When does disability occur: Your guide to clarity and financial security
11 May 2025
Katrin Straub
Managing Director at nextsure
One in four employees in Germany will become unable to work during their lifetime. But when exactly is one considered unable to work, and when does the insurance pay out? This article provides you with the answers and shows you how to secure your financial future.
The topic in brief and concise terms
Occupational disability usually occurs if you are expected to be able to perform less than fifty percent of your job for at least six months.
A private disability insurance is essential, as the state disability pension is often insufficient and subject to strict conditions.
Mental illnesses are the most common cause of occupational disability, followed by musculoskeletal disorders.
Immediate Overview: When Does Occupational Disability Occur?
An occupational disability exists when you are unable to perform at least fifty per cent of your last job due to health reasons for an expected period of at least six months. This regulation is anchored in the Insurance Contract Act (VVG) and forms the basis for most private occupational disability (BU) contracts. A doctor's prognosis for this six-month period is decisive. Many insurers then pay retroactively from the start of these six months.
Understanding the 50% Threshold: What Does Partial Occupational Disability Mean?
The so-called fifty-percent rule is a key criterion in answering the question "When does occupational disability start?". It states that you are entitled to benefits if you can perform your professional activity at less than fifty percent. For example, if a software developer can program for only three hours a day instead of eight, this threshold would be reached. The exact definition and assessment can vary depending on the contract, so a look at your insurance conditions is essential. It's not just about pure working hours, but also about whether the defining tasks of the profession can still be carried out. This aspect is often crucial for the approval of benefits.
The Six-Month Period: Forecast and Reality
For recognition of occupational disability, a forecast period of at least six months is crucial. A doctor must certify that you are likely unable to continue your profession as usual for this duration. If a roofer is expected to be unable to work on the roof for seven months following an accident, the condition is met. It is important that the occupational disability is not only temporary, but anticipated over this extended period. Most insurers will then provide benefits from the start of the six-month period, also retrospectively. The claims assessment by the insurer can take some time.
Legal situation versus private provision: Why disability insurance is so important
Since the first of January 2001, there is no longer a state occupational disability pension for those born after 1961. Instead, there is the reduced earning capacity pension, which is tied to stricter conditions and often results in significantly lower benefits. To be considered as having reduced earning capacity, you often must be unable to perform any work for more than three hours a day. A private occupational disability insurance is therefore essential for most employees to maintain their standard of living. It pays out if you can no longer perform your last job, not just any job. The difference between occupational disability and reduced earning capacity is significant.
Expert Depth: Legal Foundations and Pitfalls
The definition of occupational disability can be found in § 172 of the Insurance Contract Act (VVG). It states: "A person is considered occupationally disabled if they can no longer perform their last job, as it was without health impairment, due to illness, bodily injury, or more than age-appropriate physical decline, either fully or partially, and likely permanently." For persons born before the second of January 1961, different regulations partially apply according to § 240 SGB VI. Pay attention to clauses in your contract, such as the "abstract referral". This could entitle the insurer to refer you to another job that you could theoretically still perform, even if it does not match your qualifications or previous social standing. Good contracts do not include this clause. Recent judgments, such as regarding specific referrals, highlight how important precise contract design is.
Common Causes: From Mind to Skeleton
Mental illnesses are the most common cause of occupational disability, accounting for around 34.5 percent. This includes depression and burnout, which often lead to extended periods of absence. Second on the list are disorders of the skeletal and muscular systems, such as herniated discs, with approximately twenty percent. Cancer and other malignant tumors comprise about seventeen percent of cases. Contrary to popular belief, accidents are a less frequent cause, accounting for under eight percent. These statistics highlight that occupational disability can affect anyone, regardless of the type of occupation. An occupational disability insurance for the self-employed is equally important.
Young People and Occupational Disability: An Often Underestimated Risk
Young people, such as school pupils, students, and trainees, often underestimate the risk of occupational disability. Early conclusion of disability insurance is particularly sensible, as contributions are usually lower and there are often few or no pre-existing conditions. Young individuals generally do not yet have five insurance years in the statutory pension scheme and thus have little entitlement to state incapacity benefits. A private solution is therefore an important component for financial security right from the start. Many insurers offer special starter tariffs with more favourable initial contributions. The most common causes of occupational disability, such as mental illnesses, can also affect young people.
Expert Tip: Important clauses and pitfalls when concluding
When taking out disability insurance, pay attention to the following points:
Waiver of abstract referral: The insurer must not refer you to another profession that you could theoretically still exercise.
Prognosis period: Six months is common practice. Shorter periods are rare, longer ones are disadvantageous.
Retrospective benefits: The insurance should pay from the onset of occupational disability, even if the report is made later (within certain periods).
