Insurance requires retirees not to smoke

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Court: No extra oxygen for smoking retirees

In a recent ruling, the Heilbronn Social Court denied a sick smoker a mobile device for the supply of oxygen. His health insurance company and the judges believe that he must stop smoking beforehand.

Smoker for over 50 years According to his own information, the 66-year-old retiree Walter S. from Steinheim an der Murr in the Ludwigsburg district has been a smoker since he was 14. In the past decades, he has consumed up to two packs of cigarettes a day; today there are ten self-rolled ones a day. In 1995, a piece of the lungs had to be removed because of an apparently benign tumor, and about four years ago the medical diagnosis was: "chronic obstructive pulmonary disease", better known as smoking lung.

Apparatus for home Because of his shortness of breath, Mr. S.'s health insurance fund financed him an apparatus that can compensate for the insufficient concentration in his blood by adding oxygen. The pensioner used this so-called oxygen concentrator irregularly at best, among other things, because it was banished to his own four walls. Now the 66-year-old also wanted a mobile system that would help him get more air, for example when walking. His insurance, the commercial health insurance company (KKH), refused to assume the costs after examination by the medical service.

Monthly therapy costs of 180 euros According to the "Schwäbisches Tagblatt", the reason given was: "Anyone who lowers the oxygen content in the blood from smoking cannot expect us to finance the lifting with a device." S. defended himself against this with a lawsuit the Heilbronn Social Court and also submitted an urgent request. At least until the final judgment, he wanted to have the portable oxygen supply available to ward off possible shortness of breath. According to the "Stuttgarter Nachrichten", the legal dispute involved therapy costs of 180 euros per month.

Smoking not compatible with the danger of explosion of the device The Heilbronn judges had decided before the turn of the year (file number S 9 KR 4030/13 ER) that the sick smoker was not entitled to a mobile usable liquid oxygen system as long as he did not stop smoking. The decision, which has now become final, emphasizes that the pensioner can await the outcome of the pending lawsuit, since the insufficient oxygen concentration can be "adequately treated" with the existing apparatus. In addition, it was found that the device requested was not suitable as long as S. did not stop smoking, because there was "risk of explosion if fire was used at the same time." A 52-year-old from Filderstadt, who was dependent on a ventilator, only had a few weeks ago injured himself when lighting a cigarette, since the open flame led to a deflagration. The man had to be taken to a special clinic with severe burns.

Unclear when the main proceedings will take place At the moment it is still unclear when the main action will be taken on the lawsuit (S 15 KR 4254/13), said Joachim von Berg, spokesman for the social court. The health insurance company has not yet responded and a doctor may have to be heard or an expert opinion obtained before an oral hearing - “or both”. (ad)

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