For family members only
The term “reduced earning capacity” is defined as a reduction in earning capacity, assumed to be permanent or long-term, resulting from the effects of a physical, mental or psychological condition caused by congenital anomaly, illness or accident, preventing the person concerned from carrying out paid work in spite of treatment and rehabilitation measures appropriate to the situation.
Eligibility
An application for the payment of an allowance for reduced earning capacity may be made for a family member (eligible person) of a CHIS Main Member (active employed member of the personnel, former member of the personnel who is a pensioner or a deceased member of the personnel), provided that the following conditions are all met at the time of the application :
| Eligible persons | Conditions for entitlement to the allowance |
|---|---|
| The Main Member must be, or have been, a staff member, graduate or fellow |
The application may be made where the eligible person’s earning capacity :
|
| The Main Member must have served the Organization for at least two uninterrupted years in this capacity | |
| The Main Member and the eligible person must have been Members of the Scheme with normal health insurance for at least one year | |
| The eligible person must not be a Compulsory Main Member of the Scheme | |
| All attempts to restore the earning or working capacity of the eligible person must have proven either completely or partially ineffective | |
| The eligible person must have reached the age of 18 but must not have reached the CERN retirement age |
Procedure for requesting an allowance
The allowance for reduced earning capacity may be applied for at any time provided that the conditions are met. The application may be submitted by the eligible person him- or herself or by a third-party representing him or her. If the application is accepted, the effective date will be the first day of the month in which the application was submitted. The allowance may be paid retroactively for a maximum period of 12 months if the person concerned proves that the conditions justifying the payment were met continuously.
Anyone applying for the allowance must, at his or her own cost, provide the Third-Party Administrator UNIQA with a detailed medical report, by the competent national authority, setting out the cause, nature, start date and probable duration of the reduced earning capacity, as well as details of the physical injuries or intellectual or physical deterioration of the person concerned. This report must also indicate the level of reduced earning capacity as determined by the person’s medical practitioner, and a statement on the chances of recovery.
Within the six weeks following receipt of the application in the form set out above, UNIQA informs the person concerned and, where applicable, the Scheme’s Manager, of its decision in writing. If the decision is favourable, the level of the allowance and the date from which it is payable are specified. UNIQA is entitled to defer the decision by a maximum of one year after medical treatment is completed if the medical report leaves doubts as to whether the reduced earning capacity is permanent and as to its extent.
Benefits
| Allowance | Conditions | Amount of the allowance |
|---|---|---|
| Full allowance | If the eligible person is diagnosed as having at least a two-thirds reduction in earning capacity. |
The reduced earning capacity allowance is equal to the minimum allowance that the disability insurance scheme of the Swiss Confederation would pay in the same circumstances, regardless of the State of residence of the eligible person. |
|
Half allowance |
If the eligible person is diagnosed as having at least a 50% reduction in earning capacity. |
In accordance with Article V 2.02, the amount of any benefit of the same nature received as a result of compulsory membership of a national social security scheme will be deducted from the reduced earning capacity allowance. Members are required to inform UNIQA if they are in receipt of such benefits as soon as possible. However, the disabled orphan’s pension, granted under the Rules of the CERN Pension Fund, may be paid concurrently with the benefits described above.
For further information and guidance on procedures and the necessary supporting documents needed, please contact UNIQA.