Facts
A., born in 1976, had a motorcycle accident on June 26, 2007 and suffered a polytrauma with multiple injuries to the left lower extremity and contusion of the left shoulder. In a decision dated June 17, 2013, Basler Insurance, as the responsible service provider, granted him, in addition to a disability pension and an integrity indemnity, further medical treatment, in particular regular medical check-ups and permanent support through outpatient physiotherapy.
In early 2017, Basler Insurance had the insured re-examined and subsequently adjusted the medical treatment by limiting the physiotherapy to three series of nine sessions per year and an osteopathic treatment, initially one to two times per week and subsequently a maximum of once per month.
The insured filed a complaint against this adjustment of the medical treatment benefits, which was partially upheld by the Federal Supreme Court.
Considerations
The Federal Supreme Court states that medical treatment benefits under Art. 21 para. 1 lit. c AFIA are to be qualified as permanent benefits. For their revocation or substantial adjustment, a ground for revision within the meaning of Art. 17 para. 2 ATSG is required, i.e., a significant change in the facts that is capable of sustainably influencing the existence and scope of the awarded medical treatment from the perspective of the integration objective (preservation of earning capacity).
In the present case, however, the lower instance did not…