Accident, long sick leave and disability for cross-border workers: who pays, how much, and for how long

A cross-border worker who stops working discovers within days that their income depends neither on their health insurer, nor on a social security fund in their country of residence, nor on their years of service there, but on three Swiss texts they have never read: the Accident Insurance Act, article 324a of the Code of Obligations and the Disability Insurance Act. Depending on whether the stoppage comes from an accident or from an illness, the same employee receives 80% of insured earnings until recovery, or three weeks of salary and then nothing. This guide separates the cases, puts 2026 figures on each of them, and says where and when to file — because with disability, a claim filed three months late costs three months of pension.

1. Accident or illness: why does everything hinge on this first question?

Because Switzerland made one compulsory and left the other to freedom of contract. All employees in Switzerland are covered on a compulsory basis by accident insurance. There is, by contrast, no compulsory loss-of-earnings insurance for illness: the Health Insurance Act provides only for optional daily benefits insurance. Two stoppages of the same length, with the same employer and the same salary, therefore do not open the same rights.

The dividing line runs through the cause, not the place

Accident insurance covers occupational accidents, occupational diseases and non-occupational accidents — those during leisure, at home and in traffic. There is no geographical condition: a skiing fall in Haute-Savoie, a cycling accident in Annemasse or a burn at home in the Ain is a matter for your employer's Swiss accident insurer, exactly like a fall on the office stairs in Geneva. The only condition is working at least eight hours a week for the same employer; below that threshold, non-occupational accidents are covered by health insurance, and commuting accidents are then treated as occupational accidents.

The reflex most often missing: reporting the non-occupational accident to the employer in Switzerland. A cross-border worker who breaks an ankle at home on a Sunday instinctively calls their local doctor and treats the matter as private. It is not: the employer reports the case immediately to the competent insurer, and it is that report which triggers full coverage of treatment and payment of daily allowances.

What you already pay for this cover

Premiums for compulsory insurance against occupational accidents and occupational diseases are borne by the employer. The share covering non-occupational accidents is in principle borne by the employee, unless a more favourable arrangement applies — that is the "AANP" or non-occupational accident insurance line on your payslip. Our guide to understanding your Swiss payslip sets out each of these deductions.

2. After an accident, how much do you receive and from when?

80% of insured earnings, from the third day following the day of the accident, and until working capacity is fully recovered or a pension is granted. During the waiting period the employer maintains pay at 80%. Where incapacity is partial, the allowance is reduced proportionately.

The cap nobody looks at until they need it

Insured earnings are capped. The maximum amounts in force are CHF 148,200 a year, that is CHF 12,350 a month or CHF 406 a day. The maximum daily allowance is therefore CHF 324.80, whatever your actual salary.

On the last line the gap is clear: 80% of actual salary would be CHF 11,047 over 30 days. The cap removes CHF 1,303 over 30 days. An executive in Geneva finance or Vaud watchmaking earning above CHF 148,200 a year therefore has a structural shortfall that only supplementary cover can close — supplementary accident insurance, extra-mandatory benefits from the pension fund, or a contractual top-up from the employer. A line worth checking in the employment contract before you need it.

Treatment itself is covered in full

This is the most visible difference from the LAMal: accident insurance covers medical treatment, medicines, hospitalisation, auxiliary devices and transport with no deductible and no co-payment. For a cross-border worker used to a LAMal deductible of CHF 300 to CHF 2,500, the difference on a hospital stay runs into thousands of francs. Travel, transport and rescue costs incurred abroad are covered up to 20% of maximum annual insured earnings, that is CHF 29,640.

If incapacity becomes permanent: the accident insurance pension

An accident insurance disability pension is granted from 10% permanent loss of earning capacity — a far lower threshold than the 40% required by the IV. For total disability it amounts to 80% of insured earnings, reduced proportionately for partial disability, so at most CHF 118,560 a year. Where the insured person is also entitled to an AHV or IV pension, accident insurance pays a complementary pension equal to the difference between 90% of insured earnings and the first-pillar pension: the two benefits do not simply add up, they are capped at 90% together. A compensation payment for loss of physical or mental integrity may be added, paid as a lump sum according to the severity of the damage.

3. If you fall ill, how long must your employer keep paying you?

Three weeks in the first year of service, then a rising period set by a scale developed in case law. That is all the law guarantees. Article 324a of the Code of Obligations requires the salary to be maintained for a limited time, provided the employment relationship has lasted, or was concluded for, more than three months.

Which scale applies to you?

