Key Benefits:
November 29, 1976 (State 1 Er January 2016)
1 This order defines the right of insured persons to the grant of auxiliary means or replacement benefits recognised by art. 21 to 21 Ter The Federal Disability Insurance Act of June 19, 1959 (ATIA) 1 , as well as the reimbursement of ancillary means within the meaning of Art. 21 Cc , para. 1, let. A to c, ATIA. 2
2 Sections 3 to 9 apply, mutatis mutandis, to the provision of treatment facilities that are necessarily part of a medical rehabilitation measure within the meaning of s. 12 and 13 ATIA and are not listed in the Annex.
1 RS 831.20
2 New content according to the c. I of the O of the DFI 28 Nov 2012, in force since 1 Er Jan 2013 ( RO 2012 6849 ).
1 Are entitled to the auxiliary means, within the limits laid down, by the list in the annex, the insured persons who need them to travel, to establish contacts with their entourage or to develop their personal autonomy.
2 The insured person is not entitled to the auxiliary means designated in this list by an asterisk ( * ), whether it is necessary for him to engage in a gainful occupation or to carry out his usual work, to study or learn a trade or for the purposes of functional habituation or to carry out the activity named by the corresponding figure of The Annex. 1
3 The right extends to the accessories and adaptations made necessary by the invalidity.
4 The insured person is entitled only to ancillary means of a simple, adequate and economical model. It supports the additional costs of another model. Where the list in the Annex does not mention any of the instruments provided for in Art. 21 Cc LAI 2 For the delivery of an auxiliary means, the actual costs shall be reimbursed. 3
5 Where an insured person is entitled to the furnishing of an auxiliary means listed in the Annex but is satisfied with another less expensive means of performing the same duties, the latter shall be given to him even if he is not included in the list. 4
1 New content according to the c. I O ' O of the DFI of 21 Sep. 1982, in effect since 1 Er Jan 1983 (RO) 1982 1931).
2 RS 831.20
3 New content according to the c. I of the O of the DFI of 28 November 2012, in force since 1 Er Jan 2013 ( RO 2012 6849 ).
4 Introduced by ch. I of the O of the DFI of 24 Nov 1988, in force since 1 Er Jan 1989 (RO) 1988 2236).
1 Auxiliary means shall be returned to property, unless otherwise provided for in this order.
2 The costly ancillary means that could be used by nature for other persons are provided on loan.
1 New content according to the c. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 In the cases described in the Annex, insurance may be paid to the insured:
2 The amount of the repayments is set out in the Annex.
1 Introduced by ch. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 If the conditions laid down for the loan of auxiliary means according to Art. 21, para. 1, I 1 , are no longer satisfied, the insured can continue to use them for as long as they are required to travel, to establish contacts with their surroundings or to develop their personal autonomy. 2
2 The insured person has the right to acquire at any time, with a fair purchase price, the auxiliary means which have been given to him in loan.
Auxiliary means provided for loan to which the insured person is no longer entitled and who are not left for further use must be returned and will be stored by the insurance in a special deposit until the time of their reuse.
1 The auxiliary means provided by the insurance must be used with care.
2 When an auxiliary means becomes prematurely unusable because it has not been used with care, the insured person pays the insurance an appropriate allowance.
1 New content according to the c. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 The insured must use the amounts collected under s. 3 Bis , para. 1, let. A and b, in accordance with the intent.
2 In order to ensure compliance with the intended purpose, the provision of an auxiliary means may be accompanied by conditions. When an auxiliary means becomes prematurely unusable because the insured person has failed to comply with these conditions, the insured must pay the insurance an appropriate allowance.
1 Introduced by ch. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 Where the insured person requires special training to use the auxiliary means, the insurance shall bear the resulting costs.
2 The insurance shall bear, in the absence of a responsible third party, the costs of repair, adaptation or partial replacement necessary in spite of the careful use of the auxiliary means. The insured person may be required to participate in the fee. The amount of the participation is set out in the Annex.
3 The insurance shall grant an annual contribution equivalent to the actual cost but not more than 485 francs to the cost of maintenance and use of the auxiliary means, unless the annex sets another amount. It does not cover the cost of maintenance and use of motor vehicles.
