DP
David P

1 reviews | Active since Apr 2020

06 Oct 2025, 19:11

Clarification Required on Assessment Discrepancies

I am writing to request urgent feedback regarding multiple discrepancies identified in the final assessment submitted to RMA. Firstly, there are no ICD-10 codes recorded for the documented nerve damage as reflected in the nerve conduction (EMG) report. The Occupational The******’s report clearly outlines limited range of motion in all limbs, loss of strength and sensation, and makes specific reference to nerve damage. None of these findings are reflected in the final assessment. Secondly, the ICD-10 code used for the fracture is incorrect. According to the Section 91 form, the upper end of the humerus was fractured, yet the assessment lists a fracture of the lower end of the humerus. It is also unclear why the medical reports submitted to RMA were not incorporated into the final assessment. The EMG report, which was less than 12 months old at the time of assessment, should have been valid and considered. Both the nerve damage and loss of range of motion in multiple limbs were clearly documented in the EMG and Occupational Therapy reports but were excluded from the final findings. All relevant reports were received by RMA and were referenced in email correspondence with Vuyo Msuthu, yet there is no indication that they were taken into account. I therefore request a comprehensive explanation for the above omissions and an updated review of the assessment to accurately reflect all available medical evidence.

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Replies (3)
Rand Mutual Assurance (rma)
Rand Mutual Assurance (rma)'s reply07 Oct 2025, 09:45
Official
Hi David,

Thank you for bringing these issues to my attention. I’ve noted your concerns regarding the missing ICD-10 codes for the documented nerve damage, the incorrect coding of the humerus fracture, and the omission of the EMG and Occupational Therapy findings in the final assessment.

I’ll refer this to our internal team, and they will ensure that all relevant medical evidence is reflected accurately. They will also provide a detailed response once the investigation is complete.
Kind Regards 
Rand Mutual Assurance (rma)
Rand Mutual Assurance (rma)'s reply22 Oct 2025, 12:31
Official
Mr David,

Once again, we would like to thank you for bringing this matter to our attention.

We are pleased to confirm that we have closed the complaint. 

We would like to extend our sincere apologies for any inconvenience that may have been caused.

Kind regards, 

The RMA Team
DP
David P's update27 Oct 2025, 12:27
Reviewer Update
Claim number ***

I am writing to express my concern regarding the ongoing delays and lack of communication about my claim.

On Tuesday, 21 October at 3:00 PM, I was contacted by an agent who informed me that my complaint had been resolved, and that I would shortly receive a call from the Pension Department, followed by the PMCA. Later that same day, at 5:00 PM, another agent called and repeated the same information.

On Wednesday, 22 October at 11:00 AM, I received yet another call confirming that I would be contacted soon. However, it is now Monday, 27 October, and I have still not received any follow-up calls from either the Pension Department or the PMCA.

I have also tried contacting the RMA Call Centre, but each time my call was disconnected and I was redirected to a service rating option instead.

These repeated delays and lack of follow-up are extremely frustrating, especially considering the length of time this matter has already been ongoing over the past few months.

Please provide me with an urgent update on the status of my case and confirm when I can expect to receive a call from the relevant departments.