Three scales coexist in Switzerland. The Basel scale applies in Basel-Stadt and Basel-Landschaft, the Zurich scale in Zurich, Schaffhausen, Thurgau, Graubünden and Zug, and the Bernese scale in every other canton — so in Geneva, Vaud, Valais, Fribourg and Neuchâtel, which is where most cross-border workers of the Lake Geneva area are employed.

Two points matter in practice. The period is calculated per year of service, not per calendar year: the year of service starts on the date work actually began. And the entitlement is consumed by all absences within the year of service, not by each absence taken separately — three one-week stoppages in the first year already use up the whole credit.

Daily sickness benefits insurance: the line to check tonight

Many Swiss employers take out daily sickness benefits insurance, which replaces the statutory obligation and generally pays 80% of salary for 720 days within a 900-day period, after a contractual waiting period. It is common, often required by a collective agreement — but it is not compulsory. Whether it exists, at what rate, with what waiting period and how the premiums are split is set out in the employment contract, the staff regulations or the applicable collective agreement.

4. When does disability insurance take over, and why file immediately?

Because entitlement to a pension can arise at the earliest six months after the claim is filed. That period runs from the filing, not from the start of the stoppage: filing in the eleventh month of incapacity guarantees that nothing will be paid before the seventeenth. Every month of delay is a month of pension lost for good.

Early detection, from thirty days of incapacity

The Swiss system favours rehabilitation over pensions. There is an early detection mechanism for that, which can be triggered after just thirty days of incapacity. The claim may be filed by the insured person, a family member, the employer, the treating doctor, the daily benefits insurer or the accident insurer. An early intervention phase of up to twelve months follows, designed to adapt the workstation, redeploy the employee or fund training. That phase does not open entitlement to IV daily allowances.

Where do you file as a cross-border worker?

On this point, the information in general circulation often diverges from the applicable rule. The general rule for an insured person living in an EU or EFTA State is to approach the institution of the last country where they paid contributions, which forwards the file to the IV Office for Insured Persons Resident Abroad. But cross-border workers holding a G or L permit are an exception: their claim is filed directly with the IV office of the canton where they are, or were last, professionally active. For a cross-border worker employed in Geneva, that is the disability insurance office of the canton of Geneva, not an institution of the country of residence and not the office for insured persons abroad.

The three conditions for a pension

• At least three full years of contributions before the disability arises. Insurance periods completed in another EU or EFTA State count towards reaching that threshold, through the aggregation rules of European coordination.
• An average incapacity for work of at least 40%, without significant interruption, for a whole year, and a loss of earning capacity of at least 40% that persists at the end of that year.
• No reasonably available rehabilitation measure can restore, maintain or improve earning capacity.

During rehabilitation measures, the IV pays daily allowances equal to 80% of previous income where those measures prevent work for at least three consecutive days, with a child supplement of CHF 9 per day per child. The total is capped at CHF 407 a day — a cap specific to IV daily allowances, distinct from the daily insured earnings under accident insurance.

5. What is a Swiss disability pension actually worth?

With a complete contribution record, a full IV pension ranges from CHF 1,260 to CHF 2,520 a month depending on average annual income. The calculation is identical to that of the AHV old-age pension and uses the same pension scale 44. A child's pension equal to 40% of the main pension is added for each child up to 18, or up to 25 if in education.

The linear system, since 2022

The old quarter-pension steps are gone. The degree of disability now determines a continuous share of the full pension:

Between 40% and 49%, each additional point of disability adds 2.5 points to that share. The degree of disability is not itself a medical measure: it is a comparison of incomes. The IV office compares the income you would earn without the health impairment with the income you could reasonably earn despite it, after any reasonably available rehabilitation measures. An income without disability of CHF 60,000 and a disabled income of CHF 20,000 give a loss of earnings of CHF 40,000, that is a degree of 67%.

The specific shortfall of a cross-border worker who arrived late in Switzerland

A full pension assumes a complete contribution record, that is no gap since the year of your 21st birthday. One missing contribution year reduces the pension by at least one forty-fourth. A cross-border worker who moved to Switzerland at 35 accumulates fourteen years of gaps in AHV/IV terms: those running from the year of their 21st birthday to the year of their 34th. Foreign insurance periods open entitlement — they count towards the three years required — but they do not increase the Swiss amount, which is still calculated on Swiss contributions alone. Fourteen missing years therefore remove at least fourteen forty-fourths of the pension, close to a third, and the loss is heavier the earlier the disability arises: the expected contribution period is then shorter, and each year of gap weighs more within it.

Set against a cross-border worker's salary, the contrast is stark: for someone earning CHF 8,000 a month, a full IV pension at the cap is less than a third of their previous income. That is precisely why the second pillar and any individual provision represent, beyond the IV, the bulk of replacement income.

