended for persons in such dire
need that they are unable to meet their or their
families' most basic needs.
• It usually in the form of a food parcel or food
voucher (not cash).
• Social Relief of Distress is paid to South African
citizens or permanent residents, who have
insufficient means and meet one or more of the
following criteria:
 Social Relief of Distress Award
criteria

• The applicant is awaiting an approved social

grant;
• The applicant has been found medically unfit to
undertake remunerative work for a period of
less than 6 months;
• The applicant has been affected by a disaster as
defined in the Disaster Management Act, 2002
• The person is not receiving assistance from any
other organization
 Grant for older persons
• The applicant:
• Must be a South African citizen / permanent resident
• Must be resident in South Africa;
• Must be 60 years or older (no more gender
discrimination since April 2010);
• Spouse must comply with the means test;
• Must not be maintained or cared for in a State Institution;
• Must not be in receipt of another social grant for him or
herself.
 Means test
ASSET THRESHOLD

Older person's and disability grant

Single person R 831 600
Married person R 1.7 M
INCOME THRESHOLD (annual income)

Older person's and disability grant

Single person R 49 920
Married person R 99 840
Child support grant
Single R 33 600
Married R 67 000
Care-dependency grant
Parent/PCG: Single R 144 000
Parent/PCG: Married R 288 000
 Finance Minister Pravin
Gordhan:
• “It is... proposed that the old age grant
means test should be phased out by
2016.”
• This would simplify its administration and
“address the disincentive to save that
arises from the present means test”.
• 2.8 million people are receiving old age
grants
 Disability grants
• The applicant:
• Must be a South African citizen
• Must be resident in South Africa;
• Must be 18 to 59 years of age;
• Must submit a medical / assessment report
confirming disability, not older than 3 months old;
• Must comply with the means test;
• Must not be maintained or cared for in a State
Institution
 
 DG Guidelines
• A disabled person is any person who has
attained the prescribed age of 18 and is
owing to his or her physical or mental
disability unfit to obtain by any virtue of
any service, employment or profession the
means needed to enable him or her to
provide for his or her maintenance.
• A grant for the disabled can only be applied for on
health reasons (medical diagnosis). A grant for the
disabled can only is allocated if the health condition
results in functional impairment, which prevents the
applicant from gainful employment.
• A disability grant is not designed to alleviate
unemployment.
• A distinction has to be made between:
• Those who as a result of an impairment are unable to
work.
• Those who cannot find work because of
unemployment
• Those who do not wish to follow their treatment.
• Only an applicant who as a result of impairment is
unable to work is eligible for a grant.
• The applicant must not refuse without good
reason to undergo the necessary medical or
other treatment recommended by a medical
officer, medical practitioner, psychiatrist or an
assessment panel.
• Lack of motivation to work or participate in a
rehabilitation programme is not a reason for
disability unless there is a psychiatric condition
in which case a psychiatric report must be
completed.
• Patients must be rehabilitated whenever
possible.
• Alcohol and substance abusers must be referred
for rehabilitation.
 Completing the form
• The patient must be present at the time of
completing the form.
• Applicant should be identified by ID
document, surname and full names should
be same as in the ID.
• Medical report to be completed in legible
handwriting or print.
• Patient to be considered globally and
assessed according to objective criteria.
• Eligibility for the grant depends on the
severity of the impairment and to what
extent it affects the person’s ability as a
whole. Conditions such as backache,
single joint arthritis, diabetes, coronary
artery disease, valve replacements, etc.
do not automatically ensure eligibility.
 Respiratory
• 25 year old male with asthma, has Std 10, tried
working as a gardener but struggled. Has not
tried any other occupations. On steroid inhaler,
needs reliever twice a week. Peak flow 450.
• 36 year old patient with HIV and disseminated
TB, stopped working due to illness, was too
weak.
• 51 year old with COPD, peak flow 150, still
smoking. Grade 2 dyspnoea. Worked as a driver
before.
 Respiratory
• Dyspnoea – indicate the cause.
• II. Effort tolerance from grades 1 – 2 (b) to be
considered in the global picture.
• III Tuberculosis – depending on his general
health, consider 6-month grant and review.
Patient must comply with treatment.
• Asthma - the number of acute episodes needs to
be taken into account. Is the patient on
maximum steroid therapy? Do peak flow and
record as percentage of normal.
 Cardiovascular
• Do all patients with angina need a DG?

