Invalidity insurance benefits
Invalidity insurance aims to ensure the labour market (re-)integration of individuals who are disabled owing to a congenital or other illness, or as the result of an accident. Individuals only receive an IV pension if it has been determined that their professional (re)integration is not feasible. In this system, rehabilitation measures are always preferred above pension payments. Since 2008, the 5th revision of the IV provides for additional rehabilitation measures, some of which offer companies effective support with their efforts to incorporate disabled employees in the workforce. These include financial assistance, employee induction allowances, as well as compensation for absenteeism. For their part, the disabled can avail of additional benefits, such as retraining, job placement and job coaching services. IV is a compulsory nationwide insurance scheme; contributions are deducted together with the compulsory AHV contributions.
What constitutes a “disability”?
In accordance with the federal law on the general part of social insurance law (in force since 1st January 2003), disability is defined as “a full or partial earning incapacity that is likely to be permanent or persist in the longer-term”. This is understood to mean “continuing full or partial loss of ability to take up employment in the relevant job market due to impaired health in spite of reasonable treatment and rehabilitation”. Earning incapacity also refers to the inability to carry out day-to-day activities (e.g. housework, child rearing, education). There are three disability criteria: impairment to health (regardless of whether it is congenital, illness-related or accident-related) leading to earning incapacity (medical criterion), a permanent or longer-term earning incapacity (economic criterion), and a causal link between them.
The principal benefits to which the disabled are entitled are those which prevent their health impairment from deteriorating, remedy the condition (certain medical measures) or alleviate its effects (supply of appliances, as well as occupational measures). IV pensions are only a subsidiary entitlement.
Rehabilitation before a pension
Targeted rehabilitation measures should assist the disabled to restore, fully or partially, their earning capacity and to become as independent as possible. By supporting and reinforcing the self-determination of individuals and their desire to be re-integrated in society, such measures afford them the possibility of leading their life as they see fit.
Where necessary and appropriate, claimants who are disabled or likely to become disabled are entitled to rehabilitation measures to restore, maintain or improve their earning capacity or their ability to perform day-to-day activities. They are entitled to these measures irrespective of whether they were gainfully employed prior to the onset of their disability. In this context, the anticipated working life of the person is taken into consideration.
Invalidity insurance benefits aimed at the rehabilitation of the disabled include:
Provision of aids
Medical measures to treat a congenital disability (Art. 13 InvIA; ConDisO) or a more or less stabilised medical condition (Art. 12 InvIA) insofar as these measures contribute to a permanent and real improvement in the person's earning capacity. The IV awards these measures until the claimant reaches the age of 20.
Early detection and early intervention
Provision of aids – as listed in the Federal Ordinance on the Provision of Aids under the Invalidity Insurance (InvIAO; SR 831.232.51), which are necessary for maintaining or improving the earning capacity of the disabled people r their ability to perform day-to-day tasks (e.g. housework), for attending school, for undertaking basic and further training and for functional re-adaptation purposes. Aids to help the disabled become mobile, communicate with others or increase their independence are awarded irrespective of whether they are employed or not.
Flat-rate payment towards the purchase of hearing aids
(Further information is available in french, german and italian)
The aim of the early detection instrument is to spot the early signs of disability and to take swift action to prevent, where possible, the health problems from becoming chronic. This instrument should make it easier to adopt, swiftly and with a minimum of red tape, initial measures that are intended to allow the incapacitated person to remain either fully or partly in their current job or to take up new employment.
If a person has been unable to work for at least 30 days or is repeatedly absent from work on health grounds, (s)he can provisionally register with the IV. Provisional registration with the IV can also be carried out by a legal representative, a family member living with the insured, the employer, the treating physician, the relevant social and private insurers or social welfare. However, the third party must inform the person concerned of their intentions. The provisional registration form can be obtained from the cantonal IV offices and compensation offices, or downloaded from the internet. The IV office investigates whether the insured presents with a risk of disability and can arrange a meeting with her/him to discuss matters related to the early detection of his/her disability. It then informs the person in writing whether they should proceed with registering with the IV or not.
Once the insured has registered with the IV, specialists in the IV offices can introduce, swiftly and with a minimum of red tape, early intervention measures that are intended to allow the person to stay in his/her current job or to offer them new employment. Following a comprehensive assessment, an integration plan is drawn up and the actual measures to be taken are set out in a written goal agreement. These measures include adaptation of the work environment, training courses, job placement, careers’ advice, socio-occupational rehabilitation and transitional employment measures. As a general rule, the early intervention process runs for six months, starting from the receipt of the IV registration form and ending with the final decision on whether the integration route is a viable option or whether an examination of pension eligibility should be pursued instead. To reach this decision, eligibility for integration measures is also investigated during the early intervention phase. The IV does not award any cash benefits during the early intervention phase. The insured have no legal entitlement to early intervention measures.
