List of Serious Injuries the RAF Pays for in South Africa

The Road Accident Fund (RAF) pays general damages only for injuries that qualify as “serious” under the Road Accident Fund Act 56 of 1996 (as amended) and its 2014 Regulations. A serious injury is one that results in at least 30% Whole Person Impairment (WPI) as assessed by a medical specialist using the American Medical Association (AMA) Guides — or, for transitional claims that arose before 1 April 2014, falls under the previous Schedule 6 list of serious injuries. Examples that typically qualify include traumatic brain injury with permanent cognitive impairment, complete spinal cord injuries resulting in quadriplegia or paraplegia, amputation of a limb, severe burns, and total loss of sight or hearing in both eyes. Past and future medical expenses and loss of earnings are claimable separately for any injury caused by a motor vehicle accident, regardless of whether the WPI threshold is met.

Statutory Definition: What Counts as a “Serious Injury”

The 2014 amendments to the RAF Act closed the previous “serious injury” loophole by introducing a fixed numerical threshold. Under the post-2014 dispensation, a “serious injury” is defined as a physical injury resulting in at least 30% Whole Person Impairment, expressed as a percentage of the whole person, and assessed by a medical specialist using the AMA Guides. The threshold is intended to draw a clear line between injuries that justify general damages for pain, suffering, and loss of amenities of life, and those that do not.

Pre-1 April 2014 claims remain governed by the old Schedule 6 list of serious injuries, which used a different set of categorical injuries rather than a percentage threshold. The 2014 Regulations prescribe the medical assessment methodology and the report format used to determine whether the threshold is met, and they govern the impairment rating process for any claim where the cause of action arose on or after 1 April 2014.

It is worth noting that the regulatory framework has continued to evolve. In Road Accident Fund v Mothole [2024] ZACC 23, handed down on 30 October 2024, the Constitutional Court declared the prescribed structure for serious injury assessment constitutionally invalid. Claimants whose impairment falls below 30% WPI can no longer recover general damages through the serious injury route; only special damages (past and future medical expenses and loss of earnings) remain recoverable. The Constitutional Court suspended the order of invalidity for a defined period to allow Parliament and the Minister to correct the defect, so the 30% WPI threshold continues to apply operationally in the interim. Any claimant contemplating a serious injury claim should confirm the current regulatory position with a qualified attorney before lodging.

Qualifying Injuries: Common Examples Under the WPI Threshold

The 30% WPI threshold is satisfied by an impairment rating, not by a list of named injuries. The injuries below are the ones most commonly found to meet the threshold in practice, but each case turns on the actual medical assessment:

• Traumatic brain injury with documented permanent cognitive impairment.
• Spinal cord injury resulting in quadriplegia or paraplegia.
• Amputation of a limb, or major joint function loss rising to the threshold.
• Severe burns covering more than 30% of body surface, or with permanent scarring that meets the 30% WPI bar.
• Loss of sight in both eyes, or total loss of hearing.
• Permanent disfigurement of the face, head, or neck that meets the WPI threshold.
• Internal organ damage with permanent functional loss (e.g., kidney failure, severe lung damage).
• Multiple fractures that, in combination, cause at least 30% WPI.

The 30% figure is treated as a fixed threshold, not a sliding scale — injuries assessed at 29% WPI do not qualify for general damages, even where the underlying trauma is severe. This is one of the most common reasons the RAF disputes a serious injury claim.

How the WPI Threshold Is Assessed

An accredited medical specialist — typically an orthopaedic surgeon, neurosurgeon, or rehabilitation physician — assesses the claimant using the AMA Guides. The report specifies the impairment percentage per body system (musculoskeletal, neurological, sensory, etc.), and the impairment percentages are then combined according to the prescribed Combining Table to arrive at the overall WPI rating.

The RAF may commission its own assessment through its panel of accredited specialists. Where the claimant’s and the RAF’s assessments differ, the parties commonly settle on a “joint minute” recording the medical findings they agree on. The joint minute is then handed to the court as the agreed evidentiary basis for the WPI rating, and the matter proceeds on quantum.

Where the parties cannot agree, the dispute is referred to a panel process under the RAF Regulations, and ultimately to the High Court for determination. The RAF-appointed panel system is the statutory mechanism for resolving disputes on impairment percentage before litigation escalates.