6. Does the second pillar pay a disability pension too?

Yes, and it is often the larger part of replacement income. Entitlement to occupational benefit disability payments belongs to people who are at least 40% disabled within the meaning of the IV and who were insured when the incapacity for work whose cause led to the disability first arose.

The occupational benefit disability pension is calculated on the projected retirement assets up to the reference age, as if you had kept contributing until retirement. A disabled person's child pension is added, of the same amount and duration as an orphan's pension. Most funds also waive contributions for the duration of the disability. The detail of the mechanism, the conditions in the fund regulations and the position of unmarried partners are covered in our guide to occupational provision, the Swiss second pillar.

7. What is left for your country of residence?

Healthcare, and possibly a pro-rata disability pension. Nothing else. The sections below describe the case of a cross-border worker resident in France; the coordination principle of Regulation (EC) No 883/2004 is the same for every EU and EFTA State of residence, but the forms, the competent institutions and the tax treaty differ from one country to another.

Care received in your country of residence

If you stayed with the LAMal, you are registered with the health insurance fund of your place of residence using portable document S1. Care received there is then reimbursed by that fund on behalf of the Swiss scheme, on the basis of the local tariffs. If you opted for the health insurance of your country of residence, your care there falls under that national scheme and your care in Switzerland goes through the European Health Insurance Card.

Is a foreign disability pension possible?

Yes, if you also paid contributions in your own country. Switzerland does not appear in Annex VI to Regulation (EC) No 883/2004, and neither does France: both disability legislations are of type B, the kind whose amount depends on the length of insurance periods. As soon as Swiss periods are involved, the case therefore falls under the type B rules of Chapter 5 — whatever your State of residence. Entitlements are then examined and awarded by each of the schemes the person has been subject to, under the same rules as old-age pensions: aggregation of periods to open entitlement, then a pro-rata calculation based on the periods actually completed under each legislation.

In practice, someone who worked twelve years in their own country and then fifteen in Switzerland may receive two separate benefits: a Swiss IV pension calculated on Swiss periods alone, and a foreign disability pension calculated pro rata to the local periods. The file is handled by the institution of the place of residence or that of the last State of employment, acting as the liaison body. It is not automatic: the claim has to be made, and the foreign file does not open by itself because a Swiss IV office has issued a decision.

How these pensions are taxed

Between France and Switzerland, pensions paid in respect of private employment are taxable only in the beneficiary's State of residence, under article 20 of the tax treaty. An IV pension, an occupational benefit pension or an accident insurance pension paid to a resident of France is therefore declared in France, on form 2047 and then in boxes 1AM or 1BM of the 2042 return. A tax credit is available only where Switzerland actually taxed the pension — which is not the case for first-pillar benefits. The regime for former Swiss public servants of Swiss nationality is separate and falls under article 21 of the treaty. For any other country of residence, the double taxation treaty applicable in that country governs. Our guide to cross-border worker taxation covers all the boxes concerned.

8. Why does a Swiss pension paid abroad lose value?

Because the conversion is no longer yours to make. The rule applied by the Swiss Compensation Office is explicit: the benefit is debited in Swiss francs from the office's account and the beneficiary receives the equivalent in the currency of their country. Only payments to a bank or postal account in Switzerland are made in francs.

An IV pension paid into an account abroad therefore arrives in the local currency, at a rate and on a date the beneficiary does not choose. The office also warns that an account not held in the local currency can trigger a second conversion charged by the receiving bank, or even a refusal to convert and a returned payment.

The calculation is worth setting out, because a disability pension runs for decades rather than months. On a pension of CHF 2,000 a month, assuming a gap of one and a half points between the interbank rate and the rate applied — a common gap for a bank conversion — the conversion costs about CHF 30 a month, that is CHF 360 a year and close to CHF 7,200 over twenty years, at a constant pension amount and a constant exchange gap. The same trade-off arises during the daily allowance period, where the monthly amounts are far higher.

Receiving the pension in francs on a Swiss IBAN, by contrast, lets you convert when you choose. ibani is a Geneva-based financial intermediary, not a bank, specialising in transfers between Switzerland and the euro area, with a personal Swiss IBAN: the pension or allowance arrives in francs, conversion happens when you decide, and the transfer goes out to the euro account that pays the household bills. The principle is the same as for salary, set out in our guide on transferring your Swiss salary; the day's rate can be followed on our CHF-EUR converter, and our cross-border worker service page explains how it works.

9. Frequently asked questions