The mother and guardian of an adult obtains, independently of her ex-husband and co-guardian, a disability compensation benefit for additional transport costs: the story.
I – The facts
Mr and Mrs X have a child with a disability who goes horse riding at an equestrian centre. He also loves football and, here again, he will attend adapted football sessions. Needless to say, it is his parents who take him there. He also attends an occupational therapy centre and a neuropsychology practice. The number of kilometres driven by both parents is obviously considerable, month after month and year after year.
This is why the departmental centre for disabled persons (MDPH) grants him the Disability Compensation Benefit (Prestation de Compensation du Handicap, PCH) of €32 per month on account of his parents’ journeys.
II – The legal and case-law principles governing the payment of additional transport costs caused by a disability
The right to have the additional transport costs incurred because of a person’s disability covered is governed by several statutory provisions and court decisions.
Under Article R322-10 of the French Social Security Code, the transport costs of the insured person or their dependant are covered when they are obliged to travel in order to receive care or undergo examinations appropriate to their condition, in particular for patients recognised as suffering from a long-term illness. Furthermore, Article L871-1 of the French Social Security Code provides that insurance policies do not cover the flat-rate contribution and the deductible, but may include full or partial payment of the insured person’s contribution to the rates used as the basis for calculating health insurance benefits.
Case law has also clarified the conditions under which additional transport costs are covered. For example, the Riom Court of Appeal held in a ruling of 8 September 2009 that the PCH may be allocated to costs relating to the adaptation of the disabled person’s home and vehicle, as well as to any additional costs arising from their transport. Likewise, on 8 December 2022 the Versailles Court of Appeal rejected a claim for exceptional leisure-related expenses, but recognised the need to demonstrate the additional cost of ordinary transport caused by the disability.
III – The procedure
The Departmental Centre for Disabled Persons (MDPH) of Finistère provides for the payment of the additional transport costs of a child with a disability. It was on this basis that young X’s parents applied on 4 January 2024 for the 16 km journeys made in their own vehicle once a week to adapted football sessions to be covered. By letter of 22 January 2024, young X’s mother lodged a mandatory prior administrative appeal, as the MDPH had refused to cover the additional cost of taking him to equine-assisted therapy and to the neuropsychology and occupational therapy centre.
By decision of 17 May 2024, the Commission for the Rights and Autonomy of Disabled Persons (CDAPH) confirmed that only the additional cost of transport to the adapted football sessions would be covered. The mother then sought payment of the additional transport costs for the two other activities for the period from 1 April 2023 to 31 March 2033, in the amount of €10,000, i.e. a maximum monthly amount of €83.33 at the rate of €0.50 per kilometre in a private vehicle. The MDPH argued that her appeal was invalid because joint parental authority required both parents to make the applications needed for young X’s upbringing and well-being.
The social division of the Brest Judicial Court (Finistère) upheld her claim, since the MDPH had made no provision for covering journeys, in particular those relating to paramedical needs such as occupational therapy sessions.
IV – The scope of the judgment
The social division of the Brest Judicial Court made it clear that it does not matter what the Brest MDPH decided to cover, provided that the additional transport cost is proven. The case law is, moreover, strictly applied.
In order to demonstrate the additional cost of ordinary transport caused by the disability and be entitled to have it covered, several criteria must be met under the legislation and case law:
- The law provides that transport costs are covered on medical prescription, issued in accordance with Articles L. 162-4-1 and L. 162-5-15 of the French Social Security Code;
- The prescription must specify the mode of transport best suited to the patient’s condition and whether that condition is incompatible with shared transport;
- Transport costs are covered on the basis of the least expensive journey, taking into account the transport conditions and the number of patients transported;
- Case law has made clear that, in order to have the additional transport cost linked to the disability covered, it is necessary to provide evidence of the cost of ordinary transport and to establish the additional cost caused by the disability.
For example, in the case of Ms [M] mentioned above, the Versailles Court of Appeal upheld the judgment, stating that Ms [M] had not shown an additional transport cost linked exclusively to her disability, since she could prove neither that she held a driving licence nor that she owned a vehicle, and her journeys were merely declared.
By contrast, on 8 February 2023 the Rennes Court of Appeal awarded the disability compensation benefit for additional transport costs to Ms [G], in her capacity as guardian of her son, on account of the actual number of kilometres driven, well over 166 per month, directly resulting from her son’s severe disability.
In conclusion, in order to demonstrate the additional cost of ordinary transport caused by the disability and be entitled to have it covered, it is essential to provide concrete evidence of the cost of ordinary transport and of the additional cost linked to the disability, often by means of travel records and medical prescriptions. Case law thus clearly shows that demonstrating the direct link between the disability and the additional cost is crucial to obtaining coverage.
When will the Court of Cassation rule on the matter?