False IV Reports Destroy Livelihoods: “Turns Life To Hell”

False IV Reports Destroy Livelihoods: “Turns Life To Hell”

Sven Ziegler and Tobias Ochsenbein

Thomas W. * (67) still sees bewilderment. As he tells his story, his mood changes from anger to sadness. “Even years later, I still don’t understand how a single report, half an hour of conversation, can turn your life into hell,” says W. His case is well documented. All documents are available.

He was four years old when he contracted polio. He is not affected by the late effects for many years. This changes in January 2015. W. hurts every day and can no longer stand. He is always tired. The neurologist concludes: W. suffers from postpolio syndrome, muscle weakness and chronic fatigue. It is now considered “reduced performance” and can no longer work.

Suddenly there is no more money

W. therefore registers for the IV insurance and for the daily allowances. In order to collect the money, he is sent to PMEDA and to doctor Henning Mast for an expert opinion. “The evaluation was a joke,” says W. Mast today based on a conversation that lasted about 30 minutes.

A month later he receives a report. W. is “100 percent” fit, adapted activity “not necessary,” he says. “I almost got hit,” he recalls.

The consequences are serious: in January 2016 W. will cancel all the money. Only his savings and the support of family and friends keep him afloat for a year. Having to be fed as an adult was humiliating. – Masha’s report almost ruined my life. My life has become hell “- says W.

At least five criminal cases

Thomas W. goes to court. His lawyer wants a different opinion. W. was examined by five doctors for several weeks. The result at the end is unequivocal: “Our assessment is inconsistent with that of prof. Mast “- conclude the doctors. W. is severely limited and no longer suitable for “physically demanding” tasks. Bottom line: You’d think Mast had another patient in front of him.

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The assessment is effective. In early July 2017, the court ordered the daily allowance insurance company to pay the allowance retroactively.

The IV Mast expert has made headlines many times, and at least five criminal proceedings are pending against his company PMEDA in the Canton of Zurich. The prosecution does not say exactly how many there are. One of the procedures, however, is “very advanced.”

As disability assessors are civil servants, the prosecution must first obtain authorization from the courts. For this reason, the allegations could not be investigated for a long time.

That’s why the case against PMEDA is taking so long

The IV case assessments are commissioned by the IV office of the respective canton. Reviewers are selected at random. As appraisal is a public-law task, appraisers become civil servants.

Under this status, they are protected against reckless criminal proceedings. Therefore, in order to examine any possible infringements of the law or uncleanness, the prosecutor’s office must submit the so-called application for a permit. The Federal Department of Justice and Police then decides whether an expert investigation can be initiated at all. Such decisions can sometimes take a long time.

Authorization decisions in the proceedings against PMEDA were made available. Investigations are ongoing but are sometimes complex. The prosecutor’s office in Zurich did not provide further information.

The IV case assessments are commissioned by the IV office of the respective canton. Reviewers are selected at random. As appraisal is a public-law task, appraisers become civil servants.

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Under this status, they are protected against reckless criminal proceedings. Therefore, in order to examine any possible infringements of the law or uncleanness, the prosecutor’s office must submit the so-called application for a permit. The Federal Department of Justice and Police then decides whether an expert investigation can be initiated at all. Such decisions can sometimes take a long time.

Authorization decisions in the proceedings against PMEDA were made available. Investigations are ongoing but are sometimes complex. The prosecutor’s office in Zurich did not provide further information.

Henning Mast can therefore continue to carry out expert opinions. Although even the federal government has already had to curb the Mast, it still receives evaluation orders. Criminal proceedings do not automatically mean that criminal acts have actually taken place. Therefore, the presumption of innocence applies to the Mast and all employees.

In 2020, IV paid PMEDA CHF 2.9 million for 262 orders, authorities informed Blick on request. According to the Federal Office of Social Insurance, “This equates to an average of around 11,000 francs for a polydisciplinary report involving three or more specialists.”

It is not an isolated incident

Thomas W. is not an isolated incident. According to the PMEDA report, NTB * (46) also has to fight for its daily allowances. In 2001, he had a serious accident, the consequences were serious. He suffers from severe migraines and needs to take medication. In 2014, doctors from the Hirslanden Clinic determined that in the future he would be 100 percent incapable of work.

In 2015 he also joined PMEDA. “Even Mast himself did not talk to him,” he says.

Authorities sometimes step back

NTB says that several important clarifications have not been introduced. Nevertheless, PMEDA certifies: The patient is fit for work. Daily allowance insurance accounts for and cuts funds. As a result, a single father has to live without work and income for a year and a half.

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In 2017, Canton IV contested the report. He orders a new one. The result is clear. The results of the physical examination of the PMEDA study are “at least noteworthy and difficult to explain.” And: ÔÇťAlthough the appraisers had not assessed the ability to work at that time and further hospital explanations were deemed necessary and advisable, the responsible daily allowance insurer discontinued benefits after the above-mentioned period. evaluation “.

Authorities are at least partially backing down because of this new report. IV since 2017, pays out a quarter of the old-age pension.

“Something like this can never happen again”

The Federal Office of Social Insurance, which is responsible for overseeing the expert bodies, continues to cooperate with PMEDA despite pending criminal proceedings. Cooperation only ends when those responsible have been convicted of a crime or the quality of the reports is insufficient.

Blick would also like to receive a statement from PMEDA and Dr. Henning Mast. But both the telephone and the two written inquiries with the question list go unanswered.

The NTB says he got back to work today, but only on a high dose of medication – and punched the poke with his fist. “Because at some point you just give up because you can’t fight the mills of the insurance companies.”

Thomas W. is also convinced that some things have to change with experts IV. Because: “Someone will destroy your existence with false reports. Something like this must never happen again. “

* Names changed

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