Treatment of congenital defects in children of cross-border workers employed in Switzerland

Facts

The IV office for insured persons abroad (IVSTA) had denied the respondent A.'s entitlement to medical measures for the treatment of his congenital defects from the time of his departure from Switzerland to Germany, as he no longer fulfilled the insurance-related requirements. The Federal Administrative Court had overturned this decision and granted A. medical measures beyond 30 June 2013. The IVSTA then filed an appeal with the Federal Supreme Court.

Considerations

The Federal Supreme Court states that Art. 9 para. 2 InvIA, which exempts the children of cross-border workers employed in Switzerland from being subject to the Swiss Disability Insurance, remains valid within the framework of Regulation (EC) No 883/2004 on the coordination of social security systems and is in particular compatible with the principle of equal treatment under Art. 4 of the Regulation. Although the treatment of congenital defects falls within the scope of both the Disability Insurance and the Health Insurance, the exclusion of children of cross-border workers not residing in Switzerland from medical measures under Art. 13 InvIA is objectively justified. This is because these measures are materially equivalent to an obligatory federal health insurance…