Kosten für Krankenbehandlung bei selbst beschaffter Krankenbehandlung der sozialen Entschädigung Erstattung

If you have procured necessary treatment for the consequences of your injury yourself and have incurred costs for this, you can receive a reimbursement.

Self-procured necessary treatment for the consequences of injury can be, for example, medical treatment or medication. You can receive reimbursement for this if you have covered the costs of the treatment yourself and

1. you had the consequences of your injury treated after the injury before you submitted an application for social compensation or the claim was recognized, or
2. the benefit could not be postponed or was wrongly refused.

The costs will only be reimbursed after your consequences of injury have been recognized.

Please note that your regional association (LVR or LWL) will decide whether and to what extent you receive support.

If necessary, you must provide evidence:

• Proof of the costs of the necessary treatment of the consequences of the injury procured by yourself
• Proof of the recognized consequences of the injury
• Proof of the damaging event, for example:
  • Evidence of the criminal proceedings (for example, police reports, court decisions, court judgments, witness statements)
  • Evidence of the vaccination
• Medical evidence of the consequences of the injury and the treatment history, for example
  • Hospital report
  • therapy report
  • Medical certificates

• You have suffered a health impairment in Germany or, under certain conditions, abroad (§ 15 SGB XIV) due to a damaging event.
• The health impairment has resulted in physical, mental, psychological or sensory impairments.
• You have incurred costs for medical treatment that you paid for yourself before you submitted an application for social compensation or before your claim was recognized, or
• You have incurred costs for the recognized consequences of your injury, which you paid for yourself, and the benefit could not be postponed or was wrongly refused.

When you apply for social compensation benefits, the Landschaftsverband responsible for you (Landschaftsverband Rheinland or Landschaftsverband Westfalen Lippe) will check whether you are entitled to reimbursement of the costs of medical treatment you have obtained yourself. The regional association in whose district you are resident or habitually resident is responsible. You will receive a notification of the decision and, if applicable, information on the benefits granted as well as other necessary evidence.

You can apply for social compensation benefits online or in writing.

• If necessary, you can make an appointment with your contact person at the Landschaftsverband Rheinland (Social Compensation Department Tel: +49 221 809 5401; e-mail: SER@lvr.de) or Landschaftsverband Westfalen Lippe (Office for Social Compensation Law Tel: +49 251 591 01; e-mail: SER@lwl.org).
• We will then discuss with you whether you are entitled to social compensation benefits and what support services can be offered.
• If necessary, the case management can discuss the further procedure and possible benefit claims with you, which go beyond the general duty to provide information and advice.
• If you are entitled to social compensation benefits, your contact person will discuss the next steps with you.
• The contact person will provide you with the relevant documents. If necessary, complete the documents, enclose the required evidence or supporting documents and send the documents back to the Landschaftsverband responsible for your application.
• Your entitlement will be determined ex officio on the basis of the documents. The authority will inform you of the result in the form of a decision, which is usually sent to you by letter.
• If entitlements to benefits have been determined, you will receive an approval notice. If no entitlements are determined, you will receive a rejection notice.
• However, you also have the option of submitting the application online. To do this, you must complete the online application and upload the necessary supporting documents.
• The eligible costs and approved cash benefits will be transferred to the account you have specified.

Appeal: An appeal can be lodged against a decision within one month of its notification. Further information on the procedure and the competent authority to which you can lodge an appeal can be found in the notification of your application. The appeal can be submitted in writing and electronically.

• Costs of medical treatment for self-procured medical treatment for social compensation Reimbursement
• Benefit conditions:
  • One or more recognized consequences of injury
  • Necessary treatment due to the consequences of the injury has taken place and costs have been incurred
• Costs: the application is free of charge
• Discretionary benefit, no legal entitlement
• Responsible in NRW: Landschaftsverband Rheinland (LVR) and Landschaftsverband Westfalen-Lippe (LWL)