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  • Title: [Legal context of prioritization in rehabilitation].
    Author: Welti F.
    Journal: Rehabilitation (Stuttg); 2012 Apr; 51(2):89-95. PubMed ID: 22570155.
    Abstract:
    Participation benefits (rehabilitation) in Germany are granted on the basis of public social security law. Allocation and prioritization, hence, are to be seen in a legal context. As far as they belong to subsistence level requirements, participation benefits have to be granted unconditionally in case persons are needy. As all kinds of participation benefits also are part of social assistance law it can be assumed that they are part of subsistence. In light of individual basic freedoms, members of an obligatory system of social security have to be granted essential benefits in case of major contingencies. Basic equality rights demand objective reasons for making distinctions. Discrimination on the basis especially of religion, race, gender and disability is forbidden. This has to be taken into account also in prioritization by benefit usefulness. Substantial criteria for prioritization have to be stipulated by law. The divided system of rehabilitation in Germany impedes a systematic prioritization because benefits continue to be granted according to different criteria. The social code book 9--SGB IX--demands common guidelines for the rehabilitation administration bodies, but these guidelines are not concrete enough so far. It remains to be seen whether prioritization criteria can be extracted from the various benefit prerequisites. Prioritization is subject to narrow limits as far as persons are basically entitled to a benefit. This holds true also in case of rehab budgets such as those in statutory pension insurance. Anyhow, research needs to be done on whether these lead to prioritization in practice and which criteria would be relevant. A highly prioritizing impact is exercised by decisions about the available infrastructure of rehabilitation services and facilities, but there is neither a clear legal basis nor research on this subject. Finally, not only prioritization within rehabilitation has to be discussed but also prioritization between rehabilitation and acute medicine.
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