This article was first published in the 4th-quarter 2015 edition of Personal Finance magazine.
It seems particularly perverse when disability happens in the pursuit of good health and fitness. Jonathan Samuels (not his real name) was 35 years old and riding with a group of cyclists on a rural road in the Western Cape when his wheel hit a pothole and he was sent flying over the handlebars. Instead of hitting the road, he fell into a nine-metre-deep culvert beside the road and landed with his back on a sharp rock.
He says he remained conscious and knew immediately that he had broken his back, since he had no sensation in his lower body. In fact, he had broken his spine at the sixth vertebra, but that was not all: his ribs, shoulder and right leg were shattered too. He was in hospital and rehabilitation for six months and emerged a paraplegic, with no sensation from the sternum down and the prospect of coping with the repercussions for the rest of his life.
Fourteen years on, he says: “People see someone in a wheelchair and think ‘he can’t walk – that’s terrible’. In fact, that’s the least of my problems. Walking, on my wish list, is about number 10. I can get around with the help of a wheelchair. Before that, you want bladder control, bowel control and sexual function – they’re far more important.”
Actuaries have statistics relating to the frequency of the common health complications that go with disability, but some cannot be foreseen – or even imagined by an able-bodied person. For example, at the time of writing, Samuels’s left leg was broken in three places – the result of an over-eager car guard tipping him out of his chair while trying to be helpful. And it’s not the first time he has broken a limb.
“When you don’t put weight on your limbs, they become very fragile,” he says. And ever the pragmatist, he adds: “It’s supposed to be in a brace, but I figure ‘What the hell, I can’t feel it anyway’.”
Not only do your bones lose density and your muscles waste away rapidly when you no longer stand upright or move around, but you become vulnerable to blood clots and infections.
Samuels is as active as he can be, still cycles 400km a week and participates in races on his special three-wheeled, recumbent cycle (cost: R80 000, plus R60 000 for a set of wheels). In fact, he certainly gets around more than many able-bodied, but sedentary, middle-aged men.
“But fit as I am, things still go wrong. Before my accident I never took a single tablet. Now I take 47 tablets a day. Soon after the accident I developed high blood pressure. I’ve got diabetes and I take medication to keep my body working. I’m in constant pain, but you can’t take painkillers because they affect other systems. I can’t cough properly and I can’t sneeze properly. So there’s all sorts of weird stuff.”
Mobility might be attainable, but only at a price and depending where you live. “The sad reality is that if you live in a crowded township and end up in a wheelchair, you can’t get around the streets, so you become invisible, or you are pushed around in a wheelbarrow,” Samuels says. “The vast majority of people ride around in R5 000 wheelchairs. Then you get quite a lot of people who are in R50 000 or R60 000 wheelchairs, like me. If it’s electric, it’s over R100 000.”
And wheelchairs need to be replaced as often as every three years. Taking into account his competitive cycling and the specially adapted, hand-controlled car he drives, Samuels says his equipment costs alone can amount to R300 000 every few years – for a level of mobility that the rest of us take for granted. He points to the seat cushion of his wheelchair as an example of one of the hidden costs of his condition: it is made of high-tech material encasing pockets of air, to minimise the risk of pressure sores – price tag, R7 000.
It’s hardly surprising then that Samuels has a close relationship with his financial adviser – the same man who persuaded him to take out disability assurance just a month before the accident. “He is also a cyclist and he had been nagging me to have disability cover,” Samuels says. “Eventually I said yes, but just enough to cover my bond. Of course, now I wish I had taken out the maximum.” But it was enough to clear one major debt, and that proved critical to his financial well-being and peace of mind immediately after the event.
Samuels was lucky, too, in the timing of his accident, he says. At 35 he was young and fit – an important factor in his recovery. His career with a marketing company was well established and he had the benefit of a contributory pension fund and a top-of-the-range healthcare plan, which paid most of his immediate costs and continues to provide good benefits. After rehabilitation, he went back to work in a less demanding position and continued to work for 12 years, until he was boarded on a proportion of his salary. He also pursued a claim for compensation, which took three years to bring to court and was eventually settled in his favour. A non-disclosure clause prevents him from discussing the details.
