BEG - FAQ Medical treatment
- My father is 78 years old. Way back in 1969 his chronical depressive state and gastritis were recognised to have been due to persecution with the result that his claims for health treat-ment were also recognised.
Up to 3 years ago he still regularly took a cure. In the last year but one he fell down and had the misfortune to suffer a femoral neck fracture and since that time could no longer stand up on his own two legs properly. Moreover, he is sometimes really depressive. I must help him to wash the laundry, clean the apartment, cook and go shopping for him. Have my fa-ther or I any claim to nursing care money? - All her life long my mother has suffered depressions as a result of her fate due to persecu-tion and draws a pension for ill health as a result of this.
After the death of my father her state of health became dramatically worse. She can no longer live alone and without care and attention. She is no longer in a position to look after herself. She hardly ever gets out of her bed, ignores food, clothing, personal hygiene and had already tried to commit suicide once. Without us - my entire family - encouraging my mother and making her do the normal things in daily life, she would do nothing for herself. Can we demand recompense for this? - Due to her many years of persecution my mother was granted medical treatment for perse-cution trauma, anxiety psychosis and a spinal column complaint.Unfortunately, she died in May. The compensation authorities had consented to take over the costs for a three week cure in Tiberias in spring.
a) Can I as heir be reimbursed with the treatment costs awarded before the death of my mother for the spinal column complaint?
b) Can I take this cure instead of my mother? - I have claim to health treatment due to a "spinal column complaint" which in the sense of restricted permanent deterioration has been recognised with a diminution in the ability to earn a living of 15%. My own medical practitioner has now prescribed 10 x physiotherapy treatment due to my continuous backache.
Can I demand reimbursement of the costs? - I am an NS persecutee living in Israel. In my case "the cardiac decompensation defect with joint rheumatism" has been recognised in my case as a disorder due to persecution with the result that my claim for health treatment was recognised.
Last year I was operated on in Houston, Texas, USA, for this disorder. The compensation authorities refused to take over these costs because I did not get their approval before the operation. Is this correct?
1. My father is 78 years old. Way back in 1969 his chronical depressive state and gastritis were recognised to have been due to persecution with the result that his claims for health treat-ment were also recognised.
Up to 3 years ago he still regularly took a cure. In the last year but one he fell down and had the misfortune to suffer a femoral neck fracture and since that time could no longer stand up on his own two legs properly. Moreover, he is sometimes really depressive. I must help him to wash the laundry, clean the apartment, cook and go shopping for him. Have my fa-ther or I any claim to nursing care money?
No provision is made for lump sum nursing money under the Federal German Indemnification Act [BEG]. However, upon application the costs for nursing services will be reimbursed should such nursing services for the health treatment selected be deemed necessary due to suffer-ing that has been recognised to be the result of persecution. However, these conditions are not fulfilled in the described case to point.
Firstly this is a matter of activities which you have to carry out for your father to help him keep house. Nevertheless, these activities do not fall under the term nursing services, but are to be understand under these services is assistance given for personal hygiene, when tak-ing a bath, going to the toilet and climbing stairs, etc., by way of examples.
Secondly, the need to provide help to keep house as a result of suffering persecution is already taken into consideration when a pension is granted and the amount to be paid is set for the dam-age to health pension. The degree of incapacitation as a result of persecution is namely the main criteria to determine the amount of pension paid. This means to say that such assistance and ser-vices become necessary as a result of his suffering due to persecution has become worse and he can make application for an increase to the health damage pension (deterioration application).
In addition some aspects are reflected here that indicate that the help he needs is not only associ-ated with the recognised suffering due to persecution but as a result of falling down. However, in individual cases this has to be clarified by a medical appraisal.
2. All her life long my mother has suffered depressions as a result of her fate due to persecu-tion and draws a pension for ill health as a result of this.
After the death of my father her state of health became dramatically worse. She can no longer live alone and without care and attention. She is no longer in a position to look after herself. She hardly ever gets out of her bed, ignores food, clothing, personal hygiene and had already tried to commit suicide once. Without us - my entire family - encouraging my mother and making her do the normal things in daily life, she would do nothing for herself. Can we demand recompense for this?
