Special cases

Article 350, section 9, of the Social Security Code specifies that 'The same Grand-Ducal regulation may provide for the times required for different conditions and clinical situations on the basis of a set allowance.' Articles 2 to 6 of the 'Amended Grand-Ducal regulation of 18 December 1998 establishing the conditions for determining dependency' lists these conditions and their allocation criteria:

Art. 2. Any person whose hearing in their best ear, while fitted with a permanent hearing correction device and/or a cochlear implant – unless they cannot be fitted with such a device or implant – is reduced by at least 75 dB as measured by pure-tone audiometry, or whose threshold of intelligibility is equal to or greater than 70 dB as measured by free-field speech audiometry, is entitled to a set allowance of 361 minutes a week. The loss of hearing, as measured by pure-tone audiometry, is to be determined by calculating the arithmetic mean of the hearing loss at the thresholds of the four conversational frequencies of 500, 1000, 2000 and 4000 Hz. If the hearing loss cannot be measured at any one of these four frequencies, the threshold will be considered to be at 120 dB. Speech audiometry is to be performed in a free field, with a hearing device or a cochlear implant.

Art. 3. Any person who is totally blind, or whose visual acuity in their best eye while fitted with a permanent corrective device – unless they cannot be fitted with such a device – is less than 1/20, or whose visual field is less than 10°, regardless of their visual acuity, is entitled to a set allowance of 361 minutes a week.

Art. 4. Any person with a symptomatic form of Spina Bifida is entitled to a set allowance of 361 minutes a week.

Art. 5. Any person suffering from aphasia such that it prevents normal verbal communication, or from dysarthria such that it prevents normal verbal communication, is entitled to a set allowance of 361 minutes a week.

Art. 6. Any person who has undergone a laryngectomy is entitled to a set allowance of 361 minutes a week.

The set allowance of 361 minutes a week corresponds to the payment of EUR 162.5 a week (equivalent to lump-sum allowance 7).

These cash benefits may not be combined with one another – i.e. the insured is only entitled to one set allowance of 361 minutes, even if they satisfy the criteria for several of the pathological conditions mentioned above – and are only granted as a subsidiary measure if the insured is not dependent on others to perform activities of daily living (ADLs) in the sense of Articles 348 and 349 of the Social Security Code (an insured person whose summary of coverage entitles them to 210 minutes or more a week of care and assistance to perform activities of daily living does not qualify for these set allowances).

Insured persons who wish to receive these set allowances must file a standard application with the CNS by submitting the administrative application form and the 'Primary care physician's report for the purpose of examining an application for long-term care insurance benefits' (R20).

The State Office for Assessment and Monitoring of the long-term care insurance (AEC) works with ENT specialists and ophthalmologists, who will assess the insured persons once they have filed their application, pursuant to Articles 2 and 3 respectively.

Moreover, in addition to this set allowance, the long-term care insurance provider may cover the cost of assistive technology under certain conditions: vision-correcting devices for insured persons with a loss of visual acuity; signage and way-finding aids for insured persons with a loss of hearing; and communication aids for insured persons with aphasia or dysarthria.