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Entitlement to an exoskeleton as an assistive device (Social Court decision)

A student who has been paraplegic since an accident at the age of 15 is entitled to a motor-driven exoskeleton to enable him to move upright again. The health insurance company was not allowed to refuse the aid because of the plaintiff's height (1.93m) or bone density - according to the Aachen Social Court.

That's what it's about

The plaintiff is a 23-year-old student. He had suffered a fracture of the spine in a mountain bike accident in January 2015, resulting in paraplegia from the fourth thoracic vertebra downwards.

He applied to the Aachen Social Court for a supply of a motor-driven, computer-controlled exoskeleton. This enables its user to walk naturally by means of externally applied orthoses from the ankle to the hip, which are moved by small changes in the body's center of gravity.

The statutory health insurance had previously rejected the benefit. With a height of 1.93 m, the plaintiff was too tall for the use of the exoskeleton. In addition, the plaintiff suffers from osteoporosis; however, a healthy bone density is a prerequisite for the use of the aid.

This is what the court says

The social court did not follow this and awarded the plaintiff the supply with the exoskeleton. The court held that the aid fulfills a basic need, as it enables the plaintiff to stand and walk. Based on a corresponding expert opinion, the court also considered the provision with the exoskeleton to be suitable and necessary.

It was not only the overall body size that had to be taken into account, but in particular the leg length. Fit problems did not occur during the exoskeleton trials, which were shown as video documentation at the oral hearing. Despite a reduced bone density value on the plaintiff's left femoral neck, he had a healthy bone density overall.

The mineral content of people who regularly sit in wheelchairs is generally reduced in the lower extremities due to the lack of weight-bearing. Therefore, the WHOP criteria should not be applied. In addition, the value measured for the plaintiff was significantly higher than the value considered sufficient according to the user manual.

Tom Illauer

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