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Benefits in the event of a need for care for persons insured under the statutory accident insurance scheme

If you need care as a result of an occupational accident, commuting accident or occupational disease, you can receive care allowance and other benefits from the statutory accident insurance.

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Gewerbliche Berufsgenossenschaften
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Procedure details

Your employers' liability insurance association or accident insurance fund, as the body responsible for accident insurance, will pay care allowance.

The amount of the care allowance depends, on the one hand, on the type or severity of your health impairment. On the other hand, the extent of the assistance required plays a role. Both together result in the so-called need for care, which is measured with a percentage. There is no nursing degree determination as in the statutory nursing care insurance.

Your percentage of need for care determines the amount of your care allowance. There is a minimum and a maximum amount set by law.

Care at home, if desired, has priority over placement in an inpatient care facility. Both private caregivers, such as relatives, and professional outpatient services can provide you with care at home.

The benefits of the statutory accident insurance due to the need for care have priority over the benefits of the social long-term care insurance and the associated long-term care insurance funds. Therefore, if you receive corresponding benefits from the statutory accident insurance, a claim to care benefits from the social long-term care insurance is suspended.

You are entitled to care benefits from the statutory accident insurance from the day on which you are helpless or in need of care. This means that you

  • require the help of other persons to a considerable extent
    • for the usual and regularly recurring activities of daily living
    • due to the consequences of an insured event
      • accident at work, commuting accident or occupational disease

  • Required Documents
    • You do not need to submit any documents.

Your employers' liability insurance association or accident insurance fund will check on its own initiative ("ex officio") whether you are entitled to care benefits.

  • The examination begins as soon as there are indications that you are in need of care.
  • Your employers' liability insurance association or accident insurance fund determines the percentage of the need for care.
  • You will receive a corresponding notice.

You do not have to submit an application. Nevertheless, you are free to apply for care benefits from your Berufsgenossenschaft or Unfallkasse online or by mail.

Online service:

  • Call up the online service.
  • You will be guided through the procedure on the accident insurance service portal.
    • If you would like to receive the response from your workers' compensation insurance association or accident insurance fund in the mailbox of your BundID account or My Company Account, you must have an account and authenticate yourself.
    • If you would like to receive the response by mail, you can also proceed without logging in.
  • Select your responsible employers' liability insurance association or accident insurance fund or determine it using the industry search.
  • Upload the required documents.
  • Fill out the online form and submit it.
  • Your report will be automatically forwarded to your accident insurance provider.
  • You will receive a response via the requested channel.

Online service of your employers' liability insurance association or accident insurance fund:

  • If you have access to the portal of your employers' liability insurance association or accident insurance fund, you can also submit the report electronically there, if necessary.

Reporting by mail:

  • Send an informal letter to your employers' liability insurance association or accident insurance fund.
  • Make sure you provide the required information and enclose the necessary documents.

There are no costs involved.

There is no deadline.

1 bis 2 Wochen

There are no indications or specifics.

  • Appeal
  • Detailed information on how to lodge an appeal can be found in the notification from your employers' liability insurance association or accident insurance fund.

Status: 10.03.2025
Editorially responsible for prodecure description: Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung
Source: Federal Portal