46 URII 22/06•Advice assistance for challenging a care-insurance classification
46 URII 22/06Tribunal de première instance1 juin 2006Droit des assurances socialesRejeté
Extrait par Omnilex
The applicant appealed the Eschweiler District Court registrar's decision refusing advice assistance for challenging an adverse care-insurance decision concerning care-level classification. The court dismissed the appeal. It held that retaining a lawyer through advice assistance was unnecessary because the applicant could reasonably approach the care fund directly for information about the legal basis and reasons for the refusal and the prospects of an objection. No costs decision was necessary.
BerHG § 1 Abs. 1 Nr. 2; advice assistance for challenging a care-insurance decision on care-level classification. Obtaining a lawyer by way of advice assistance is not necessary where the applicant can reasonably seek advice directly from the care fund. This includes asking the fund about the legal basis and reasons for its adverse decision and the prospects of an objection. The possibility that the decision concerns an important social-insurance benefit does not, by itself, make representation by counsel necessary.
Entscheidungsdatum: 2006-06-01
Aktenzeichen: 46 URII 22/06
ECLI: ECLI:DE:AGAC2:2006:0601.46URII22.06.00
Dokumenttyp: Beschluss
Spruchkörper: Abteilung 46
Normen: BerHG § 1 Abs. 1 Nr. 2; VwVfG § 25; SGB XI 7 Abs. 2
Auch bei ablehnenden Bescheiden der Pflegeversicherung wegen der Einstufung in eine Pflegestufe ist die Einschaltung eines Rechtsanwaltes im Wege der Beratungshilfe nicht notwendig, weil es für den Antragsteller grundsätzlich zumutbar ist, die Pflegekasse aufzusuchen und sich dort über die Rechtsgrundlagen, die Gründe der ablehnenden Entscheidung und die Erfolgsaussichten eines Widerspruchs beraten zu lassen
Die Beschwerde vom 12.05.2006 gegen den Beschluss der Rechtspflegerin des Amtsgerichts Eschweiler vom 27.03.2006 wird zurück gewiesen.
Eine Kostenentscheidung ist nicht veranlasst.
Whether obtaining a lawyer through advice assistance was necessary to challenge the care insurer's refusal to assign the requested care level.
A lawyer was not necessary; the applicant could reasonably seek information and advice directly from the care insurer.
The applicant could visit the care fund and ask about the legal basis and reasons for the adverse decision and the prospects of an objection.
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