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Applying for rehabilitation or a cure: differences, responsibility and application

Rehabilitation services are meant to restore your health and ability to work. Depending on the goal, a different body is responsible: the pension insurance when it is about preserving earning capacity, the health fund for medical rehabilitation. What matters are the correct application and medical justification.

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Your chances of getting your money back

If it is about preserving or restoring your earning capacity, the pension insurance is usually responsible; for purely medical rehabilitation the health fund. An application filed with the wrong body is generally forwarded.
If the application is refused, you can object within one month (§ 84 SGG). A good medical justification (findings, necessity) significantly increases the prospects of success.

What you should do now

  1. 1

    1. Clarify the goal

    Is it about earning capacity (pension insurance) or about medical rehabilitation/health (health fund)?

  2. 2

    2. Involve the doctor

    Have the necessity medically justified (findings report). That is the basis of the application.

  3. 3

    3. File the application

    File the application with the responsible provider. If unsure, it is forwarded to the right body.

  4. 4

    4. Object if refused

    Object on time and add medical evidence. If needed, a social advice service helps.

How to spot the scam

  • The application is filed without a sufficient medical justification.
  • The refusal is justified only in general terms.
  • The one-month deadline for the objection is overlooked.

Frequently asked questions

What is the difference between rehabilitation and a cure?

A medical rehabilitation aims at restoring health and participation after illness; the colloquial 'cure' is usually a preventive or rehabilitation measure. What is decisive is the goal and the responsible provider (health fund or pension insurance).

Who is responsible, the fund or the pension insurance?

If it is about preserving or restoring earning capacity, generally the pension insurance; for purely medical rehabilitation the health fund. If you file the application with the wrong body, it is forwarded.

What if the rehabilitation is refused?

You can object within one month (§ 84 SGG) and strengthen the medical justification. A concrete presentation of the health necessity increases the chances. Social advice services support you with this.

Take action now

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General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.