Judgment Medical foot treatment exceptionally by the podiatrist

LSG Potsdam sees "system deficiency" when no doctor performs treatment
The statutory health insurance companies must cover the costs of a medical pedicure, if they can not appoint a doctor for an actual medical treatment, who performs this. This was decided by the Landessozialgericht (LSG) Berlin-Brandenburg in Potsdam in a judgment published on Monday, 6 November 2017 (Ref .: L 9 KR 299/16). Specifically, it is about a special treatment for ingrown toenails.

Foot care for protection and healing. Image: VadimGuzhva - fotolia

In the case of the plaintiff, the nail on the left big toe repeatedly grew chronically in the toe. This can be treated with a nail correction clasp. This is placed under the nail edge so that the nail grows normally. Until then, the clasp must be checked and adjusted regularly.

This is actually a medical treatment. However, the applicant could not find a doctor to carry out this treatment. Even her health insurance could not call her a doctor for this. The woman decided therefore for a treatment with a medical Fußpflegerin (Podologin).

At the cost of a total of about 300 euros, the health insurance participated only in terms of material costs with 100 €. This is not possible with the treatment. With the exception of the diabetic foot, medical foot care services are excluded from the benefits catalog of the statutory health insurance.

The LSG Potsdam agreed to this in principle, but still gave the patient right. Because if it concerns a medical treatment, there must also be doctors who perform this. The health insurance company, however, could not name a doctor for this.

This was rated by the Potsdam judges as "a system shortage". This allowed "exceptionally the use of a non-medical service provider", here the podiatrist.

There is no doubt about their qualification. Because the job title podiatrist or podiatrist may lead only who has completed a strictly prescribed training and a state examination. The training program also includes nail clip treatment.

Against this now written decision of October 11, 2017, the LSG was due to fundamental importance, the revision of the Federal Social Court (BSG) in Kassel. mwo