The big picture
Samuels, through his own determination and a certain amount of luck, represents the acceptable face of disability – a tiny proportion of the whole picture. Disability statistics are controversial: the World Health Organisation and World Bank estimate that 15 percent of the world’s population has a disability of one kind or another, with a higher proportion in developing countries, while Statistics SA says the percentage in South Africa is exactly half that – 7.5 percent, or almost three million people – based on Census 2011.
More accurate, perhaps, are the statistics produced for the assurance industry, showing what proportion of the workforce in South Africa takes the risk of disability seriously enough to have taken out disability cover. A 2013 study by True South Actuaries and Consultants, updated this year (“Disability cover: assessing the efficiency of the South African insurance market in its provision of disability cover”, available on www.truesouth.co.za), came to the following conclusions:
* Due to persistent under-insurance, consumers remain massively exposed to the possible financial impact of both permanent disability and temporary disability. In respect of permanent disability, only 40 percent of the total need was insured in 2013. The figure for temporary disability was even lower, with only between 12 percent and 27 percent of the total need being covered.
* Theoretically, the average breadwinner should have more disability cover in place than life cover. However, new assurance sales continue to be dominated by life cover, at 61 percent of sales, with disability comprising only 29 percent of sales in recent years. As such there is sustained evidence of market inefficiency that overly skews the sale of new cover towards life (away from disability).
The study also found that temporary disability cover in 2015 is less than half of what it should be: 1.4 percent of total disability cover, compared with the three percent actuaries recommend.
Figures published by Old Mutual in August 2015 reveal that it paid out R343 million for disability and R441 million for illness and physical impairment in 2014 to claimants aged between 22 and 64. The causes of disability, according to Jaco Gouws, protection marketing manager at Old Mutual, ranged from visual and musculoskeletal impairment to disorders of the nervous system, digestive system, urinary tract, ear, nose and throat, and respiratory system.
Momentum Retail Insurance paid out a similar amount (R767 million) for critical illness, disability and income protection claims in 2014 – more than 28 percent of the total payout for risk assurance that year. For each rand paid in death benefits, Momentum’s flagship product, Myriad, paid out 65 cents in incapacity benefits, according to Stephen van Niekerk, head of retail life assurance products at Momentum’s holding company, MMI. He attributes the upward trend to increasing longevity and, as a result, an increase in the diseases of old age.
Liberty’s Claims Explorer website (www.claimsexplorer.liberty.co.za), which tracks what the company pays out in life and disability benefits, shows that men under the age of 35 are most likely to claim for road accident-related disability, while critical illnesses become the bigger risk after the age of 45. Claims for incapacity caused by cancer peak between the ages of 55 and 64.
Van Niekerk says, for Momentum, critical illness was the largest claims category in 2014 after death claims, so “it is crucial that critical illness benefit design should ensure breadth of cover, and claim definitions should not be limited to cover against the Big Four (heart attack, heart bypass, cancer and stroke). Even though those conditions accounted for 71 percent of the critical illness claims, it also means that the remaining 29 percent of claims were the result of conditions that fall outside of these,” he says.
Old Mutual’s statistics show that 83 percent of critical illness payouts were for the Big Four: cancer (60 percent), heart attacks (19 percent), coronary artery bypass (11 percent) and strokes (10 percent).
Assurance options
Disability assurance pays out in two ways: a lump-sum benefit, or monthly income (the latter is referred to as an income protection policy). A lump sum can be a boon in the early stages of disability, when there is a sudden rush of expenses, but, according to the Old Mutual report, “the well-advised consumer should probably be buying the bulk of his or her disability cover in the form of income benefits”. In fact, this year’s figures show that only 18 percent of new disability policies pay income benefits.
The attraction of lump-sum policies is that they are generally cheaper than income protection policies, because the risk to the insurer is clearly defined.
The risk to you is that you run out of money very quickly, Nicholas van der Nest, divisional director for risk products at Liberty, says. It is up to you to choose a lump-sum amount that can be invested to produce a return equivalent to your income needs … and to actually invest that amount in the face of multiple expenses. With an income protection policy, the assurance company carries the risk of paying you a salary-related amount until you reach retirement age.
Liberty, for example, offers three layers of income protection: a core layer, which provides temporary income cover for up to 24 months; an extended layer, which pays out for permanent disability after 24 months to your chosen retirement age; and a comprehensive layer, which covers you for additional risks and can include cover for life.
