European court brings VAT relief to osteopaths and chiropractors
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European court brings VAT relief to osteopaths and chiropractors

A chiropractor at work © Creative Commons/James Kelly

Belgium’s osteopaths and chiropractors should be exempt from charging clients VAT, placing them on equal terms with medical and other paramedical professionals, the European Court of Justice (ECJ) in Luxembourg has ruled.

Until now, osteopaths and chiropractors have not been considered medical or paramedical disciplines, as opposed for example to physiotherapists, who like doctors and dentists are exempt from charging VAT.

The associations representing the two sectors brought a case against the Belgian government before the country’s Constitutional Court, which in turn sent a question to Luxembourg requesting an opinion on the European legal situation in the matter.

The issue is of importance to the sector not only because it recognises their status as paramedical professionals, but also because it reduced the cost to patients, and with many consultations not being reimbursed, the price difference could be important in turning to the practitioners, usually for complaints of the muscular-skeletal system.

The ECJ took the side of the complainant, and ruled that the exemption from VAT did not only apply to paramedical professions as defined by the member state. While the member state may make rules to determine who may practice such a profession, it is a breach of the principle of fiscal neutrality for two practitioners who perform a similar function – an osteopath and a physiotherapist, for example – to be subject to different tax regimes.

The Belgian government was ordered to amend its law on this matter. In the meantime, the two professions must be exonerated from VAT immediately. The provisional continuation of VAT while awaiting a change to the law was not acceptable, the Court said.

Procedurally, it will now be the job of the Constitutional Court to make that happen as soon as possible, no matter how long it takes for amended legislation to be agreed by parliament.

The ECJ had also to respond to a question in a case brought by the industry association of plastic surgeons, who complained that they were subject to paying a higher rate of VAT for equipment and medication for cosmetic surgery than surgeons performing medical operations. In that case, the ECJ declined to overturn the current rules differentiating the two.

Alan Hope
The Brussels Times