[Determination or expert assessment of eligibility for intensive nursing care?--Comments on a decision by the Federal Social Court (4RK 1/92, passed down 30 September 1993)].

A decision by the Bundessozialgericht, the Supreme Social Court of Germany, determining "Schwerpflegebedürftigkeit" (permanent need of very intensive nursing care) is discussed from the viewpoint of a physician in the Medical Service of Health Insurances, in respect of the Court's definition of "Schwerpflegebedürftigkeit", which is different from the one the Health Insurances had agreed upon so far, the physician's part in finding out who is entitled to the benefits related to "Schwerpflegebedürftigkeit", the question whether and to what extent "Schwerpflegebedürftigkeit" has to be assessed by an expertise of the Medical Service of the Health Insurance, the possibly increasing importance of court decisions in the procedure of gaining benefits justified by "Schwerpflegebedürftigkeit".