Federal Social Court, 02.02.2012, Ref.: B 8 SO 9/10 R
Integration assistance for people with disabilities is a social welfare benefit whose law is standardised in the Twelfth Book of the German Social Code (SGB XII).
Under certain conditions, people with disabilities are entitled to integration assistance if they are not only temporarily mentally, emotionally or physically disabled or at risk of such a disability.
In accordance with the principles of social welfare law, integration assistance was designed as a subordinate benefit. This means that all benefits from all other service providers, such as health insurance funds or other insurance providers, must be exhausted before integration assistance benefits are utilised.
The following measures may be covered by integration assistance:
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- Integrative support for children who are not yet of school age
- School support measures for school-age children
- Support measures for training for other appropriate work
- Support measures for obtaining a suitable job (e.g. workshops for people with disabilities)
- Medical measures to prevent, eliminate or alleviate the disability
- Help with participation in community life (e.g. outpatient assisted living, residential centres for people with disabilities)
- So-called mobility aid
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In the above-mentioned case before the Federal Social Court, the parties disputed whether the Rhineland Regional Association, as the defendant, was obliged to pay mobility assistance in the amount of 7934.76 euros for the purchase and installation of a swivelling car seat.
Facts of the Case:
The plaintiff was blind, hard of hearing and partially paralysed
The plaintiff, born in 1984, was blind, hard of hearing and partially paralysed (degree of disability of 100; characteristics "G", "aG", "H", "RF" and "Bl"); she received home care benefits from the care insurance fund in accordance with care level III.
The plaintiff lived in the town of Hü, which belongs to the district of H, and worked in a workshop for disabled people (WfbM). The costs of the transport service for the journey between home and the sheltered workshop were borne by the defendant; for private journeys, a transport service for the disabled was set up at the expense of the district of H, which the claimant used (up to four journeys per month, each covering a distance of up to 35 km).
Plaintiff requested assumption of the costs for the installation of a swivelling car seat
At the beginning of March 2004, the plaintiff contacted the statutory health insurance fund (KK) responsible for her because of the conversion for the disabled of a new car she had already ordered and delivered at the end of April 2004 at a price of 29,815.19 euros, but also applied for the costs for the installation of a swivelling car seat to be covered in a letter submitted to the city of Hü, received by the district of H on 22 March 2004 and forwarded to the defendant on 26 March 2004.
At that time, in addition to the benefits from the social care insurance, the plaintiff received a blind person's allowance of 441.50 euros in accordance with the (North Rhine-Westphalian) law on assistance for the blind and deaf and a training allowance of 67 euros per month from the Federal Employment Agency (until 22 September 2004).
At the end of 2004, she was granted basic security benefits in old age and in the event of reduced earning capacity as well as assistance with care in accordance with the Federal Social Assistance Act (BSHG) with retroactive effect from 1 April 2004. At the end of April 2004, the claimant had a current account balance of 24,362.17 euros, a savings account balance of 86.48 euros, securities with a value of 3529.56 euros and 10,000 euros that she had received as a loan from her parents.
The plaintiff was also the owner of an (older) car, which she sold at the beginning of May 2004 at a price of 8,500 euros; at the same time, she commissioned a company to convert the new car at a price of 10,051.08 euros.
Both the health insurance company and the LVR refused to cover the conversion costs
After the health insurance fund had already refused to cover the costs of converting the car for the disabled, the defendant, Landschaftsverband Rheinland, also refused to pay the benefit because, in its opinion, the plaintiff had sufficient assets and had already covered her needs herself.
An appeal against this decision filed with the Social Court of Aachen was rejected in a judgement dated 8 August 2007, and the appeal filed with the Regional Social Court of North Rhine-Westphalia was rejected in a judgement dated 22 February 2010.
The plaintiff lodged an appeal against these decisions with the Federal Social Court and applied for the judgements of the LSG and the SG as well as the refusal of the defendant in the form of the objection notice to be set aside and for the defendant to be ordered to pay her 7934.76 euros.
Decision of the Federal Social Court
The Federal Social Court partially followed the plaintiff's opinion and ruled that the plaintiff's appeal was justified in the sense that the LSG judgement was set aside and the case was referred back to this court, as the proceedings had suffered from a procedural defect that had to be observed ex officio and the LSG's factual findings (Section 163 SGG) were not sufficient for a final decision.
The BSG referred the case back to the lower court due to a procedural defect
The procedural defect to be observed ex officio in the present case was that the City of Hü (or the health insurance fund) was not summoned to attend the hearing in accordance with Section 14 SGB IX.
According to § 75 para. 2 sentence 1 first alternative SGG, third parties are to be summoned if they are involved in the legal relationship in dispute in such a way that the decision can only be made uniformly against them.
In the present case, this is to be affirmed for the city of Hü, but possibly also for the health insurance fund; the Regional Social Court will have to examine this again.
Whether the claimant's entitlement was not already excluded due to her income and financial circumstances pursuant to § 28 para. 1 sentence 1 BSHG in conjunction with §§ 79 ff BSHG could not be assessed by the BSG on the basis of the factual findings of the LSG.
The lower court had to examine whether the plaintiff was dependent on the car and its conversion
According to § 28 para. 1 sentence 1 BSHG, assistance in special circumstances is (only) granted if the person seeking assistance cannot reasonably be expected to raise the funds from their income and assets in accordance with §§ 79 to 89 BSHG. The LSG therefore had to re-examine whether the claimant was dependent on a new car worth around EUR 30,000 and whether a used car would not have sufficed.
The question of whether the plaintiff fulfils the eligibility requirements of §§ 39, 40 para. 1 sentence 1 BSHG in conjunction with § 55 para. 2 no. 1 SGB IX and § 9 para. 2 no. 11 Eingliederungshilfe-VO on the merits can also not be assessed by the BSG according to the factual findings of the LSG and must therefore be redetermined by the LSG.
In particular, this also concerns the question of whether the plaintiff is generally dependent on a motor vehicle within the meaning of § 9 para. 2 no. 11 of the Integration Assistance Ordinance. This is primarily assessed according to the meaning and purpose of integration assistance, which is to eliminate or alleviate an existing disability or its consequences and to integrate the disabled person into society (§ 39 para. 3 BSHG).
Source: Federal Social Court
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