The integration measures introduced as part of the 5th IV revision (Art. 14a InvIA) are aimed especially at those insured whose incapacity is at least 50% and is caused by psychological problems. The aim of these measures is to create the necessary conditions for the person concerned to undertake any of the available occupational measures or to return to the labour market.
There are four reintegration measures; they fall into two categories: socioprofessional rehabilitation and transitional employment. Measures in the first category enable the person to use his/her existing skills - familiarisation with work processes, social integration and motivation thanks to resilience training, progressive training and practice-based rehabilitation with active workplace support (WISA/REST). To avail of these measures, the person must show a rehabilitation potential.
Measures in the second category provide the person with transitional employment with a view to maintaining their capacity to work. Rehabilitation measures also enable the person to establish a daily routine. This option is offered to individuals who are at risk of becoming unfit to work or suffering serious disruption to their day-to-day life while they are waiting to be retrained or to take up a new job.
Daily cash benefits as ancillary benefits
The guiding principle of invalidity insurance – “rehabilitation before pension” - is both the aim and the instrument. Before the IV office assesses a pension claim, the person must be informed of possible (re)integration measures. The IV offers a wide range of occupational rehabilitation measures and accompanying benefits, such as career advice, re-training, job placements, capital grants, daily cash benefits and reimbursement of travelling expenses. This approach is underlined in Article 18 of the Federal Invalidity Insurance Act, whereby parliament clearly grants claimants who are unfit for work but have integration potential the right to active assistance and advice on finding suitable employment. When a placement is found, the employer concerned is entitled to an allowance during the employee induction phase. The IV may also compensate the employer for any increase in its contributions to the compulsory occupational pension scheme and the daily cash allowance insurance scheme owing to the person becoming unfit for work again.
Claimants are entitled to daily cash benefits if rehabilitation measures prevent them from attending work on at least three consecutive days, or if their degree of incapacity to perform day-to-day tasks is 50% or over. To be eligible for daily cash benefits, claimants must be at least 18 years old and in gainful employment prior to the onset of their incapacity. While in receipt of rehabilitation measures, those insured who were not gainfully employed prior to the onset of their incapacity receive an allowance for the costs of looking after their children or family members requiring care. Claimants taking up occupational training for the first time, as well as those under 20 and not yet gainfully employed, may receive a daily cash benefit if their earning incapacity is disability-related. These benefits are basic compensation payments which are equivalent to 80% of the income of the insured prior to the onset of the disability. Anyone insured under the invalidity insurance scheme may claim these benefits. Claimants with children may also be awarded child support, insofar as their earned income does not include a family or training allowance.
The benefits are paid out in the form of a pension, a helplessness allowance or a personal assistance allowance.
A person is only entitled to an invalidity pension if the rehabilitation option has been exhausted. The degree of disability determines the type of pension a claimant will receive: claimants with a degree of disability of at least 40 percent are eligible for a quarter pension. If their degree of disability is at least 50 percent, they will be eligible for a half pension, and 60 percent disability entitles them to a three-quarter pension. Only claimants with a degree of disability over 70 percent are entitled to a full IV pension.
The insured are only eligible for an IV pension if they meet the following requirements:
- their earning capacity has fallen by at least 40% on average over one year without significant interruption.
- an earning incapacity of at least 40% persists after one year.
Entitlement to an IV pension falls due no earlier than six months after an application has been submitted to the IV, and for minors, no earlier than the month following their 18th birthday.
Personal assistance allowance
Helplessness allowances are awarded to claimants who require the help of a third person to perform day-to-day tasks (e.g. dressing, eating and bathing), who need permanent care or one-to-one supervision.
Helpless minors may also be eligible for a helplessness allowance. In their first year, they are entitled to this allowance if it is likely that their helplessness will persist for more than 12 months.
Under certain circumstances, minors requiring a limited minimum period of intensive care will be awarded an additional allowance. This does not apply if this care is administered in a residential nursing home.
Helpless adults are defined as persons who live in their own home but require permanent and regular help with day-to-day tasks. This means that as a result of their health problems, these individuals:
- cannot live independently and therefore must always be supervised by a third person,
- are reliant on assistance from a third person in relation to activities and contact outside the home, or
- are at serious risk of long-term isolation.
Only recipients of at least a quarter-pension are eligible for this type of allowance.
The IV distinguishes between three levels of helplessness: slight, moderate and severe. The severity of helplessness differs according to whether the claimant lives in a residential home or in his/her own house. Claimants who live in a residential home are entitled to half the allowance awarded to those still living in their own home.
The personal assistance allowance enables recipients of a helplessness allowance who regularly rely on assistance but would still like to remain in their own home to hire a person who can provide them with the necessary help. The insured are entitled to a personal assistance allowance if they are in receipt of an IV helplessness allowance and live at home. If the insured person lives in a care home but plans to move out of this facility, they can apply to the IV for a personal assistance allowance.
Supporting providers of services for the disabled
Further information is available in french, german and italian.
Last modification 13.04.2018