Loss of Earnings, Medical Expenses, and Other Heads of Damage

The 30% WPI threshold only applies to general damages. Other heads of damage are claimable in their own right, regardless of whether the injury meets the serious injury threshold:

Head of damage	Claimable for any injury?	Notes
Past and future medical expenses	Yes	Lodged on the prescribed RAF claim form; subject to tariff and reasonableness.
Past and future loss of earnings	Yes	Requires documented economic impact and a contingency deduction.
General damages (pain, suffering, loss of amenities)	Only for serious injuries	Requires a 30% WPI rating under the AMA Guides, or a Schedule 6 injury for pre-2014 claims.
Funeral expenses and loss of support	Yes, in fatal cases	Claimable by close family in terms of section 4 of the RAF Act.
Driver’s emergency and rescue costs	Yes	Claimable where they arise directly from the accident.

The distinction matters in practice: a claimant with a 25% WPI rating cannot recover general damages but can still recover the full cost of past medical treatment, projected future medical costs, and loss of earnings.

How an RAF Serious Injury Claim Works

The serious injury claim pathway follows a defined sequence. The steps below reflect the process as operated under the 2014 Regulations and the Uniform Rules of Court, and remain the framework to follow pending the legislative response to the Mothole judgment.

1. Lodge the claim on the prescribed RAF claim form, generally within three years of the accident (or two years after the claim arose, whichever is later).
2. Serve the claim on the RAF and note the matter on the Fund’s register so the limitation period is interrupted.
3. Undergo the medical assessment for serious injury where general damages is sought — an accredited specialist rates the claimant using the AMA Guides.
4. Receive the Fund’s response — either a settlement offer or a denial of liability, including any dispute over the WPI rating.
5. Set the matter down in the High Court of the province where the claimant resides if the Fund disputes the seriousness of the injury or the quantum of damages.
6. Resolve the claim either by agreement (commonly on a joint minute of agreed medical findings) or by trial judgment.

Where the matter is contested, the majority of RAF claims in Gauteng are filed in the South Gauteng High Court in Johannesburg, given its proximity to the RAF’s head office, while Pretoria and Centurion claimants typically file in the Gauteng Division, Pretoria seat. RAF-appointed medical assessments are arranged through the RAF’s panel of accredited specialists, generally in the metropolitan area nearest to the claimant.

Common Reasons the RAF Disputes a Serious Injury Claim

The RAF disputes serious injury claims on a relatively narrow set of grounds, and most disputes turn on the medical evidence rather than liability:

• The WPI assessment falls below 30%, placing the injury outside the threshold.
• The amputation, spinal injury, or other catastrophic injury is disputed as pre-existing rather than accident-caused.
• The medical assessor is not accredited to the RAF panel, or uses a non-prescribed methodology.
• The accident itself is denied — no proof of negligence, or contributory negligence is alleged.
• The claim is lodged beyond the three-year prescription period.

On the medical side, the most common dispute is the impairment rating itself. A claimant assessed at 30% by their own specialist and at 25% by the RAF’s specialist is in the typical “borderline” dispute; this is usually resolved by joint minute, and only escalates to trial if the gap cannot be bridged.

What to Do If You’re Unsure Whether Your Injury Qualifies

Three practical steps make sense before committing to litigation:

1. Get the medical records in order. Hospital files, discharge summaries, X-ray and MRI reports, and the treating specialist’s notes are the foundation of any WPI assessment.
2. Request a pre-litigation WPI assessment from an accredited specialist — typically an orthopaedic surgeon or neurosurgeon, depending on the dominant injury. This is the most reliable way to test whether the threshold is met before costs are incurred.
3. Consult a qualified RAF attorney for an early candid view on prospects. Most RAF attorneys, including the general litigation practice at Burger Huyser Attorneys, offer an initial consultation where liability is clear and the injury is potentially serious.

The point of an early assessment is to avoid signing a mandate on a claim that the WPI threshold will ultimately exclude from general damages. A candid early view is one of the recurring themes in the firm’s client feedback, and it is exactly the kind of checkpoint to insist on before litigation costs begin to mount.

Where to File: Jurisdiction and the Local Filing Layer

The Road Accident Fund is a national statutory body, but the practical claim process is anchored in the province where the claimant resides. The claim is lodged at the RAF’s regional office covering the claimant’s area, and where the matter goes to litigation, it is filed in the High Court of South Africa for that province.

For Gauteng claimants, the picture is divided between the two seats of the Gauteng Division: the Pretoria seat for Centurion and Pretoria residents, and the Johannesburg seat for those in Johannesburg, Randburg, Sandton, Roodepoort, Bedfordview, and Alberton. The magistrate’s courts do not hear RAF civil claims — a recurring point of confusion for claimants who arrive at the wrong door with a personal injury claim that should be filed in the High Court.

