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What is the difference between being unfit for work and occupational disability in Germany?

In short

What is the difference in Germany between being unfit for work (Arbeitsunfähigkeit) and occupational disability (Berufsunfähigkeit)? Time. Unfit for work means illness stops you working for now; your doctor certifies it, then employer and health insurer pay. Occupational disability means you are expected to be unable to do at least 50 percent of your job long term, often six months or more. Then a BU policy pays.

What is the difference between being unfit for work and occupational disability in Germany?

What it costs

What is paid at each stage, and what a BU policy costs that carries on after sickness benefit ends.

ExampleTypical range
Continued pay from your employer100 percent of salary for up to 6 weeks
Statutory sickness benefit 202670 percent of gross pay, at most EUR 135.63 gross per day
Duration of sickness benefitat most 78 weeks per illness within three years
BU policy, age 30, office job, EUR 1,500 pensionaround EUR 70 a month

As of November 2026.

Sickness benefit and continued pay by law, the cap from a publication on the 2026 values,

the BU premium from publicly quoted tariff examples.

Whether a tariff has a sick leave clause and after how many months of sick leave the continuing

condition counts as occupational disability varies by policy;

the six months are a guide value from our quoting practice.

Your premium depends on age, job and health; we obtain the exact quote for you.

Worked example

Nurse, 38, slipped disc

Over several months a sick note turns into occupational disability. This is how the terms and the money shift.

Weeks 1 to 6: unfit for worksalary from the employer
From week 7: still unfit for worksickness benefit, 70 percent of gross pay
Month 4: the doctor expects that lifting and positioning patients will not be possible againBU claim filed
Bedside care made up 70 percent of his working day50 percent threshold exceeded

The insurer accepts the occupational disability and pays back to the date it began. Sickness benefit and BU pension run side by side until sickness benefit ends; the BU pension continues.

Unfit for work: a look at today

Under the German sick leave guideline (Arbeitsunfähigkeits-Richtlinie), you are unfit for work if illness means you cannot do your most recent job, or could only do it at the risk of getting worse. Your doctor confirms this, and the certificate goes to your health insurer and your employer.

A sick note is about getting better. It says nothing about whether you will manage your job a year from now. Even during a gradual return to work (stufenweise Wiedereingliederung), when you start again with a few hours a day, you still count as unfit for work.

Occupational disability: a look ahead

The German Insurance Contract Act (VVG) defines occupational disability as being expected to be permanently unable, fully or in part, to do your last job as it was before your health problems began (§ 172 (2) VVG). Policies usually turn this into a 50 percent threshold and a forecast, often over six months.

So this is a prediction. The insurer asks for medical reports, a description of your working day with the time spent on each task and a doctor's view of how long your condition will last. A sick note alone is not enough.

PointUnfit for workOccupational disability
QuestionCan you work today?Can you still do at least 50 percent of your job in the long run?
Time frametemporaryexpected to be lasting, in many policies six months
Decided bytreating doctorinsurer after reviewing the documents
Moneycontinued pay, then sickness benefitthe agreed BU pension
Endsrecovery or after 78 weeks of sickness benefitimprovement, end of the policy or end of the benefit term

How the two are linked

Long sick leave often turns into occupational disability. Many policies have a rule for this: if you were unable to do at least 50 percent of your job without a break for a set period, the continuing condition counts as occupational disability. The model terms of the German insurance association (GDV) include this rule, and each tariff sets its own number of months.

It does not work the other way round. You can be occupationally disabled without a sick note. A nurse with a damaged back may be fit for a desk job and still be occupationally disabled in nursing.

Who pays at which stage

For the first six weeks your employer keeps paying your salary (§ 3 of the Continued Remuneration Act, EntgFG). After that your statutory health insurer pays sickness benefit: 70 percent of your regular gross pay, capped at 90 percent of net pay (§ 47 SGB V), in 2026 at most EUR 135.63 gross per day.

Sickness benefit for the same illness runs for at most 78 weeks within three years. Without a BU policy, what is left after that is often unemployment benefit or, if you can no longer work more than six hours a day in any job, the state reduced earning capacity pension (Erwerbsminderungsrente). A BU pension can start while you still get sickness benefit, and then both are paid side by side.

The sick leave clause in BU policies

Some BU tariffs already pay during long sick leave, before occupational disability has been assessed. This benefit is usually limited in time and needs a minimum period of sick leave. Whether your policy has it and how long it lasts is only in your own terms.

The clause helps when an assessment takes a long time. It does not replace good disability cover, because it stops when the sick leave ends or the maximum period is reached.

Points to know if you moved to Germany

The sick note system and sickness benefit apply to you as an employee with statutory health insurance, whatever your nationality. If you have private health insurance, sickness benefit is replaced by daily sickness allowance (Krankentagegeld), but only if you included it in your policy.

Policy terms and forms are usually in German, and the German wording counts in a claim. Your doctor's reports should describe your job in detail, not just name a diagnosis.

Step by step

  1. Keep your sick notes without gaps so sickness benefit does not stop.
  2. Ask your doctor for a forecast: will you be unable to do your job for six months or longer?
  3. Check your policy terms for a sick leave clause and the rule on continuing incapacity.
  4. Write down your working day with the time each task takes before you file the BU claim.
  5. File the BU claim early, not only when sickness benefit is about to end.

Checklist

  • Sick notes without any gap
  • Written medical forecast on how long it will last
  • Job description with hours per task
  • Policy terms checked for a sick leave clause
  • End date of sickness benefit in your calendar

Common mistakes

  • Assuming long sick leave already counts as occupational disability
  • Waiting with the BU claim until sickness benefit runs out
  • Thinking you must be on sick leave to be occupationally disabled
  • Treating the sick leave clause as a replacement for disability cover

Questions and answers

Frequently asked

Am I automatically occupationally disabled after six months of sick leave?

No.

Many policies let a long, unbroken incapacity of at least 50 percent count as occupational

disability,

and the number of months is in the policy.

The sick notes are evidence, but the insurer decides.

Can I be occupationally disabled without a sick note?

Yes.

BU cover asks about your job in the long run, not about a certificate.

If you can no longer do half of your job and work in a different role,

you may still be occupationally disabled.

Does the BU policy pay while I get sickness benefit?

Yes, if the conditions are met.

Sickness benefit is not suspended because of a private BU pension,

so both can be paid at the same time.

Am I unfit for work during a gradual return to work?

Yes.

Under the sick leave guideline, the incapacity continues during a gradual return to work.

How is this different from reduced earning capacity?

Reduced earning capacity (Erwerbsminderung) only applies if you cannot work six hours a day in any

job on the general labour market.

Occupational disability only looks at your own job.

Who decides on occupational disability?

The insurer, based on medical reports, expert opinions and your job description.

If it refuses, you can turn to the insurance ombudsman (Versicherungsombudsmann) or go to court.

Sources

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