Another option is “accelerated” life cover, which pays out for disability from a life assurance policy, so it costs less than stand-alone cover. The benefit is deducted from your life cover and reduces the pay-out to beneficiaries when you die. Despite the obvious risk of your life cover being insufficient after a disability payout, accelerated cover is very popular, making up slightly less than half of all new disability assurance sales (49 percent), according to Old Mutual. Again, the relatively low cost is the main attraction.
The calculation of how much disability and dread disease cover you need and how it is structured is a matter for discussion with a financial adviser or broker. For a very rough estimate of your needs, as a starting point, Outsurance has a calculator on its website that estimates the level of life and disability cover you need based on: the percentage of your income needed in the event of your death or disability; additional costs to adapt your lifestyle after becoming disabled; the amount needed to pay off debt; and the amount of lump-sum and/or income replacement cover you already have in place via other policies.
Compensation claims
You’ve heard it in advertisements: if your disability is somebody else’s fault, you may have a personal injury claim against an individual or organisation or, in the case of a motor vehicle accident, against the Road Accident Fund (RAF). For most people, the mystery is how claims are calculated and what determines the final award, given that the sums are often in the hundreds of thousands or millions of rands.
Once the liability of another party has been proved, the extent of the claim is based on the calculation of damages. Claims often seem exorbitant at a glance, until you consider that damages should restore the injured party to the financial position he or she was in before the harm was done. Depending on age, the total of lost earnings, alone, can run into many millions of rand.
Personal injury lawyer Henry Shields, a partner at Shields Chiat Attorneys in Cape Town, says serious injuries change lives and result in the victims requiring goods and services they would never have needed but for the incident.
“It has become known as the ‘but for’ test,” he says. “The principle is simple: to restore the integrity of the victim, and that means putting them back where they were previously. There is no magic or deep mystery about quantifying the costs: just think about a shopping list of items that are required to keep going and to function as closely as possible to the way things were before.”
Lawyers like him turn to experts who specialise in drawing up that shopping list. In the case of a spinal injury and paralysis, Shields says, it might begin like this:
* Two-year intensive rehabilitation programme;
* Quarterly check-ups for life;
* Wheelchair purchase and replacement every three years;
* Wheelchair maintenance, spare parts and tyres;
* Home alterations: ramps to replace steps, appliances that are easy to operate, window catches that are within reach, low-level hob, bathroom adapted for wheelchair access, and much more;
* Higher travel costs; and
* Home assistance or home nursing.
“An able-bodied person can hop onto an air transport bus, carry their bags and travel economy class,” Shields says. “A disabled person may require special transport with assistance, and the airlines will often not accept them other than in business class.
“He or she might have had domestic help once a week before the injury, but now needs to be turned over every couple of hours to avoid bed sores and could require 24/7 assistance on a shift-rotation basis with allowance for sick leave and holidays.
“And the list goes on,” he says. “None of this is anything like clever American-lawyer money grabbing. Every item is evaluated by the defendant (usually an insurer, which does this every day of the week) and, typically, an expert is hired to examine the list and suggest more economical ways of achieving the same results. And, certainly, to challenge any excessive claims.
“Imagine a person of 20 years of age with a life expectancy of 80 years going out shopping to stock up for the next 60 years. That is how costs are claimed in personal injury cases,” Shields says.
Having compiled the costs that would not have occurred but for the injury, the total amount must be capitalised by an actuary over the life expectancy of the claimant (which is calculated by another actuary). In other words, if the list adds up to expenditure of R10 million at today’s prices over 60 years, it must be adjusted for two things:
* Inflation, since everything, from appliances to domestic help, and transport to physiotherapy, will get more expensive over that period, and
* The return on investment, because the claim will be paid out as a once-off lump sum, which is expected to be invested (in a reasonably conservative way) so that it earns dividends and interest.
The result is usually much less than what is ultimately needed, Shields says. “Historical experience is that seemingly massive sums of money are not really massive. The legendary American spinal rehabilitation expert, Dr Allie Key, has informed many judges from the witness box that she knows of many claimants who have outlived the damages awarded to them, but she does not recall a single one whose damages outlived them,” he says.
Road Accident Fund
The RAF is a government-run compensation scheme that insures all drivers on South Africa’s roads against serious injury or loss of life (within limits) as a result of accidents in which they were not at fault. It also indemnifies at-fault drivers from liability for the costs of causing injury or death, since the RAF has removed the right of innocent victims to claim against individuals or their families.
