How you can recoup some expenses for learning difficulties

Laura du Preez | 13 October 2023

Laura du Preez has been writing about personal finance topics for more than 20 years, including eight years as personal finance editor for two leading media houses.

If your children are diagnosed with learning difficulties, you can now fortunately get help from medical professionals, therapists, medication, specialised schooling, tutoring and other learning aids.

Unfortunately this help comes at a high cost which is often not covered by your medical scheme.

Psychoneurological impairments that cause learning problems range from Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) to dyscalculia, dysgraphia and dyslexia.

Children with these disorders often require regular assessments at a cost of thousands of rands, and consultations with professionals who are in demand and charge high fees.

Ongoing medication for these conditions is also expensive – often over R1 000 a month.

Tax deductions

These expenses are often not covered by medical schemes, but you may be able to get some relief by claiming your unrecouped medical expenses from tax.

If you are on a scheme that does not offer cover for your child’s treatment, you may be able to claim healthcare and educational expenses paid out of your own pocket (not recouped from your medical scheme) as a tax deduction. The extent to which you can claim, however, depends on a number of factors:

1.  Disability expenses

If your child’s learning disability is severe enough, the treating health professional may complete a South African Revenue Services form, the ITR-DD form, stating that your child has a disability, Jaco Kruger, a tax practitioner at Jaco Kruger Disability Tax, says.

This form allows you to claim a portion of not only your child’s unrecouped medical expenses, but your entire family’s unrecouped expenses, as well as non-medical expenses related to the learning disability – for example, the cost of a tutor. You may also be able to claim some of your medical scheme contributions as a tax deduction providing greater relief than just the medical scheme fees tax credits that all scheme members enjoy.

To calculate the deduction you can include contributions for you, your spouse and children to your scheme that exceed three times the medical scheme fees tax credit. Check the credit amounts in our tax tables. You can include all the unrecouped medical and non-medical expenses, as long as the non-medical expenses are related to the disability.  The deduction is limited to one third of these expenses.

You don’t need to calculate these amounts – SARS will do it for you, just enter the amounts on your tax return.

Annece Olivier, director at Bendels Consulting, says if the expense is a medical one you have not been able to claim from your medical scheme, it must be claimed, as any taxpayer would claim it, under the source code 4020 if the expense is recorded on your medical scheme tax certificate or 4034 if it is not.

If it is a non-medical expense, for example, school fees or special equipment or devices, and the expense is a consequence of the disability recorded on the ITR-DD form, you can claim these expenses under code 4023, she says.


2.  Expenses when the disability is mild

If your child’s disability is mild or not permanent, it is treated differently and may not qualify for as high a rate of tax relief as it would if it was moderate to severe, Olivier says.

The practitioner treating your child may complete the ITR-DD form but record the disability as mild.

This means you can claim medical and other non-medical expenses as an impairment, but you will only enjoy a deduction if these expenses plus your medical scheme contributions above a certain limit exceed a relatively high threshold.

For mild or temporary impairments, your medical scheme contributions will only count if they exceed four times the normal medical scheme tax credit.

The sum of these excess contributions and any medical expenses you have not recouped from your scheme must exceed the threshold of 7.5% of your taxable income. You can claim 25% of what exceeds this threshold.


3.  Not disabled

If your medical practitioner does not believe your child has a disability and will not complete the SARS ITR-DD form, you will not be able to claim any non-medical expenses.

You can still claim unrecouped medical expenses, but only if they exceed the relatively high thresholds – the sum of your unrecouped medical expenses and your contributions in excess of four times the medical credit must exceed 7.5% of your taxable income. Only when they do will you qualify for a deduction of 25% of the qualifying amount.

It is possible that one practitioner will complete the ITR-DD form for your child and another will not.

Kruger says parents know their children best. Both he and Olivier recommend getting a second opinion when a medical specialist has said a child does not qualify for disability.

Olivier says the ITR-DD should be completed for the “unmedicated” child. Therefore, if the child is not able to cope in mainstream school without supportive measures such as medication, it may be an indication of a disability or impairment, she says.


Special needs schooling

Your child does not need to attend a special needs school in order for you to be able to claim the disability medical tax credit.

Olivier says the type of disability and the severity dictates what you can claim.

Kruger says the key is that the disability must have some impact on your child’s life and result in you incurring expenses beyond what a child without a learning disability may need by way of therapy or tutoring.

Many children struggle with concentration and need tutoring, but some children require a lot of extra tutoring, special educational equipment, exam concessions, therapy or strong medication, he says.

Medical scheme cover

Very few medical schemes offer benefits specifically for conditions such as Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD), dyscalculia, dysgraphia and dyslexia.

These conditions are not prescribed minimum benefits (PMBs). Medication and consultations with healthcare practitioners will typically only be covered by your day-to-day benefits. This often means you must fund these costs from your medical savings account.

Unless you are on an expensive medical scheme option with an above-threshold benefit, you may find your savings account quickly depleted and be forced to pay these expenses out of pocket.

Only a few schemes, like Momentum, Fedhealth and Profmed, have options that offer benefits specifically for ADHD but not the other conditions. 

These options are typically more expensive, and offer cover for a specified list of chronic conditions in addition to those that are PMBs.

Olivier says modern technology allows children with, for example, hearing impairments to be accommodated in mainstream schools. Mainstream school fees are not tax deductible, but the additional costs of accommodating the child in the school - such as special equipment - may be deductible, she says.

Olivier says a child with autism and delayed speech may attend a mainstream school, but incur other expenses, such as speech therapy, occupational therapy, educational therapy and specialist consultations that can be claimed as a deduction with a higher rate of relief if the parent has a valid disability form.

“It is greatly underestimated how expensive it can become to have a child with these almost ‘invisible’ disabilities that you would only really see when they are in the classroom or attempting to function independently,” Olivier says.

A few things to remember

  • The SARS website notes that if your child does attend a special needs school, you can only claim expenses that exceed normal school fees.

  • You can only claim expenses within the amount of tax you pay SARS. For example, if you pay R20 000 in tax but have R90 000 costs, you may be entitled to relief of R30 000 (33.3%) but you will only get a refund of R20 000, Kruger says.

  • Even if you do not belong to a medical scheme, you can claim for medical expenses and expenses that are a consequence of disability. These will qualify for the higher rate of relief as long as you have a completed ITR-DD form, Olivier says.

  • Disability expenses can only be claimed for yourself, your spouse or your own child and not, for example, a sibling. If you are supporting a sibling with a learning disability, you can only claim the deduction as an impairment.