SASSA Medical/Assessment Referral
Source: South African Social Security Agency
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Download Blank PDFHow to Fill the SASSA Medical Referral Form
The SASSA Medical/Assessment Referral form is used to refer a grant applicant to a medical practitioner for a disability or care dependency assessment. It is completed by the treating practitioner and submitted as part of the Disability Grant (DG) or Care Dependency Grant (CDG) application. The form records the client's medical history, diagnosis, treatment compliance, and recommends the type of assessment needed.
Documents Required
- South African ID document (valid green ID book, Smart ID card, or temporary ID certificate for the client)
- SASSA grant application reference number (issued when the initial DG or CDG application was submitted)
- Existing medical records or specialist reports relevant to the disability or condition
- List of current medications and dosages prescribed to the client
- Hospital discharge summaries, if the client has been hospitalised for the condition
- X-ray, MRI, or scan results relevant to the diagnosis, if available
Step 1: Obtain the referral form from SASSA
When you apply for a Disability Grant or Care Dependency Grant at your nearest SASSA office, SASSA will issue the Medical/Assessment Referral form. Take this form to your treating doctor or health practitioner. Do not attempt to fill in the medical sections yourself — the form must be completed by a registered health professional.
Step 2: Fill in the client's personal details
Enter the client's South African ID number, gender, form of identification, surname, and full names. These details must match the client's ID document exactly. The SASSA office may pre-fill some of these fields before issuing the form.
Step 3: Complete the medical history section
The treating practitioner fills in the presenting problem or symptoms, clinical diagnosis, any complications, whether the client is compliant with treatment, and whether the client abuses illegal substances. The practitioner also records how the condition has changed over the past 6 months (improved, stabilized, or worsened) and provides remarks on functional capacity.
Step 4: Recommend the assessment type
The practitioner selects the type of health professional recommended to conduct the disability assessment: MP (Medical Practitioner), PT (Physiotherapist), OT (Occupational Therapist), AUD (Audiologist), or Other. Choose the specialist most appropriate for the client's condition.
Step 5: Sign the practitioner declaration
The treating practitioner enters their full names, date, telephone and cellphone numbers, and professional registration number (HPCSA or SANC). The practitioner must sign the form to certify the information provided is accurate.
Step 6: Return the form to SASSA
Take the completed and signed referral form back to the SASSA office where the grant application was submitted. SASSA will use the form to schedule a medical assessment appointment. The medical assessment is free of charge — SASSA arranges and pays for it. Do not pay anyone who claims to conduct a SASSA assessment privately. Keep a copy of the completed form for your records.
Common Mistakes to Avoid
- Not having the form completed by a registered health professional — the medical sections must be filled in by a doctor, physiotherapist, occupational therapist, or other HPCSA/SANC-registered practitioner
- Entering an incorrect ID number — the 13-digit SA ID number must match the client's identity document exactly
- Leaving the diagnosis or presenting problem blank — these fields are required for SASSA to schedule the correct type of assessment
- Forgetting to include the practitioner's registration number — the HPCSA or SANC number validates the practitioner's credentials
- Not signing the practitioner declaration — an unsigned form will be returned by SASSA and delay the assessment
- Submitting the form without returning it to SASSA — the form must be handed back to the SASSA office to trigger the assessment scheduling
Tips for Success
- Ask your treating doctor to be as detailed as possible in the diagnosis and functionality remarks — this helps the assessor understand your condition
- Bring all your medical records, specialist letters, and medication lists to the practitioner appointment to ensure the form is completed accurately
- If you see multiple specialists, ask the one most familiar with your primary disability to complete the form
- Keep a photocopy of the completed form before returning it to SASSA — you may need it if you appeal the assessment outcome
- If your condition worsens before the assessment date, ask your practitioner to provide an updated medical letter to present at the assessment
- Call the SASSA toll-free number 0800 60 10 11 to check on the status of your medical assessment appointment
Frequently Asked Questions
What is the SASSA Medical/Assessment Referral form?
The SASSA Medical/Assessment Referral form is used by the South African Social Security Agency to refer a grant applicant to a medical practitioner for a functional or medical assessment. It is part of the application process for the Disability Grant (DG) and Care Dependency Grant (CDG). The form is completed by the treating practitioner and contains the client's medical history, diagnosis, and a recommendation for what type of assessment is needed.
Who fills out the Medical Referral form?
The form is primarily completed by the client's treating medical practitioner (doctor, physiotherapist, occupational therapist, or other registered health professional). The practitioner fills in the client's medical details, diagnosis, treatment compliance, and recommends which type of health professional should conduct the formal disability assessment. The client's personal details (name, ID number) may be pre-filled by the SASSA office.
When do I need this form?
