Disability and expatriation

Expatriation is an exciting adventure that requires good preparation. When you have a disability, the following questions are even more important. What is expatriation like with a disability? What should I consider before expatriating with a disability? Does my destination country have adapted infrastructures? How will my health expenses be covered? We will try to shed some light on the subject to make your departure easier.

1. What do I need to consider before deciding to expatrite with a disability?

"You have to know yourself. Know what you can and can't do, and care about one more than the other."
If you have a disability or if you plan to expatriate with a person requiring additional health assistance you will need to think about:
- the equipment available locally and the possibility of repairs (cane, wheelchair, prostheses, adapted furniture, etc.);
- Medication, local treatment/medecine, does it exist on site and how is it prescribed and delivered;
- the paramedical professions that may be useful to you: physiotherapists, occupational therapists, etc.
You will also have to find out about the social protection and aid system, but before that, you will have to check the conditions for obtaining visas. Some countries, such as Australia or Canada, may require medical visits to obtain visas for extended stays.

2. The main challenges of expatriation

When you receive benefits (disabled adult allowance, disabled child education allowance, disability compensation benefit for children and/or adults), you should also be aware that these benefits are only conditional on the beneficiary's residence address in France. Payment will be suspended if you move to another country, except in three specific situations
- continuing your studies ;
- learning a foreign language ;
- professional training.

Concerning the education of a child with a disability, this is not granted automatically. However, if the child's disability allows it, schooling can be arranged in AEFE (Agence pour l'Enseignement Français à l'Etranger) schools, MLF (Mission Laïque Française) schools and in a number of approved schools.

As you can see, from one country to another, the care and support "offers" are different. In other words, what was 100% covered in your home country may not be covered at all in your dream destination.

3. Which country should I choose?

3.1. Getting around

Some people with disabilities are able to get around in a car as long as it is equipped and adapted to the driver. For example, if the disability is in the legs, the driver can accelerate by pulling a lever and then brake by pushing it. If he cannot use his arms, a foot steering wheel will be installed. There will be a box placed on the steering wheel or on the driver's chest that groups all the additional controls such as the lights, the indicators, the horn, etc. You will have to see if this type of vehicle exists in your destination country, but also how the driving licenses work there and the existence of license transfer agreements to avoid having to apply for a new one there.

Although it is not always easy to do "like everyone else" when the notion of disability follows you, several organizations have revised their services to offer ones adapted to everyone. Most airlines offer services that are adapted to your disability, some agencies prepare your stay according to your needs. Many means of transport have a "reserved" area, indeed, you will find that the places near the entrances of buses and coaches have adapted seats or a space for the wheelchair.

3.2. Some countries to consider

Little by little, countries are taking the measure of the urgency of the situation and are setting up support systems as well as special infrastructures to facilitate travel for all. Many countries have federal organizations and accessibility policies are managed by the regions (states, provinces, territories...); within a country there can therefore be great disparities between regions and even cities. So there is only one solution to find out exactly what to expect: go to the country and test it out before deciding to settle down there.

Here is a list of some countries or cities where special efforts have been made:

In the UK: Newer buildings are wheelchair accessible, as are large hotels set in manor houses in the countryside. Manchester city center was redesigned in the late 1990s, with wide walking paths and lowered entrances to many stores, restaurants and bars.

Poland: The main access points to the city (airport and train stations) are adapted for people with reduced mobility.

Canada: The Canadian authorities have created an Accessibility Resource Center, which centralizes all the aid available for people with disabilities. The Center also reports on all the improvements; in terms of housing, the challenge is twofold: to create new housing, adapted to each disability / to rehabilitate existing housing, to make it accessible to people with disabilities.

Finland: The country has launched two types of new housing:
- "Supported housing": designed for people who need assistance to live independently. Assistance is tailored to the individual's needs.
- "Serviced housing": designed for people who need occasional help, but do not require hospital care.

USA: Certainly the most accessible country to all people with disabilities thanks to the actions of advocacy associations for many years.

Spain (Barcelona): Facilities are provided in 80% of metro stations and in 100% of the buses. Access to various sites, including the Sagrada Família, is prioritized or even free for people in wheelchairs. There is also the possibility of walking along La Rambla from end to end and moving around the Boqueria market; even the beach, with staff on hand, is accessible to people in wheelchairs.

Singapore: One of the best-designed cities in the world for people with disabilities:
- no steps at the entrance to most buildings
- many sidewalks are lowered
- some cabs are equipped to accommodate electric wheelchairs

Australia (Melbourne): One of the most disability-friendly cities in the world, with a well-developed public transportation system and a compact city center.

For children, special schools and classes have been developed in Belgium; Germany; Netherlands; Czech Republic; Hungary.

4. Disability and health insurance

4.1. Countries with a developed public health insurance system

Even though it may suffer from many criticisms, the social security system has the advantage of being inclusive and of covering medical expenses without distinction of disability. This will also be the case in many other countries, notably in the EU, without any particular installation restriction for European citizens. However, be aware that many countries operate with a strict distinction between public and private care (UK, Ireland, Spain, Portugal, Italy...). In these countries, public health care is free, but you will have to make sure that it is actually available in your city. There may be waiting lists or certain treatments may only be available in private practice and in this case, unlike in France, the fees are completely unrestricted.

Outside the EU, the situation is even more complicated. Countries such as Canada, Australia and New Zealand have very valid disability insurance policies, but they are generally limited to nationals and permanent residents. Some visas may even be denied on medical grounds.

4.2. Private insurance

Whether local or international, private insurances all have a common trait that may seem unimaginable to a French person: they exclude all costs that may be related to a medical condition that existed prior to subscription. To learn more about this, read our special file Expatriating with a health problem.

The consequence will be simple, medical expenses related to a handicap prior to the subscription will not be reimbursed unless the insurer has explicitly accepted this coverage after a health questionnaire.

For French and EU citizens, the solution may be to join the Caisse des Français de l'Etranger, which does not practice this type of exclusion within the framework of its public service health insurance delegation. However, it will only provide partial coverage, which can then be supplemented by an appropriate expatriate complementary insurance. Depending on the disability, solutions may exist, but they are studied on a case-by-case basis. Do not hesitate to read our CFE file to learn more.

These exclusions apply to all contracts taken out on an individual basis, but they may also apply to company contracts, whether they are international or local. If you are expatriated by your company and a member of your family is affected by a disability, this is an aspect to take into account and to anticipate as soon as possible with your HRD.