According to § 74 SGB V, gradual reintegration is intended to help employees who are unable to work to gradually become accustomed to their previous workload. Which conditions must be present for it, read free of charge in an excerpt from our hot off the press councellor BEM – reintegration in small and middle enterprises of Edeltrud Habib.
Gradual reintegration, often called the "Hamburg model," is only possible as long as the employee is still entitled to sick pay. It is suggested by the doctor in agreement with the patient, the health insurance company and the employer. It is said to facilitate the return to the old profession after prolonged illness.
Individually adapted increase of working hours
Gradually, the employee is reintroduced to the full workload at the previous workplace in order to achieve the transition to full working capacity. Through an individually adapted increase in working hours and workload within the framework of a medically, work-physiologically and psychologically justified as well as medically monitored reintegration plan (step-by-step plan), the aim is to have a favorable influence on the recovery and rehabilitation process. Fear of being overtaxed. To reduce a relapse of illness.
Employee must be sufficiently resilient
Gradual reintegration is a measure of medical rehabilitation. In principle, all employees are entitled to gradual reintegration by the statutory health insurance fund after a long illness. The medical prerequisite for gradual reintegration is sufficient resilience and the prognosis that gradual reintegration will lead to the restoration of the ability to work in the old job. (from: "BEM – Wiedereingliederung in kleinen und mittleren Betrieben", S. 54)
Note from the online editorial team:
Claim against the employer
According to the now prevailing opinion of labor law, employees are entitled to have their employer enable them to reintegrate in stages. This opinion is summarized by the Regional Labor Court (LAG) of Hamm as follows:
"Among the required measures of the operational integration management according to § 84 para. 2 SGB IX (since 1.1.2018: § 167 para. 2 SGB IX) also includes the implementation of a medically recommended gradual reintegration. The earlier view that the employer is free to decide on this is outdated following the introduction of Section 84 SGB IX. In the event of refusal, the employee is entitled to claim damages pursuant to § 280 BGB, § 823 Abs. 2 i.V.m. § 84 para. 2 SGB IX into consideration."(LAG Hamm, judgment of 4.07.2011 – 8 Sa 726/11).
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Participation is voluntary for employees
If a gradual reintegration is suggested by the employer or the doctor, the employees can decide for themselves whether to accept the offer. Written consent is required. A refusal has no negative consequences – not even for the further payment of sick pay or transitional allowance until recovery.
– The statutory health insurance pays sickness benefit in full during gradual reintegration. The same requirements apply as for payment of sickness benefits for incapacity for work. – The statutory pension insurance continues to pay transitional benefits until the end of gradual reintegration, if
a) the gradual reintegration within four weeks begins after the end of the benefits for medical rehabilitation of the statutory pension insurance (cf. § 15 SGB VI in connection with § 28 SGB IX [since 1.1.2018: § 44 SGB IX]) and b) the Necessity The works council has the right to determine whether a person is fit for gradual reintegration until the end of the medical rehabilitation services financed by the statutory pension insurance and whether reintegration has been initiated by the rehabilitation facility.