Diabetes and severe disabilitySevere disability due to diabetes with a GdB of 50 can be the consequence of diabetes.
What is behind the GdB (degree of disability) of 50, please read here.
Diabetes is a metabolic disease. The healthy pancreas regulates sugar metabolism in the human body through endogenous insulin. Due to poor diet, lack of exercise, smoking, alcohol and also due to genetic defects, it can come to disorders in the pancreas. Up to the total loss. Then third-party insulin must be injected for sugar regulation. This can also permanently damage other organs, such as the kidneys, the eyes and the cardiovascular system. The consequence of this illness is then also the determination of a disability or a severe disability. What is a severe disability, you can read here.
The regional social court Saxonia-Anhalt has itself in a judgement from 17.05.2017, L 7 SB 2/16, dealt with the ies of severe disability due to diabetes mellitus. It is a case-by-case decision.
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The Regional Social Court rejected the requested GdB of 50.
Severe disability due to diabetes: what was it about??
The plaintiff, who was born in 1997, requested a determination of a disability with a GdB of 50, the mark G and B.
He stated that he suffers from diabetes mellitus type 1 and submitted a report of findings from a clinic for pediatric and adolescent medicine. Since 2013 he suffers from diabetes type 1.
Initially he had "syringe fear". However, he overcame this in the course of time. He was well adjusted to diabetes in the clinic. He injects himself with insulin. In his spare time he does self-defense and gliding. He can consciously perceive hypoglycemia, unconsciousness and convulsions have not yet occurred. He submitted his blood glucose diary to the action proceedings. The defendant granted the plaintiff a GdB of 40. The plaintiff's mother filed an appeal against the decision. It wanted to have determined a GdB of 50. The plaintiff has severe impairments due to the illnesses. Had to give up his dream job as a pilot. Especially for young people the sugar values have to be measured several times during the night. Therefore the plaintiff is strongly impaired. The defendant rejected the objection. Left it with the determined GdB of 40. Thus no severe disability due to diabetes.
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The complaint at the Social Court Dessau-Roblau was unsuccessful. The plaintiff said he is required to measure blood glucose 6 to 12 times a day. As a result of his illness, his participation in social life was massively impaired. He had to cancel a class trip. He can no longer pursue his dream job as a pilot. The many blood sugar measurements alone are in themselves a massive restriction on his personal life. Then followed an enumeration by the sugar diary of the plaintiff Court-obtained findings reports did not establish any organ damage to the eyes and kidneys. Hypoglycemia could be prevented in time by the plaintiff. The plaintiff is well adjusted.
The court dismissed the claim. As reason it stated that the plaintiff reached the for a GdB required five to six times independent insulin injections daily. He also has to inject himself with the long-acting insulin twice a day. The therapy effort is very high.
But the plaintiff reaches a stable metabolic situation, so that emergency treatments and inpatient stays are not necessary. Participation in life is not so significantly restricted.
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The appeal by the plaintiff
The court of appeal again obtained reports of findings. The plaintiff suffers from diabetes mellitus type 1. The HbA1c value was 6.6%. His disease is a diabetes without complications. He/she can drive a car with a good attitude. The choice of occupation is restricted. Hypoglycemia is rare. Slightly pronounced at best. The plaintiff is currently training as a carpenter. Since 2016 he has had extreme sugar fluctuations. He has hypoglycemia every night. Therefore, the intervals for checking have become much shorter for him. New medical examiners' reports confirm the plaintiff's factual claims. The fluctuations that occurred are to be explained by the change from school to working life. Due to the change into the professional life there are changes in the physical strain, which require an adjustment to the therapy plan.
The blood measurements by the plaintiff are made by means of a sensor
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Severe disability due to diabetes: The decision of the LSG
The LSG Saxony-Anhalt dismissed the appeal. The established GdB of 40 is lawful. People are entitled to a disability if their physical function, mental ability or mental health is very likely to deviate from the typical condition for their age for more than 6 months and their participation in society is therefore impaired.
The assessment of the severity of the functional impairments is based on the GdS rate applicable on 01.01.The pension application is based on the German Ordinance on Medical Care (Versorgungsmedizin-Verordnung – VersMedV), which came into force in 2009. For the plaintiff this means that the GdS table of the part B of the regulation is to be taken as a basis. The GdS rates mentioned in the tables are reference points.
The plaintiff's condition concerns internal sectretion and metabolism, according to part B no. 15 ff. In 15.1 of Table Part B states, among other things:
"People suffering from diabetes, who carry out an insulin therapy with at least four insulin injections daily, whereby the insulin dose must be varied independently depending on the current blood sugar, the following meal and the physical strain, and who are seriously impaired in their way of life due to considerable cuts, suffer a pronounced participation impairment due to this therapy effort. The blood glucose self-measurements and insulin doses (or insulin doses via the insulin pump) must be documented. The GdS is 50.
Metabolic conditions that are exceptionally difficult to regulate can cause higher GdS values in each case."
In the supreme court case law of the Federal Social Court on the subject of diabetes and disability, the BSG in its ruling of 2.12.2010 ( B 9 SB09/R), the assessment of the individual GdB is based not only on the quality of the setting, but also in particular on the amount of therapy required, insofar as this has a detrimental effect on the disabled person's participation in life in society.
The following rule of thumb applies:
The GdB is to be set lower, if a balanced metabolic situation can be achieved with a lower therapy expenditure. If the therapy effort is higher or the therapy success decreases, the GdB is to be assessed higher.
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Basic requirements for a GdB of 50 for diabetes!
The determination of a GdB of 50 in diabetes mellitus type 1 requires the following:
– not only at least 4 insulin injections per day, – self-adjustment of the insulin dose, – the metabolic quality or other Auswrikungen of the illnesses, such as secondary diseases, must lead to a disease-related substantial Beitrachtigung in the Lebensfuhrung, so the BSG with judgement of 25.10.2012, B 9 SB 2/12 R, – the lifestyle impaired (part B no. 15. 1) means not only therapy-related, but also that, in addition to the actual therapy effort due to the necessary insulin injections and the dose adjustments, an additional evaluation is necessary to justify the GdB 50, – the handicapped person must prove generally serious cuts in the lifestyle due to the therapy effort to be considered in isolation, – for the GdB 50, exceptionally difficult to regulate metabolic conditions must be present, which, taken alone, already justify an increase in the GdB.
Rule of thumb
A GdB of 50 for diabetes mellitus type 1 is conditional:
– Minimum of 4 insulin injections per day, – Independent adjustment of the insulin dose – In the context of an overall consideration of all areas of life, there must be a serious impairment of the way of life.
Severe disability due to diabetes: overall assessment by the court
The regional social court has an overall assessment of all areas of life of the plaintiff, as the case law of the Federal Social Court with judgment of 16.12.2014 , B 9 SB 2/13 R, calls , carried out. The plaintiff is not entitled to a GdB of 50.
Although he must measure blood sugar six to eight times a day and inject himself with insulin six times a day. He thus achieves the therapy intensity required for a GdB of 50. But the plaintiff lacks the clear, substantial cuts, which affect his way of life. In the plaintiff's case, there are no such impairments in his way of life in the subareas of his life that would justify a GdB of 50 in comparison to other patients with the disease.
His disadvantages restrict the plaintiff in his way of life, but not severely.
He can pursue his desired profession, meets friends, does sports when time permits, and drives a car.