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Disability consulting

Transparent, independent, and unbiased vocational incapacity and ill health assessments.

Disability consulting

Transparent, independent, and unbiased vocational incapacity and ill health assessments.

Disability Consulting

Soma specialises in the assessment of an individual’s impairment so as to determine the impact of this impairment on ability to perform a certain job; this requires a specific skillset, expertise, and experience. Our assessments produce objective, accurate, appropriate, and legally robust disability claim recommendations. Assessment is complex and not merely based on medical reporting but comprises a multi-disciplinary process with legal, ethical, and statutory components.

Our service includes:

  • Disability and Incapacity assessment and management for both Employers and Benefit Funds
  • Assisting Trustees and Employers in determining the true extent of an employee’s functional limitations and associated occupational impairment
  • Guiding Trustees and Employers in the validation or repudiation of disability claims
  • Incapacity management
  • Functional Capacity Evaluation for both existing clients and on an ad hoc basis
  • Work-site analysis; job evaluation
  • Facilitation of independent specialist medical examinations
  • Real-time, web-based administration
  • Providing independent, factual, unbiased, and fair disability assessment reports on the validity or otherwise of disability claims

Health Risk Management intervention must be effective and accepted. It should encompass the principles of consistency, objectivity, fairness, and equitability. Employers and the associated role players need to understand the importance and relevance of the various Statutory Acts and Legal Framework and their respective roles in the incapacity and ill health retirement arena. These include the following:

  • Labour Relations Act 66 of 1995
  • Public Service Act of 1994
  • Basic Conditions of Employment Act 75 of 1997
  • Employment Equity Act 55 of 1998
  • Code of Good Practice
  • Public Service Co-ordinating Bargaining and Industrial Council Agreements

Add a liberal and far-reaching South African Constitution to this, and the performance criteria of both pension fund and employer become onerous. It is key that the role and inter-relationship of the above Acts, Employment Codes, Agreements and disability criteria are comprehensively and adequately addressed within any assessment process. Also key is a clear understanding by the relevant Health Risk Manager. The principles underlying Physical or Mental Impairment and Occupational Disability are vast, and stakeholders must be able to clearly distinguish between these two related concepts.

Impairment refers to a deviation from the functional capabilities expected of an average healthy individual, such as hearing loss, loss of eyesight, poor lung function, psychiatric disorder, or restriction in joint motion, and are not necessarily disabilities nor render a person automatically unfit for work.

Disability on the other hand, and specifically in respect of one’s ability to work, refers to an impairment (as determined by a medical specialist) that results in a handicap (as determined by a multi-disciplinary professional team – in other words, a Health Risk Manager) that prevents the person from performing a task or occupation, or limits the performance of the occupational tasks.

The ability to assess an individual’s impairment and determine the impact of this impairment on functionality to perform a certain job requires a specific professional skill, expertise, and experience.

Disability Risk Underwriting

Considering disability and ill health retirement claims assessment, Soma assists self-insured funds and schemes in evaluating insurable risk and applying appropriate underwriting limitations and/or restrictions. Soma designs specific health risk assessment protocols, profiling both death and disability risk to a fund. Risk underwriting allows accurate premium determination and maximum employee risk benefits all while maximising retirement benefits. We believe that proactive risk determination is far more beneficial than retrospective claims evaluation in controlling costs and safeguarding retirement assets.