Disability in the Workforce
Disability in the Workforce: Why Earlier Health Action Matters
A health condition can affect someone’s ability to work long before they leave their job. Pain may make physical tasks harder. Fatigue may reduce concentration. Depression may lead to repeated absence. With treatment and workplace support, many people can continue working. For others, a condition may eventually lead to long-term disability or medical boarding.
For employers, the question is how to recognise a need for support early enough to act. For employees, it is whether they can get help while they still have choices.
How many people are medically boarded?
There is no single, reliable published figure for the number of employees medically boarded each year in South Africa or worldwide. Medical boarding, disability insurance claims and people living with disabilities are different measures. They should not be presented as interchangeable.
The available figures still show the scale of the issue:
The 360-degree employee wellness framework
Region
What the figure measures
Reported figure
Income earners expected to become disabled in 2025, based on ASISA’s actuarial estimate
About 145 a day, or approximately 53,000 over a year
Workers awarded Social Security Disability Insurance benefits in 2024
594,749
People currently experiencing significant disability, across all ages
Approximately 1.3 billion
None of these figures is a medical boarding count. The South African number is a projection, the US number counts benefit awards, and the global number describes people living with disability rather than new cases or workforce exits.
What health conditions affect people’s ability to work?
The causes vary by job, age, severity and access to care. They also differ depending on whether a source measures temporary income protection or longer-term disability.
In South Africa, Liberty reported that musculoskeletal conditions accounted for 22.7% of its income protection claims in 2024, followed by cancer at 16%. Discovery Employee Benefits also identified rising claims linked to cancer, respiratory disease, nervous-system conditions, mental and behavioural disorders, and endocrine and metabolic disease in its claims experience for the year ended June 2023. These are insurers’ claims patterns, not a national ranking of medical boarding causes.
US disability award data offers another view. Among workers newly awarded Social Security disability benefits in 2024, the leading diagnostic groups were musculoskeletal and connective-tissue conditions (35.3%), mental disorders (13.5%), cancers (12.4%), circulatory conditions (10.8%), and nervous-system and sense-organ conditions (9.6%).
These categories include conditions with very different outcomes. A diagnosis does not, by itself, mean that a person cannot work. Treatment, rehabilitation, adjustments to duties and the employee’s own circumstances all matter.
What does disability cost?
The greatest cost to an affected employee may be lost income alongside treatment, rehabilitation, transport or care needs. ASISA estimates that the average South African family would need R3 million in disability cover to maintain its standard of living after an income earner becomes totally disabled. Its study found that formal income earners collectively held enough life and disability cover to meet only 39% of their families’ estimated needs at the end of 2024. This is an insurance shortfall, not a bill paid by employers.
Employers may face prolonged absence, replacement and training costs, disrupted work, and the loss of an experienced colleague. These costs are specific to each workplace; a credible business case should use the employer’s own absence and staffing data.
At a wider scale, the US Disability Insurance Trust Fund paid approximately US$155 billion in benefits in 2024. Globally, the World Health Organization estimates that depression and anxiety alone account for 12 billion lost working days and US$1 trillion in lost productivity each year. The US benefit payments are programme costs; the WHO figures concern depression and anxiety. Neither is a total cost of medical boarding.
Why does earlier action matter?
Some conditions are easier to manage when symptoms or risks are investigated promptly. The WHO, for example, says earlier cancer diagnosis can improve outcomes by enabling care at an earlier stage. Mental health support, rehabilitation and appropriate adjustments at work can also help people remain in, or return to, employment. Early detection cannot prevent every disability, and screening only creates value when it leads to suitable clinical assessment and support.
That is where H360 WHIP can contribute. Its digital screening is designed to flag potential risks across 100+ health conditions and guide employees towards follow-up. A positive screen is a prompt for assessment, not a diagnosis. The platform presents employers with anonymous, aggregated patterns across areas such as mental health, chronic conditions, absenteeism and productivity, helping them decide where support may be needed.
For example, a workforce pattern of musculoskeletal complaints could prompt an ergonomics review. A pattern of fatigue and stress could prompt a review of workloads and access to support. An individual employee who receives a risk flag can seek advice from an appropriate healthcare professional. Clinical decisions and any decision about fitness for work or medical boarding remain with qualified professionals and the relevant process.
The goal is to help more people get timely care and stay supported at work wherever possible. H360 WHIP gives organisations a way to see broad health risks earlier and act on them, while treating disability as a matter of employee wellbeing, inclusion and dignity.
