Rs 831.232.51 Order Of The Dfi On November 29, 1976, Concerning Delivery Of Auxiliary Means By Disability Insurance (Omai)

Original Language Title: RS 831.232.51 Ordonnance du DFI du 29 novembre 1976 concernant la remise de moyens auxiliaires par l’assurance-invalidité (OMAI)

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831.232.51 order of the DFI on delivery of auxiliary means by disability insurance (OMAI) of November 29, 1976 (Status January 1, 2016) the federal Department of Home Affairs (FDHA), view the art. 14 and 14 of the regulation of January 17, 1961, on disability insurance (di), stop: Section 1 scope of application art. 1. this order defines the right of the insured to the granting of auxiliary means or replacement benefits that is recognized by the art. 21 to 21 of the Federal Act of 19 June 1959 on disability insurance (LAI), as well as the reimbursement of AIDS within the meaning of art. 21, al. 1, let. a to c, LAI.
Articles 3 to 9 apply by analogy to the delivery of treatment which are necessarily part of a medical measure of rehabilitation to the senses of the art. 12 and 13 ATIA and are not on the list in the annex.

RS 831.20 new content according to section I of the O of the DFI 28 nov. in force since Jan. 1, 2012. 2013 (2012 6849 RO).

Section 2 means auxiliary arts. 2 right to AIDS are entitled to the auxiliary means, within the limits set by the list in the annex, holders who need to move, establish contacts with their entourage or develop their personal autonomy.
The insured is entitled to the AIDS referred to in this list by an asterisk (), as if he needs to engage in a gainful activity or do its regular work, to study or learn a trade or for purposes of functional habituation or to carry out the activity named the corresponding digit of the annex.
The right extends to Accessories and adaptations made necessary by the disability.
The insured is entitled to auxiliary means of a simple, adequate and economic model. It bears the additional cost of another model. When the list in the annex mentions none of the instruments provided for in art. 21 LAI for the delivery of a subsidiary means, expenses are reimbursed.
When an insured person is entitled to the delivery of a subsidiary means listed in the annex but that it merely another less expensive way filling the same functions, the latter must be delivered even if it is not in the list.

New content according to chapter I of I'O of the DFI on Sept. 21. 1982, in force since Jan. 1. 1983 (1982 1931 RO).
RS 831.20 new content according to section I of the O of the DFI on nov 28. in force since Jan. 1, 2012. 2013 (2012 6849 RO).
Introduced by section I of O of the DFI on Nov. 24. 1988, in force since Jan. 1. 1989 (1988 2236 RO).

Art. 3Forme of rehabilitation AIDS are released property, unless the Ordinance provides otherwise.
Expensive auxiliary ways which, by their nature, could be used to other people are given on loan.

New content according to chapter I of O of the DFI from 22 nov. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Art. 3Remboursement of the auxiliary means in the cases described in the annex, the insurance can pay to the insured: a. unique contributions or periodical to AIDS acquired by him; b. a package for the acquisition of a subsidiary means; (c) the amount of the rental costs for leased auxiliary means.

The amount of refunds is fixed in annex.

Introduced by section I of O of the DFI of Nov. 22. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Art. 4 extension of the term of the loan if the conditions set for the discount on loan from auxiliary means according to art. 21, al. 1, LAI, are no longer met, the insured can continue to use them as long as they are needed to move, establish contacts with his entourage or develop personal autonomy.
The insured has the right to purchase at any time, a fair purchase price, the AIDS which have been given to him on loan.

RS 831.20 new content according to section I of the O of the DFI on Nov. 13. 1985, in force since Jan. 1. 1986 (1985 2010 RO).

Art. 5 recovery of the auxiliary means for re-use AIDS given on loan to which the insured is more entitled and which are not left for future use must be returned and will be stored by the insurance in a special deposit until ready to reuse.

Art. Careful 6Usage the auxiliary means given by insurance must be used with care.
When a subsidiary means become prematurely unusable because it has not been used with care, the insured shall pay to the insurance appropriate compensation.

New content according to chapter I of O of the DFI from 22 nov. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Art. 6Usage in accordance with the insured must use the amounts collected under art. 3, al. 1, let. a and b, in accordance with the intended purpose.
To ensure a consistent with the intended purpose use, delivery of a subsidiary means may be subject to conditions. When a subsidiary means become prematurely unusable because the insured has not met these conditions, it must provide appropriate compensation to insurance.

