Erstattung der Kosten für selbst beschaffte Krankenbehandlung von Schädigungsfolgen beantragen

Under certain conditions, injured parties can receive reimbursement of the costs of medical treatment for the consequences of an injury that they have obtained themselves. You can find out more here

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 social compensation provider 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.

The application is free of charge.

When you apply for social compensation benefits, the social compensation law institution will check whether you are entitled to reimbursement of the costs of medical treatment you have obtained yourself. 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 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 required 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.

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.

There is no deadline.

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

Appeal: An appeal can be lodged against a decision within one month of its notification. Further information regarding 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: competent body, usually the pension offices or state offices for social affairs

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: