Case Study
Retraining of a nurse with bowel disease and alcohol addiction to become a social security clerk


The company is a health insurance company that hired a disabled employee after retraining.

Disability and functional restriction of the employee:

The man has a bowel disease. The disease occurred while he was already working as a nurse and manifested itself in severe diarrhea and bleeding. Because his large intestine was littered with ulcers, it was removed and replaced with an artificial anus in the abdomen. The man therefore carries an ostomy or colostomy bag. It can no longer be used for activities that require heavy lifting and carrying as well as the use of certain postures. This is particularly true when handling loads in a hunched or stooped posture, as this results in pressure in the abdominal area. Over time, he also developed a drinking problem and became addicted and unreliable. This could be related to taking certain drugs that contain opiates. When he took it off, he switched to alcohol, shifting his addiction.

Training and job:

After the secondary school leaving certificate, the man learned the profession of automotive mechatronics technician. He then signed up for several years as a soldier in the German Armed Forces and trained as a nurse there. When his bowel disease broke out, he had to give up this job and became unemployed. He kept himself afloat for a while doing odd jobs, but during this time he began to drink more alcohol.


The man decided to go on weaning therapy. But in order not to fall into the void after weaning, he tried to get rehabilitation from the employment agency. There it was suggested to him to find a career in a vocational support organization. The vocational support organization came to the conclusion that employment with a health insurance company, as a social insurance specialist, was a professional perspective for him. First he attended a three-month rehabilitation preparation course at the vocational support organization. Following this, he completed the actual vocational training or retraining, which he also successfully completed. The transition and learning did not cause him any problems. As for the job search, he quickly found a job in his new job with the help of the vocational support organization and the employment agency, which he attributes to his now self-confident appearance when applying for jobs. During his training he was looked after by the psychosocial and medical service of the vocational support organization.

Work environment - mobility:

Although he was banned from driving because of his alcoholism, he was able to get his driver's license back by passing the Medical-Psychological Examination. This was an important prerequisite for his new professional activity.

Assistive devices used:

Aids for ostomy care

Funding and participation:

The costs for finding a job, the rehabilitation preparation course and vocational training at the vocational support organization were borne by the employment agency. Advice and placement was also provided by the employment agency. The employment agency also paid the company or health insurance company an integration allowance as a wage subsidy.

Keywords and Further Information

No information about funding available.

ICF Items

Reference Number:


Last Update: 6 Jan 2021