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PubMed1982

[Mental health damages in social insurance].

Disablement Insurance As a rule there cannot be claimed medical measures for treatment of schizophrenia, cyclic and organic psychoses, neuroses, hypochondria and hysteria. A mental disturbance substantiates the claim for the disablement pension if due to its seriousness the utilization of the working capacities of the insured on the labour market cannot be demanded or if such a utilization is not bearable for the society. Compulsory Accident Insurance The Swiss Accident Insurance Organization is only liable for those neuroses that are in an adequate causality to the accidental occurrence it covers. Here belong the genuine accident neurosis, the fear neurosis and the therapy neurosis, however not the covetous neurosis. Health Insurance The insured afflicted with a neurosis cannot claim the sickness benefit as long as he is capable to overcome his reluctance to the assumption of sufficient work.

Disability Evaluation↗
PubMed2000

Employer-sponsored health insurance: are employers good agents for their employees?

Employers in the United States provide many welfare-type benefits, such as life insurance, disability insurance, health insurance, and pensions, to their employees. Employers can be viewed as performing an agency role in purchasing pension, health, and other welfare benefits for their employees. An exploration of their competence in this role as agents for their employees indicates that large employers are very helpful to their employees in this arena. They seem to contribute to individual employees' welfare by providing them with valued services in purchasing health insurance.

Decision Making↗
PubMed1997

Cash benefits for short-term sickness, 1970-94.

This note has reviewed the extent of protection of workers against income loss during the first 6 months of illness or injury. National income loss in 1994 was $81.1 billion, of which $49.4 billion (60.9 percent) was replaced by income-protection programs, including sick leave, group insurance, temporary disability insurance under statutory State provisions, individual insurance, workers' compensation, and (during the 6th month) the Social Security Disability Insurance program. In 1994, wage and salary workers in the private sector lost $55.2 billion because of nonoccupational illnesses or injuries, of which $19.0 billion (34.5 percent) was replaced. Wage replacement rates are higher for full-time professional and technical employees with longevity in large or medium firms, and especially public employees. The lowest level of coverage is given to part-time employees with limited seniority who work in production and related areas in small, private firms. Approximately 70 percent of wage and salary workers in the private sector have some protection through their employment against earnings losses caused by short-term illness. Forty-four percent of these workers have short-term disability insurance,and only half have sick-leave coverage.

Acute Disease↗
PubMed1992

[Practical experiences in legal counseling of foreign workers].

When foreign workers ask for legal advice, very often their questions concern primarily insurance rights for disability. Most uncertainties exist about specific clauses in the legislation on disability insurance and about the measurings of disability. Primarily, discussions arise from controversy about claims made to the state disability insurance. The legislation on disability insurance establishes strict requirements for foreigners asking for insurance rights for disability. However, the Agreement on Social Security signed worldwide by over 20 nations being more tolerant in terms of disability insurance, Swiss legislation can be applied only to a minority of foreigners. That is why the system of legislation has become so complex. There are two major points that are rigidly to be observed: On one hand, the process of reintegration measures can start only if the prescribed minimum duration of contributions is guaranteed. On the other, proceedings for disability pensions can be initiated only after the currently valid waiting period. In both cases, it is considerably important that the patient has a domicile in Switzerland or a valid residence permit. Numerous disagreements can possibly result during the evaluation of the degree of disability, as certain factors-such as language problems, lack of education or the labour market situation-, which are not directly linked to the disability, are not taken into consideration.

Disability Evaluation↗
PubMed1987

The cost of disability.

Approximately 16.5% of the adult population in the United States is disabled. About half of the disabled are severely limited and unable to work regularly. Musculoskeletal disorders are the most frequent type of disability. In the United States, there are three major types of disability insurance: Social Security Disability Insurance (a federal program), Workers' Compensation Insurance (usually a state-regulated program), and private health insurance. Recent years have seen a greater demand for private long-term disability insurance, as the trend increases toward less than total reliance on public programs to support disabled workers. The most recent statistics available indicate that Social Security Disability Insurance benefits are currently about $16.8 billion per year; workers' compensation benefits, $16.1 billion; and private disability income protection benefits, $5.2 billion. These figures add up to almost $40 billion in insurance costs. However, insurance costs are only part of the total cost because not everyone is covered by insurance, and insurance does not cover all disabilities. Disability can never be totally prevented or eliminated, but disability and its costs can be substantially reduced through more effective treatment and rehabilitation, including patient education and vocational rehabilitation.

Adolescent↗
PubMed1991

Actuarial status of the OASI and DI Trust Funds.

This article presents the "Summary of the 1991 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Disability Insurance Trust Funds." The Board reports the Old-Age and Survivors Insurance (OASI) Trust Fund, by itself, and the combined OASI and Disability Insurance (DI) Trust Funds meet the short-range test of financial adequacy, based on intermediate assumptions. However, under conditions that are more pessimistic than the intermediate assumptions, the DI Trust Fund would be depleted during the next 10 years. Under intermediate assumptions, the long-range 75-year estimates, excluding the effects of interest income, indicate the OASDI program will experience about 26 years of positive annual balances, with annual deficits indefinitely thereafter. Including interest, the trust funds would continue to grow, in dollars, for another decade, before steadily declining to exhaustion 50 years from now.

Actuarial Analysis↗
PubMedDate not supplied

Estimated economic costs of obesity to U.S. business.

OBJECTIVE: To estimate the economic costs of obesity to U.S. business. METHODS: Standard epidemiologic methods for risk attribution and techniques for ascertaining cost of illness were used to estimate obesity-attributable expenditures on selected employee benefits, including health, life, and disability insurance and paid sick leave by private-sector firms in the U.S. in 1994. Data were obtained from a variety of secondary sources, including the National Health Interview Survey, reports from the Bureau of Labor Statistics and other federal agencies, and the published literature. Attention was focused on employees between the ages of 25 and 64 years who were classified according to body mass index (BMI) as "nonobese" (BMI < 25 kg/m2), "mildly obese" (BMI = 25-28.9 kg/m2), or "moderately to severely obese" (BMI > or = 29 kg/m2). RESULTS: The cost of obesity to U.S. business in 1994 was estimated to total $12.7 billion, including $2.6 billion as a result of mild obesity and $10.1 billion due to moderate to severe obesity. Health insurance expenditures constituted $7.7 billion of the total amount, representing 43% of all spending by U.S. business on coronary heart disease, hypertension, type 2 diabetes, hypercholesterolemia, stroke, gallbladder disease, osteoarthritis of the knee, and endometrial cancer. Obesity-attributable business expenditures on paid sick leave, life insurance, and disability insurance amounted to $2.4 billion, $1.8 billion, and $800 million, respectively. CONCLUSIONS: The health-related economic cost of obesity to U.S. business is substantial, representing approximately 5% of total medical care costs. Further research is needed to determine the cost-effectiveness of worksite weight management programs and of other efforts to reduce the prevalence of obesity in the U.S. workforce.

Adult↗