The scheme is funded by a levy on fuel, which is currently R1.54 a litre. Thus, the aim is to put everyone on the road – rich or poor, South African citizens or not – on an equal footing and minimise the financial, social and economic impact of motor vehicle accidents.
The RAF accepts claims from:
* Drivers, passengers and pedestrians who are injured in an accident that was caused by someone else;
* A driver who is injured in a car owned by someone else, if the accident was caused by the owner’s negligence (for example, if the brakes failed because of poor maintenance);
* A child, spouse or other person who depended on the income of a person killed in an accident; or
* A close relative who paid for the funeral of the person who was killed.
You have no claim if:
* You caused the accident; or
* There was no other person or vehicle involved in the accident.
You can claim compensation for:
* Medical expenses.
* Funeral expenses.
* Pain and suffering.
* Lost earnings if you were/are unable to work, but only to a limit of R234 366 a year. If you earn more than this, or expect to, you cannot hope to be compensated fully.
* Loss of support when the breadwinner of a household is killed in an accident as a result of someone else’s negligence.
Although the fund does have an outreach programme and offers help with the claims process through its local offices, the RAF says 70 percent of claims are submitted by attorneys. Confidence in the fund’s willingness and ability to pay out has been undermined by reports of a R98-billion funding shortfall at the beginning of this year and accusations by the Democratic Alliance that the RAF was using fraudulent means to defer payments. This has been vigorously denied by the RAF board chairman, Ntuthuko Bhengu, who told the media that cash flow was being carefully managed and payments were being made as revenue from the fuel levy allowed.
The levy was increased by 50c a litre to its current level in April in an attempt to help the fund deal with a payment backlog, according to Bhengu, of R6.7 billion, but this is acknowledged to be only a stopgap. Controversial proposals exist to replace the RAF with the Road Accident Benefit Scheme, which would take the “fault” element out of the compensation equation, but until that happens, or another solution is found, the process is likely to be agonisingly slow.
The RAF assures claimants they can claim without the help of lawyer and has commented on and been involved in at least one court case exposing excessive charges by lawyers claiming from the RAF. But the Law Society of South Africa and personal injury lawyers have an easy case justifying the ser-vices of a lawyer to road accident victims. A Law Society brochure says you can claim directly from the RAF, but:
* Claiming direct is a complicated and technical process;
* Medical reports need to be completed by doctors and paid for;
* Documents need to be obtained from the police and paid for;
* An affidavit explaining how the accident took place must be prepared and lodged with your claim;
* Medical records need to be obtained from hospitals and doctors and paid for;
* You need to quantify your claim (see “Compensation claims”, above) – which means stating what you are claiming as general damages (pain and suffering, loss of amenities of life, disfigurement, disability and shock), and special damages, such as loss of income, loss of earning capacity, future medical costs and past expenses; and
* For your general damages claim, you need to lodge a serious injury assessment report from a suitably qualified medical expert who has assessed your injury as “serious” as provided for in the Road Accident Fund Act and regulations.
The Law Society warns that there are time limits on claims and that you will have to carry the costs of prosecuting the claim until a settlement is reached. With a lawyer representing you, you have recourse to your provincial law society or the courts if your interests are not protected, and you have someone with experience to help you decide whether or not a settlement proposal is fair and reasonable in the circumstances.
Payment for an attorney’s services may be delayed until a claim is settled and paid out, and most personal injury firms offer to represent clients on a contingency basis (no win, no fee). These fees can be substantial, but are subject to legal maximums, and a small portion of the costs can be recovered as part of the RAF settlement.
Tracy Boltman, a personal injury lawyer and partner at Davidson England Attorneys in Cape Town, specialises in RAF claims and says the fund is a blessing to many, despite its problems. How else would innocent victims without resources be compensated for their injuries?
She says claims never take less than two years and can take 10 years. That is partly the fault of the process, but it is also wise not to claim before the long-term implications of injuries are clear.
“You must wait as long as possible, so you can predict the future, but you don’t want to hold up the settlement. So it’s a really tricky balance,” Boltman says. “A lot of work goes into calculating future loss of income and compensation for pain and suffering, and a lot of experts are involved: neurosurgeons, neurologists, psychiatrists, occupational therapists, orthopaedic surgeons, industrial psychologists … sometimes all of those. Even then, you can have a battle on your hands.”
