IV must pay an Insured up to 100’000 Swiss francs

IV-Doctors do not come again and again in the criticism, because you decide from the point of view of the associations of the Disabled, regardless. "We note th

IV must pay an Insured up to 100’000 Swiss francs

IV-Doctors do not come again and again in the criticism, because you decide from the point of view of the associations of the Disabled, regardless. "We note that many of these Doctors instruct as part of the IV system, with its strict requirements first, unilateral assessor and then their results uncritically by waving it," says Alex Fischer of Procap, the biggest member Association of and for people with disabilities.

Two cases show how the disability insurance (IV) made only to a court order for a medical reassessment.

The IV Protocol by Daniela B.* documented a long suffering history. The 40-year-old employee of a chemical cleaning reported in 2012 at the IV site in Lucerne, because they suffered after several operations on the spine with severe pain. Several times the Doctors agreed to give her a 100 percent inability to work.

The daily allowance insurance as noted at the beginning of 2013 on the basis of a medical opinion that the woman "is hardly able any longer to sit a quarter of an hour, to stand, a pain behavior, indicating a pronounced pain intensity".

at that time had two surgeries: a fusion of two lumbar vertebrae and an intervertebral disc prosthesis. Additional operations after registration for the IV aggravated the Situation.

doctor refused to Meet with patient

The regional medical services (RAD) of the IV ordered medical reports came to the conclusion that the wife had borne, after several operations, physical damage, and in the profession could no longer work. In the adapted activity of a 70% working capacity, however, is available.

To this opinion of the WHEEL is supported during the whole process and insisted that the woman in a seat of activity for a workload of 70 percent is reasonable. A pension is only 40 per cent of incapacity to work.

as warden of the port attorney by Daniela B., interferes with the action of the WHEEL doctor. These have consistently refused to see the patient personally. The inclusion consultant, the IV held in February 2016, in writing, that the patient had spent the whole conversation "cowering sitting on the floor and complained of pain".

The job placement came to the conclusion that the health-related condition "is neither a structure of training allows for a work attempt," and recommended the WHEEL doctor to examine the patient personally.

But this didn't stop there: "Why the work placement is recommended a personal assessment, is for me to understand. (...) Further investigations are not displayed, since medical questions are open."

the port obtained finally, with a complaint to the cantonal court of Lucerne, a new review. Because of this medical opinion, the IV of the woman's last December, to language, from 2013 until the end of 2015, retroactively, with a full pension and from 2016, a quarter of the pension, because after the last spine surgery the health condition improved. The IV of the woman has to pay 100’000 Swiss francs for the your since 1. January 2013 attributable to the IV and children's pension, 17’000 Swiss francs interest.

constant pain, or fully able to work?

in another case, the IV granted the office of Lucerne, an applicant for a pension, after he had obtained through the court to an external medical review. PC technician Roger H.* had registered by the end of 2015, because of the strong, burning pain in the hands, legs and feet to the IV.

The investigations revealed that the then-40-Year-old to a genetic deficiency of minerals is suffering, the damage the nerve permanently. The WHEEL was, however, that the symptoms can be treated by replacing the missing minerals "complete" and the man was 100 percent able to work.

The medical reports, the the Affected person rode before the court, attested to him, however, a "constant pain and suffering." The stinging pain attacks may only be triggered by simple touch. Whether the medical treatment bring a relevant improvement, be open. The IV spoke to the man at the end of 2018, a full IV pension.

The two WHEEL-Doctors were set according to the lawyer, the port is insufficient, with the lack of effect of therapy apart. This will show the to the IV Protocol in-depth discovery of the WHEEL: "The therapeutic replacement of potassium is mandatory, since the Childhood and, therefore, not new." The IV-Physicians overlooked the fact that the person received only 40, the specific diagnosis, which allowed a drug treatment and the replacement of the minerals. The man had already suffered irreparable damage.

"No orders to "healthy capitalization""

says Daniela B. competent doctor on the case again and again by the fact that he was writing IV-applicant is healthy, even if the medical facts speak clearly for a pension, port. He doesn't want to throw all of the WHEEL in the same pot. There are some cantons, such as Lucerne, where the practice was particularly restrictive, and wanted to keep the number of Neurenten as low as possible.

comes To a similar conclusion the Association Procap. "In the restrictive cantonal IV Offices, we are not forced again and again to complaints, with which we, as in the described cases is rarely a reassessment," says Alex Fischer.

The IV site Lucerne rejects the accusations port decided. "There are no jobs to WHEEL Doctors to "healthy capitalization" of the disabled Insured." The WHEEL was not for the pension decisions responsible for medical assessment regardless. The WHEEL doctor by Daniela B. had acted "legally, correctly and independently". Since there was already a polydisziplinäre assessment had been that it was not reasonable, the insured Person to invite to a personal investigation.

The IV of Lucerne, however, regrets that has undergone the procedure about six years: "This is not our Standard." In the case of Roger H. the IV refers to the fact that it was a very rare disease with a rare complication. It acknowledges, however, that "the evaluation of the WHEEL was in all points applicable".

*name changed by the editors

Created: 04.03.2020, 09:15 PM

Updated Date: 04 March 2020, 15:02

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