{"id":659840,"date":"2026-04-23T14:11:46","date_gmt":"2026-04-23T12:11:46","guid":{"rendered":"https:\/\/kohenavocats.com\/tribunal-judiciaire-de-grenoble-le-9-decembre-2025-n23-01270\/"},"modified":"2026-04-23T14:11:46","modified_gmt":"2026-04-23T12:11:46","slug":"tribunal-judiciaire-de-grenoble-le-9-decembre-2025-n23-01270","status":"publish","type":"post","link":"https:\/\/kohenavocats.com\/zh-hans\/tribunal-judiciaire-de-grenoble-le-9-decembre-2025-n23-01270\/","title":{"rendered":"Tribunal judiciaire de Grenoble, le 9 d\u00e9cembre 2025, n\u00b023\/01270"},"content":{"rendered":"
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Le tribunal judiciaire de Grenoble, statuant en mati\u00e8re sociale le 9 d\u00e9cembre 2025, a examin\u00e9 un litige relatif \u00e0 une demande d’exon\u00e9ration du ticket mod\u00e9rateur. Un assur\u00e9, atteint d’une dysplasie de la hanche non inscrite sur la liste r\u00e9glementaire, sollicitait cette exon\u00e9ration au titre d’une affection longue dur\u00e9e hors liste. La caisse primaire d’assurance maladie avait rejet\u00e9 sa demande, estimant que les conditions l\u00e9gales n’\u00e9taient pas r\u00e9unies. Le juge devait donc d\u00e9terminer si l’affection de l’assur\u00e9 ouvrait bien droit \u00e0 cette prise en charge sp\u00e9cifique. Le tribunal a fait droit \u00e0 la demande de l’assur\u00e9 en accordant l’exon\u00e9ration pour une dur\u00e9e de vingt ans.<\/p>\n

La v\u00e9rification rigoureuse des conditions l\u00e9gales de l’ALD hors liste<\/p>\n

Le cadre juridique de l’exon\u00e9ration est strictement d\u00e9fini par le code de la s\u00e9curit\u00e9 sociale. L’article L.160-14 pr\u00e9voit que la suppression du ticket mod\u00e9rateur pour une affection hors liste est subordonn\u00e9e \u00e0 deux conditions cumulatives. Il faut une “affection grave caract\u00e9ris\u00e9e” ou plusieurs affections entra\u00eenant “un \u00e9tat pathologique invalidant”. Cette affection doit en outre n\u00e9cessiter “un traitement prolong\u00e9 et une th\u00e9rapeutique particuli\u00e8rement co\u00fbteuse” (article L.160-14 du code de la s\u00e9curit\u00e9 sociale). Le d\u00e9cret du 22 d\u00e9cembre 2008 pr\u00e9cise ces notions en exigeant un traitement sup\u00e9rieur \u00e0 six mois et un co\u00fbt particuli\u00e8rement \u00e9lev\u00e9. La jurisprudence rappelle que “l’exon\u00e9ration du ticket mod\u00e9rateur doit \u00eatre accord\u00e9e au malade reconnu atteint d’une affection qui, bien que non inscrite sur la liste […] comporte un traitement prolong\u00e9 et une th\u00e9rapeutique particuli\u00e8rement co\u00fbteuse” (Soc. 23 janv. 1992, n\u00b089-19.034). Le juge proc\u00e8de donc \u00e0 un examen concret de chaque crit\u00e8re au regard des \u00e9l\u00e9ments du dossier.<\/p>\n

L’appr\u00e9ciation souveraine du juge sur le caract\u00e8re co\u00fbteux de la th\u00e9rapeutique<\/p>\n

Le juge op\u00e8re une distinction nette entre les outils d’instruction et les crit\u00e8res contraignants. En l’esp\u00e8ce, le m\u00e9decin-conseil de la caisse avait appliqu\u00e9 un crit\u00e8re issu d’une circulaire administrative. Ce texte propose de retenir un “panier de soins pr\u00e9visible” consid\u00e9r\u00e9 comme co\u00fbteux s’il comporte trois \u00e9l\u00e9ments parmi cinq list\u00e9s. Le tribunal \u00e9carte l’application automatique de ce crit\u00e8re au motif qu’il “ne s\u2019impose pas au juge”. La circulaire est qualifi\u00e9e de “non imp\u00e9rative” et ayant pour simple objectif de “proposer un arbre d\u00e9cisionnel”. Le juge r\u00e9affirme ainsi son pouvoir souverain d’appr\u00e9ciation des preuves. Il n’est pas li\u00e9 par les grilles d’analyse internes de l’administration, m\u00eame lorsqu’elles \u00e9manent du contr\u00f4le m\u00e9dical. Cette analyse permet de pr\u00e9server l’\u00e9quit\u00e9 au cas par cas face \u00e0 une approche potentiellement trop rigide.<\/p>\n

