Supervision of IV expert witnesses: Who actually supervises the work of IV assessors? - When structural weaknesses decide on pensions
Expert opinions play a central role in IV proceedings. Whether or not a pension is awarded often depends almost exclusively on the assessment of a medical expert. But how neutral and reliable are these reports really? And who checks the IV experts?
As a lawyer specializing in social security law, we see time and again how strongly structural factors can influence the course of proceedings – often to the detriment of the persons concerned.
Expert opinion with weight – but without counterweight
Anyone applying for an IV pension will sooner or later end up with an assessor. This assessment is usually the pivotal point in the procedure. This is because the IV office and the doctors at the regional medical service often accept what is written in the report almost blindly.
The structural problem here is obvious: in the case of bi- and multidisciplinary reviews, the reviewers are selected at random via the distribution platform SuisseMED@P from a corresponding pool of experts . Remuneration is paid by IV. The insured person only has a limited say in this. It can
PMEDA scandal: a system under fire
A recent case shows particularly clearly how vulnerable the current system is. Two senior doctors at the PMEDA are currently on trial on suspicion of systematic fraud. They are accused of manipulating IV assessments – with sometimes serious consequences for those affected.
The authorities reacted promptly:
The IV offices no longer issued any new orders to PMEDA, and the Federal Social Insurance Office (FSIO) ordered internal reviews of reports that had already been written.
But the basic problem remains: The monitoring of IV experts remains inadequate, especially as long as the inspectors are also inadequately monitored.
More transparency through expert lists – a step, but not a breakthrough
Since 2023, the IV offices have had to publish annual lists with details of the appointed assessors. Based on this, the Federal Social Insurance Office FSIO publishes a nationwide overview. It shows which doctors have written how many reports, how often an incapacity for work was determined – and how much money they received for their work.
Sounds like transparency. But practice shows: These figures are difficult to classify without context. High numbers of experts or conspicuously low recognition rates raise questions – but do not yet provide answers. And who draws conclusions from this? As a rule, no one.
No real independence – and limited legal protection
A particularly critical point is that the expert opinions are not only commissioned by the other party, they are also not reviewed independently. Although the law provides for the insured person’s right to participate, in reality this is often superficial.
Contradictions in the expert opinion? Methodological deficiencies? Relevant symptoms ignored? Without legal support in appeal proceedings, such points usually go unnoticed – or unheeded.
What is needed now: real structural reforms
The calls for a fairer system are not new, but they are more topical than ever:
- Independent assessment centers that work independently of the IV
- Random principle also in the selection of monodisciplinary experts
- Binding quality standards and genuine verifiability
- Stronger rights for insured persons, for example to a counter-expert opinion or access to files before the expert opinion is used
Such measures would not only make the procedure fairer – they would also strengthen confidence in the IV and Suva as institutions.
Conclusion: When structure is more important than substance
As long as IV reports are produced under structurally one-sided conditions, the outcome of many proceedings will remain questionable. The current debate – triggered by the PMEDA case – shows that more than cosmetic corrections are needed.
Until then, anyone going through an IV procedure should seek legal advice at an early stage. Especially in the case of mental illnesses or complex diagnoses, gaps and contradictions in IV assessments often only become apparent with support – without an objection, this can have fatal consequences.
As lawyers for social insurance law, we support you in critically examining medical reports, raising objections and consistently asserting your rights.
Are you facing an IV assessment or struggling with a rejected pension?
If Suva or IV have ordered an expert opinion or rejected your pension on the basis of an expert opinion, please do not hesitate to contact us.
FF-Law Your contact for social security law
Our lawyers in Winterthur specialize in social insurance law and IV appraisal control and support you competently, carefully and with assertiveness.
We offer a detailed initial consultation (1 hour at CHF 330), on site or via video call. We clarify the next steps together.
Matthias Fricker
Attorney at law and partner at Fricker and Füllemann Attorneys at Law
Studied at the University of St. Gallen, graduating with a Master in Law (M.A. HSG in Law) in 2012, registered in the Bar Register of the Canton of Zurich, member of the Zurich Bar Association.
Fabian Füllemann
Attorney at law and partner at Fricker and Füllemann Attorneys at Law
Studied at the Universities of St. Gallen and Zurich, graduating with a Master of Law UZH in 2013, registered with the Zurich Bar Registry, member of the Zurich Bar Association.
