Probative Value of an Evaluation Report by the IV Office to Determine the Disability-Related Care Needs in Home Care

Facts

The case concerns an insured person who has filed a complaint with the Federal Supreme Court against the decision of the IV Office of the Canton of Zurich and the Social Insurance Court of the Canton of Zurich. It is about the question of the probative value of an evaluation report by the IV Office to determine the disability-related care needs in home care pursuant to Art. 14 para. 3 of the Federal Act on Disability Insurance (IVG) and the related provisions of the Ordinance on Disability Insurance (IVV).

Considerations

The Federal Supreme Court states that the on-site evaluation provided for in Art. 69 para. 2 IVV is the appropriate measure for determining the care needs. Various factors must be taken into account for the probative value of such a report:

It is essential that a qualified person acts as the reporter, who has knowledge of the local and spatial conditions as well as the impairments and disabilities resulting from the diagnoses of the person in need of care. Furthermore, the information provided by the caregivers must be taken into account, whereby divergent opinions of the parties involved must be shown in the report. The report text must be plausible, reasoned and detailed with regard to the individual, specific measures of treatment and basic care, and be in accordance with the information collected on site.

If all this applies, the evaluation report is fully probative. The court only intervenes in the discretion of the person conducting the evaluation if there are clearly identifiable misjudgments. This is particularly necessary because the professionally competent evaluating person is closer to the specific facts than the court.

Although…