Introduced by section I of O of the DFI of Nov. 22. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Art. 7entrainement of the disabled in employment of auxiliary means, repair and maintenance of these when the insured needs special training to use the auxiliary means, insurance pays the costs resulting.
Insurance, if a liable third party, the costs of repair, adjustment or partial replacement necessary despite the careful use of the auxiliary means. The insured may be required to contribute to the costs. The amount of participation is set in the annex.
Insurance grants an equivalent annual contribution to the actual costs but 485 francs at most at the expense of maintenance and use of auxiliary means, unless the annex sets a different amount. It does not charge fees, maintenance and use of vehicles motor.
It contributes to the maintenance costs of a guide dog for the blind by a monthly benefit. The amount thereof is fixed in the annex.

New content according to chapter I of O of the DFI from 22 nov. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Section 3 benefits of alternative art. 8Droit to the reimbursement of the costs incurred by the acquisition of auxiliary means if the insured made himself the acquisition of a subsidiary means set out in the list in the annex or if he realizes, at his own expense, an adaptation rendered necessary by the disability, he is entitled to the reimbursement of expenses that would be incumbent on insurance if she had provided to the acquisition or adaptation in question.
If it means auxiliary, designated as costly by the federal Office of insurance social and that, by nature, could be used eventually to others, assumed by the insurance refund in the form of annual depreciation allowances. These are fixed according to the fees and probable duration of the use of the auxiliary means.
Insurance can make the refund to certain charges ensuring adequate use of the auxiliary and far-sighted way in the case of non-use of it, its ownership will be transferred to the insurance.

New content according to chapter I of O of the DFI from 22 nov. 2007, in force since Jan. 1. 2008 (2007 6039 RO).

Art. 9 right to the reimbursement of expenses incurred by a third party the insured is entitled to reimbursement of the costs associated with disability, which are duly established and caused by the special services of third parties he needs, instead of a subsidiary means for: a. go to his work; b. engage in a gainful activity; OUC. Acquire special skills that allow to maintain contacts with other people.

The monthly payment may exceed neither lucrative activity of the insured monthly income nor once and a half of the minimum amount of the ordinary retirement pension.

New content according to section I of the O of the DFI on Nov. 13. 1985, in force since Jan. 1. 1986 (1985 2010 RO).
New content according to section I of the O of the DFI on Nov. 6. 1998, in force since Jan. 1. 1999 (RO 1998 3024).

Section 4 provision final art. 10. the order of 4 August 1972 concerning the delivery of AIDS by disability insurance in special cases (OMA) is repealed.
This order comes into force on January 1, 1977.

[1972 1776 RO]

Transitional provision of the amendment of November 22, 2007 transitional provision of the amendment of transitional provisions of the amendment on November 28, 2012 on 25 May 2011 requests for typewriters, telephonoscripteurs, mobile phones with special software or fax submitted before the entry into force of the amendment on November 28, 2012 are processed according to the old law.
If the given devices must be repaired or replaced, insurance take fees in accordance with art. 7, al. 2, even after the entry into force of the amendment on November 28, 2012.

Annex list of ancillary means 1 prostheses reimbursement according to wage agreement with the Swiss Association of orthopaedics (ASTO) technicians.

1.01 functional prostheses final for the feet and legs 1.02 final prosthetics for hands and arms 1.03 Exoprotheses final of the breast after mastectomy or if there is a syndrome of Poland or Agenesis of the breast. Maximum contribution per calendar year: CHF 500 for one side, 900 francs for both sides.

2 Orthotics


Refund according to tariff agreement with the ASTO.

2.01 Orthotics legs 2.02 Orthotics arms 2.03 Orthotics of the trunk, functional of the spinal column failure reflected by significant back pain and alterations of the spine revealed by clinical and radiological, review if this failure can not be resolved by medical measures, or can be only insufficiently.

2.04 Orthotics neck 3...

4 shoes and insoles foot refund according to tariff agreement with foot & shoe (ASMCBO) Association.

4.01 shoes orthopedic custom and series orthopedic shoes, fresh production included, when a discount according to 4.02 to 4.04 points is not possible. The insured must contribute to the costs at the rate of 70 francs until the age of twelve and 120 francs from the age of twelve years. In case of repair, the interest amounts to 70 francs per calendar year.

