Standard procedure

Disability insurance claim (AI) — step by step

Filing an AI pension claim at the Geneva OAI and defending the file: conditions of LAI art. 4 ss, qualifying period, TAPI appeal then Federal Tribunal.

Total duration: ~18 months

Procedure steps

  1. 01

    Early detection and pre-registration

    Before formal filing, LAI arts. 3a-3b foresee 'early detection': signal by the insured, employer, treating physician or insurer. Enables faster reintegration. Use this if work capacity begins to decline durably.

    • Authority: Office AI Geneva (OAI)
  2. 02

    File the pension claim (Form 318.001)

    Download form from ai-ge.ch or collect from OAI Geneva. Attachments: detailed medical certificate from treating physician, hospitalisation reports, employment contract and last 5 years' payslips, employer's certificate. Legal deadline: file within 6 months of lasting work incapacity.

    • Duration: ~14 days
    • Cost: CHF 0
    • Authority: Office AI Geneva (OAI)
  3. 03

    Qualifying period — 1 year of incapacity

    LAI art. 28 al. 1 let. b requires work incapacity of at least 40% over 1 year, without notable interruption. During this year, the insured falls under the employer's loss-of-earnings insurance or unemployment insurance. Preserve medical records month by month.

    • Duration: P1Y
    • Authority: Loss-of-earnings / unemployment insurance
  4. 04

    Medical instruction by SMR

    The Regional Medical Service (SMR) reviews the file on the documents and, if needed, calls the insured for assessment. Possible multidisciplinary expert opinion at a COMAI centre. Important: the insured has the right to submit additional questions to the expert and produce a private expert report.

    • Duration: ~6 months
    • Authority: Regional Medical Service (SMR) + COMAI
  5. 05

    Determination of the degree of invalidity (LPGA art. 16)

    Comparison between income without health impairment and income reasonably expected with impairment. According to the applicable method (ordinary, mixed, comparison of activity fields), key thresholds: 40% (quarter pension), 50% (half), 60% (three-quarters), 70% (full). High vigilance — frequent contentious ground.

    • Authority: Office AI Geneva (OAI)
  6. 06

    Pre-decision then OAI decision

    OAI first notifies a pre-decision. Hearing deadline: 30 days to file motivated objections. Then formal decision. Subject to appeal.

    • Duration: ~3 months
    • Authority: Office AI Geneva (OAI)
  7. 07

    Appeal to the TAPI

    Appeal to the Chamber of Social Insurance of the TAPI within 30 days of notification (LPGA art. 56 ss). Procedure generally free. Private expert reports admitted.

    • Duration: ~6 months
    • Cost: CHF 0
    • Authority: Chamber of Social Insurance — TAPI Geneva
  8. 08

    Appeal to the Federal Tribunal

    TAPI decision subject to appeal to the Federal Tribunal (art. 82 ss LTF) within 30 days. Review limited to law (and arbitrariness for facts). Representation by counsel in practice mandatory.

    • Duration: ~9 months
    • Cost: CHF 2500
    • Authority: Federal Tribunal — Lausanne

Legal basis

Coordination with supplementary benefits (LPC)

If the AI pension does not cover basic needs, file a supplementary-benefits (PC) claim at the Service des prestations complémentaires (SPC) — Geneva. Cumulable with the AI pension, subject to income and asset calculation.

Frequently asked questions

What is the minimum disability threshold for an AI pension?

40% loss of earning capacity is the threshold for any pension. The fraction depends on the exact rate: 40-49% gives a quarter pension; 50-59% a half pension; 60-69% three-quarters; 70% or more a full pension (art. 28 al. 2 LAI). The calculation under art. 16 LPGA compares the income without health impairment against the income reasonably expected with impairment.

How long does AI instruction take in Geneva?

Count 18 to 24 months between filing and the OAI's final decision. Minimum one year of qualifying period (art. 28 al. 1 let. b LAI), then 6 to 9 months of medical instruction by the SMR or COMAI, then the pre-decision (30-day opposition window) and the formal decision. Add 6 to 12 months for a TAPI appeal; 9 to 12 months more for a Federal Tribunal appeal.

Do I need a lawyer to file an AI claim?

Not for the initial filing — the OAI procedure is free and accessible. A lawyer becomes useful at the unfavourable pre-decision stage (motivated opposition), when contesting a medical expert report (additional questions, private expert opinion), or for a TAPI appeal. For a Federal Tribunal appeal, representation is in practice mandatory.

Can I work part-time during the AI instruction?

Yes, within the limits of your medically certified residual capacity. Part-time work doesn't disqualify the application — on the contrary, it's consistent with art. 7 LPGA requiring the insured to make use of their residual work capacity. Preserve all month-by-month medical evidence. The mixed method (LAI art. 28a al. 3) applies to people with a partial professional activity who also keep a household.

This procedure overview is provided for information only and does not replace individual legal advice.

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