Manuel Acereda Herrera v Servicio Cántabro de Salud.
Date: 2006-06-15
27. As is confirmed by the second subparagraph of Article 22(2) of Regulation No 1408/71, the sole purpose of Article 22(1)(c)(i) of that regulation is to confer on the insured person granted authorisation by the competent institution the right to have access to ‘treatment’ in another Member State on conditions for reimbursement as favourable as those enjoyed by patients covered by the legislation of that other State (see Case C‑368/98 Vanbraekel and Others  [2001] ECR I‑5363, paragraph 32; Case C‑56/01 Inizan   [2003] ECR I‑12403, paragraph 21; and Case C‑372/04 Watts  [2006] ECR I-0000, paragraph 135).
29. The essential characteristic of ‘benefits in kind’ within the meaning of Regulation No 1408/71 is that they are ‘designed to cover care received by the person concerned’, inter alia, by the direct payment or reimbursement of ‘medical expenses’ incurred by that person’s state (see, in the context of a statutory scheme of social insurance against the risk of reliance on care, Case C-160/96 Molenaar  [1998] ECR I-843, paragraphs 32 and 34; see also Watts , paragraph 137).
30. The concept of ‘cash benefits’ within the meaning of Article 22(1)(c)(ii) of Regulation No 1408/71 must also be given an autonomous interpretation in Community law (see, to that effect, Molenaar , paragraphs 31 and 33 to 36).
31. That concept essentially covers the benefits designed to compensate for loss of income linked to an incapacity to work (see, to that effect, Molenaar , paragraph 31) and such as to affect the standard of living of the individual concerned and any members of his family, if he has one. Such is apparent from the reference, first, in Article 23 of Regulation No 1408/71, to the method of calculation based on the earnings of the individual and which may vary with the number of members of his family and, second, from Articles 18 and 24 of Regulation No 574/72, which, as a general rule, make the drawing of cash benefits, under Article 22(1)(c)(ii) of Regulation No 1408/71, contingent on submitting a notification of having ceased work or, if the legislation administered by the competent institution so provides, a certificate of incapacity for work issued by the doctor treating the worker concerned.
34. Moreover, according to settled case-law, Article 22(1) of Regulation No 1408/71 is intended to allow an insured person, authorised by the competent institution to go to another Member State to receive there treatment appropriate to his condition, to receive sickness benefits in kind, on behalf of the competent institution, in accordance with the provisions of the legislation of the State in which the services are provided. By contrast, interpreted in the light of its purpose, that article is not intended to regulate the ‘reimbursement by Member States, at the tariffs in force in the competent State, of costs incurred in connection with treatment provided in another Member State’ (Case C‑158/96 Kohll  [1998] ECR I‑1931, paragraph 27, and Vanbraekel and Others , paragraph 36).
47. It must be recalled that, according to settled case-law, it is solely for the national court before which the dispute has been brought, and which must assume responsibility for the subsequent judicial decision, to determine in the light of the particular circumstances of the case both the need for a preliminary ruling in order to enable it to deliver judgment and the relevance of the questions which it submits to the Court (see, inter alia, Case C-415/93 Bosman and Others [1995] ECR I-4921, paragraph 59, and Case C‑36/99 Idéal tourisme  [2000] ECR I‑6049, paragraph 20).
48. Nevertheless, the Court has held that it cannot give a preliminary ruling on a question submitted by a national court where it is quite obvious that the ruling sought by that court on the interpretation or validity of Community law bears no relation to the actual facts of the main action or its purpose, where the problem is hypothetical, or where the Court does not have before it the factual or legal material necessary to give a useful answer to the questions submitted to it (see Bosman and Others , paragraph 61, and Idéal tourisme , paragraph 20).
49. The justification for a reference for a preliminary ruling is not that it enables advisory opinions on general or hypothetical questions to be delivered but rather that it is necessary for the effective resolution of a dispute (Case C‑314/96 Djabali  [1998] ECR I‑1149, paragraph 19).