ROUTE
Medical rehabilitation: application and refusal
Rehabilitation comes before pension. You may file with the wrong body, but the insurerβs letter carries a hard ten-week deadline and an objection just one month.
β Checked: 02/08/2026
The German social system rests on a principle that sounds dry yet explains almost everything here: rehabilitation before pension. The state prefers to invest in restoring earning capacity while it can still be restored, rather than granting a permanent benefit. Rehabilitation therefore goes not to whoever is worst off, but to those whose capacity to work is at risk and can still be preserved.
COSTS AND DEADLINES
Deadlines you cannot miss
- Ten weeks from the insurerβs letter β a statutory deadline: missing it costs your sick payWhen rehabilitation becomes the issue, and why waiting is costlyhard deadline
- Two weeks from receipt of the application β the deadline for settling responsibilityWho pays: the pension insurer or the health insurerhard deadline
- One month from receipt of the decision β the standard objection deadline, stated in the decision itselfRefusal and objection: the month that decides everythinghard deadline
Amounts follow official fees as of each stepβs verification date. Your city may charge a different rate β check the step itself.
βΊ More about this route
This five-step route covers the whole path: when the question arises at all and why long-term sick leave carries a hard deadline, who pays and why you need not establish that beforehand, how to build an application that gets read on the merits, what to do about a refusal, and what happens after approval.
Two things are worth knowing up front. First: if your health insurer has demanded an application, ten weeks are running, and letting them lapse costs your sick pay. Second: you may file with the wrong body β the law obliges it to settle responsibility within two weeks and forward the application itself.
REQUIRED DOCUMENTS
All possible documents for this route
- Pension insurance record (Versicherungsverlauf)
- Medical report on your condition
- Application form of the relevant body
- Medical report (Befundbericht)
- Discharge summaries and specialist findings
- Pension insurance record
- The decision letter (Bescheid)
- New medical findings
- Copy of the objection with proof of dispatch
- Approval decision
- Discharge report from the rehabilitation facility
- Plan for the gradual return to work
WHERE PEOPLE MOST OFTEN LOSE MONEY AND TIME
- Waiting until the condition is obviously severe. Rehabilitation is granted while earning capacity can still be preserved, not after it has been lost.
- Setting aside the insurerβs letter demanding an application. It is the only letter in this area with a hard ten-week deadline, and missing it ends sick pay.
- Spending weeks establishing who is responsible. The body must settle that within two weeks and forward the application itself where it is not responsible.
- Accepting a refusal as final. The objection runs for one month, and missing it throws you back to the start β while refusals are often issued on formal or fixable grounds.
FREQUENTLY ASKED QUESTIONS ABOUT THIS ROUTE
Who actually receives rehabilitation?βΎ
People whose earning capacity is significantly at risk or already reduced and can be preserved or restored. It is not about the severity of an illness as such but about the working perspective: the provision exists for early intervention.
Where do I apply if responsibility is unclear?βΎ
To either body. By law it determines within two weeks of receipt whether it is responsible and otherwise forwards the application itself. The wrong addressee costs you neither the deadline nor a fresh application.
Does rehabilitation eat into my annual leave?βΎ
No. The Federal Leave Act provides that measures of medical prevention or rehabilitation may not be set off against annual leave, so far as a right to continued pay under the sick pay rules exists. Leave days therefore do not disappear because of a rehabilitation stay.
How soon can rehabilitation be repeated?βΎ
The law sets an interval: medical rehabilitation is not provided before four years have passed since such or similar measures whose costs were borne from public funds. Cases where earlier measures are urgently necessary on health grounds are excepted.
What if the body stays silent longer than provided for?βΎ
Send a written status enquiry referring to the date of receipt and keep proof of dispatch. The law sets the body deadlines for settling responsibility and for deciding, so documented correspondence carries the next steps if the silence drags on.