Since the beginning of the pandemic, Long COVID has not only posed challenges in the healthcare system but also poses new questions for the social insurance system. On January 30, 2025, the Federal Social Insurance Office (FSIO) published a report that for the first time provides a comprehensive analysis of the significance of Long COVID for disability insurance (IV).
The study is based on data from 2021 to 2023 and provides a detailed insight into the number of cases, health impairments and the impact on pension awards.
Just under two percent of new IV applications relate to Long COVID
Between 2021 and the end of 2023, around 2,900 people with Long COVID registered with the IV. This corresponds to around 1.8 percent of all new registrations. While the number of cases rose at the beginning of the pandemic, the report shows that they decreased again in 2023.
Compared to people who register for IV due to other illnesses, people affected by Long COVID usually suffer from particularly severe symptoms: nine out of ten are on 100% sick leave, and around 85% struggle with fatigue or stress intolerance. 60% of cases have neurocognitive disorders, including memory and concentration problems. Women are affected more often than men and account for two thirds of Long COVID IV registrations.
"Integration before retirement" - Despite reintegration measures, many of those affected remain unable to work.
The IV basically follows the principle of "integration before retirement": Those affected should be reintegrated into the labor market as far as possible. According to the FSIO report, around 60% of people affected by Long COVID show slight improvements in their ability to work in the first two years after registering.
Nevertheless, a significant proportion – especially older people or people with multiple health restrictions – remain permanently unable to work. The prognosis therefore remains uncertain, which complicates the assessment for the IV.
Compared to other IV applicants, people with Long COVID are more likely to receive a pension. At the end of 2023, 12% of those who registered with the IV in 2021 or 2022 were receiving a pension – compared to 9% in the control group without Long COVID.
This proportion could rise even further. Among people who registered with the IV in 2021, 20% of people affected by Long COVID receive a pension compared to 13% in the comparison group.
The figures underline the fact that Long COVID leads to long-term or even permanent incapacity for work in many cases. Nevertheless, the total number of pension recipients with Long COVID is relatively low in relation to the total of 251,000 IV pensions (as of 2023).
Long COVID is a complex challenge for the IV
The study concludes that Long COVID is a serious clinical picture for IV, which is often associated with complex, lengthy and uncertain investigations. One of the reasons for this is that the clinical picture changes over time in many of those affected, not all those affected have a medical diagnosis of Long COVID and the long-term prognosis is difficult.
The IV does not follow diagnosis-specific procedures but decides on applications on a case-by-case basis. Various medical assessments and investigations are used to individually assess the insured person's ability to work.
To facilitate the assessment of Long COVID cases, a working group of the Swiss Insurance Medicine (SIM) has developed insurance medicine guidelines. The use of the "Evidence-based post-Covid-19 Assessment" (EPOCA) is recommended for the assessment. A digital version of the EPOCA assessment was developed by movos AG in collaboration with SIM and Altea and is available in the Altea Care app.
The FSIO report provides an important basis for future discussions on the social and economic consequences of Long COVID. It shows that even years after the start of the pandemic, the issue is far from over – neither for those affected nor for the social security systems.
