Private occupational pension and sick pay simultaneously: How to secure your income doubly
18 May 2025
9
Minutes
Katrin Straub
CEO at nextsure
Can you receive a private occupational disability pension and sick pay at the same time? Many policyholders are unsure about how these benefits relate to each other. This article clarifies the situation and shows you how to avoid financial disadvantages.
The topic in brief and concise terms
Private disability insurance benefits and statutory sick pay can generally be claimed simultaneously and without deductions.
Be cautious with private daily sickness benefits: Payments are often suspended or offset when receiving disability pensions.
An incapacity for work clause (AU clause) in the occupational disability policy can expedite financial support before the occupational disability has been conclusively assessed.
Quick Facts: The key information on disability pension and sickness benefit at a glance
Receiving a private occupational disability pension and statutory sickness benefit is generally possible concurrently. Your health insurance fund is typically not allowed to reduce the sickness benefit just because you receive a private disability pension. A judgement by the Social Court of Trier has confirmed this practice since 2011.
The situation is often different with private daily sickness allowance. Contracts often stipulate that payments cease in the event of occupational disability. Therefore, examine your contract terms carefully to avoid surprises. The disability pension itself is a benefit from a sum insurance, and therefore is not reduced by other income such as sickness benefits. However, note that contributions to health and long-term care insurance may apply to your disability pension if you are legally insured; these are approximately eighteen percent. Meticulous planning of your financial security is therefore essential. This section provides you with the key facts for a quick overview.
Statutory sick pay and private disability pension: A combination without deductions?
Many employees wonder if statutory sick pay is reduced when they also receive a private disability pension. The good news: usually no. Statutory sick pay is a wage replacement benefit from statutory health insurance (GKV). You receive it after the six-week period of continued pay from the employer ends. It amounts to seventy percent of the gross, but no more than ninety percent of the net income.
The private disability pension, on the other hand, is a benefit from a private contract. It secures your standard of living if you can no longer perform your profession by at least fifty percent. A ruling by the Social Court of Trier in 2011 (File number S 5 KR 40/11) clarified that the private disability pension must not be offset against statutory sick pay. You can therefore receive both benefits in full simultaneously. This provides important financial support during a challenging phase of life. Find out more about disability pension as income in our blog. The clear separation of the systems safeguards your entitlements. The next question often concerns private sick pay.
Private sickness benefits: Different rules apply here compared to statutory sick pay
While statutory sickness benefits mostly continue to flow alongside the disability pension without reductions, it often looks different with private daily sickness allowances (KTG). The KTG is a private additional insurance that is particularly relevant for self-employed individuals and high earners above the contribution assessment ceiling. Many KTG contracts include clauses that provide for the suspension of benefits once disability is determined and a disability pension is paid. This can lead to problems, especially if the disability pension is approved retroactively. In such cases, KTG insurers often demand the repayment of daily sickness allowances that have already been paid. Pay attention to clauses about exclusion of repayment in your KTG contract.
However, some insurers also offer policies where the KTG is paid in parallel with the disability pension, at least for a transitional period. Therefore, it is crucial to examine the exact conditions of your daily sickness allowance contract. Here's a brief checklist of what you should pay attention to:
Check the definition of disability in the KTG contract.
Clarify whether a crediting or suspension of the KTG payment in the event of disability benefits is provided.
Observe regulations regarding retroactive granting of disability benefits and possible KTG repayment claims.
Find out about potential deadlines for reporting disability to the KTG insurer.
These points will help you avoid pitfalls. Coordinating both insurance benefits is complex, but feasible.
The Disability Clause (AU-Klausel): A Bridge to the Occupational Disability Pension
A so-called incapacity clause (AU clause) in disability insurance can be an important financial bridge. It provides benefits when you have been continuously signed off sick for a certain period, often six months (a certificate of incapacity from a doctor is sufficient). The advantage: You receive benefits equivalent to the agreed disability pension, even if the often lengthy assessment of occupational disability is not yet completed. The benefit period from the AU clause is usually limited to eighteen to thirty-six months. The AU clause significantly speeds up the financial support.
Note that benefits from the AU clause and daily sickness benefits can also affect each other. Some daily sickness benefit insurers cease their payments as soon as benefits from an AU clause commence. Make sure to clarify this with your insurers. The AU clause is particularly interesting for the self-employed, who have no entitlement to statutory sick pay. Find out more about the difference between statutory sick pay and daily sickness benefits. The exact conditions of the AU clause vary depending on the provider and tariff. Next, we will look at the deductions from your disability pension.
