How the terminally ill Ralph Knoepfel had to fight for money
In the event of disability, the pension is usually paid out years later. There are always mistakes that can cost those affected a lot of money.

Due to a serious illness, Ralph Knoepfel is dependent on an invalidity pension. He thinks that his former employer’s billing was “unfair”.
Photo: Urs Jaudas (Tages-Anzeiger)
His extra-occupational studies in curative education were almost over when Ralph Knoepfel received the devastating diagnosis in 2016: he had Cushing’s disease. His doctor later spoke of “one of the nastiest diseases that ever existed”. It is rare, which is why doctors often recognize it late. It only affects three out of a million people.
Ralph Knoepfel’s body releases vast amounts of the stress hormone cortisol – around ten times as much as in healthy people. This destroys the body: It leads to a variety of stressful symptoms such as brittle bones (osteoporosis), sleep disorders, constant headaches, muscle wasting, fatigue, irritability, depression and high blood pressure, which greatly increases the risk of a stroke.
Haven’t slept properly in years
Knoepfel no longer sleeps properly for years. The overall symptoms are so severe that he requires immediate surgery shortly after diagnosis. In several procedures, doctors remove organs that are responsible for cortisol production. As if that weren’t enough, a malignant brain tumor is later discovered. There were a total of thirteen interventions, some of them serious.
At the time of the diagnosis, Knoepfel was employed by the city of Zurich. He is increasingly absent from work and receives continued salary payments from the daily sickness benefits insurance. Finally, two years ago, he was granted a disability pension.
It usually takes two to three years for the IV pension to be approved after the application. As a result, those affected receive a larger sum retrospectively for the past few years.
Until the decision of the disability insurance, other bodies finance the livelihood of the person concerned. This can be employers, daily sickness allowance insurance or social assistance. As soon as the IV pension is approved and paid out, these offices demand the advance money back.
Incorrect calculation basis?
The City of Zurich has requested and received a refund from Ralph Knoepfel based on 100 percent employment. The city got more than it was entitled to, argues Knoepfel. At the time of his illness, he was only working part-time for 65 percent. Calculated in this way, he would have had to give up less money.
The bill looks like this: Knoepfel had to give up his entire IV pension of CHF 2,141 a month for the total of two years of continued salary payments. If his former employer or her daily sickness benefit insurance had instead expected a 65 percent workload, it would have been an amount of CHF 1,392. Over two years, an additional 17,000 francs would have been left for Knoepfel.
Michael Meier, Senior Assistant for Social Security Law at the Universities of Zurich and Lucerne, basically agrees with Ralph Knoepfel’s assessment. He explains that 65 percent of the IV pension is based on a restriction on gainful employment, while the remaining 35 percent is based on a restriction on private household management.
To clarify his position, Meier cites another example: If an IV recipient was employed by two different employers with 50 percent each, neither of the two employers can claim 100 percent of the IV pension.
Consider the employment contract
However, Meier points out that other factors such as the employment contract or the personnel regulations can also play a role. Knoepfel’s lawyer has checked this and sees his client’s interests as confirmed. Accordingly, the relevant personnel regulations provide that IV pensions may be taken into account “insofar as they are intended to cover loss of earnings due to incapacity to work”.
Since in the present case a loss of earnings of 65 percent should be covered, the city of Zurich should not actually make any higher demands, the lawyer concludes.
However, in a statement to this newspaper, the city of Zurich insists that it can count the entire IV pension. She justifies this with, among other things, the provisions of Zurich’s implementation ordinance on the Personnel Act.
Michael Meier from the University of Zurich confirms that such questions are legally tricky, since the law does not provide for any express regulation. He recommends examining such controversial cases, and quickly. The objection period is thirty days. Anyone who only contacts a lawyer shortly before the deadline may be left out in the cold, as lawyers usually need a certain amount of lead time.
Thousands of people are affected every year
Ralph Knoepfel is not an isolated case. Several thousand people in Switzerland are confronted with it every year. There are around a quarter of a million IV pensioners and another quarter of a million receive contributions in connection with reintegration measures.
If in doubt, those affected should consult a legal expert who is familiar with social insurance. Because although the authorities generally work well, there are always errors when it comes to offsetting IV funds.
The following two criteria in particular should be checked: the amount of the claim and the timing. Since IV back payments are often settled retrospectively over several years, the correct chronological assignment is an error-prone task.
Although there are costs for people without legal protection insurance, a check can be worthwhile. Because often it is about significant sums that justify a lawyer’s fee for two to three hours of work.
If you miss the deadline, you lose
After the 30-day period has expired, there is practically no longer any legal way to ward off disputed offsetting. Ralph Knoepfel, who missed the deadline for various reasons, also had this painful experience. The city of Zurich has taken the trouble to check the case again afterwards. In February, however, Knoepfel received an email saying that the responsible office “had not come to a new assessment”.
Knoepfel is at odds with the negative decision of his former employer. He does not understand how, despite a manageable amount, this decision, which he considers “unfair”, could have come about. “For me it’s about a lot of money – for the city of Zurich that would be a piece of cake.”

Without medication, Ralph Knoepfel would die after a short time. For emergencies, he has therefore got a tattoo that points to this.
Photo: Urs Jaudas (Tages-Anzeiger)
Medication determines everyday life
But compared to his health challenges, financial issues remain secondary. Planning and dosing an extensive drug cocktail determine Ralph Knoepfel’s everyday life. Without medication, which takes up both a suitcase and a lot of space in the fridge, he would be dead within a day. He has just had an emergency tattoo made, which points to the urgently needed medication if he is no longer responsive.
The disease is also a psychological burden. The persistent tiredness bothers him. So he has to take medication to find enough strength to walk his dog. “Everyone has dreams and wishes – in my life that no longer exists,” says Knoepfel.
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