Hartz IV No money without proof of treatment

For their medical care, Hartz IV recipients must give priority to their health insurance. Additional funds from the Jobcenter come only at "inevitable" costs into consideration, if the health insurance does not take them, as the Bavarian State Social Court (LSG) in Munich in a Tuesday, 20 June 2017, announced an emergency decision (Az .: L 7 AS 167/17 B ER). Without evidence of the efficacy of a treatment, this will be ruled out.

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The applicant suffers from dysregulations of the masticatory muscles and the temporomandibular joint. This so-called cranio-mandibular dysfunction (CMD) is considered a collective term for various complaints. In this case, for example, misaligned teeth over the lower jaw and spinal column "descending" can lead to discomfort right down to the legs. Conversely, a malformation of the pelvis "ascending" may be the cause of discomfort in the mouth.

In view of these multiple possible causes and complaints, the diagnosis is difficult, and for many offered healing methods, the effectiveness is not proven.

In the case of the dispute, various complaints are found which the patient attributes to a CMD. Due to her illness she has additional costs, for example for trips to more distant medical specialists or for medicines not paid by the statutory health insurance. For this purpose, it claimed a so-called Hartz IV additional needs.

As the LSG Munich emphasizes, the health insurance companies are also primarily responsible for the health insurance of Hartz IV recipients. "In order not to open the door to any desired medicine financed with tax revenue", a cost assumption by the job center would only be considered if the costs are "unavoidable, that is absolutely necessary". This is only possible if a treatment is medically indicated, which in turn requires a connection between the disease and the need for treatment.

However, this is lacking here, according to the LSG in its resolution of 9 March 2017, which has already been published in writing. It is completely unclear whether the treatments claimed or desired by the patient promise to improve. The certificates suggested rather a pain therapy, but probably would be taken over by the health insurance.