Woman cannot claim being short as illness: German court

A court in Bremen has ruled that short stature is not a legal illness on Monday, after a woman sued her health insurance provider over leg lengthening surgery.

The plaintiff insisted that the company should pay for the treatment, but the insurance company argued that being shorter than normal should not be covered under benefits and did not amount to legal disfigurement in this case.

"Leg lengthening alone was not sufficient to justify this invasive surgery,” the insurance provider said in a statement.

In turn, the woman argued she suffered from Noonan syndrome — a genetic disorder that prevents development in parts of the body. She pointed out that her height of 1.5 meters (4 feet 11 inches)  puts her in the shortest 3% of the women and poses challenges in her daily life. She also claimed she was not viewed as a full person which justified her need for a height correction operation.

"The plaintiff had recurring depressive phases. She experiences handicaps in everyday life in the form of an environment that is too high," her representatives said. .

The defendant also said that she had been rejected from pilot school because of her height and was thus restricted in job choices.

What is the court's stance?

The Bremen court sided with the insurance provider, saying that the company did not have a duty to cover their client's leg-lengthening surgery. The woman's height did not constitute an irregular physical condition, according to the ruling. The court also noted that the plaintiff did not ask for treatment for her Noonan syndrome, but instead wanted to gain height.

Difficulties that the woman encountered in everyday life could be remedied with aid or an assistive living facility, according to the court, and her psychological issues could also be treated with therapy.

The court also noted that being excluded from certain professions "have no impact on the issue" of whether or not the health insurance provider should pay for the surgery.

The woman was applying for an invasive procedure that would help her achieve her dream height of being between 1.60m (5 feet 3 inches) and 1.65m (5 feet 5 inches) tall. Under leg-lengthening operations a patient's upper and lower leg bones are cut to implant an extension system that stretches the bone and soft tissue. Complications that can arise from the surgery include poor regeneration and limb misalignment.

A wide range of complications that arise from limb modification has been recorded in English literature. But there are still a small number of papers published by surgeons who operate on limb lengthening patients over a long time. This makes it hard to estimate long term effects from the surgery on patient health according to research published in the National Library of Medicine.