The harsh truth is that, however long it takes to settle a case, there is little prospect of an interim payment to see claimants through. Once the RAF has accepted liability, Boltman says, you can apply for such a payment, “but that would be for past medical expenses and loss of income only, and it really is rare,” she says. This is where cover for temporary disability comes into its own, as it typically pays out for two years, while the extent of your disability is being assessed.
The RAF uses a contract known as an “undertaking” to cover future expenses that are a direct result of the accident, based on a “pay now, claim later” principle. Boltman says it is possible to apply for an undertaking before the claim is settled, to relieve financial pressure, but she says attorneys are reluctant to do this, because the undertaking has to cover everything that might be needed in future.
“If you are still busy getting specialist reports, you might leave something out and there’s no going back. Unfortunately, without the undertaking, people without medical cover who are injured might not have access to medical treatment unless they sit in a state hospital for hours or days,” she says.
TAX BREAKS FOR DISABILITY
Jonathan Samuels imported his car taking advantage of a tax break for disabled people on the import-duty component of the price of a car. This can amount to a tax deduction of up to 27 percent of the cost of a fully imported car, subject to certain criteria, and is the Department of Trade and Industry’s way of compensating people for the cost of the adaptations required – in Samuels’s case, hand controls. For him, driving a car is a potent symbol of independence and the discount is about more than money: it has made the difference between having a car that is on a par with the one he had before the accident and one that is purely functional and imposed on him by his disability.
Not everyone is equipped to make the most of every opportunity – especially in stressful circumstances – and there is evidence that far too few people who are paying the price of disability (their own or a family member’s) are claiming the tax relief due to them.
According to the 2014 Tax Statistics handbook published by the South Africa Revenue Service (SARS), 44 033 taxpayers were allowed deductions for expenses related to disabilities, totalling R1 723 million, which translates to an average of R39 112 per person. This is an increase in taxpayers receiving relief in 2010 (about 27 000), but a fall in the average deduction, from R41 500.
Bendels Consulting, a tax practice specialising in tax consulting to taxpayers with disabled family members, previously told Personal Finance that tax statistics show that only about a fifth of taxpayers who should be claiming for disabilities (about five percent of the population) are, in fact, claiming deductions.
So financial advice, including tax advice, is critical when personal circumstances change dramatically. Some taxpayers who are not themselves disabled, but who support a disabled spouse or child, for example, might not realise that they can claim all qualifying out-of-pocket expenses in full. (The system has changed from one of tax deductions to medical tax credits.)
On its website, SARS distinguishes between disability and physical impairment.
* Disability is defined as a “moderate to severe” limitation, and the taxpayer must have an ITRDD form (confirmation of diagnosis of disability – external) completed and signed by a medical practitioner before claiming.
* Physical impairment is a “restriction on a person’s ability to function or perform daily activities, after maximum correction, which is less than a ‘moderate to severe’ limitation”. A taxpayer who is physically impaired, or whose spouse or child has an impairment, can claim qualifying prescribed expenses, but people under the age of 65 are subject to the limitations that apply to taxpayers in the same age group without a physical impairment.
The national Association for the Physically Disabled, with branches in all the provinces (www.apd.org.za), is a starting point for support and information.
CASE STUDY: MLUNGISI LUPUWANA
“When I came out of hospital, there was a ‘for sale’ sign on my house.”
It is no exaggeration to say that, six years ago, Mlungisi Lupuwana went to bed able-bodied and woke up disabled. He was 43 then – a tall, rangy, strong man with a flourishing career in chemical engineering, three children aged between 12 and 21, and a comfortable lifestyle. His wife had worked for I&J for many years and they had bought their house in Khayelitsha with a R150 000 bond from First National Bank.
When he woke with a pain in his back, he bent forward to feel the spot … and could not straighten up again. Doctors at Tygerberg Hospital located a tumour on his spine of no known origin (it was not malignant or the result of TB) and had to remove it in the hope of relieving the pressure on his spine. He emerged from the operation paralysed from the chest down and with more than a year in a rehabilitation facility ahead of him.
