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The deductibility of medical expenses relating to special care

Thursday, 06 November 2014   (0 Comments)
Posted by: Author: SAIT Technical
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Author: SAIT Technical

Q: My Client is 88 years old sold her flat in an old age home a year ago to move to frail care. She has Parkinson’s disease and can’t look after herself anymore. She must be bathed and fed and cannot walk without assistance. The question is can the frail care which is about R8000 per month, be claimed as a medical expense under disability. If yes, must the doctor complete a ITR-DD form? He refused to complete the form when we asked him, but with motivation from SAIT, I am sure we can change his mind if it is deductible.

A: SAIT can’t, as you request, provide a document to the medical practitioner to request completion of the ITR-DD form.  SARS sets out the prescribed diagnostic criteria for a disability in paragraph 9.3 of the Guide on the Determination of Medical Tax Credits and Allowances (Issue 4).  The doctor must issue the ITR-DD in accordance with the SARS prescriptions.  

As defined (in paragraph (a)(ii)) ‘qualifying medical expenses’ means any amounts (other than amounts recoverable by a person or his or her spouse) which were paid by the person during the year of assessment to any duly registered nursing home or hospital or any duly registered or enrolled nurse, midwife or nursing assistant (or to any nursing agency in respect of the services of such a nurse, midwife or nursing assistant) in respect of the illness or confinement of the person or any dependant of the person…  

In the prescribed list of expenditure for purposes of section 18(1)(d) (disability) of the Act (see the SARS Guide on the Determination of Medical Tax Credits and Allowances (Issue 4)) the following is said:


Expenditure that is incurred and paid for purposes of special care, for special services to assist, guide, care for a person with a physical impairment or disability, regardless of the place the services are rendered (for example home, nursing home, retirement home etc.)

Examples of expenditure in this category include nursing services, special care for a person with a disability etc.

This will include salaries paid to care attendants, agency fees if the care attendant is provided by an agency as well as fees for professional services performed by, for example, nursing homes. 

If the expenses are not qualifying expenses (paragraph (a)(ii) ones) the ITR-DD is required to make the deduction.  

Disclaimer: Nothing in this query and answer should be construed as constituting tax advice or a tax opinion. An expert should be consulted for advice based on the facts and circumstances of each transaction/case. Even though great care has been taken to ensure the accuracy of the answer, SAIT do not accept any responsibility for consequences of decisions taken based on this query and answer. It remains your own responsibility to consult the relevant primary resources when taking a decision.



Section 240A of the Tax Administration Act, 2011 (as amended) requires that all tax practitioners register with a recognized controlling body before 1 July 2013. It is a criminal offense to not register with both a recognized controlling body and SARS.

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