A Lottner1, H Iro2, A Schützenberger3, U Hoppe4. 1. Cochlear-Implant-Centrum Erlangen, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland. anna.lottner@uk-erlangen.de. 2. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland. 3. Abteilung für Phoniatrie und Pädaudiologie, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland. 4. Cochlear-Implant-Centrum Erlangen, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland.
Abstract
BACKGROUND: Since the indication for receiving a cochlear implant (CI) has widened (single-sided deafness [SSD], electric acoustic stimulation [EAS], bilateral CI, CI for long-term deafness), more and more patients come into consideration for such a treatment. Hence, disputes increasingly arise between patients and their insurance companies concerning the question of whether surgery and follow-up treatment have to be paid for by statutory health insurance. OBJECTIVE: This work provides an overview of judgments rendered by the German social courts. We investigated whether and in which cases it is advisable for a patient to go to court, and how long the proceedings may take. MATERIALS AND METHODS: We looked for judgments in the two biggest commercial legal databases and in the database of the German social courts, using combinations of the search parameters "Cochlear," "Cochlea," "Implant," and "Implantat." Three verdicts were attained by directly contacting the court; another one was mentioned in an article. The reviewed judgements were issued between 2003 and 2017. RESULTS: A total of 12 judgments were found. The patients won in all but one of the main proceedings. The case that was lost concerned exceptional circumstances. One patient didn't get the desired interim measure, but won in the main proceedings. The proceedings took between 1 year and 8 months, and 9 years and 5 months. CONCLUSION: Despite the amount of time the patient has to invest, taking legal action is worthwhile. The proceedings at the social courts are generally exempt from charges. In most cases, the statutory health insurance is ordered to pay for a CI.
BACKGROUND: Since the indication for receiving a cochlear implant (CI) has widened (single-sided deafness [SSD], electric acoustic stimulation [EAS], bilateral CI, CI for long-term deafness), more and more patients come into consideration for such a treatment. Hence, disputes increasingly arise between patients and their insurance companies concerning the question of whether surgery and follow-up treatment have to be paid for by statutory health insurance. OBJECTIVE: This work provides an overview of judgments rendered by the German social courts. We investigated whether and in which cases it is advisable for a patient to go to court, and how long the proceedings may take. MATERIALS AND METHODS: We looked for judgments in the two biggest commercial legal databases and in the database of the German social courts, using combinations of the search parameters "Cochlear," "Cochlea," "Implant," and "Implantat." Three verdicts were attained by directly contacting the court; another one was mentioned in an article. The reviewed judgements were issued between 2003 and 2017. RESULTS: A total of 12 judgments were found. The patients won in all but one of the main proceedings. The case that was lost concerned exceptional circumstances. One patient didn't get the desired interim measure, but won in the main proceedings. The proceedings took between 1 year and 8 months, and 9 years and 5 months. CONCLUSION: Despite the amount of time the patient has to invest, taking legal action is worthwhile. The proceedings at the social courts are generally exempt from charges. In most cases, the statutory health insurance is ordered to pay for a CI.
Entities:
Keywords:
Deafness; Hearing; Judgment; Social law; Surgery
Authors: S Arndt; R Laszig; A Aschendorff; R Beck; C Schild; F Hassepass; G Ihorst; S Kroeger; P Kirchem; T Wesarg Journal: HNO Date: 2011-05 Impact factor: 1.284