4 It contributes to the cost of maintaining a blind guide dog by a monthly benefit. The amount is set out in the Annex.
1 New content according to the c. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 If the insured person himself acquires an auxiliary means provided for in the list in the Annex or if he realizes, at his own expense, an adjustment made necessary by the invalidity, he shall be entitled to reimbursement of the expenses which would have been the subject of the insurance if It had provided the acquisition or adaptation in question.
2 In the case of ancillary means, designated as costly by the Federal Office of Social Insurance and which, by its very nature, could possibly be used by other persons, the reimbursement of insurance is in the form of compensation Annual depreciation. These are based on the costs and the likely duration of the use of the helper.
3 The insurance may make the reimbursement subject to certain charges ensuring adequate employment of the auxiliary means and providing that, in the event of non-use of the latter, the property will be transferred to the insurance.
1 New content according to the c. I of the O of the DFI of 22 Nov 2007, in force since 1 Er Jan 2008 ( RO 2007 6039 ).
1 The insured person is entitled to the reimbursement of disability-related expenses, which are duly established and caused by the special services of third parties which he or she needs, instead of an auxiliary means, for:
2 The monthly reimbursement shall not exceed the monthly income of the insured person's gainful occupation or one and a half times the minimum amount of the ordinary old-age pension. 2
1 New content according to the c. I of the O of the DFI of Nov 13, 1985, in force since 1 Er Jan 1986 (RO) 1985 2010).
2 New content according to the c. I of the O of the DFI of 6 Nov 1998, in force since 1 Er Jan 1999 ( RO 1998 3024 ).
1 Applications for typewriters, telephone operators, mobile phones with special software or faxes submitted prior to the entry into force of the November 28, 2012 amendment are dealt with under the old right.
2 If the apparatus granted is to be repaired or replaced, the insurance shall bear the costs in accordance with Art. 7, para. 2, even after the entry into force of the November 28, 2012 amendment.
Refund under tariff agreement with the Swiss Association of Orthopaedic Technicians (ASTO).
| 1.01 |
Final functional prostheses for feet and legs |
| 1.02 |
Final protheses for hands and arms |
| 1.03 |
Definitive breast prostheses |
| After mastiectomy or if there is a Poland syndrome or an agenersia of the breast. Maximum contribution per calendar year: 500 francs for one side, 900 francs for two sides. |
Refund under tariff agreement with ASTO.
| 2.01 |
Orthotics of the legs |
| 2.02 |
Orthotics of arms |
| 2.03 |
Trunk orthotics, |
| In the case of functional insufficiency of the vertebral column resulting in significant back pain and by alterations of the spinal column revealed by the clinical and radiological examination, if this deficiency cannot be remedied Medical measures, or can only be insufficiently done. |
|
| 2.04 |
Cervical orthotics |
Refund under tariff agreement with Association Pied & Chaussure (ASMCBO).
| 4.01 |
Custom orthopaedic footwear and serial orthopaedic footwear, including manufacturing costs, |
| When a remission under the c. 4.02 to 4.04 is not possible. The insured person must take part in the costs at a cost of 70 francs up to the age of twelve and 120 francs at the age of twelve. In the case of compensation, the participation amounts to 70 francs per calendar year. |
|
| 4.02 |
Orthopedic and orthopaedic features incorporated into the cabins S Clothing or special orthopaedic footwear. |
| 4.03 |
Special orthopaedic footwear: |
| The insured person must take part in the costs at a cost of 70 francs up to the age of twelve and 120 francs at the age of twelve. In the case of compensation, the participation amounts to 70 francs per calendar year. |
|
| 4.04 |
Use of Additional Clothing Footwear Due to Disability |
| 4.05 * |
Orthopedic plantar seeds, |
| If they constitute the important complement of medical rehabilitation measures |
| 5.01 |
Eye prostheses: |
