Family members (as defined in the CERN Staff Rules and Regulations) to a CHIS Main Member insured with the Normal Cover are eligible to claim the allowance provided the following conditions are fulfilled cumulatively at the time of the application:
- the Main Member is (or have been, in the case of former members of the personnel) a staff member, a fellow;
- the Main Member have, or have had, at least two years of uninterrupted service within CERN with uninterrupted contracts as a staff member, a fellow;
- the Main Member and the eligible person have been CHIS Members with the Normal Health Insurance Cover for at least one year;
- the eligible person is not a member of the CERN personnel;
- all attempts to restore the earning or working capacity of the eligible person have proven either completely or partly ineffective;
- the eligible person have reached the age of 18, but not the official retirement age laid down in the CERN Staff Rules and Regulations.
A person is eligible to claim the allowance where:
- his earning capacity is permanently reduced by at least 50%; or
- where his earning capacity has been reduced, with no significant interruption (i.e. more than 30 consecutive days), by an average of at least 50% over 360 days, and where his earning capacity is still reduced by at least 50%.
Reduced earning capacity means a reduction in earning capacity, assumed to be permanent or of a long duration, resulting from the effects of physical or mental illness caused by congenital infirmity, illness or accident, preventing the person concerned from carrying out his normal work.
Depending on the degree of reduction of the earning capacity either a full allowance or a half allowance is payable.
The full allowance shall be equal to the minimum allowance which would be payable by the AI (disability insurance) of the Swiss Confederation in the same circumstances, irrespective of the state of residence of the person concerned, with the deduction of any allowance, pension or sum of money for reduced earning capacity, disability or old age received by the entitled person (except for allowances from a voluntary private insurance in return for payment).
If the claim is accepted, the effective date is the first day of the month in which the claim was made.
In case there is a change (improvement or deterioration) in the earning or working capacity of a Member receiving the allowance for reduced earning capacity UNIQA shall immediately be informed. Where a person in receipt of a half allowance suffers a further deterioration that results in a reduced earning capacity of at least two thirds, the allowance becomes full from the day on which the change is medically certified.
The benefit and the applicable conditions and procedures are defined in Annex II of the CHIS Rules.(link)
Further information and guidance on:
- the reduced earning capacity allowance and how to claim it is given by UNIQA.
- your personal situation is given by CERN's Social Affaires Office.
How to claim?
Applications for the reduced earning capacity allowance shall be made in writing to UNIQA and accompanied by a detailed medical report by the competent national authority. The report shall set out the cause, nature, commencement, history and probable duration of the illness, injuries or the intellectual and physical deterioration of the person concerned. The report shall also state the extent of reduced earning capacity determined by a medical practitioner and a certificate indicating the chances of recovery. UNIQA shall be entitled to request any useful information and proof; and may themselves, carry out investigations and have the Member concerned examined by the medical practitioners of UNIQA’s choice.
Within six weeks following receipt of the supporting documents, UNIQA shall inform the person concerned in writing whether it has decided to grant an allowance for reduced earning capacity and, if this is so, giving details of the amount and the date from which it is payable.
Further guidance on claiming the allowance and the necessary supporting documents is given by UNIQA.