4.02 orthopedic retouching and orthopedic elements incorporated to manufacture shoes or special orthopedic shoes.

4.03 special orthopedic shoes: the insured must contribute to the costs at the rate of 70 francs until the age of twelve and 120 francs from the age of twelve years. In case of repair, the interest amounts to 70 francs per calendar year.

4.04 use of additional manufacturing shoes for disability 4.05* Plantar insoles, if they constitute the complement of medical rehabilitation measures 5 auxiliary means for the skull and face 5.01 ocular prostheses: refund according to the agreement reached between the federal Office for social insurance and the suppliers of ocular prostheses. Art. 24, al. 3, RAI is reserved.

5.02 5.03 facial Epitheses...

5.04...

5.05* dentures so they are an important supplement to medical rehabilitation measures.

5.06 wigs: maximum annual contribution: 1500 francs.

5.07 hearing in case of impairment of hearing, when such a device substantially improves hearing ability and opportunities for communication of the insured with his entourage. The insured is entitled to a flat-rate reimbursement, that can be requested every six years at most, unless a significant change to your hearing requires the replacement of the devices before the expiry of this period. The hearing must be given by a qualified person.

The package is 840 francs for a monaural fitting and 1650 francs for a binaural off repairs and batteries.

The package for the purchase of batteries is by calendar year, 40 francs for a monaural equipment and 80 francs for a binaural.

The package for the costs of repairs performed by the manufacturer is of 200 francs for electronic damage and 130 francs for other damage. These packages are granted at the earliest from the second year of operation of the device.

The federal Office of social insurance draws up a list of devices meeting the requirements of the insurance and for which the payment of a package is allowed.

For the purchase and repair of hearing aids, the packages are paid upon presentation of the invoice total amount and corresponding receipts.

5.07.1 hearing devices implanted or attached by bone anchoring the Office federal social insurance defines the participation of the insurance to the external components of the hearing devices implanted or attached by bone anchorage and the middle ear implants.

For adults, middle ear implants and the package of benefits for adaptation and the follow-up of the hearing set by bone anchorage is 1000 francs for a monaural fitting and 1500 francs for a binaural. For children under 18 years old, he is 1300 francs for a monaural fitting and 1950 francs for a binaural.

The package is paid upon presentation of the invoice total amount and corresponding receipts.

The package for the purchase of battery for cochlear implants is by calendar year, 400 francs for a monaural equipment and 800 francs for a binaural. The package for the purchase of batteries for hearing aids set by bone anchorage and middle ear implants is by calendar year, 60 francs for a monaural equipment and 120 francs for a binaural.

5.07.2 * regulation of the case of hardship for the federal Office of social insurance hearing controlgear defines cases in which prices higher than the amounts provided for in section 5.07 can be paid for a monaural or binaural fitting.

5.07.3 hearing aids for children under the age of 18 years the maximum amount reimbursed for the equipment and monitoring is 2830 francs for a monaural fitting and 4170 francs for a binaural, VAT included. The contribution can be requested every six years at most, unless a significant change to your hearing requires the replacement of the devices before the expiry of this period.

The contribution is paid directly to pediatric audiologists authorized in accordance with the order of May 25, 2011 regarding the empowerment of paediatric audiologists.

The contribution to the purchase of batteries is by calendar year, 60 francs for a monaural equipment and 120 francs for a binaural.

Repair costs are reimbursed as provided for in section 5.07.

5.08 speech devices after operation of larynx 6...

7 glasses and contacts 7.01* glasses, if they are the complement of medical rehabilitation measures. Maximum contribution for the mount: 150 francs.

7.02* contact lenses if they should necessarily replace glasses and constitute the complement of medical rehabilitation measures.

8...

9 chairs wheelchairs refund according to tariff agreement with the Federation of Swiss associations of trade and industry of technology medical (FASMED) and the ASTO.

9.01 wheelchair without motor: If a stroller is given instead of a wheelchair, the participation fees amounts to 300 francs for children under the age of 30 months. The collection takes place in the form of loan.

9.02 electric wheelchairs for insured persons who cannot use a common wheelchair and can move only through a wheelchair driven electrically. The collection takes place in the form of loan.

10 vehicles engine and vehicles of invalids, for holders who probably permanently employed to cover their needs, cannot do without a personal motor vehicle to get to their work.

