The Disability Insurance Office for the Canton of Vaud (OAI) has been put in order. In a ruling dated November 4, the Federal Court disavowed it in a case opposing it to a young person suffering from a genetic disability from birth, i.e. severe autism with mental retardation.
To understand the dispute, we must go back to February 21, 2023. That day, the OAI responded favorably to a request filed by the young man’s father, a year earlier. Better yet. Noting that the conditions for granting a helplessness allowance were met from the insured’s 18th birthday in 2014, it granted him a retroactive amount of 120,650 francs. But the good news is short-lived.
The next day, the OAI reversed its decision. Ultimately, the young person will only be entitled to 28,740 francs, i.e. arrears dating back only to March 2021. Why such a turnaround? The OAI considers that the request for allocation was made late. In these cases, the law provides that benefits are granted only for the twelve months preceding the request.
Represented by his father, the boy, now 28 years old, appealed against this rectification. The Vaud Cantonal Court partially followed it, setting the start of the right to the allowance retroactively five years before the request. A twist that did not please the OAI. According to him, the insured’s parents, with whom he lives and who take care of him, knew his state of health and could have made the request within the year following his 18th birthday. The Disability Insurance Office appealed to the Federal Court, demanding the annulment of the Vaud decision.
-The Mont-Repos judges put an end to the saga at the beginning of November. Given the young man’s disability, it is clear that he could not realize his situation and know that he was entitled to benefits. All the more so “as he was incapable of carrying out any administrative procedure or even instructing a third party to act on his behalf”, indicates the TF. In these circumstances, the law provides that arrears of benefits are allocated to the insured for a period of up to five years, from the filing of the application.
Furthermore, according to case law, the ignorance of his parents cannot be attributed to him, unless they are his legal representatives. Which was not the case. They were appointed co-curators for their son in 2022. Between his majority in 2014 and the curatorship established eight years later, the young man had no legal representative. Conclusion: the insured can benefit from arrears of benefits for a period of five years before filing the request. The amount should reach more than 70,000 francs.