How to select appropriate cases for rehabilitation management - approach of the German Social Accident Insurance

Abstract

In Germany, people injured in occupational-related accidents are offered comprehensive benefits ranging from medical care to occupational and social reintegration. Statutory accident insurance, funded solely by employers’ contributions, has developed specific structures and practical guidelines for rehabilitation management. This management process involves comprehensive planning, coordination and targeted encouragement and support for those needing rehabilitation. Rehabilitation management must commence promptly, be properly coordinated and achieve long-term effects. The measures deployed aim at restoring health and fitness to work as quickly and comprehensively as possible. In cases involving serious injury, rehabilitation management includes individual counselling and support as a follow-up to the primary medical care and extends beyond medical rehabilitation to include measures that assist occupational and social inclusion. Rehabilitation management demands considerable financial and human resources. To justify this relatively high expenditure, the cases involved need to be identified carefully based on relevant criteria. The accident insurance institutions have investigated how well this works in practice on the basis of their own experience and a wide range of case studies. An extremely important factor is the severity and complexity of the injury. A prognosis of inability to work for more than 112 days determines eligibility as a case needing rehabilitation management because occupational or social integration is at risk. Medical, psychological and social risk factors also need considering, as do the specific occupational requirements. A person's social and professional environment has to be taken into account from the very start. These variables must be examined and analysed as methodically as possible to establish the appropriate course of action.