Facts
The claimant, born in 1944, requested the Disability Insurance (InvIA) to cover medical measures in April 1975. The physicians diagnosed a condition after mitral valve prosthesis, an intraoperative stroke with spastic paresis of the left hand and significant sensory disturbances, as well as a reduced memory capacity and rapid fatigue. They recommended the continuation of occupational therapy and physiotherapy. The compensation fund refused to cover these measures, considering that they were not capable of improving or preserving the insured's earning capacity in a sustainable and essential manner. The cantonal appeal commission confirmed this decision. The claimant appealed to the Federal Insurance Court, requesting that the Disability Insurance (InvIA) be required to cover the integration measures in accordance with Art. 12 InvIA. She argues that the rehabilitation measures already carried out and still necessary (occupational therapy and physiotherapy) have proven effective in the short term and would restore earning capacity. The physician also criticizes the case law of the Federal Insurance Court regarding medical measures after an ischemic stroke.Considerations
According to case law, medical measures aimed at treating the disease itself, whether causal or symptomatic, do not fall under the Disability Insurance (InvIA), but under the Health and Accident Insurance. Only measures directly aimed at professional reintegration and capable of improving or preserving earning capacity in a sustainable and essential manner are covered by the Disability Insurance (InvIA).
In the present case, the fundamental disorder of the claimant is the latent predisposition to new emboli. The anticoagulant treatment aims to prevent new…