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Refusing Wlz-indication in Zoetermeer: your rights and step-by-step plan

Wlz-indication refused in Zoetermeer? Discover your rights, reasons for refusal and step-by-step plan for appeal at CIZ, BCZ and Rechtbank Den Haag. Free help via Juridisch Loket.

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Refusing Wlz-indication in Zoetermeer: your rights and step-by-step plan

When your application for the Long-Term Care Act (Wlz) in Zoetermeer is refused, 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 Zoetermeer, we explain what you can do, which steps to follow and what rights you have in the event of a CIZ decision.

Refusal of a Wlz-indication by the health insurer or the CIZ (Centre for Needs Assessment Care) means that they judge that your care needs do not meet the Wlz criteria. This can be due to insufficient severity of the condition, lack of evidence or better alternatives such as Wmo or Zvw. Fortunately, you can file an appeal and strengthen your file.

Legal basis: Wlz and appeals procedure in the Den Haag region

The Long-Term Care Act (Wlz) determines which long-term care is reimbursed. Indications are set by the CIZ. In the event of refusal in Zoetermeer, you can file an objection and appeal.

Important laws and regulations:

  • Article 11 Wlz: Application processing and indication setting.
  • Article 12 Wlz: Possibility of appeal in case of refusal.
  • Decision Appeals Committee Care (BBZ): Procedure for appeals.
  • General Administrative Law Act (Awb), art. 6:1 and 6:10: Deadlines and rules for objection and appeal.

Your appeal is handled by the independent Appeals Committee Care (BCZ). For Zoetermeer, this falls under the jurisdiction of the Rechtbank Den Haag.

Common reasons for Wlz-refusal in Zoetermeer

The CIZ can refuse an indication for various reasons. Typical causes:

  • Insufficient permanent care needs: Your situation does not meet the Wlz requirements for 24-hour care or sustenance.
  • Incomplete medical file: Missing or insufficient medical statements.
  • Alternative care possible: Wmo via the municipality of Zoetermeer or Zvw covers your needs better.
  • Procedural errors: Late submission or incomplete application.
  • Temporary care needs: Wlz is exclusively for structural, permanent care needs.

Step-by-step plan in case of Wlz-refusal for Zoetermeer residents

Follow these steps if your Wlz application is rejected:

  1. Analyze the refusal letter: Understand the reasoning of the CIZ. The letter states the exact reasons.
  2. Consult experts: Contact your general practitioner, specialist or a local care broker in Zoetermeer.
  3. File appeal in time: Within 6 weeks in writing with the Appeals Committee Care (BCZ). Download the form at www.bcz.nl.
  4. Strengthen your file: Add new medical reports, daily statements or witness statements.
  5. Seek professional help: Visit the Juridisch Loket Zoetermeer (Stationsplein 99, 2711 HC Zoetermeer) for free advice. Or engage a care law lawyer via the Rechtbank Den Haag (district).
  6. Await BCZ decision: Normally within 8 weeks. In case of delay, you can request urgency.
  7. Proceed to Rechtbank Den Haag: Dissatisfied with BCZ? Appeal within 6 weeks to the Rechtbank Den Haag, Administrative Law sector.

Local support in Zoetermeer

In Zoetermeer you can go to:

  • Juridisch Loket Zoetermeer: Free first-line legal advice. Call 0900-8020 or walk in.
  • Municipality of Zoetermeer Wmo desk: For alternative care options.
  • Rechtbank Den Haag: Handles appeals from this region (Prins Clauslaan 5, Den Haag).
  • Patient organisations such as Ieder(in) for peer contact.

Tip: Start immediately after refusal. Deadlines are strict!