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Shaykh Faraz Rabbani from SeekersHub addresses this question in the video below:
If you’re unable to fast during Ramadan, do you have to pay a fidya– expiatory payments?
So, if someone is elderly and it is such that their health condition is most likely not to improve, so they’ll no longer be able to fast, then they can give a fidya.
Otherwise, one keeps track of the fast one was unable to perform. And if one is able to fast, then one does. So, the fidya, the expiatory payment, is only obligatory if one reaches an age when one is no longer able to fast. Or there’s some clear, long-term health condition.
So, if someone is diabetic, for example, there are different cases of people who are diabetic, some diabetic people are able to fast, or many of them are, and some aren’t.
Depends on one’s condition which one has to see. If one wishes to give the expiatory payment, [he/she] may give a fidya, which is to feed, you know, to feed a poor person, one is rewarded for it, one is rewarded for it.
But it’s not obligatory except in that case. So, someone who’s pregnant and they’re not able to fast or someone who’s nursing and they’re not able to fast or someone who’s sick and they’re unable to fast, they don’t have to give any kind of expiatory payment.
If they choose to do, they’re rewarded for it, they’re rewarded for it. But such a person, they’re under Allah’s mercy in that, if they have the wish that were I able to, I would have fasted, you have the full reward of that. And doubting that is doubting Divine Mercy.
Allah (SWT) and His Messenger have informed us: the Prophet (SAWS) said, the person who is sick or travelling has the full reward of all that they used to do when they were healthy or resident. And that’s from the vastness of Allah (SWT) Allah’s mercy.
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