Apply for stress testing and occupational therapy from the statutory health insurance company
If, for example, you have been unable to work for a long time due to an accident or a serious physical or mental illness, you are entitled to support for your return to work. Occupational therapy and stress testing are designed to support you in this. They are part of the services of medical rehabilitation.
Your health insurance will cover the costs if no other social security institution is responsible.
Normally, the costs for stress testing and occupational therapy are covered by your pension insurance institution. In some cases, a professional association or the Federal Employment Agency are also responsible.
The stress test is an examination in which experts determine your health resilience. On the basis of various questions and tests, the following will be determined:
- how efficient you are physically, mentally and spiritually,
- how well you can adapt to different social situations and
- what your strengths are.
The stress test is intended to show whether you are resilient enough in the long run to return to your old profession or whether you need to take up a new appropriate profession.
Occupational therapy is the practice of concrete work steps from professional life for the training and promotion of
- Handcrafts
- manual and technical skills or
- mental and psychological abilities, for example interest, self-confidence, perseverance, punctuality, appearance, ability to communicate, willingness to cooperate.
The goals of occupational therapy are:
- the improvement of resilience
- the maintenance and development of skills and abilities necessary for your professional reintegration.
Occupational therapy starts when occupational integration is not yet possible at the time of stress testing.
If you take part in a stress test or occupational therapy financed by your health insurance company, you will continue to receive sickness benefit during this period.
Process flow
You can submit the application for reimbursement of the costs of your stress test or occupational therapy by post or - with many statutory health insurance companies - hand it in personally at the office.
- Get a medical report in which your doctor recommends stress testing or occupational therapy.
- Submit the medical report to your health insurance company together with your application. Your health insurance company now has 2 weeks to check whether it is responsible. If this is not the case, your health insurance company will forward your application to the competent institution.
- If the assumption of costs is approved, your health insurance company will issue you with a cost commitment. In addition, your health insurance company can tell you the institutions with which it has a contract.
- Once you have decided on an institution, present the cost commitment to it. In many cases, the health insurance company also transmits the cost commitment directly to the respective institution.
- The costs of stress testing or occupational therapy are now covered by health insurance. You don't have to worry about anything anymore.
Requirements
Your statutory health insurance will cover the costs of stress testing and occupational therapy if:
- this is prescribed by a doctor and
- no other social security institution is responsible. In most cases, the costs are covered by the pension insurance, the statutory accident insurance (employers' liability insurance association or accident insurance fund) or the employment agency. If they are not responsible, the statutory health insurance companies will finance the treatment.
Which documents are required?
Your health insurance company will inform you which documents are required, for example a medical report on the necessity of the requested measures.
What are the fees?
You don't have to pay anything for the application.
What deadlines do I have to pay attention to?
You don't have to pay attention to any deadlines.
Processing duration
It usually takes about 3 to 6 business days to process.
For a quick processing and decision, your health insurance company must have the necessary information and, if necessary, the necessary documents complete and meaningful.
The health insurance company decides on applications in a timely manner, whereby the statutory processing deadline is observed in order to protect patients' rights.
Please note that the stated processing time is an average value of all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and can be extended accordingly. The same applies if documents or records are sent by post to you or your health insurance company.
If necessary, the medical service must be involved. This requires an additional 5 weeks to process your request.
Applications / forms
- Forms available: no
- Written form required: no
- Informal application possible: yes
- Personal appearance required: no
- Online service available: no
For further information on the application, please contact your health insurance company directly.
Appeal
- Contradiction
- Action before the Social Court
Technically approved by
Federal Ministry of Health (BMG)
Professionally released on
19.01.2023
Author
The text was automatically translated based on the German content.
