educational psychologists and claiming medical tax credits

The latest unexpected challenge that has emerged from SARS is the disallowance of s6B medical credits for Disability diagnosis - because “an educational psychologist is not qualified to sign the ITR-DD diagnosis form”. I pull that issue apart here, clarifying where that is not true at all, and provide taxpayers with the resource to push back against this and ensure they can claim what is rightly theirs.

ITR-DD form signed by an Educational Psychologist

 This is my view, as a General Tax Practitioner, on the matter. This does not constitute professional tax advice for your specific situation - to take things further, please do reach out and make an appointment.

DEFINITION:

In South Africa, educational psychologists are not classified as “medical practitioners” — that term is reserved for doctors registered with the Health Professions Council of South Africa (HPCSA) in the Medical and Dental Professions Board.

However:

• Educational psychologists are recognised as registered healthcare professionals.

• They are registered with the HPCSA under the Professional Board for Psychology, in the category “Educational Psychologist.”

• They can have a BHF practice number and bill medical aids for certain psychological services, but do not diagnose or treat medical conditions in the way a medical doctor does.

• Their scope of practice is focused on learning, developmental, and educational functioning, assessment, and intervention — and not medical treatment.

QUESTION:

So is an educational psychologist qualified to diagnose and sign an ITR-DD form under section 6B of the Income Tax Act in South Africa, given the “duly registered medical practitioner” wording. 

Unpacking:

Wording in the Income Tax Act

• Section 6B: “Disability … is diagnosed by a duly registered medical practitioner in accordance with criteria prescribed by the Commissioner.”

• Key term: duly registered medical practitioner.

Wording in SARS “Guide on the Determination of Medical Tax Credits" (Issue 17) 

• SARS expounds on the wording in paragraph 3.3.3 (b) on p16:

• "The ITR-DD must be completed and endorsed by a duly registered medical practitioner* who is qualified to express an opinion on the disability.(*Registered with the HPCSA)"

• So, registered with the HPCSA and qualified to express an opinion on the disability are SARS' measures of “duly registered medical practitioner”.

• SARS go on to differentiate between types of disabilities, with different examples of "duly registered medical practitioners specially trained to deal with a particular disability":

• It is important to keep in focus that each type of disability has different specialists that are qualified and practiced to diagnose and deal with it.

Who counts as a “medical practitioner”?

• In the strict medical law sense, medical practitioner means a doctor registered with the Medical Board.

• In SARS’s operational sense (as per their guide), they prescribe 'HPCSA-registered professional' as the chief qualifier.

• HPCSA has multiple Professional Boards, including:

• Medical and Dental Professions Board (where “medical practitioners” — doctors — are registered).

• Professional Board for Psychology (where educational psychologists are registered).

• Educational Psychologists are registered with the HPCSA and fall under the Professional Board for Psychology

• So they clearly meet the scope of SARS requirement from the guide.

• But is diagnosing and assessing within their practice scope?

Educational Psychologist’s scope

• The SCOPE OF PRACTICE OF EDUCATIONAL PSYCHOLOGISTS [Section 5, Regulation 704 of 2011] includes:

• (a) "assessing, diagnosing, and intervening in order to optimise human functioning

in the learning and development; assessing cognitive, personality, emotional,

and neuropsychological functions of people in relation to the learning and

development in which they have been trained";
"‘diagnosing’ refers to the ability to make a diagnosis of a mental disorder using current recognised and approved mental disorder diagnostic nomenclature. In South Africa this includes both the Diagnostic and Statistical Manual for Mental Disorders (DSM) and the International Classification of Disease (ICD)."

• p15 of SARS guide, indeed, specifies the above-mentioned 'DSM' for diagnosis

• (b) identifying, and diagnosing psychopathology in relation to the learning and

development; identifying and diagnosing barriers to learning and development;

• This means:

• If the disability is in the learning, developmental, or cognitive domain (e.g. ADHD, dyslexia, autism spectrum disorder affecting learning), they can be the “qualified practitioner” to diagnose and sign off on the ITR-DD form.

• If it’s a physical, sensory, or medical disability, they cannot sign — that would be outside scope.

Conclusion:

Most probable outcome in tax law and practice

• SARS uses “medical practitioner” loosely in the guide — meaning HPCSA-registered and appropriately qualified for the type of disability.

• Therefore:

• An educational psychologist can sign the ITR-DD if the disability falls within their HPCSA-defined scope (learning/educational/developmental/cognitive disorders).

• But ideally should not sign if it’s a medical, physical, or sensory disability outside that scope.