I had an accident in 1984 that required knee reconstruction. In 2000 recurring knee problems required further surgery. The case was closed in 2001. The affected knee is still causing problems to the point now (2022) where it has become quite painful to just walk. I do not live in Switzerland anymore, what are my options?
This is not my understanding. ( http://www.suva.ch/fr-ch/accident/ac…ns-d-assurance ) notes that there is no limitation in time or cost (Les assurés ont droit au traitement médical des lésions résultant d’un accident ou d’une maladie professionnelle, sans aucune limitation temporelle ni financière).
Contact the insurance company that handled your original knee injury and see what they say. They've likely got your records still. What would you be expecting, though? To come back to Switzerland for treatment or for the insurance to cover your treatment in your current country of residence? Either way, I think it will be a fairly unusual situation.
Yes I agree and take it back, I think you are right. I would be interested to see if anyone else has any insight on this. Knee's will naturally degenerate so after 38 years I wonder what they will say, because in principle your case stands, if it is the accident that has caused you to have your current problems.
But seriously, what are you expecting? You are no longer insured by Suva, surely this is something to bring up with your current insurer? The page you linked to contains information for "assurés" i.e. people who are insured by Suva.
Whether I am presently insured by the Suva or not is irrelevant. What matters is that at the time of the accident I was insured by the CNA (Art 77 Federal Law 832.20). The surgery performed in 2000 was covered by the Suva despite me taking residence and work outside the EU since 1989.
I think you know the answer. They should pay. Any surgery on that knee could be because of the original accident, for which you are covered for life.
They might refuse to pay, however, and you might need legal help to get them to pay, assuming you will have a report which indicates that the pain is likely caused by something related to the accident or the following reconstructive surgery.
I had a knee surgery after an accident 5 years prior. They refused to pay because I didn't have the surgery at the time of the accident and their expert medic determined my pain was not because of the accident. Luckily i had opened a case at the time of the accident, and with the help of my legal insurance, they ended up paying.
Why have an internet forum ? Why have shows on telly which help people with customer service instead of just telling everyone "well why not ring up the company ?". Why do we have Ombudsman organizations who question and judge on whether businesses are telling the truth ? Why have Asloca, when you can just ring up your landlord and ask him why he hasnt returned the deposit ?
Because the company has a chance of painting a picture so its favorable to them and therefore garnering the experience of others before such a conversation is useful.
This is a valid request for some people's first hand experience on accidents which have happened historically, and as the poster has said, they already had one surgery on the accident after leaving switzerland and Suva were ok with it, but at 40 years its worth asking around before speaking to them.
To the poster, I wish you good luck in your endeavour and please don't take these kind of one line answers as the standard phrasing on English Forum, which is a helpful resource for Expats around life in Switzerland in the great majority.
As far as I know, for accidents and any situation arising from them, it's always the company that insured you at that time that is responsible to pay. That is also why, for example, international insurance like Cigna asks you whether what you are declaring is an accident or illness (despite the coverage not changing for one or the other as would be in CH).
My own belief is only that after so many years and as one ages, there may be argument that this is not related to original accident.
OP I would also be careful to the sense that if you push for Suva to pay but they end up getting away, your current insurance may also refuse as they may deem it related to accident.
Do you have health insurance that would cover this nowadays? If so, I would probably just go that way. If not then it's worth a call to SUVA but in this case, I would position it not as a question but a demand and take it from there.
It does largely also depend on where you are now. If your in a country with a national health system then nothing can be denied and although the treatment may take longer of course you can then really ask Suva to pay knowing your fallback is an no-deny system. If as is being said you are in a country where there is still accident vs sickness then its good advice to be a bit more questioning than demanding. I wish you good luck, i know what knee problems are like.
I don't think the fact that your current system or insurance covers it impacts whether or not Suva is responsible. It does however impact how much of a fight you want to put up.
Update: Email communication with Suva is very slow, about 4-5 weeks to respond to any and each of my emails. The case has been 'reopened' as a 'rechute' (~ relapse) in October 2022, the same qualifier as last time/claim. We are at the stage where they have all medical documents in their possession (March 2023) and they have to make a decision.
Bonne chance, and do up-date. I wonder how far back it can go.
I had a terrible car crash in 1970, between my first 6 months in London, and later return to UK. Smashed femur to smitereens and 4.5 months in traction, with the weight bearing pin through the knee (a big mistake said the London Consultant a year later, should have been through the tibia below the knee). Part broken again after 5 months, and as it had healed in a bow, re-broken by surgeon to straighten (then massive Küntscher nail to hold the lot in place). Resulting in almost 2 years to walk again and a leg 2.5cm shorter than the other.
Had to replace both knees a few years back. One due to initial damage, and teh other due to having to do all the work to support the other. I didn't even try to approach the Insurance I had then, working for Adia Interim in Neuchâtel. Wonder what would have happened if I did.
Update: I have received an email from Suva confirming payment of insurance benefits for the consequences of the relapse related to accident dated xx xx 1984. Suva covers treatment fees directly to doctors, therapists, hospitals or pharmacies in Switzerland. This a pleasantly surprising outcome to say the least.
Thanks for the update. But if you do not live in Switzerland anymore how will this work? Do you have to come back for treatment or they will pay wherever you are?