Two, three or four-wheeled mopeds 10.01*: the annual depreciation allowance amounts to 480 francs for mopeds two-wheeled and 2500 francs for three or four-wheeled mopeds.

10.02* light motorcycles and motorcycles: the annual depreciation allowance amounts to 750 francs.

10.03*...

10.04* cars: the annual depreciation allowance amounts to 3,000 francs. The contribution for an automatic garage door opening is around 1500 francs.

10.05 transformations of motor vehicles required by the disability 11 AIDS for the blind and disabled serious of sight white canes 11.01 and 11.02 guide dogs for the blind pedestrian navigation systems, where it is established that the insured will be able to take care of a guide dog, and thanks to it, it will be able to travel alone outside his home. Insurance supports the costs according to the tariff agreement with guide dogs schools. The monthly contribution amounts to 80 francs for the cost of food and 30 francs for veterinary fees. If the latter exceeds 360 francs a year, overtaking is reimbursed upon presentation of the corresponding receipts.

11.03...

11.04 listening for audio carriers devices allowing the blind and people severely disabled from the view to listen to recorded sound media texts. The maximum contribution amounts to 200 francs. The collection takes place in the form of loan.

11.05* listening devices for audio carriers for the blind and severely disabled persons of the view that, without these devices, could exercise a lucrative activity or do their usual work. The collection takes place in the form of loan.

11.06 systems reading and writing for the blind and severely disabled persons from the view who cannot read that with such a system or when its use significantly facilitates contacts with other people, if the insured has needed to use intellectual faculties. The learning of typing fees charged to the insured. The collection takes place in the form of loan.

11.07 eyeglasses-magnifiers, binoculars and filter glasses for eyesight severely disabled people who cannot read with such means or where they notably improve their Visual ability.

12 accessories to facilitate Walking canes crutches 12.01: takes place in the form of loan.

12.02 walkers and ambulatory AIDS: takes place in the form of loan.


13 tools for landscaping work stations, to perform normal work, or facilitating the schooling or training of the insured; architectural measures helping him get to work 13.01* work Instruments and appliances necessitated by the disability; facilities and ancillary devices; necessary adaptations to the manipulation of devices and machines: the insured pays insurance participation in the acquisition cost of devices that able-bodied people also need standard. The auxiliary resources acquisition cost does not exceed 400 francs are paid by the insured. The contribution of insurance to purchase batteries for FM devices amounts to 40 francs per calendar year.

13.02* seats, beds and standing holders adapted to the infirmity of individually: the insured pays insurance participation in acquisition of devices costs that able-bodied people also need standard. The auxiliary resources acquisition cost does not exceed 400 francs are paid by the insured.

13.03* work Surfaces adapted to the infirmity of individually: the insured pays insurance participation in acquisition of devices costs that able-bodied people also need standard. The auxiliary resources acquisition cost does not exceed 400 francs are paid by the insured.

13.04* costs of development, needs by disability, workplace and premises in the field of usual activity of the insured (deleted enumeration) 13.05* Installation of platform lifts and monte-railings as well as removal or modification of architectural barriers inside and in the vicinity of places of habitation, work, training and schooling, if these measures allow the insured to go to work the school or his place of training, or perform his usual work. The collection takes place in the form of loan.

14 auxiliary methods used to develop personal autonomy 14.01 WC - showers and toilet-drying facilities, as well as supplements to existing health facilities, when the insured cannot do alone toilet them without such facilities. The collection takes place in the form of loan.

14.02 elevators for sick, for private home use. The collection takes place in the form of loan.

14.03 electric beds (with stem but without mattress and other accessories) for use in the home of the insured who depend on to bed and stand up. The collection takes place in the form of loan. Permanently bedridden policyholders are excluded from this right.

The purchase price of a bed is reimbursed to a maximum of 2500 francs. The contribution to the costs of delivery of the electric bed amounts to 250 francs.

14.04 facilities of the remains of the insured for disability: adaptation of the bathroom, of shower and WC on the disability, moving or deleting partitions, enlargement or replacement of doors, put bars support and additional handles, handrails, removal of thresholds or construction of ramps of thresholds, pose installation of signs for the deaf and deficient hearing serious and for the deaf-blind. The contribution to the installation of signage facilities amounts to 1300 francs at most.