| Reimbursement according to the agreement between the Federal Social Insurance Office and the suppliers of eye prostheses. Art. 24, para. 3, RAI is reserved. |
|
| 5.02 |
Facial Theses |
| 5.03 |
... |
| 5.04 |
... |
| 5.05 * |
Dental prostheses |
| If they are an important complement to medical rehabilitation measures. |
|
| 5.06 |
Wigs: |
| Maximum annual contribution: 1500 francs. |
|
| 5.07 |
Hearing aids for hearing impairment, |
| When such a device significantly improves the auditability and communication possibilities of the insured person with his or her entourage. The insured person is entitled to a lump sum refund, which may be claimed every six years, unless a significant change in hearing acuity requires replacement of the equipment before the expiration of that time limit. Hearing aids must be delivered by a qualified person. |
|
| The package consists of 840 francs for a monaural apparatus and 1650 francs for a binaural apparatus, excluding repair and battery. |
|
| The package for the purchase of batteries is, per calendar year, 40 francs for a monaural apparatus and 80 francs for a binaural apparatus. |
|
| The package for the cost of repairs made by the manufacturer is 200 francs for the electronic damage and 130 francs for the other damage. These packages are awarded as soon as possible from the second year of operation of the aircraft. |
|
| The Federal Office of Social Insurance shall draw up a list of aircraft which meet the requirements of insurance and for which the payment of a package is allowed. |
|
| For the purchase and repair of a hearing aid, the packages shall be paid on presentation of the overall amount invoiced and the corresponding supporting documents. |
|
| 5.07.1 |
Hearing apparatus implanted or fixed by bone anchoring |
| The Federal Office of Social Insurance defines the participation of insurance in the external components of hearing aids implanted or fixed by bone anchoring and middle ear implants. |
|
| For adults, the benefit package for the adaptation and monitoring of hearing aids fixed by bone anchorage and middle ear implants is 1000 francs for a monaural apparatus and 1500 francs for a binaural apparatus. For children under the age of 18, it is 1300 francs for a monaural apparatus and 1950 francs for a binaural apparatus. |
|
| The package is paid on presentation of the overall amount invoiced and the corresponding supporting documents. |
|
| The package for the purchase of batteries for cochlear implants is, per calendar year, 400 francs for a monaural apparatus and 800 francs for a binaural apparatus. The package for the purchase of batteries for hearing aids fixed by bone anchorage and middle ear implants is, per calendar year, 60 francs for a monaural apparatus and 120 francs for a binaural apparatus. |
|
| 5.07.2 * |
Regulation of thoroughness for hearing aids |
| The Federal Office of Social Insurance defines cases in which packages exceed the amounts set out in c. 5.07 may be paid for a monaural or binaural apparatus. |
|
| 5.07.3 |
Hearing aids for children under 18 years of age |
| The maximum amount reimbursed for the equipment and the follow-up is 2830 francs for a monaural apparatus and 4170 francs for a binaural apparatus, including VAT. The contribution may be requested every six years, unless a significant change in hearing acuity requires replacement of the equipment before the expiration of that time limit. |
|
| The contribution is paid directly to the paediatric audioprothetists authorised in accordance with the order of 25 May 2011 concerning the clearance of paediatric audioprothetists 2 . |
|
| The contribution to the purchase of batteries is, per calendar year, 60 francs for a monaural apparatus and 120 francs for a binaural apparatus. |
|
| The repair costs shall be reimbursed as provided for in the c. 5.07. |
|
| 5.08 |
Orthophonic apparatus after operation of the larynx |
| 7.01 * |
Eyewear, |
| If they are the major complement of medical rehabilitation measures. Maximum contribution for the frame: 150 francs. |
|
| 7.02 * |
Contact Veres |
| They must necessarily replace eyeglasses and are the major complement to rehabilitation medical measures. |
Refund under tariff agreement with the Federation of Swiss Trade Associations and the Medical Technology Industry (FASMED) and ASTO.
