64 case.234 a) Consequential damages 247. The representatives argued that the State should pay compensation for the expenses incurred in the course of the domestic judicial proceedings during nearly 27 years, as well as the lawyers’ fees. They also requested reimbursement of Mr. Muelle Flores’ medical expenses, including those already incurred and “future” expenses, as a consequence of having developed “severe hypoacusia with loss total of hearing in one ear and significant decrease in hearing in the other,”235 and the aggravation of his general health owing to Alzheimer’s disease and the femoral fracture. The representatives stressed that those expenses resulted from the fact that Mr. Muelle Flores could not access social health insurance on the same terms as other pensioners, because his pension had not been paid. Therefore, they requested the payment, in equity, of a sum no less than US$52,000.00 (fifty two thousand US dollars) “based on an estimated value of US $2,000.00 (two thousand US dollars) per year.” 248. The State opposed the request of the representatives and held that the expenses arising from the domestic judicial proceedings could not be considered pecuniary damage, and should have been requested as costs and expenses. It asked the Court to reject this demand “because it was not consistent with the nature of the measure requested.” Likewise, it indicated that the representatives did not attach documentation accrediting the costs incurred in the domestic judicial proceedings, or the costs of treating the hearing disability of the presumed victim, both invoked as consequential damages. In addition, it emphasized that no causal link existed between the State’s responsibility and the effects on Mr. Muelle Flores’ health; it argued that, according to the pleadings and motions brief, the origin of his ailment preceded the facts that prompted this case, and that it had not been claimed that Mr. Muelle Flores currently did not have access to medical treatment or medicines. Consequently, it concluded that “the necessary conditions were not met to be validly grant[ed] pecuniary compensation for consequential damages,” and asked the Court to dismiss that claim. 249. The Court will consider, under the heading of consequential damages, the expenses incurred by Mr. Muelle Flores that are not related to the processing of the case, both at the domestic level and before the Commission, which will be analyzed in the section on costs and expenses236 (infra paras. 270 to 273). 250. As to consequential damages, the Court notes that the representatives based the amount requested on various medical expenses incurred by Mr. Muelle Flores as a consequence of the physical ailments caused by the deterioration of his health (supra paras. 52 and 164). In this regard, the Court determined that the State was internationally responsible for failure to comply with and enforce the domestic rulings which, had these been implemented, would have enabled the victim to have access to health services and benefits on the same terms as other beneficiaries of the Decree Law N° 20530 pension system, as indicated by this Court (supra para. 149). Furthermore, the Court concluded that the failure to realize his right to social security prevented Mr. Muelle Flores from Cf. Case of Bámaca Velásquez v. Guatemala. Reparations and costs. Judgment of February 22, 2002. Series C No. 91, para. 43, and Case of Women Victims of Sexual Torture in Atenco v. Mexico, supra, para. 369. 235 In their final written arguments, the representatives made it clear that, in relation to the State’s objection in this regard, the victim is not claiming reimbursement for medical treatment received in the United States between 2001 and 2008, as this did not generate any costs for Mr. Muelle because it was provided through the support of an NGO. Mr. Muelle Flores merely referred to that treatment in his petitions in order to justify his change of residence before the Court, and to emphasize the need for promptness in the inter-American proceeding given his disability. Cf. Brief of final arguments of the representatives (merits file, folio 704, footnote 169). 234 236 Cf. Case of the Serrano Cruz Sisters v. El Salvador. Merits, reparations and costs. Judgment of March 1, 2005. Series C No. 120, para. 152, and Case of V.R.P., V.P.C.* et al. v. Nicaragua, supra, para. 410.