14.05 stair lifts and ramps for policyholders who are unable to leave their homes without such a facility. If a monte-railings is installed instead of a stair, the maximum contribution amounts to 8000 francs. In this case, the repair costs are not reimbursed. The collection takes place in the form of loan.

14.06 assistance dogs for the disabled, if it is established that the insured will be able to take care of an assistance dog, and thanks to it, it will be able to live at home in a more autonomous way. The right is limited to adults with severe motor disabilities who are paid an allowance for helpless for a medium importance or serious. Insurance, shall, at the time of delivery of the assistance dog, a flat-rate contribution in the amount of 15 500 francs, distributed in the following way: 12 500 francs for the purchase of the dog for assistance and 3,000 francs for food and veterinarian expenses. Delivery of insurance can be claimed at least every eight years, but only once for the same dog.

15 auxiliary means allowing the disabled to establish contacts with his entourage 15.01...

15.02 devices of electric and electronic communication, for the severely disabled insured speech and writing that depend on such a device to maintain daily contact with relatives and who have intellectual and motor skills necessary for its use. The collection takes place in the form of loan.

The maximum contribution for the services required for delivery (review, installation and training to employment) is 140 francs earlier, excluding VAT. It also covers the management and logistics of the service provider, tasks that cannot be billed separately. For the auxiliary means, have it pay the cost; can be paid extra, at most, a package of 190 francs, excluding VAT handling, by delivery of auxiliary means. For necessary travel, the vendor is paid at the maximum rate of 70 ct. / km (excluding VAT).

15.03.

15.04 Turners of pages, when the paralyzed person who cannot not read books or magazines of independent needs such a device. The collection takes place in the form of loan.

15.05 environmental control devices, when the insured very seriously paralyzed, who is not hospitalized, or placed in an institution for chronic illness, can establish contacts with his entourage by means of this device, or when the latter allows him to move around in electric wheelchairs to independently instead of home. The collection takes place in the form of loan.

The maximum contribution for the services required for delivery (review, installation and training to employment) is 140 francs earlier, excluding VAT. It also covers the management and logistics of the service provider, tasks that cannot be billed separately. For the auxiliary means, have it pay the cost; can be paid extra, at most, a package of 190 francs, excluding VAT handling, by delivery of auxiliary means. For necessary travel, the vendor is paid at the maximum rate of 70 ct. / km (excluding VAT).

15.06 SIP video phones, when an insured person, totally deaf or severely disabled hearing and who communicates through sign language, does not establish the necessary contacts with his entourage in a different way or when such an effort cannot reasonably be required of him, and when he has the intellectual and motor faculties necessary to use a videophone. The collection takes place in the form of loan. The maximum contribution amounts to 1700 francs, VAT included.

15.07 contributions to made-to-measure clothing, when the insured cannot wear clothing manufactured in series due to disorders of growth or deformations of the skeleton.

15.08 helmets of protection for epileptics or hemophiliacs 15.09 elbow pads and knee pads to protect hemophiliacs 15.10 special (reha) child seats for the car for children who cannot control the head and trunk: the participation fees is around 200 francs for children up to the age of twelve less than 150 cm.

Update by seven I of O of the DFI 21 clause. 1982 (RO 1982-1931), of 2 August 1983 (RO 1983 1165), from 13 nov. 1985 (RO 1985 2010), from nov 24. 1988 (RO 1988 2236), of 9 October. 1992 (RO 1992 2406), from 8 Jan. 1996 (RO 1996 768), section II of the O of the DFI on Dec. 19. 1996 (RO 1997 563), section I of the O of the DFI on Dec. 16. 1999 (RO 2000 616), from 18 dec. Nov 17, 2000 (RO 2000 3085). 2003 (RO 2003 4069), section II of the O of the DFI from 22 nov. 2007 (RO 2007 6039), c. I of O of the DFI of Nov. 24. 2009 (RO 2009-6555), March 17, 2010 (RO 2010 1053), may 25, 2011 (RO 2011 2665), section II of the O of the DFI on Nov. 28. 2012 (2012 6849 RO), Nov. 21. 2013 (2013 4521 RO) and section I of the O of the DFI on Nov. 18. 2015, in force since Jan. 1. 2016 (2015 4983 RO).
RS 831.201.26 State on January 1, 2016

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