“When I came home, my wife had to give up work to look after me. Even worse, there was a ‘for sale’ sign on our house. I had insurance on the bond, but it had fallen short and we owed R8 000. I was not consulted and I am still fighting it. We could easily have paid the money, but the bank must have decided I was disabled and wouldn’t have the money and just went ahead. It was sold to Absa and we have just been told it has been sold again. We received an eviction order. I wrote a letter to the clerk of the court explaining the situation. The sheriff didn’t come, but I don’t know what happens now. All I know is I am not going to move out of the house. This has been going on for five years and I will fight it to my last breath.
“I also had a life policy with Sanlam, which paid out a lump sum for disability and I invested that for my children’s education. Two are finished school and qualified; only the youngest is still in Grade 12.
“My hospital and rehab costs came to R167 000 and the company medical scheme paid three-quarters of it. When I resigned, the company paid me a lump sum from the pension fund. I thought about being boarded, but I didn’t wait for that. It was a chemical company and I was working with chlorine gas – I thought maybe that was the cause of my tumour. The doctors couldn’t find any evidence, but I did research on the internet and that is my suspicion. So I was frustrated and upset.
“I couldn’t accept being someone who was disabled and I went into a depression. But I had some counselling and that cleared my head – I thought, I can’t just live like this; I have to do something. So now I focus on uplifting people who are vulnerable. I work as a peer supporter and manager at Phambili VIP Bangani in Khayelitsha, an NGO that provides workshops for 115 people with all kinds of disabilities. Some of them were kicked out of special schools at age 18 and they have no more skills than a six- or seven-year-old. We teach practical and life skills and do sport and recreation. We have just got 10 computers, so we can start computer courses.
“For all of us, money is a battle every day. I got my wheelchair from the Western Cape Rehabilitation Centre, but I had to put rails in the house and make alterations to the bathroom, kitchen, bedroom and living room, everything. My wife assists me with getting up and going to bed, but I need help if I am going out and that costs R100 every time. It is R150 for each visit to Tygerberg and I sometimes have three appointments a month. The Western Cape government has a service called Dial-a-Ride for disabled people who can’t use public transport and I try to register for it, but keep getting turned down.
“I have learnt that, should this happen to you, you need to be around people who are in your situation.
By working here, I discovered that there are people who are worse off than I am and it is uplifting to be able to help them. Many of them have sight or hearing loss, so we help each other: I am their eyes and ears and they are my legs.”
CASE STUDY: CHARLENE EDEM
“My children feel very responsible for me and that hurts.”
Most accidental injuries seem freakish in retrospect, given the slim line between hit and miss, but 17 years on, Charlene Edem still struggles to come to terms with the mundane incident that changed her life. She was 33, mother of two, working in early childhood development with Child Welfare and planning to become a qualified junior primary school teacher. She was, she says, “vibrant, a go-getter, aspirational, an activist”.
On that ordinary morning, she was on her way to work, with her 18-month-old daughter in the car and her husband driving. Just five minutes from home, a woman in another car accidentally hit the accelerator instead of the brake and drove into them. Freakishly, the only injury Charlene suffered has deprived her of her eyesight.
“My husband had a gash on his head that needed 24 stitches and the baby was fine, but a bit of the broken metal window frame pierced my right eye. What was so terrible was that it was my good eye. I had had cornea problems – the result of an allergic condition – for years, affecting both eyes, but I had had a transplant in that eye, which had been very successful and restored my vision completely. That was the eye that was 100 percent. The other eye was blurry because a cornea transplant in that eye had gone wrong.
“After the accident, the doctor tried to save my eye, but two or three years later it had to be removed. So I was left blind in one eye and with very poor vision in the other. I couldn’t go back to work, because you can’t work with small children without good eyesight, and I was boarded on 75 percent of my tiny salary. Thank goodness my husband had medical scheme cover through his job, so the medical expenses were covered. We are divorced now, so that has come to an end.
“I had a Sanlam life policy with trauma cover, but they wouldn’t pay out because they said I had a pre-existing medical problem with my eyes. I didn’t feel like fighting it, so I let it go. I received a small lump sum from cover provided by Child Welfare and, fortunately, my husband had a good job. But I felt small and vulnerable asking him for things.
“With the help of a lawyer, I made a claim through the Road Accident Fund, and a couple of years after the accident they paid out a lump sum for loss of earnings of R200 000. There was no payment for past medical expenses and they gave me an undertaking for future expenses of, I think, about R1 million. But I have never used it, because they always tell me I have to pay upfront first and I can’t afford to do that.
