Decision on the Assumption of Costs for Home Care Services for a Child with Congenital Defects

Facts

V., born on February 26, 2007, suffers from a medulloblastoma, a brain stem-adjacent tumor, which is classified as a congenital defect. The IV-Stelle Schwyz (IV Office Schwyz) covered the costs for medical measures to treat the congenital defect, approved a helplessness allowance, and a supplementary allowance for intensive care. However, it rejected the assumption of costs for home care services.

Considerations

The Federal Supreme Court confirms the case law that only measures carried out by a physician or by medical professionals on the physician's orders are considered medical measures within the meaning of the Invalidity Insurance Act (IVG). Measures that can be carried out by persons without medical training, even if they are instructed and supervised, do not fall under the term of medical measures.

In the case of congenital defects, the IV is obliged to cover both the actual therapeutic treatment and the non-therapeutic care and support. However, the distinction between these two service areas must be observed. The home care services requested in the present case do not constitute medical measures…