Applying for medical treatment for social compensation for injured parties as a result of recognized consequences of injury

Injured parties with recognized consequences of injury can receive health treatment benefits. You can find out more here.

You can receive health treatment benefits (curative treatment) for recognized consequences of injury.

The following benefits, among others, are eligible:

• Medical treatment including psychotherapy as medical and psychotherapeutic treatment
• Dental treatment
• Provision of dental prostheses including dental crowns and superstructures
• Provision of medicines, dressings, remedies and aids as well as digital health applications
• Home nursing care, non-clinical intensive care and home help
• Hospital treatment
• medical rehabilitation benefits and supplementary benefits.

The principles of service provision under statutory health insurance law apply.

Coordination takes place with the relevant competent authority, which will inform you which other benefits you may be eligible for.

Your social compensation provider will decide whether and to what extent you will receive support.

The Hessian Offices for Care and Social Affairs (HÄVS) in Darmstadt, Frankfurt am Main, Fulda, Gießen, Kassel and Wiesbaden are responsible for this in the state of Hesse.

You can find the HAVS responsible for your place of residence under the following link:

If necessary, you must provide evidence:

• Medical evidence of the consequences of the injury and treatment history, for example:
  • Hospital report
  • therapy report
  • Medical certificates

• As the injured party, you have suffered a health impairment in Germany or, under certain circumstances, abroad (§ 15 SGB XIV) as a result of a damaging event.
• The health impairment has resulted in physical, psychological, mental or sensory impairments which are recognized as already recognized as consequences of damage with a degree of damage.
• You currently have a need for medical treatment with regard to these recognized consequences of injury.

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.

When you apply for social compensation benefits, the social compensation law institution will check whether you are entitled to medical treatment for injured parties as a result of recognized consequences of injury. The authority examines your application and decides on the granting of the benefit and its scope. You will receive a notification of the decision and, if applicable, information about 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 pension authority or at your responsible office.
• They 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 team can discuss the further procedure and possible entitlements to benefits with you that 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 necessary evidence or supporting documents and send the documents back to your contact person.
• Your claims 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.

There is no deadline.

The prerequisite for processing is that all mandatory information has been provided. The processing time varies depending on the competent authority and the individual case. It is not possible to give an exact time and it depends on the complexity of the individual case.

The application is free of charge.

Further information can be found on the website of your country or your competent authority.