RAF-appointed medical assessments are arranged through the RAF’s panel of accredited specialists, generally in the metropolitan area nearest to the claimant. Specialist panel composition varies by region, and waiting times for panel appointments can run into several months, which is one of the structural reasons serious injury claims often take longer than ordinary personal injury matters.

For Gauteng claimants, the nearest intake point depends on where the claimant lives:

Claimant location	Branch to start at	Contact
Pretoria, Centurion	Centurion branch	012 644 4990
Johannesburg, Sandton, Bedfordview, East Rand	Sandton or Bedfordview branch	011 253 3080 / 011 201 7190
West Rand (Roodepoort, Florida, Krugersdorp)	Roodepoort branch	011 668 0030
Outside Gauteng	Head office (Linden, Randburg) as first point of contact	011 888 0246

Burger Huyser Attorneys’ general litigation practice fields serious injury claims through its Gauteng branch network, with file management run by senior attorneys in the relevant branch. The firm is also a member of the Johannesburg Attorneys Association and the Gauteng Family Law Forum, and its broader industry links across the Gauteng legal profession are useful for triaging cases that need to be referred where a particular head of damage falls outside the firm’s scope.

Frequently Asked Questions

What injuries does the RAF pay general damages for in South Africa?

The RAF pays general damages only for “serious injuries” as defined in the RAF Act 56 of 1996 and its 2014 Regulations. A serious injury is one that results in at least 30% Whole Person Impairment (WPI) as assessed by a medical specialist using the American Medical Association Guides. Common qualifying examples include traumatic brain injuries, complete spinal cord injuries (quadriplegia/paraplegia), limb amputation, severe burns, and total loss of sight or hearing. Past and future medical expenses and loss of earnings are claimable separately for any injury, not just serious ones.

How is a serious injury assessed for an RAF claim?

A medical specialist (typically an orthopaedic surgeon, neurosurgeon, or rehabilitation physician) assesses the claimant using the AMA Guides, rating impairment per body system and totalling the percentages. If the total WPI is at least 30%, the injury qualifies as a serious injury for general damages. The RAF may commission its own assessment; where the two differ, the parties usually settle on a joint minute of agreed findings.

Are pre-2014 claims grandfathered under the old Schedule 6 criteria?

Yes. For claims where the cause of action arose before 1 April 2014, the old Schedule 6 list of serious injuries still applies. These claims use a different set of categorical injuries (quadriplegia, loss of sight in both eyes, severe brain injury) rather than the WPI threshold. The 2014 amendments introduced the WPI threshold and the new regulations, but transitional provisions preserved the old regime for legacy claims.

Can I claim for loss of earnings even if my injury is not “serious”?

Yes. Loss of earnings and medical expenses are claimable for any injury caused by a motor vehicle accident, regardless of whether the injury meets the serious injury threshold. The 30% WPI threshold only applies to general damages (pain, suffering, loss of amenities of life).

How long does an RAF serious injury claim take?

RAF serious injury claims typically take 18 to 36 months from lodgement to settlement or court order, depending on the complexity of the medical assessment, whether the RAF disputes the seriousness of the injury, and the trial court’s calendar. Cases resolved by joint minute of agreed medical findings settle faster; cases that require trial take longer.

What if the RAF has already rejected my claim for serious injury?

A rejection is not the end of the road. A qualified RAF attorney can review the rejection letter, assess the underlying medical reports, and advise whether the WPI assessment can be challenged, whether a supplementary report can be obtained, or whether the matter should be set down in court for determination. Many RAF rejections are overturned on review.

How Burger Huyser Attorneys Can Help with a Serious Injury Claim

If you have suffered a serious injury in a motor vehicle accident and want to know whether your injury qualifies for general damages under the RAF, contact Burger Huyser Attorneys for an initial consultation. The firm fields RAF serious injury claims through its general litigation practice, with file management run by senior attorneys in the relevant branch — call the head office on 011 888 0246 or your nearest branch (Centurion 012 644 4990, Bedfordview 011 201 7190, Sandton 011 253 3080, Roodepoort 011 668 0030).

The firm’s reviews consistently highlight honest advice about prospects and personalised service, and the team will give you a candid early assessment of whether your injury is likely to meet the 30% WPI threshold before you commit to litigation.