| 9.01 |
Wheelchairs without engines: |
| If a stroller is replaced by a wheelchair, the fee is 300 francs for children under 30 months of age. The rebate takes place in the form of a loan. |
|
| 9.02 |
Electric wheelchairs |
| For those who are unable to use a common wheelchair and can only travel by means of an electrically driven wheelchair. The rebate takes place in the form of a loan. |
| For those insured persons who, in a likely sustainable way, an activity which allows them to cover their needs, cannot be without a personal motor vehicle in order to get to work. |
|
| 10.01 * |
Two -, three-or four-wheeled mopeds: |
| The annual depreciation allowance is 480 francs for two-wheeled mopeds and 2500 francs for three or four-wheeled mopeds. |
|
| 10.02 * |
Light motorcycles and motorcycles: |
| The annual depreciation allowance is 750 francs. |
|
| 10.03 * |
... |
| 10.04 * |
Motor Cars: |
| The annual depreciation allowance amounts to 3000 francs. The contribution paid for an automatic garage door opening is 1500 francs. |
|
| 10.05 |
Transformations of motor vehicles in need of disability |
| 11.01 |
White Cannes and pedestrian navigation systems |
| 11.02 |
Dogs for the Blind, |
| When it is determined that the insured person will be able to take care of a guide dog and that he/she will be able to move alone out of his or her home. Insurance supports fees under the tariff agreement with guide dog schools. The monthly contribution amounts to 80 francs for food and 30 francs for veterinary costs. If the latter exceed 360 francs per year, the excess shall be reimbursed only upon presentation of the relevant supporting documents. |
|
| 11.03 |
... |
| 11.04 |
Apparatus for listening to sound carriers |
| Allowing blind and severely disabled people to listen to texts recorded on sound media. The maximum contribution is 200 francs. The rebate takes place in the form of a loan. |
|
| 11.05 * |
Apparatus for listening to sound carriers |
| For blind and severely disabled persons who, without these devices, would not be able to engage in a gainful occupation or carry out their usual work. The rebate takes place in the form of a loan. |
|
| 11.06 |
Read and write systems |
| For the blind and severely disabled persons of the view who can read only with such a system or where the use of such a system significantly facilitates contact with those around them, if the insured person has the intellectual faculties necessary for the Serve. The cost of learning typing is the responsibility of the insured person. The rebate takes place in the form of a loan. |
|
| 11.07 |
Magnifying glasses, binoculars and filter glasses |
| For severely disabled persons in the view who can read only with such means or when they significantly improve their visual capacity. |
| 12.01 |
Cannes-crutches: |
| The rebate is in the form of a loan. |
|
| 12.02 |
Ambulatory and ambulatory walkers: |
| The rebate is in the form of a loan. |
| 13.01 * |
Work instruments and appliances rendered necessary by disability; ancillary facilities and appliances; neal adaptations S Equipment and machine handling equipment: |
| The insured person pays an interest in the cost of acquiring devices that are also required by a valid person in a standard format. Auxiliary means whose cost of acquisition does not exceed 400 francs shall be borne by the insured. The contribution of insurance to the purchase of batteries for FM devices is 40 francs per calendar year. |
|
| 13.02 * |
Seats, beds and supports for standing individually adapted to the infirmity: |
| The insured person pays an interest in the cost of acquiring equipment that is also required by a valid person in a standard format. Auxiliary means whose cost of acquisition does not exceed 400 francs shall be borne by the insured. |
|
| 13.03 * |
Working surfaces adapted to the infirmity in an individual way: |
| The insured person pays an interest in the cost of acquiring equipment that is also required by a valid person in a standard format. Auxiliary means whose cost of acquisition does not exceed 400 francs shall be borne by the insured. |
|
| 13.04 * |
Accommodation costs, requirements for disability, accommodation at the place of work and in the usual scope of the insured (list deleted) |
| 13.05 * |
Installation of stair lifts and ramps, as well as removal or modification of architectural barriers within and around residential, work and form locations A Tion and education, |
| Whether these measures allow the insured person to go to work, to the school or to his or her training place, or to carry out his usual work. The rebate takes place in the form of a loan. |
| 14.01 |
WC-Showers and WC-séchoirs, as well as additions to existing sanitary facilities, |
| When insured persons cannot make their own toilet without such facilities. The rebate takes place in the form of a loan. |
|
| 14.02 |
Elvers for patients, |
| For use in the private home. The rebate takes place in the form of a loan. |
|
| 14.03 |
Electric bits (with gallows but without mattresses and other accessories) |
| For the private home use of the insured persons who depend on them for sleeping and rising. The rebate takes place in the form of a loan. Susdurably grabbed policyholders are excluded from this right. |
|