• Do all stroke patients need a DG?

 Cardiovascular
• Frequent angina not responding to treatment
coupled with target organ involvement –
consider permanent grant.
• Stroke – if limbs are affected, considered 6
months grant, refer for rehabilitation and review
thereafter. Consider physical, communication
and cognitive aspects.
 Diabetes
• 47 year old Mrs S, schooling Std 5, single
parent of 4 children. Type 2 diabetic and
HT. Compliant on meds, HbA1c =6, BP
130/80.
• Says she cannot find a job to support her
children and wants a grant because of her
“sugar”
 Diabetes
• Consider grant only if target organ involvement.
• Amputation – needs rehabilitation
• Hypertension, diabetes, coronary artery disease
is not an automatic right to a disability grant.
• Consider functional impairment.
• Person must be able to use public transport
independently in rush hour traffic to and from
work timeously. Consider level of education and
ability to use public transport.
 Visual acuity and deafness
• Do all blind and deaf people need grants?
 Visual acuity and deafness
• Refractive error – refer for glasses.
• Partial and total blindness with no education or skill
competencies should be considered.
• Cataracts refer for surgery and give temporary grant for
the disabled according to waiting list for surgery.

• Deafness: If a patient lacks effective communication

skills with people other than family members
consideration is given for a grant. Consider
communication skills, hearing aid and global picture.
Look at the whole patient. Language barriers are not a
reason for disability.
 Epilepsy and intellectual disability
• 30 year old epileptic with frequent seizures. Poor
adherence to medication, abuses alcohol.
Previously worked as a manual labourer.

• 25 year old epileptic, seizures 4/month despite

optimal medication. Also mild MR, highest
education std 2. Unable to use public transport
on her own because seizures any time.
 Epilepsy and intellectual disability
• Less than 3 seizures/month – consider globally.
Note compliance with medication and
substances, levels, maximum therapeutic
medication and options. Note co-existence of
mental retardation.
• IQ below 70 qualifies for disability. This is
equivalent to 10 years of age and below.
Consider ability to function independently or
without supervision. Addendum gives details.
 Psychiatric illness
• The Medical Officer should furnish a clear diagnosis
after assessment of the Applicant. A description of
symptoms is not sufficient.
• The Medical Officer should provide a clear description
of the features of the illness which results in functional
impairment of the applicant.
• In the case where Substance Abuse (Alcoholism and
other Drug Dependence) or Personality Disorder is the
sole diagnosis, applicants should not be considered
eligible for a disability grant.
• Annexure A gives more detail, e.g. for major
depression or anxiety only 6 months grant then review.
 Chronic conditions
• Malignancies – new case on radiotherapy
treatment – consider 12 months grant, review.
Advanced case – permanent grant.
• HIV Positive – on its own – not eligible. Consider
on stage of disease, complications and
general state of health. Judge according to
symptoms.
 Musculo-skeletal
• Patient with backache - when do they
qualify for DG?
 Musculo-skeletal
• Residual strength out of 5 to be considered in
the global picture e.g. educational and skills
competencies.
• Consider patient’s ability to actively participate in
an 8-hour day of physical activity. Note presence
of normal lumbar lordosis, degree of straight leg
raise and range of motion on examination and in
functional tasks. Note if there is neurological
fallout.
• Hand and peripheral nerve injuries: Labourers
need bilateral hand function. What was the
compliance in the rehabilitation process?
• Indicate the period of disability. Where in your
opinion the patient does not qualify, state
reason(s) why not.
• All permanent disabilities may be medically
reviewed after five (5) years.
• Temporary disability may be for six or twelve
months and will be terminated after the period
expired. These beneficiaries will need to re-
apply for a grant.
• Indicate whether grant needs to be administered
(epilepsy, intellectual disability, psychiatric
illness, substance abusers, those who not know
the value of money)
• The form must be marked with your institutions
stamp and date. Sign the form and write your
name and credentials legibly.
• The form is kept to be collected by Social
Services, the patient is given a slip as proof that
a medical assessment was completed.
• Patient has to go to Social Services to complete
the application (documents for means test, etc.)
 Questions?

Documents (on Vula):

SASSA guidelines
Annexure A – psychiatric
Annexure B – intellectual disability
Annexure C – administration of grants