Step by step reintegration after illness up company practice

Kea Blum is a health journalist in the medical media team. Has been writing regularly for up|unternehmen praxis since 2016. After studying ecotrophology, she turned to journalism and specialized in the fields of medicine and health. She also writes frequently on topics related to social media.

"I will be absent for at least three months!" Such a message from employees makes every practice owner rotate. Recovery comes first – no question about it. But what happens afterwards? Can the employee provide the same full performance from one day to the next as before the breakdown?? Depending on the disease and the duration of the outbreak, the answer can be "no". The so-called Hamburg Model, a step-by-step plan for reintegration, helps to ensure that the return to work is successful.

An employee suffers a double herniated disc. The hospital stay is followed by eight weeks of rehab. She will be absent for a total of three months. In the practice, however, everyday life must continue, colleagues temporarily take over their patients. When the therapist returns to her job, however, nothing is the same as before. Standing or sitting for long periods of time? Missing. Frequent bending? Impossible. She grits her teeth -. Falls out again a few weeks later for several months.

After a lengthy illness, it is not possible for many employees to return to full performance from one day to the next. If they do try, it can happen, as in the example, that an employee is out of work even longer – and may not even be able to work as a therapist anymore.

Become active yourself

Offer your employees gradual reintegration on your own initiative. Both practice and employee benefit from this. Such a measure of medical rehabilitation is also known as the "Hamburg Model". It helps to gradually introduce your employees to the full load at their previous workplace after a protracted illness. The corresponding legal regulation is laid down in the Social Security Code (§ 74, SGB V). Whether your employees accept the reintegration measures is up to them, however. If they do not, they return to their old job as usual – if possible – after the end of the period of incapacity for work. As an employer, however, you are not allowed to reject the measures – for example, if your employee takes the initiative himself and approaches you about the Hamburg model. If you do, claims for damages are imminent.

By the way: The Hamburg Model is available to all employees, regardless of whether they are permanent, temporary, part-time, fixed-term or severely disabled. Also the kind of the illness does not play a role. And one more thing: Even during reintegration, your employee is not obliged to tell you the exact reason for the absence. Theoretically, he can simply call it "disease.

Six weeks: The magic limit

The Hamburg model only applies if employees are unable to work for at least six weeks – at a stretch or within a year (twelve months). All days on which incapacity for work existed are counted. This also includes absences due to rehabilitation measures.

Another prerequisite for the Hamburg model: a doctor confirms that the employee is sufficiently fit to take up work – only then are the chances of reintegration good. The prognosis that the phased integration will lead to the restoration of the ability to work at the old job is also necessary.

No additional costs for you

During the reintegration phase, your employee continues to be incapacitated for work. The six-week period during which you must continue to pay wages has already elapsed when the Hamburg model begins. He therefore receives sick pay from the health insurance company during the period of reintegration. If the measures start within four weeks after the end of a rehab, the pension insurance pays so-called transitional allowance. You can also provide additional pay as a voluntary benefit. However, this will be offset against sick pay or transitional benefits: The compensation benefits will be reduced accordingly or even eliminated altogether.

Step plan: Here's what it says

If your employee opts for the "Hamburg Model", he or she will work out the reintegration plan in consultation with you and his or her doctor. The measures included can be designed for a few weeks, sometimes they last up to several months – depending on the illness and the accompanying restrictions. The plan contains the following points:

– Start and end of reintegration after illness. – Details about the individual stages, such as the respective working hours, which slowly increase again. – The employee's right to withdraw from reintegration before the agreed end date. Participation is voluntary. – Suspension of provisions in the employment contract. After all, the employee is still classified as unable to work. – Optional: Provisions regarding the voluntarily paid salary.

The doctor accompanies your employee during reintegration. If necessary, the plan can be adapted to the state of health, extended or shortened in the meantime. In some cases, the model must also be discontinued – usually if your employee is unable to work for seven consecutive days during reintegration.

Agree and sign

Your employee finally submits the completed phased plan to you. If you agree to gradual reintegration as described, sign the plan. Your employee must then submit it for approval: If he or she is receiving sick pay, to the health insurance fund; after a rehabilitation measure, to the pension fund. If an occupational accident is the reason, the accident insurance fund is the right contact partner.

Good to know: During reintegration, the step-by-step plan replaces the employment contract and regulates the rights and obligations of you and your employee. This means – unless otherwise agreed – that your employee is not allowed to take vacation during this time, among other things. In turn, you are not entitled to expect your employee to perform at full capacity due to the existing incapacity to work, among other things.

Keep an eye on capacities

Just because an employee is back in the practice after an extended illness does not mean that everything will continue as it was before the absence. Because the fact is: Your employee will most likely be working as a therapist with significantly fewer hours at the beginning than was the case prior to the illness. Be sure to take this into account when planning your capacity. For example, only count the employee as a half-time employee. If there was a substitute, continue to employ him or her for the time being – if possible and if possible, with a lower number of hours. Depending on how capable your employee is at the start of reintegration, it may also make sense to temporarily give him or her less physically demanding tasks. About a little more desk work or only treatments, which are not so strongly stressful. Sit down in the team and discuss how to temporarily redistribute tasks. Get all employees on board right from the start. Explain the situation to them. After all, in most cases it is they who absorb the extra work – unless there is a replacement. For this to work well, team cohesion is enormously important. It is also a good feeling for the sick employee to know that all colleagues are behind him and support him in his reintegration. Because this hurdle is usually difficult enough for them – rejection within the team makes coming back even more difficult. During the reintegration process, keep talking to the employee to see if everything is going according to plan or if changes are necessary.

Hamburg model: The most important things at a glance

– Measure for reintegration after prolonged illness. – Target group: Employees who are unable to work for at least six weeks – at a stretch or within a year (twelve months). – During the reintegration there is still incapacity for work. – The employee continues to receive sick pay or transitional benefits. – A graduated plan replaces the work contract during the period. – A doctor draws up the plan in consultation with you and the employee. – The working hours are increased step by step Goal: Full performance capacity after the reintegration phase.

Knowing and taking advantage of funding opportunities

Sometimes illnesses or accidents leave lasting traces. Nevertheless, this does not mean that professionals cannot continue to contribute to the success of the practice with their expertise. It then often depends on the right environment. Many impairments can be well compensated by adapting the workplace. Be compensated with aids as well as technical work aids. Sometimes an amplified loudspeaker for the telephone is sufficient for hearing problems, or a standing aid for employees with a musculoskeletal disorder. So that you are not stuck with all the costs incurred for this, use financial support options. On the internet portal REHADAT aids you will find an overview of all aids as well as working aids and their financing possibilities.

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