Technical Aids to Compensate for Disability: Legal Framework and Need for Reform
The supply with rehabilitative technical aids in Germany is regulated in a complex way. Technical aids can be granted by different social security agencies for purposes of medical treatment, for long term care, for compensation of disabilities in the context of medical rehabilitation, for workplace participation and for participation in society.
At present, the most relevant carriers of technical aids for compensation of disabilities are the statutory health insurance funds. In practice and jurisprudence there are several problems. A distinction is made between direct and indirect compensation of disability, and the obligation to provide cover is restricted to the compensation of basic needs. Both are questionable in the light of the German disability law and the ICF.
The needs assessment cannot be carried out by physicians alone but has to be multifactorial. Fixed prices for technical aids are not always sufficient. In that case they are unlawful according to the latest jurisprudence of the Federal Social Court. The technical aids register of the statutory health insurance funds cannot restrict the rights of the insured. Further problems of legislation and practice are the responsibility for the supply with technical aids in homes for elderly or disabled persons and the tendering procedures of the statutory health insurance funds. A new codification is needed to simplify and clarify the law.