La concr\u00e9tisation des conditions l\u00e9gales par une approche globale des soins<\/p>\n

Le tribunal proc\u00e8de \u00e0 une \u00e9valuation in concreto de la situation m\u00e9dicale et financi\u00e8re de l’assur\u00e9. Il constate d’abord que la premi\u00e8re condition est remplie, l’affection entra\u00eenant un “\u00e9tat pathologique invalidant” reconnu par le m\u00e9decin-conseil. S’agissant du traitement prolong\u00e9, sa dur\u00e9e pr\u00e9visible sup\u00e9rieure \u00e0 six mois est \u00e9galement admise. Pour appr\u00e9cier le caract\u00e8re “particuli\u00e8rement co\u00fbteux”, le juge dresse un inventaire des th\u00e9rapeutiques n\u00e9cessaires. L’assur\u00e9 doit suivre un traitement m\u00e9dicamenteux r\u00e9gulier, porter des chaussures et semelles orthop\u00e9diques, et b\u00e9n\u00e9ficier de kin\u00e9sith\u00e9rapie. Il se fonde notamment sur l’avis du m\u00e9decin-consultant d\u00e9sign\u00e9 par le tribunal, qui a estim\u00e9 que les conditions \u00e9taient remplies. L’attention se porte particuli\u00e8rement sur le co\u00fbt des chaussures orthop\u00e9diques sur mesure, \u00e9valu\u00e9 entre cinq cents et six cents euros la paire. Cette approche globale et concr\u00e8te permet de satisfaire aux exigences l\u00e9gales sans se cantonner \u00e0 un d\u00e9compte arithm\u00e9tique d’actes.<\/p>\n

La port\u00e9e de cette d\u00e9cision est significative en mati\u00e8re de droit social et de proc\u00e9dure. Elle rappelle avec force l’autonomie du pouvoir judiciaire face aux instructions administratives. Les circulaires, m\u00eame \u00e9manant de l’assurance maladie, ne lient pas le juge dans son appr\u00e9ciation des conditions l\u00e9gales. Cette position garantit une adaptation du droit aux situations individuelles complexes. La d\u00e9cision op\u00e8re \u00e9galement une interpr\u00e9tation extensive mais justifi\u00e9e de la notion de th\u00e9rapeutique co\u00fbteuse. Elle consid\u00e8re que des d\u00e9penses importantes et r\u00e9p\u00e9t\u00e9es pour un \u00e9quipement essentiel, comme des chaussures orthop\u00e9diques, peuvent caract\u00e9riser \u00e0 elles seules le co\u00fbt particulier. Enfin, le jugement illustre le r\u00f4le probatoire d\u00e9cisif de l’expertise m\u00e9dicale judiciaire. L’avis du m\u00e9decin-consultant, sollicit\u00e9 par le tribunal, a pes\u00e9 de mani\u00e8re d\u00e9terminante dans la solution retenue, confirmant la valeur de ce moyen d’instruction dans les litiges techniques de prise en charge.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Le tribunal judiciaire de Grenoble, statuant en mati\u00e8re sociale le 9 d\u00e9cembre 2025, a examin\u00e9 un litige relatif \u00e0 une demande d’exon\u00e9ration du ticket mod\u00e9rat…<\/p>\n","protected":false},"author":232070755,"featured_media":3892,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_kj_source_type":"judilibre","_kj_official_id":"68ed6b370da7cb996dcb5e0f","_kj_official_url":"https:\/\/www.courdecassation.fr\/decision\/68ed6b370da7cb996dcb5e0f","_kj_judilibre_id":"68ed6b370da7cb996dcb5e0f","_kj_jur":"Tribunal judiciaire","_kj_lieu":"Tribunal judiciaire de Grenoble","_kj_chambre":"3.1 chb sociale du TASS","_kj_rg":"23\/01270","_kj_date":"2025-09-26","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[7597],"tags":[],"class_list":["post-659840","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-jurisprudence"],"yoast_head":"\nTribunal judiciaire de Grenoble, le 9 d\u00e9cembre 2025, n\u00b023\/01270 - 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