Refusing Wlz Indication in The Hague: Your Rights and Step-by-Step Plan
When your application for the Long-Term Care Act (Wlz) is refused in The Hague, you do not have to accept this just like that. A refusal does not mean that you have no right to care. In this article for residents of The Hague, we explain what you can do, which steps to follow, and what rights you have in the event of a Wlz refusal.
Refusal of a Wlz indication by the health insurer or the CIZ (Centre for Care Indication) means that they judge that your care needs do not fall under the Wlz. This can be due to insufficient severity of the condition, lack of evidence, or better alternatives. Fortunately, you can file an appeal and have your situation reassessed, specifically via institutions in The Hague.
Legal Basis: Wlz and Appeal Procedure in The Hague
The Long-Term Care Act (Wlz) governs the reimbursement of long-term care. The CIZ issues the indication. In case of refusal, you can file an objection and appeal. For cases from The Hague, the The Hague District Court, Prins Clauslaan 60 is competent for judicial proceedings.
Important laws:
- Article 11 Wlz: Application processing and indication setting.
- Article 12 Wlz: Possibility of appeal against refusal.
- Care Appeals Committee Decree (BBZ): Appeal rules.
- Awb Article 6:1 and 6:10: Objection and appeal rules.
Your appeal first goes to the Care Appeals Committee (BCZ), independent experts. In case of rejection, you can go to the The Hague District Court.
Common Reasons for Wlz Refusal
The CIZ often refuses for these reasons:
- Insufficient intensive care needs: Does not meet Wlz criteria, such as too little 24-hour care or alternatives available.
- Missing or weak medical file: Insufficient reports from doctors or specialists.
- Better fit with Wmo or Zvw: Care fits better in municipal Wmo (via The Hague) or basic health insurance.
- Procedural errors: Late application or incomplete data.
- Temporary care needs: Wlz is for permanent, structural care needs.
Step-by-Step Plan for Wlz Refusal in The Hague
Follow these steps for a successful appeal:
- Analyze the refusal letter: Understand the reasoning of the CIZ.
- Consult experts: Talk to your doctor or visit the Juridisch Loket The Hague, Lutherse Burgwal 10 for free advice.
- File objection/appeal: Within 6 weeks in writing with the BCZ. Download the form at bcz.nl.
- Add new evidence: Additional medical reports or testimonies about your care needs.
- Seek assistance: The Juridisch Loket The Hague helps with procedures; for complex cases, a healthcare law lawyer.
- Await BCZ decision: Within 8 weeks, extension possible. In case of rejection: to The Hague District Court, Prins Clauslaan 60.
- Further appeal: Possible appeal to the Central Appeals Board.
Local Support in The Hague
In The Hague, you can go to:
- Juridisch Loket The Hague: Lutherse Burgwal 10, for free legal advice on Wlz matters (tel: 0900-8020).
- The Hague District Court: Prins Clauslaan 60, for hearings and judgments.
- Municipality of The Hague for Wmo support as an alternative.
Tip: Act quickly; deadlines are strict. With good preparation, many refusals are overturned.