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Applying for sickness benefit from social compensation

If you are temporarily unable to work due to illness or injury, you can receive sickness benefit from the social compensation scheme to compensate for financial losses during your incapacity to work. You can find out more here.

  • Basic information

    Social compensation sickness benefit is a financial safeguard for employees who are temporarily unable to work due to an injury-related illness in order to compensate for the loss of earnings during this time. This also includes injured parties who are not unfit for work but who are unable to work full-time due to social compensation sickness treatment.

    As an injured person, you can also claim the benefit if you require inpatient treatment due to a recognized consequence of injury. Social compensation sickness benefit does not end before the end of inpatient treatment.

    It is a social insurance benefit paid by the statutory accident insurance, health insurance or pension insurance institutions.

    You will also receive social compensation sickness benefit if you:

    • are self-employed as your main occupation and have not made an election declaration to the health insurance fund,

    or

    • are employed and have not made an election declaration,

    or

    • are marginally employed, your employment does not give rise to compulsory insurance and you have family insurance.

    Full-time self-employed persons and employees subject to compulsory insurance who are entitled to continued payment of remuneration for less than six weeks can make a declaration of choice according to which membership is to include the statutory entitlement to sickness benefit. This entitlement can be supplemented by an optional tariff.

    Sickness benefit under the social compensation scheme amounts to 80 percent of regular pay, but may not exceed the lost regular net pay.

    Please note that your social compensation provider will decide whether and to what extent you receive support.

    Requirements

    • As the injured party, you have suffered a health impairment in Germany or, under certain circumstances, abroad (§ 15 SGB XIV) as a result of a damaging event.
    • The health impairment has resulted in physical, psychological, mental or sensory impairments.
    • You are unable to work.

  • Procedure

    When you apply for social compensation benefits, the social compensation institution will check whether you are entitled to sickness benefit. You will receive a notification of the decision and, if applicable, information on the benefits granted as well as other necessary evidence.

    You can apply for social compensation benefits in writing.

    • If necessary, you can make an appointment with your contact person at the pension authority or at your responsible office.
    • You will then discuss whether you are entitled to social compensation benefits and what support services can be offered.
    • If necessary, the case management team can discuss the further procedure and possible entitlements to benefits that go beyond the general duty to provide information and advice with you.
    • If you are entitled to social compensation benefits, your contact person will discuss the next steps with you.
    • The contact person will provide you with the relevant documents. If necessary, complete the documents, enclose the required evidence or supporting documents and send the documents back to your contact person.
    • Your claims will be determined ex officio on the basis of the documents. The authority will inform you of the result in the form of a decision, which is usually sent to you by letter.
    • If entitlements to benefits have been determined, you will receive an approval notice. If no entitlements are determined, you will receive a rejection notice.
    • The sickness benefit will be paid to you by your health insurance fund.

    More information

    Legal remedy
    Appeal: An appeal can be lodged against a decision within one month of its notification. Further information regarding the procedure and the competent authority to which you can lodge an appeal can be found in the notification of your application. The appeal can be submitted in writing and electronically.

  • Competent Department

  • Fees / Costs

    gebührenfrei

  • Deadlines & processing time

    What deadlines must be paid attention to?

    There is no deadline.

    How long does it take to process

    The prerequisite for processing is that all mandatory information has been provided. The processing time varies depending on the competent authority and the individual case. It is not possible to give an exact time and it depends on the complexity of the individual case.

  • Legal Bases

  • More Information

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This page has been automatically translated by DeepL. We cannot guarantee that the translation is correct.

The official information in German is complete and correct. 07.11.2025

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