Occupational disability cover

Disability is one of the things that can happen to anyone and that we generally have no control over. Apart from the impact on our health, our ability to work may also become limited and hence our income might suffer. The frequently asked questions set out below are intended to provide an overview of the disability cover provided by VZWL and answer the most important questions.


When does the disability cover start?

Members will qualify for disability cover as soon as they have been paying contributions for at least one month and if the disability did not exist prior to their becoming a member. The VZWL disability cover does not require the completion of a qualifying period or the fulfilment of any other insurance-related requirements.


Do I have to pay any risk premiums?

In accordance with the compulsory membership, the VZWL's AOA do not require members to pay any risk premiums in addition to their pension contributions if they start experiencing any health problems after the start of their membership. There are also no actuarially calculated risk premiums based on the annuity benefit. Members are furthermore only able to voluntarily increasing their pension by regularly paying in excess of the compulsory contributions if they have previously undergone a comprehensive medical exam.


What are the requirements for qualifying for a disability pension?

Disability pensions are predominantly intended as a substitute for a member's regular income. Hence, members will not be granted a disability pension if they are already receiving or could receive their retirement pension. Disability cover ends when members turn 62.

Disability pensions are only granted on written application. In addition to the above, the disability pension benefits a member is eligible for depend on the type of disability pension: The AOA distinguish between a permanent and temporary disability pension.
Members will only be eligible for a permanent disability pension if they are permanently unable to work, have fully ceased working as a dentist and are not employing a locum to continue their practice.
On the other hand, members will be eligible for a temporary disability pension if they have been unable to work for more than 26 weeks on submission of their application and are not working as a dentist. In these cases, there is no requirement for members to have ceased working as a dentist, which means that it is immaterial whether or not they have relinquished their state health insurance dentist license or are employing a locum to continue their practice.


What is considered a disability?

A person is considered to be disabled if they are unable to use their dentist skills in any way whatsoever for financial gain as a consequence of incapacitating health problems. In this context, dentist skills are defined as all of the activities that are involved in whole or part of training as a dentist. Hence, whether or not a person is considered disabled also depends on the work they were performing prior to their health problems. Dentist skills or working as a dentist also includes work such as working as a dental expert or being involved in dental research. Hence, a person will not be considered disabled if their health problems only affect their ability to engage with patients in part or full and they are still able to perform other dentistry-related work. Any work performed that does not involve dentistry, on the other hand, will not be taken into account. Hence, the Pension Scheme of the Dental Association of Westphalia-Lippe (VZWL) only provides income protection related to the dental profession.


What are the procedures involved in being granted a disability pension?

Disability pensions are only granted on submission of a corresponding application. The relevant application forms can be obtained from the VZWL on request. All applications for disability pensions will be decided by the VZWL's administrative board, which predominantly comprises dental practitioners. In order to provide the self-governing bodies with sufficient information on which to base their decisions, applicants will have to provide all of the available medical evidence in support of their physical incapacities that will give a clear indication of the type, extent and the impact that their health condition is having on their ability to continue practising as a dentist. If there is still any uncertainty concerning the existence of a disability, the self-governing bodies in charge of the decision will be entitled to obtain a third-party opinion.


As of what date will the disability pension be paid?

At the earliest, disability pension will be paid for the first time on expiry of the month in which the VZWL received the application, provided that the conditions for a disability pension have been met. If the applicant has not ceased to practice as a dentist by that date, the disability pension will not be paid until the applicant has stopped working as a dentist.


For how long will the disability pension be paid?

The disability pension will be paid for as long as there is a disability. The administrative board will be entitled to ask for follow-up examinations in order to determine whether the disability still exists when granting a permanent and temporary disability pension. When a disability pension recipient reaches standard retirement age, they will automatically start being paid their standard retirement pension, which will be same amount as their disability pension. Contributions paid up until 31.12.2004 are subject to special rules and a member will be entitled to a lump sum payment when they turn 65.   A disability pension that is based on old contributions will therefore only be granted until the expiry of the month before the month in which the lump sum payment becomes due.


What are the disability cover restrictions?

Members are entitled to a disability pension while they are members of the VZWL or are not receiving or would not qualify for a retirement pension (see above). If the insured person suspended their pension scheme membership by stopping to pay their contributions in the presence of the corresponding preconditions for doing so, the disability pension will be calculated without taking into account any additional periods (Zurechnungszeit). Health-related difficulties – such as incapacity to work – that are only temporary will not entitle a person to disability pension unless they have been present for at least 26 weeks on the date the disability pension application is submitted. For this reason, a disability pension is not a substitute for income protection insurance. The disability cover does not protect a member from the consequences or risk of loosing their job, including with reference to alternative jobs, because healthy insured persons are just as much affected by this risk as those who are incapacitated for work for medical reasons.


Does the VZWL support measures for restoring the capacity for work?

Members who have been declared disabled may, on written application, be granted a one-off or regular contributions to the costs of any necessary medical rehabilitation measures if this removes or defers the need to grant the member a disability pension. This contribution has to be applied for in good time prior to the initiation of such measures. These applications will be decided by the administrative board. The above rehabilitation measures do not include acute and follow-on medical care that is within the remit of the public health care system or health insurance providers.


Do I need any other insurance cover in addition to the disability cover provided by the VZWL?

Whether or not a member requires another insurance cover in addition to the disability cover provided by the VZWL depends on the relevant individual’s need for protection. In that regard, it is therefore important to note that the cover provided by the VZWL is not a substitute for income protection or health insurance. However, it is also important to bear in mind that private insurance companies may, just as the VZWL, also require insured persons to continue working in an alternative dentistry-related job where they are able to do so, should they loose their ability to practice as a dentist. Hence, an insured person will only have a level of protection above and beyond that offered by the VZWL if they are insured for the loss of or incapacity to perform their exact job in their own dental practice. In addition to the above, it may also be advisable to take out cover for partial incapacity. However, in real terms, it is often difficult to accurately determine the relevant level of incapacity in such instances. This is probably only possible where an insured person is no longer able to perform their previous job to the full extent, but only for a limited number of hours. With respect to the insured amount of any additional private insurance cover, it is important to note that, in contrast to the pensions paid by the occupational pension schemes, private insurers will stop paying their benefits once the insured person reaches retirement age. Hence, if such insurance cover is used, the insured person will require additional funds to provide for their old age.