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Unstoppable Wheelchair Users? – DAK Refuses to Cover the Cost of a Wheelchair Brake RepairLife keeps producing stories. Some are so absurd that you could hardly make them up. This is one of them. 
A young woman is dependent on a wheelchair due to a hereditary disease. And not just any wheelchair, but a functioning one. One of the defining characteristics of a functioning wheelchair is usually that its brakes work. But as is common with technical equipment, sooner or later something breaks. In this case, it was the brake cable. After years of use, it had snapped. The attentive reader may now be thinking: A brake cable? You can buy one at a hardware store for a few euros. Install it. Done. Unfortunately, the wheelchair manufacturer had other ideas. A brake cable of the type used on bicycles turned out to be unsuitable—the material is too soft. The attempt to repair the brake quickly and inexpensively in this way failed. The replacement part snapped again almost immediately. A steel cable from the hardware store produced the same result. So the usual journey through the German healthcare system began. The first stop was the family doctor. There, one had the privilege of waiting 45 minutes for a prescription to be issued. The prescription was then taken to the medical supply store assigned by DAK. There it turned out that the wheelchair manufacturer “Sorg” was not among the brands they carried. Wheelchairs equipped with brake cables also seemed to fall into the category of exotic custom-made products. In any case, finding the correct replacement part proved correspondingly difficult. Rather than waiting for someone to eventually locate the correct part number and possibly even place an order, the prescription was retrieved and the original supplier of the wheelchair was contacted instead: a medical supply store in Dresden. Yes, Dresden is not exactly around the corner. However, this medical supply store had achieved something over the years that apparently cannot be taken for granted in healthcare: reliable service. That is precisely why it came as a surprise when DAK decided a few years ago to terminate its business relationship with this supplier. The wheelchair user was asked to find another provider. Preferably one nearby. Whether that provider actually understands the assistive device seems to have been of secondary importance. The medical supply store in Dresden promptly sent a new brake cable. The installation was carried out by the wheelchair user's father. Neither an engineering degree nor certification by the European Space Agency was required for the task. The prescription and invoice were then submitted to DAK. The invoice amount: €71.88. One might assume that repairing a wheelchair brake would be considered a necessary repair of a medical assistive device. But that would underestimate the creativity of German health insurance providers when it comes to interpreting procedural regulations. DAK rejected reimbursement of the costs. Reason: The “application”—meaning the prescription—had not been submitted before the measure was carried out. In the original, it reads as follows: “Reimbursement of costs is only possible under the statutory provisions if the choice of reimbursement was made before the insured service (in this case: the assistive device) was utilized.One has to give the authors credit: they managed to use a remarkable number of lines to communicate that they do not wish to pay €71.88. The fact that a wheelchair brake exists to prevent the wheelchair from rolling away apparently played no role in the decision. Nor did the fact that this can be rather important when transferring to a toilet, for example, or when getting in and out of a car. Apparently, the more important question was whether a piece of paper (the “application”) had reached the correct desk at the correct time. Once again, the case illustrates the priorities of a system that regularly emphasizes that people are at its center. In practice, however, that center often seems to be located wherever forms, deadlines, and jurisdictional responsibilities happen to intersect. An objection was, of course, filed. When a decision will be made remains unclear. Experience suggests that the processing time will be considerably longer than the actual repair of the brake. Possibly only a few months. In addition, there are the personnel costs of the employees who now have the opportunity to deal with the matter as part of the appeals process. It would hardly be surprising if their working time ultimately costs more than the brake cable itself. But considerations of economic efficiency should, of course, play no role in a matter of such fundamental importance. If the objection is also rejected, the only remaining option will be legal action before the Social Court. At that point, a court may have to address one of the great existential questions of the German welfare state: Who is responsible for paying €71.88 for the repair of a wheelchair brake? Addendum: Online submission of the objection is not legally validThe objection was submitted via the DAK website contact form, including customer number, as a signed PDF. The following day, DAK sent an email containing the following message:“Thank you for your message.The objection was printed, signed, scanned, and uploaded as a PDF via the DAK web form – and still it is considered an “email” that is not legally valid for formal reasons. In other words, DAK’s own contact form is, from DAK’s perspective, not legally valid. The proposed solution is to print exactly this document again, then send it by post back into the analog workflow so that it can be scanned again at DAK’s mail center and then processed digitally. If that is not progress. Alternatively, there is the De-Mail procedure, a digital solution that apparently convinces mainly by the fact that it only works if one has previously spent sufficient time dealing with its lack of adoption. Fortunate is anyone who still owns a fax machine – because faxes are legally valid. The objection was sent again by fax. Twice in a row, so that no one can claim it did not arrive. Author: AI-Translation - АИИ | |
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