Receive injury benefit from the statutory accident insurance
In the event of an insured event under the statutory accident insurance scheme, i.e. an accident at work or an occupational disease, you will receive injury benefit if you are unable to work.
Injury benefit compensates for your loss of income and ensures your livelihood and that of your dependents. It is calculated individually on the basis of your regular income.
You do not have to file an application. Your employers' liability insurance association or accident insurance fund will examine possible claims on its own initiative ("ex officio") and arrange for payment. It is paid monthly for as long as you are incapacitated for work, i.e. for as long as you are on sick leave from your doctor.
The amount of the injury benefit depends on your situation:
- As a rule, the injury benefit is 80 percent of your regular pay and income from work. However, it may not be higher than your regular net pay.
- If you continue to earn money while receiving injury benefit, your earned income will be counted toward the injury benefit. This means that the injury benefit will be reduced in this case.
- If you are not employed but had earned income before your disability began, there is a different procedure. In this case, the 360th part of the earned income that you earned in the calendar year before the onset of the incapacity for work serves as the basis for calculating the injury benefit.
- Your contribution shares for pension and unemployment insurance will be deducted from the injury benefit. As long as you receive injury benefit, your employers' liability insurance association or accident insurance fund will pay your other social insurance contributions. If you are a member of a professional pension scheme, your employers' liability insurance association or accident insurance fund will pay your share for the social contributions on application. This is the case, for example, for physicians and notaries.
If you are entitled to a subsidy from your employer for private health and long-term care insurance contributions, this will be covered.
Requirements
- You will receive injury benefits from the statutory accident insurance if you are unable to work due to an insured event.
- Occupational accidents and commuting accidents as well as occupational diseases are considered insured events.
Applications / forms
Forms available: No
Written form required: No
Informal application possible: No
Personal appearance required: No
Online services available: Yes
Which documents are required?
You do not need to submit any documents.
What are the fees?
There are no costs involved.
Process flow
You do not have to apply for the injury benefit.
- Benefits from statutory accident insurance are generally determined ex officio.
- Your employers' liability insurance association or accident insurance fund will itself determine who is entitled to benefits and the necessary documents for the amount of benefits.
- If you are eligible, you will receive a corresponding notice.
You can send your Berufsgenossenschaft or Unfallkasse a message online if you have any questions.
Online service:
- Call up the online service.
- You will be guided through the process on the accident insurance service portal.
- You can log in.
- If you would like to receive the response from your employers' liability insurance association or accident insurance fund in the mailbox of your BundID account or My Company Account, you must have an account and authenticate yourself.
- If you would like to receive the response by mail, you can also proceed without logging in.
- Select your responsible employers' liability insurance association or accident insurance fund or determine it using the industry search.
- Upload the required documents.
- Fill out the online form and submit it.
- Your report is automatically forwarded to your employers' liability insurance association or accident insurance fund.
- You will receive a response via the requested channel.
Online service of your employers' liability insurance association or accident insurance fund:
- If you have access to the portal of your employers' liability insurance association or accident insurance fund, you can also submit the notification electronically there, if necessary.
Message by mail:
- Contact your employers' liability insurance association or accident insurance fund with an informal letter.
- Make sure you provide the required information and enclose the necessary documents.
What deadlines do I have to pay attention to?
none
Processing duration
The employers' liability insurance association or accident insurance fund begins to investigate and process the case as soon as it is foreseeable that injury benefits will have to be paid. As a result, there are usually no gaps between earned income, continued remuneration and injury benefit.
Legal basis
- § 45 Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 46 Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 47 Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 47a Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 48 Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 52 Sozialgesetzbuch Siebtes Buch (SGB VII)
- § 257 Sozialgesetzbuch Siebtes Buch (SGB VII)
Appeal
- Appeal
- Detailed information on how to lodge an appeal can be found in the notification from your employers' liability insurance association or accident insurance fund.