Spinal Cord Injury (SCI) usually occurs suddenly and can happen to any person. Due to the bodily impairments, activity limitations and restrictions in participation related to SCI most of the affected persons face physical, emotional and socio-economic losses1. To achieve community integration the needs of persons with SCI, including medical and rehabilitative treatment have to be comprehensively addressed. To ensure that the costs of the interventions including loss of income are covered, legal claims such as applying for social benefits are required. Taking the Swiss example, social benefits are granted irrespective of income, unlike most other countries, by means of social security legislation.

Social Security Legislation

Social security legislation plays an important role in resolving the problems a person with SCI faces after the injury and it is a tool for the implementation of social policy. Disability policy, as a part of social policy, is implemented through laws that defines the entitlements of persons with disabilities and refers to the current understanding of disability (see Box 1). There are two different areas of laws, the social security legislation and the antidiscrimination legislation. Whereas the social security legislation directly addresses the needs of persons with disabilities in providing financial benefits, antidiscrimation legislation with the aim of ensuring fair opportunities and equality, indirectly addresses the needs of persons with disabilities in targeting the barriers (e.g. inaccessibility of public places) which deny equality.

On the international level, the entitlement of social security is incorporated in the Universal Declaration of Human Rights of 19482 as well as in the International Covenant on Economic, Social and Cultural Rights (ICESCR) of 19663. It is important to note here that these conventions do not mention persons with disabilities explicitly, as these conventions apply to all human beings. To address the specific situation of persons with disabilities, the UN Convention on the Rights of Persons with Disabilities was created in 20064. On the regional level, in the European Union (EU) the law on social security is stated in the European Social Charter5, where the rights of persons with disabilities are also explicitly mentioned (Art. 15 -The right of physically or mentally disabled persons to vocational training, rehabilitation and social resettlement). And on the national level, taking the Swiss legislation as an example, there are different legal sources that implement disability policy within the Swiss legal ssystem. The Swiss Constitution6 provides the legal basis to ensure social justice, social equality and social security for all persons. Ensuring social security and improving an individual’s situation, through e.g. providing financial support for vocational re-training, the Federal Act on the Invalidity Insurance7 has to be applied. Implementing social justice and social equality, the Federal Act on the Equalization for Persons with Disabilities8 plays an essential role, e.g. to ensure accessible public transportation.

To make the law an effective tool to create fair and equal opportunities for everyone, various laws have to be applied to individuals with disabilities. This requires specific knowledge about the legal legislation which few professionals working in the health-care sector have and even fewer persons with disabilities have. Becoming a person with a disability, in particular a SCI, is often sudden and unexpected. Before the life changing event the legal framework in relation to disabilities was most likely not well-known. Now the person suddenly faces loss of income and re-training needs, which are tightly related to legal questions. Apart from the physical and emotional burden, excessive demands can occur due to legal queries. Interventions on how to build knowledge and how to navigate the legal system should start as soon as possible after the SCI and could be included in rehabilitative approaches. A “legally empowered person is the person who has sufficiently high confidence that, if a problem appears, there are legal solutions available, and he can use them to solve the problem.”

This case study provides insights into the daily struggle that a person with SCI undergoes in terms of legal questions during their first rehabilitation. The general objective of this case study is to illustrate how the implementation of disability policy contributes to optimize participation of persons with SCI. It also shows that gaining knowledge about one’s own rights could be a demand, is empowering and ensures the opportunity for a person with SCI to enjoy his rights.