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What are the most common causes of occupational disability?

In short

What are the most common causes of occupational disability in Germany? Mental illness comes first with around 32 percent of BU claims, followed by back and joint problems with almost 18 and cancer with around 16 percent. Accidents cause only about 7 percent. So cover that pays only after an accident, or only for physical illness, leaves out the biggest risks.

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What it costs

What BU cover that pays for every cause costs. Examples with a monthly pension of EUR 1,500 from published tariff examples.

Example	Typical range
Student, 20, EUR 1,500 pension	about EUR 36 a month
IT specialist, 35, EUR 1,500 pension	about EUR 37 a month
Office clerk, 35, EUR 1,500 pension	about EUR 54 to 62 a month
Medical assistant, 35, EUR 1,500 pension	about EUR 82 a month
Tiler, 35, EUR 1,500 pension	about EUR 191 a month

Premium examples as of April 2026, for applicants without previous illness.

Cause shares from an analysis of claims with data as of 2026; older analyses put mental illness at up to 36 percent.

The state pension figure comes from 2024 statistics for Baden-Württemberg.

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

Worked example

Office worker, 35: which cover pays for which cause?

She is thinking about buying only accident insurance because it is cheaper. This is the result when you put the cause shares next to it.

Mental illness, around 32 percent of claims	BU pays, accident insurance does not
Back and joints, almost 18 percent	BU pays, accident insurance only after an accident
Cancer, around 16 percent	BU pays, accident insurance does not
Accident, almost 7 percent	both pay
BU with EUR 1,500 pension	about EUR 54 to 62 a month

Accident insurance covers only a small share of cases. With a EUR 1,500 pension up to age 67, up to EUR 576,000 is at stake over 32 years, so the extra premium for BU is small by comparison.

The causes in figures

These figures come from analyses of real claims, meaning BU pensions that insurers actually pay. BU stands for Berufsunfähigkeit, the German term for being unable to work in your own occupation. The picture is clear: illness, not a fall from a ladder, ends most working lives early. Almost one in three BU pensions is paid for a mental illness.

Shares vary by a few points between data sets. The order does not change: mental illness first, then back and joints, then cancer, with nerves, accidents and heart far behind.

Cause	Share of BU claims
Mental illness	around 32 percent
Back, spine and joints	almost 18 percent
Cancer and malignant tumours	around 16 percent
Other illnesses	almost 14 percent
Nervous system diseases such as multiple sclerosis	around 7 percent
Accidents	almost 7 percent
Heart and blood vessels	around 6 percent

Why mental illness leads

Depression, anxiety disorders and exhaustion are diagnosed and treated more often than in the past. Work pressure and constant availability add to it, and these illnesses often come in phases over a long time.

For you this means: a desk job lowers your premium, but it does not protect you from the most common cause. If you moved to Germany for a demanding job, far from family and friends, this risk is real.

Why the state pension is a weak backup for newcomers

The German state pension for reduced earning capacity (Erwerbsminderungsrente) normally requires at least five years of insurance, three of them with compulsory contributions in the last five years. If you arrived recently, you may not qualify yet, or only through periods from another EU country.

Even if you qualify, the state only asks whether you can work at all in any job, not in your own one. Someone who can still work three to six hours a day in any job gets only half of the already small full pension.

What this means for choosing your cover

Accident insurance (Unfallversicherung) covers only the smallest group of cases. Basic abilities insurance (Grundfähigkeitsversicherung) pays when you lose abilities such as walking, seeing or lifting, but usually not for mental illness. Critical illness insurance pays a lump sum for cancer or a heart attack, not a monthly income.

Only occupational disability insurance (Berufsunfähigkeitsversicherung) covers every cause in the same way. It costs more than the alternatives, but it is the one that matches the statistics. If you cannot get it because of your health history, pick an alternative on purpose and know which gap remains.

When you do not need BU cover

If your savings would carry you to retirement without a salary, you do not need it. The same goes if you are close to retirement and the premium would be very high for just a few years. Civil servants (Beamte) have their own rules and need a suitable clause rather than a standard policy.

Step by step

Check honestly whether you could live without a salary until retirement.
Judge any cover by all causes, not just accidents or your own job.
Answer the health questions completely, including therapy and back problems, also treatment abroad.
With previous illnesses, ask several insurers anonymously before an application is declined.
Choose an alternative only if BU is out of reach, and know the gap that remains.

Checklist

The policy pays for every cause, including mental illness
No blanket exclusion for mental illness or the back
Pension high enough to cover your running costs
Term until your planned retirement age
No abstract referral to another occupation (Verzicht auf abstrakte Verweisung)
Therapy and back treatment declared in full on the application

Common mistakes

Thinking accident insurance is enough, although accidents are a small share of claims
Believing occupational disability only affects manual workers
Leaving out psychotherapy on the application and later losing all cover
Relying on the state pension without having paid in long enough

Questions and answers

Frequently asked

What is the most common cause of occupational disability?

Mental illness such as depression, anxiety disorders or severe exhaustion. Depending on the analysis it accounts for 32 to 36 percent of claims.

How often is an accident the cause?

Only in about 7 percent of cases. More than 90 percent of claims are caused by illness.

Are office jobs less at risk?

For physical causes yes, which is why the premium is lower. Mental illness and cancer affect office workers just as much.

Does BU pay for burnout?

If doctors diagnose an illness such as depression and you are expected to be at least 50 percent unable to do your job for six months, yes. The word burnout alone is rarely enough.

Is basic abilities insurance enough?

It is an option if you cannot get BU. For mental illness it usually pays nothing or only with an add-on, so it misses the most common cause.

Do treatments in my home country count on the application?

Yes. Health questions cover treatment anywhere in the world, so declare therapy or back treatment from abroad as well.

Sources

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