| The purchase price of a bed is refunded to a maximum of 2,500 francs. The contribution to the cost of delivery of the electric bed is 250 francs. |
|
| 14.04 |
Arrangements of the home of the insured person necessby the invalidity: |
| Adaptation of the bathroom, shower and WC to the disability, displacement or removal of partitions, expansion or replacement of doors, installation of grab bars, hand rails and extra handles, removal of thresholds or Construction of threshold ramps, installation of signage for the deaf and severe hearing impaired, and for deaf-blind. The contribution to the installation of signalling installations is at most 1300 francs. |
|
| 14.05 |
Stairs and ramps |
| For insured persons who cannot leave their homes without such accommodation. If a staircase is installed instead of a staircase, the maximum contribution is 8000 francs. In this case, the repair costs are not reimbursed. The rebate takes place in the form of a loan. |
|
| 14.06 |
Assistance dogs for disabled persons, |
| If it is established that the insured person will be able to take care of a service dog and that, thanks to it, he will be able to live at home more independently. The right is limited to adults with severe motor disabilities who receive an allowance for impotent for medium or serious importance. The insurance shall pay, at the time of delivery of the assistance dog, a lump-sum contribution of 15 500 francs, allocated as follows: 12 500 francs for the purchase of the assistance dog and 3000 francs for the cost of food and A veterinarian. The provision of insurance can be claimed every eight years, but only once for the same dog. |
| 15.01 |
... |
| 15.02 |
Electrical and electronic communications equipment, |
| For those who are severely disabled from speech and writing who depend on such a device to maintain daily contact with those around them and who have the intellectual and motor skills necessary for their use. The rebate takes place in the form of a loan. |
|
| The maximum contribution for the benefits necessary for the discount (examination, installation and training for employment) is 140 francs per hour, excluding VAT. It also covers the management and logistics tasks of the benefit provider, which cannot be invoiced separately. For the auxiliary means itself, the DI shall refund the cost; may be paid in addition, at most, a handling package of 190 francs, excluding VAT, by auxiliary means. For the necessary travel, the supplier is paid at the maximum rate of 70 ct/km (excluding VAT). |
|
| 15.03 |
... |
| 15.04 |
Page Tours, |
| When the paralyzed person who cannot read books or magazines independently is in need of such a device. The rebate takes place in the form of a loan. |
|
| 15.05 |
Environmental control apparatus, |
| Where the severely paralyzed insured, who is neither hospitalized nor placed in a specialized chronic care institution, can make contact with his or her entourage only by means of this device or when the latter allows him to Move an electric wheelchair independently to the dwelling place. The rebate takes place in the form of a loan. |
|
| The maximum contribution for the benefits necessary for the discount (examination, installation and training for employment) is 140 francs per hour, excluding VAT. It also covers the management and logistics tasks of the benefit provider, which cannot be invoiced separately. For the auxiliary means itself, the DI shall refund the cost; may be paid in addition, at most, a handling package of 190 francs, excluding VAT, by auxiliary means. For the necessary travel, the supplier is paid at the maximum rate of 70 ct/km (excluding VAT). |
|
| 15.06 |
SIP videophones, |
| Where an insured, totally deaf or severely disabled from hearing and who communicates by means of the sign language, cannot establish the necessary contacts with his or her entourage in any other way or where such an effort cannot reasonably be expected to be Required of him, and when he has the intellectual and motor skills necessary for the use of a videophone. The rebate takes place in the form of a loan. The maximum contribution is 1700 francs, including VAT. |
|
| 15.07 |
Contributions to Custom Clothing, |
| When the insured cannot wear serial clothing because of growth disorder or skeletal deformities. |
|
| 15.08 |
Protective Helmets for Epileptics or Hemophiliacs |
| 15.09 |
Protective Colors and Gums for Hemophilia |
| 15.10 |
Children's Special Seats (reha) for children who do not U Wind not control head and trunk: |
| The participation in the fees amounts to 200 francs for the children up to the age of twelve years measuring less than 150 cm. |
1 Update as per c. I of the O of the DFI of 21 7. 1982 (RO 1982 1931), August 2, 1983 (RO 1983 1165), 13 Nov 1985 (RO 1985 2010), 24 Nov 1988 (RO 1988 2236), from 9 October. 1992 (RO 1992 2406), January 8, 1996 (RO 1996 768), c. II of the 19 Dec DFI O. 1996 (RO 1997 563), c. I of the 16 Dec DFI O. 1999 (RO 2000 616), of 18 Dec. 2000 (RO 2000 3085), 17 Nov 2003 (RO 2003 4069), c. II of the O du DFI of 22 Nov 2007 (RO 2007 6039), c. I of the O du DFI of 24 Nov 2009 (RO 2009 6555), March 17, 2010 (RO 2010 1053), 25 May 2011 (RO 2011 2665), c. II of the O of the DFI of 28 Nov 2012 (RO 2012 6849), 21 Nov 2013 (RO 2013 4521) and c. I of the O of the DFI of 18 Nov 2015, in force since 1 Er Jan 2016 (RO) 2015 4983).
2 RS 831.201.26