You need this form when you apply for a Disability Grant or Care Dependency Grant at SASSA. After submitting your initial application, SASSA will issue this referral form and ask your treating doctor or health practitioner to complete it. The completed form is then used to schedule your medical assessment, which determines whether you qualify for the grant based on your level of disability or functional limitation.
What happens at the medical assessment?
At the medical assessment, a SASSA-appointed health professional evaluates your functional ability and disability. They assess your physical and/or mental capacity, review your medical history and treatment records, and determine the severity and expected duration of your condition. The assessment typically takes 30 to 60 minutes. The assessment is free of charge — SASSA arranges and pays for it. Do not pay anyone who claims to conduct a SASSA assessment privately. The assessor completes a separate report that SASSA uses to approve or decline your grant application.
Can I choose my own doctor for the assessment?
No. While the referral form is completed by your own treating practitioner, the formal disability assessment is conducted by a health professional appointed by SASSA. You cannot choose the assessor. However, the referral form allows your treating practitioner to recommend the type of specialist (medical practitioner, physiotherapist, occupational therapist, or audiologist) who should conduct the assessment based on the nature of your condition.
How long is the medical assessment valid?
The Disability Grant is typically awarded for a period of 6 months to 5 years, depending on the nature and expected duration of the disability. If granted for a temporary period, you will need to be reassessed before the grant expires. SASSA will notify you when a reassessment is due. If your condition is permanent and unlikely to improve, the grant may be awarded indefinitely, though periodic reviews can still occur.
What if I disagree with the assessment outcome?
If your Disability Grant or Care Dependency Grant application is declined based on the medical assessment, you have the right to appeal within 90 days. The appeal is lodged through the Independent Tribunal for Social Assistance Appeals (ITSAA). You can submit additional medical evidence, specialist reports, or request a reassessment. Contact SASSA at 0800 60 10 11 or visit your nearest office to start the appeal process.
What is the difference between the DG and CDG medical assessment?
The Disability Grant (DG) assessment evaluates an adult applicant's (18-59 years) functional ability and capacity to work. The Care Dependency Grant (CDG) assessment evaluates a child's (under 18) need for permanent care due to a severe disability. The CDG assessment focuses on the child's daily care needs and dependency on a caregiver, rather than work capacity. Both use a similar referral form, but the assessment criteria and grant amounts differ.
What do the practitioner type codes (MP, PT, OT, AUD) mean?
The codes on the referral form indicate the type of health practitioner recommended to conduct the assessment: MP = Medical Practitioner (doctor), PT = Physiotherapist, OT = Occupational Therapist, AUD = Audiologist. Your treating practitioner selects the most appropriate type based on the nature of your disability. For example, a musculoskeletal condition might need a PT assessment, while a hearing disability would require an AUD.
What documents should I bring to the medical assessment?
Bring your South African ID document (green book or Smart ID card), the completed referral form, your SASSA application reference number, any existing medical reports or specialist letters, a list of current medications, hospital discharge summaries if applicable, and X-ray or scan results relevant to your condition. Having comprehensive medical documentation strengthens your application and helps the assessor make an accurate evaluation.
Is my medical information safe when using FillMeIn?
Yes. FillMeIn processes all data entirely on your device. Your ID number, medical details, diagnosis, and all other information entered on the form never leave your phone or computer — nothing is sent to our servers or stored in the cloud. This privacy-first approach ensures your sensitive medical and personal information remains completely under your control.
Related Social Development Forms
- SASSA Declaration by ApplicantFill the SASSA declaration form online free and download the PDF. Required for every SASSA grant application in South Africa.
- SASSA Affidavit — Grant in AidFill the SASSA Grant in Aid affidavit (Annexure I-7) online free. R580/month extra care allowance — download completed PDF for your SASSA application.
- SASSA Disability Grant Affidavit (Annexure I-2)Fill the SASSA Disability Grant affidavit (Annexure I-2) online free. R2 400/month grant — download completed PDF for your SASSA application.
- SASSA Affidavit — Care Dependency GrantFill the SASSA Care Dependency Grant affidavit (Annexure I-5) online free. R2 400/month for a child with a disability — download completed PDF.
- SASSA Affidavit — Old Age GrantFill the SASSA Old Age Grant affidavit (Annexure I-1) online free. R2 400/month pension — download completed PDF for your SASSA application.
- SASSA Affidavit — Child Support GrantFill the SASSA Child Support Grant affidavit (Annexure I-4) online free. R580/month per child — download completed PDF for your SASSA application.
- SASSA Consent Form — Bank PaymentFill the SASSA bank payment consent form online free. Authorise SASSA to pay your grant into your bank account — download completed PDF.
- SASSA Affidavit — Foster Child GrantDownload the SASSA Foster Child Grant affidavit (Annexure I-6) PDF free. Required for foster parents with a court order to apply for the foster child grant.