Applying for sickness benefit from social compensation

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

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 unable to 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

1. are self-employed as your main occupation and have not made an election declaration to the health insurance fund,
2. are employed and have not made an election declaration, and
3. are marginally employed, your employment does not give rise to compulsory insurance and you are covered by 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 should 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.

The Hessian Offices for Care and Social Affairs (HÄVS) in Darmstadt, Frankfurt am Main, Fulda, Gießen, Kassel and Wiesbaden are responsible for this in the state of Hesse.

You can find the HAVS responsible for your place of residence under the following link:

If necessary, you must provide evidence:

• Proof of incapacity for work due to the injury
• Proof of loss of earnings

• 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, mental, intellectual or sensory impairments.
• You are unable to work.

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.

When you apply for social compensation benefits, the social compensation law institution will check whether you are entitled to sickness benefits. 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 online or in writing.

• If necessary, you can make an appointment with your contact person at the pension authority or at your responsible office.
• They will then discuss with you 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.
• However, you also have the option of submitting the application online. To do this, you must complete the online application and upload the necessary supporting documents
• The eligible costs and approved cash benefits will be transferred to the account you have specified.

There is no deadline.

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.

The application is free of charge

Further information can be found on the website of your country or your competent authority.