Lawmakers have raised concern over a wide gap between medical professionals’ disability assessment scales and those used by Rwanda Social Security Board (RSSB), warning that the inconsistency is delaying access to pension benefits for persons with disabilities.

The issue was raised on Monday, May 18, during a Lower Chamber plenary session in which the parliamentary committee on social affairs tabled its report on the analysis of the Auditor General’s special audit into the management of the pension branch covering the period between July 2015 and March 2025.

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Presenting the findings, the committee chairperson, Veneranda Uwamariya, pointed to persistent inconsistencies in disability evaluations that affect benefit decisions.

She said the law provides for a two-stage assessment process, but noted that gaps emerge during the second verification stage carried out by RSSB.

"The disability entitlement is determined based on a medical assessment carried out by a government doctor and confirmed by an RSSB medical consultant. However, we have observed significant variations between the two,” she said.

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The committee reported that in a sample of 13 cases subjected to secondary assessment, RSSB medical consultants often reduced disability ratings compared to the initial assessments made by treating doctors. In some cases, the difference reached up to 50 per cent, while in others ratings dropped from between 30 to 35 per cent to as low as 0 to 10 per cent.

Lawmakers warned that such disparities risk denying eligible beneficiaries their rightful entitlements.

The report also highlighted delays in processing appeals related to disability benefits. Under the current procedure, an employee who disputes a decision appeals to the RSSB board, after which the case is forwarded to a medical committee appointed by the Ministry of Health and later confirmed by an RSSB medical consultant. Although the process is expected to take up to 60 days, implementation has often taken much longer.

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Out of 77 appeal files submitted for secondary review at the Ministry of Health, only 41 were processed, while 35 remained pending for between three and five years. The committee attributed the delays to weak coordination between institutions, slow feedback on assessment reports, and limited follow-up mechanisms.

Officials further noted that inconsistencies in disability ratings stem from differing assessment approaches, an outdated evaluation framework, and in some cases subjective judgement by medical practitioners seeking to support patients in accessing higher benefits.

Comparative data presented to Parliament showed wide variations in disability ratings: Ministry of Health doctors at 29 per cent, RSSB medical consultants at 14 per cent, and treating doctors at 45 per cent.

Lawmakers said these differences create disputes and undermine confidence in the system, calling for urgent harmonisation.

During the debate, MP Aimée Marie-Ange Tumukunde questioned delays in finalising the necessary legal framework, noting that although the law was passed in October, the implementing regulation has not yet been issued.

MP Germaine Mukabalisa also raised concerns over inconsistencies in assessments, citing cases where disability ratings differed sharply between doctors.

"In some cases, a person is assessed at 80 per cent by a treating doctor, then reduced to 30 per cent by RSSB assessors, and even down to zero. These are very big gaps that need explanation,” she said.