According to the described facts of the matter, a claim for reimbursement of nursing costs is to be considered (apart from making a deterioration application) in so far as the condition of your mother is due to suffering caused by persecution. The reason for this is the necessity to provide help and assistance at all times has the same ranking as permanent help and assistance according to the legislation. Although your mother is physically still in a position to look after herself but fails to do so due to her psychic condition this can lead to a claim for nursing costs.But however should the need for nursing be given to the same extent as a result of old age or ill health not due to persecution there is no claim given for reimbursement of nursing costs.By the way as a matter of principle it does not matter whether the nursing services are provided by a professional nurse, trained nurse or member of the family. This only has an influence on the level of the maximum reimbursable hourly rates. In the case of nursing by members of the family 50% of the costs for a professional nurse are accordingly to be considered as appropriate for reimburse-ment.
3. Due to her many years of persecution my mother was granted medical treatment for perse-cution trauma, anxiety psychosis and a spinal column complaint.Unfortunately, she died in May. The compensation authorities had consented to take over the costs for a three week cure in Tiberias in spring.
a) Can I as heir be reimbursed with the treatment costs awarded before the death of my mother for the spinal column complaint?
b) Can I take this cure instead of my mother?
The costs for the treatment of your mother can be made valid by you and will be reimbursed to you as heir for the medical treatment in so far this treatment would have been necessary due to recog-nised suffering caused by persecution. This claim for reimbursement of treatment costs is namely freely hereditary even before this is determined by the compensation authorities.
However, not hereditary is the claim for health treatment as such. As in the case of the claim for pension this is likewise a very personal matter and can be neither inherited nor trans-ferred. As a consequence you have no claim for approval of a health cure instead of your mother.
This is also true in view of the assurance given to your mother to bear the costs for a cure. As a specific method of treatment it was approved solely for your mother and her personal needs. The assurance given to your mother to bear the costs is no longer applicable due to the death of your mother.
4. I have claim to health treatment due to a "spinal column complaint" which in the sense of restricted permanent deterioration has been recognised with a diminution in the ability to earn a living of 15%. My own medical practitioner has now prescribed 10 x physiotherapy treatment due to my continuous backache.
Can I demand reimbursement of the costs?
Your claim for health treatment is not restricted because your spinal column complaint has been recognised in the sense of "restricted permanent deterioration”. Restricted deterioration means that but only part of the given complaint is due to persecution; by the way only part of the given illness can be traced back to persecution and the complaint is also due to some extent to other causes such as, disposition, wear or as a result of accidents after the war.
Condition for any unrestricted claim to health treatment in such cases is only that health treatment is deemed necessary and that the damage caused by persecution (the restrictable deterioration) has no influence on the condition that calls for health treatment.
By the way a claim is only given for taking over treatment costs for spinal column complaints or backache, respectively, in so far as this is a matter of medically necessary and reasonable meas-ures which also must be recognised scientifically. Moreover the physiotherapy treatment must be also be prescribed by a medical practitioner.
5. I am an NS persecutee living in Israel. In my case "the cardiac decompensation defect with joint rheumatism" has been recognised in my case as a disorder due to persecution with the result that my claim for health treatment was recognised.
Last year I was operated on in Houston, Texas, USA, for this disorder. The compensation authorities refused to take over these costs because I did not get their approval before the operation. Is this correct?
As a matter of principle those people entitled to health treatment, who live outside the Federal Re-public of Germany, must take health treatment in the country in which they are resident or have their usual abode.
However, by way of an exception health treatment can be taken in the Federal Republic of Ger-many but with the previous approval of the responsible compensation authorities. Nev-ertheless, this approval can only be granted should health treatment be possible in Ger-many and no equivalent treatment can be provided, for example, in the country of residence or where the persecuted person is staying. In this case the necessary treatment can only be given in Germany. This is only providing that the travel costs incurred as a result of health treatment in Germany are in a reasonable relationship to the other health treatment costs or the entitled person will be committed to pay own travel costs incurred outside the area of validity of the law.
Reimbursement can be refused for just this reason should you not have obtained previous approval in so far as it was not a matter of emergency medical treatment, calling for an immediate operation for example, and this was necessary as a result of an emergency situation while staying in the USA.
The following is valid for all other cases and circumstances:
No claim is given for reimbursement of costs even when this is a matter of a special operation (treatment), by recognised doctors and this also applies as far as the surgeons in the USA are con-cerned or the same operation is carried out in your home country Israel. Over and above this ap-proval of the compensation authorities can only be considered as a matter of principle for treatment in Germany.
In the case of special circumstances, the costs can only be taken over to a restricted extent (to about the amount of fictive costs for an operation in your country of residence Israel). However, this is a question of the particular individual case to point and there is no legal claim given for this in any case.
As far as this is concerned it is to be emphasised once again that hospitalisation in a clinic must be immediately reported to the compensation authorities.