Cost bearers

Occupationally necessary aids (Section 49 (8) No. 4 SGB IX) are medical aids such as hearing aids or orthopaedic shoes. They are required in a professional context for the typical requirements of a specific professional activity (e.g. a special hearing aid for a teacher) or to improve occupational safety. The funding also includes necessary modifications, repairs and replacements, training in use, maintenance and technical checks. Professionally necessary aids are not required for other professional activities and are therefore not covered by statutory health insurance.

In contrast to medical aids, technical work aids (Section 49 (8) No. 5 SGB IX, Section 19 SchwbAV) generally include any work furniture, vehicles, machines, tools or hardware and software that serve to compensate for disability-related disadvantages in the performance of work activities. These can be both custom-made and commercially available products, such as screen readers, one-handed keyboards, forklift trucks with low access or special protective work clothing. Funding can be provided up to the full amount of the costs and covers the initial and replacement purchase, maintenance, servicing and training in use.

Motor vehicle assistance (Kfz-Hilfe) is available for people who, due to the nature and severity of their impairment, are permanently dependent on a motor vehicle to get to work or training and are unable to use public transport. This form of benefit includes, among other things, disability-related additional equipment such as steering wheel adaptations or body modifications, repairs and the purchase of a vehicle. The legal basis for motor vehicle assistance is SGB IX in conjunction with the Motor Vehicle Assistance Ordinance (KfzHV). The Motor Vehicle Assistance Ordinance sets out the requirements, the application process and the scope of benefits.

Housing assistance is available for people who, due to the nature and severity of their impairment, are permanently dependent on a disability-friendly home and need it for work-related reasons. This may be the case, for example, due to a job change or a move to a more easily accessible flat. Financial assistance includes structural adaptations such as kitchen remodelling or the construction or purchase of a property. The aim is to provide people with disabilities with barrier-free and independent access to their workplace.

Companies that employ or already employ people with severe disabilities are obliged under Section 164 SGB IX to take all reasonable precautions to enable disability-friendly employment and to maintain the workplace. This means that companies must bear the costs themselves if the changes are economically reasonable for them. However, there are also financial subsidies for equipping new or existing workplaces and training centres. Funding is available, for example, for work aids in the company or structural measures to create a barrier-free workplace, such as suitable access points, escape routes or sanitary facilities.

The most important funding providers for employers are the Federal Employment Agency and the Integration Offices/Inclusion Offices.

Employers can receive subsidies for the disability-friendly design of the workplace or training centre as well as workplaces, including operating facilities, machinery and equipment. The creation of part-time jobs for people with severe disabilities who can work at least 15 hours a week is also eligible for funding. Financial assistance can be provided up to the amount of the total costs and includes the initial and replacement procurement, maintenance, repair and training in the use of the subsidised work aids.

When subsidising disability-related measures, including in connection with investments as part of a new hire, the primary responsibility of the rehabilitation provider must first be checked.

For the creation of a new job for a person with a severe disability, grants or loans up to the full amount of the necessary costs are possible through the Integration Office/Inclusion Office (see § 15 SchwbAV). This applies both to new hires and to the creation of a replacement job to avoid the threat of dismissal in an existing employment relationship. Investment costs are, for example, costs for remodelling and renovation measures, for furniture, computers, software or new machines that are not disability-related and would also be incurred when hiring people without disabilities.

The Federal Employment Agency is responsible for people with disabilities who are looking for work and have reduced prospects of integration in the longer term. Funding is available, for example, for vocational training after school or for (re)integration after unemployment.

Within the framework of vocational rehabilitation, the Federal Employment Agency is also responsible for people with disabilities who are capable of work and who receive citizens' benefits through the job centres, provided that no other rehabilitation provider is responsible (see SGB III).

The statutory accident insurance institutions are responsible for occupational reintegration in the event of accidents at work, commuting accidents or occupational illnesses. These include the employers‘ liability insurance associations organised by sector, the agricultural employers’ liability insurance associations and the accident insurance funds. Statutory accident insurance is financed by employers. The benefits for medical, occupational and social rehabilitation are inextricably linked in statutory accident insurance according to the principle of ‘everything from a single source’.

The principle of ‘prevention before rehabilitation before retirement’ applies here. Insured persons whose earning capacity is significantly jeopardised or reduced due to an illness or disability are entitled to benefits for participation in working life. These benefits are intended to prevent a further deterioration in earning capacity and premature retirement from working life and, under certain circumstances, help to find a new job (see Section 16 SGB VI in conjunction with Section 49 SGB IX).

The requirements under insurance law are met if insured persons have fulfilled the 15-year waiting period or are drawing a reduced earning capacity pension, if a reduced earning capacity pension would have to be paid without these benefits or if the support benefits are required immediately following medical rehabilitation benefits in order to successfully complete rehabilitation (see § 11 SGB VI).

People with health problems for whom the community has a special responsibility are entitled to benefits. The support group includes victims of violent crimes, war victims of both world wars, people injured in community service and people injured by vaccinations.

The right to social compensation is regulated in the SGB XIV (formerly the Federal Social Security Act BVG). With the reform at the beginning of 2024, the former main welfare offices were renamed social compensation providers.

Children, adolescents and young adults up to the age of 27 who have a mental disability or are at risk of a disability are entitled to integration assistance. The public youth welfare agencies (youth welfare offices) or the municipalities (independent cities, rural districts) are primarily responsible for the services, unless another agency is responsible (see Section 86 SGB VIII, Section 35 a SGB VIII).

People who receive social assistance and are physically, mentally or emotionally significantly impaired are entitled to rehabilitation services as part of the integration assistance, provided that no other provider is responsible. Students are also among those entitled to receive this assistance. The providers of the integration assistance are determined by the federal states and can be, for example, cities, districts, state offices or regional associations (NRW) (see Section 111 SGB IX).