“With the R200 000, I bought this house bond-free and I invested some money. But houses have to be maintained and children need stuff, and the money is gone now. Already I am very behind on the rates bill.
“There are things I need that the RAF undertaking should pay for. I can still see shapes and even a bit of colour on good days, so I can just get around the house, but I need to pave the outside, so I don’t fall, and I need to adapt my kitchen. And I need someone to help me with cooking, cleaning and shopping. The RAF tells me to get domestic help through an agency and then submit the invoices, but I can’t do that – no blind person wants a stranger in their space and I have been robbed twice by helpers I didn’t know.
“My daughter is in matric now, and my son, who was five at the time, is an apprentice motor mechanic. They will leave home and then I’m going to be alone. They feel very responsible for me, and that really hurts: they are supposed to be living their own lives at this age.
“I have always been a very independent person who likes doing what I want to do, when I want to do it, so I have undergone a complete personality change. After the accident I slipped into depression – I slept all day, I ate all day. But even then I started a community youth programme, teaching life skills, and ran an anti-drug programme. Then the sight in my left eye started getting worse and I stopped doing that too. I have just bought my first retractable white stick for R350.
“I did some computer and call-centre courses for blind people, but courses don’t make you employable and I was becoming more and more despondent. Then I heard that Old Mutual was looking for disabled people for call-centre work and I was one of five people they employed. I’ve been there for three-and-a-half years now and have done a part-time course on wealth management and am busy with a two-year Advanced Diploma in Financial Management. It is so nice working for Old Mutual – they go out of their way to accommodate us and they invest in us.
“I have no background in finance and never thought I would work in this area, but when you are disabled, you know how important money is.”
CASE STUDY: MARI NELL
“The cost has been astronomical.”
It was a moment of distraction 26 years ago that changed Mari Nell’s life. She was 30 years old and driving on the N4 near her home in Witbank (now eMalahleni) with her seven-month-old son and a friend in the back seat. She was in a hurry, the baby needed to be breast-fed and she took her eyes off the road for a split second to explain how the baby’s car-seat straps worked. As the car veered off the road, Mari wrenched the steering wheel in the opposite direction, hit a ditch and rolled the car. The baby and the friend were unhurt, but Mari broke her sixth vertebra.
“I was in hospital for three months and came home to a 10-month old baby who didn’t know me. I felt shattered, rejected, useless and like some alien new breed: a quadriplegic. My house was flooded with well-meaning people, who sometimes helped and sometimes added to the problem. Carers came and went, never coping and costing a vast amount, and crying never solved anything, although it became a private pastime.
“I was an Afrikaans teacher, but I was not working at the time. I had no disability insurance, but fortunately we were on a medical scheme through my husband’s job and it covered all the hospital costs. We had just enough savings to buy a house in Johannesburg, and I sold my car to pay for a manual wheelchair, which cost R5 000.
“Now, needless to say, my medical cover runs out long before the end of each year. It covers my tablets, which qualify as chronic medication, but the apparatus grant per year is only R8 000. The electric wheelchair I have now was bought by my husband and father jointly for R110 000 and the roof-rack for the car cost R3 000.
“We had to build two ramps at each of the three houses we have lived in since the accident. The cost of a ramp is likely to be around R8 000. Modifying a bathroom costs about R80 000.
“Carers charge high rates, so I train domestic workers to help me, but there is the risk that they use the training to move on to other jobs.
“I love being at home and am very creative, so I paint and I never seem to stop having ideas about how to improve our garden and living space. I now have two carers who also do our domestic work and cooking. My gardener is a very talented man who does repairs and maintenance. Basically, I ‘create’ and they ‘do’. Salaries amount to R15 000 a month, without counting the cost of food and live-in accommodation.
“The cost has been astronomical. My husband calculated the extra cost of my disability as R30 000 a month. If you consider lost income, the total is more like R50 000. I do a little bit of private Afrikaans teaching at home, but infrequently and it gives me no more than pocket money. Apart from the monthly costs, cars need to be adapted and holiday travel is more expensive.
“My advice to anyone out there is to cover yourself with a policy for unforeseen events. You can ‘buy’ a large portion of what you need for a decent lifestyle as a disabled person, but, of course, no one can buy health … or joy, purpose or peace.”