Guaranteed adjustments: Allows adjustment of the pension amount due to certain life events (e.g., marriage, birth, salary increase) without renewed health checks.
Contribution dynamics: The pension and contribution increase annually to compensate for inflation. You often have the option to object to this.
Health questions: Answer all health questions absolutely truthfully and completely. Misrepresentation can jeopardize insurance cover.
Term: Ideally, the benefit period should extend to the planned retirement age (e.g., 67 years).
No waiting period: Good disability insurance tariffs usually have no general waiting periods. However, delayed reporting of disability can lead to benefit reductions.
Weighing costs and benefits: What a good disability insurance costs
The cost of disability insurance depends on many factors: entry age, profession, health status, desired pension amount, and contract duration. A 32-year-old chemist with fifty percent office work pays around fifty euros net for a monthly pension of 1,500 euros until the age of 67. It's worthwhile to sign up early, as the premiums are often significantly cheaper then. However, a pension set too low can lead to financial shortages if a claim is made. Experts often recommend securing about eighty percent of net income. Compare different offers and pay attention not only to the price but especially to the terms of performance. Investing in a solid disability insurance is an investment in your financial security.
Your next step towards security
The question "Professional incapacity from when?" is complex, but with the right knowledge and appropriate insurance, it can be well managed. A disability insurance policy provides you with financial protection when you need it most urgently. It maintains your standard of living and protects you from existential worries. Act early and secure your ability to work – it is one of the most important insurances ever. Take your financial future into your own hands. Request an individual risk analysis now: Have your insurance situation checked for free and receive concrete suggestions for optimisation.
More useful links
Statista shows the distribution of causes of occupational disability in Germany.
GDV provides seven important facts about occupational disability insurance.
Statista visualises the probability of an occupational disability by the retirement age of 65.
Die Versicherer inform about the most common causes of occupational disability.
Deutsche Rentenversicherung explains the official definition of occupational disability in the context of statutory pension insurance.
Deutsche Rentenversicherung offers detailed information about disability pensions and their requirements.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) provides comprehensive numbers, data, and facts on the costs of incapacity for work in Germany.
Verbraucherzentrale informs about how to effectively protect oneself against income loss due to occupational disability.
Statistisches Bundesamt (Destatis) publishes official press releases and statistics that may contain relevant data on the working world and health.
FAQ
Ab wann genau bin ich berufsunfähig?
Sie gelten in der Regel als berufsunfähig, wenn Sie Ihren zuletzt ausgeübten Beruf infolge von Krankheit, Körperverletzung oder Kräfteverfall voraussichtlich mindestens sechs Monate lang zu fünfzig Prozent oder weniger ausüben können und dies ärztlich attestiert wird.
Welche Rolle spielt der Arzt bei der Feststellung der Berufsunfähigkeit?
Der Arzt spielt eine zentrale Rolle. Er muss den Gesundheitszustand beurteilen, die Auswirkungen auf die Berufsausübung dokumentieren und eine Prognose über die Dauer der Beeinträchtigung abgeben (meist mindestens sechs Monate).
Gibt es eine Wartezeit, bevor die Berufsunfähigkeitsversicherung leistet?
Nein, die meisten Berufsunfähigkeitsversicherungen sehen keine generelle Wartezeit vor. Der Versicherungsschutz beginnt in der Regel mit Vertragsbeginn und Zahlung des ersten Beitrags. Es kann jedoch eine Karenzzeit vereinbart werden, die die Auszahlung verzögert, aber Beiträge spart – dies ist meist nicht empfehlenswert.
Was passiert, wenn ich meinen Beruf nur noch teilweise ausüben kann?
Wenn Sie Ihren Beruf nur noch zu weniger als fünfzig Prozent ausüben können (bezogen auf Zeit oder prägende Tätigkeiten), gilt dies in der Regel als Berufsunfähigkeit und löst die Leistungspflicht der Versicherung aus.
Ist die staatliche Absicherung bei Berufsunfähigkeit ausreichend?
Für die meisten nach 1961 Geborenen gibt es keine staatliche Berufsunfähigkeitsrente mehr, sondern nur die Erwerbsminderungsrente. Diese ist oft niedrig und an strenge Voraussetzungen geknüpft (z.B. weniger als drei Stunden täglich irgendeine Arbeit). Eine private BU ist daher meist unerlässlich.
Lohnt sich eine Berufsunfähigkeitsversicherung auch für junge Leute?
Ja, besonders für junge Menschen ist eine BU sinnvoll. Die Beiträge sind oft günstiger, der Gesundheitszustand ist meist besser und der staatliche Schutz ist in jungen Jahren (z.B. während Ausbildung/Studium) minimal.