Deductions from Disability Insurance Pension: What You Need to Know About Contributions and Taxes
If you receive a private occupational disability pension, it is not available in full. Statutory health insurance members must pay health and long-term care insurance contributions from their occupational disability (BU) pension. Currently, these are based on the full contribution rate, including both employee and employer contributions, which can amount to around eighteen percent of the pension (fourteen percent general contribution rate plus individual additional contribution and approximately three point four percent for long-term care insurance for the childless from the age of twenty-three). Be sure to plan for these deductions when determining your BU pension amount.
Tax aspects must also be considered. The private BU pension is taxed with the so-called imputed income portion. Its amount depends on the age at the start of the pension and its term. For a classic BU pension, this imputed income portion is often relatively low, so that the tax burden remains manageable unless there are other significant incomes. A BU pension of, for example, two thousand five hundred euros per month often results in no or only minor tax payments for a single person without other income. It is different if the BU coverage is taken out as part of a basic pension (Rürup pension) or an occupational pension scheme; different tax regulations apply here. Find out about the tax liability of the BU pension. These financial aspects are crucial for your overall planning.
Expert Depth: Understanding Legal Principles and Current Judgments
The legal basis for sickness benefits is found in the Fifth Book of the Social Code (SGB V). § 47 SGB V, for example, regulates the amount and duration of sickness benefits. In contrast, occupational disability in private insurance is defined in the respective insurance conditions, often based on § 172 of the Insurance Contract Act (VVG). An important distinction is between incapacity for work (AU) and occupational disability (BU). AU is usually a temporary condition, while BU represents a likely permanent limitation, reducing the ability to perform one's last occupation to less than fifty percent.
The already mentioned judgment of the Social Court of Trier (Az. S 5 KR 40/11) from 26 May 2011 is central to the question of simultaneously receiving sickness benefits and a private occupational disability pension. It states that offsetting the private BU pension against statutory sickness benefits is not permissible. This judgement significantly strengthens the rights of the insured. For those privately insured with entitlement to daily sickness benefits, this judgment does not apply directly; here, the contractual terms prevail. In case of uncertainties or disputes with the insurer, consulting experts can be beneficial. Knowing these basics helps you better assess your claims. Now, onto specific recommendations for action.
Practical Section: How to optimize your insurance and avoid pitfalls
To be optimally covered in the event of a claim and to avoid financial disadvantages when receiving both a private occupational disability pension and sickness benefit (or daily sickness allowance), you should keep a few points in mind. A careful review of your existing contracts is the first step. Pay attention to the exact definitions of incapacity to work and occupational disability. Clarify the conditions for possible set-offs or adjustments of benefits. Early and transparent communication with both insurers is often helpful.
Here are some concrete recommendations for action:
Ensure that the amount of your occupational disability pension is sufficient to cover your living expenses even after deducting health insurance contributions and taxes (at least eighty percent of your net income).
Check your daily sickness allowance contract for clauses regarding the reduction or cessation of benefits when receiving an occupational disability pension.
Look for a good incapacity clause in occupational disability contracts for faster initial benefits.
Keep thorough records of all doctor visits, diagnoses, and sick notes.
Report a potential occupational disability and also longer periods of incapacity to work promptly to your insurers.
If necessary, seek support from specialised advisors or insurance law experts, especially when applying for benefits.
Our expert tip: Have your contracts reviewed regularly, for example every five years, or when major life changes occur (marriage, children, job change) and adjust them if necessary. The right strategy secures your income in the long term.
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More useful links
Wikipedia offers a comprehensive overview of disability insurance.
Wikipedia explains in detail sickness benefits in Germany.
The Federal Ministry of Health provides official information on sickness benefits.
The Federal Statistical Office (Destatis) delivers current statistics on absenteeism in Germany.
The Federal Ministry of Labour and Social Affairs (BMAS) defines the concept of disability in its pension lexicon.
The German Pension Insurance provides comprehensive information on reduced earning capacity pensions.
The German Insurance Association (GDV) offers important facts on disability insurance.
The Federal Institute for Occupational Safety and Health (BAuA) examines the costs of incapacity for work in Germany.
FAQ
How long will I receive sickness benefits from the statutory health insurance?
Statutory sick pay is provided for the same illness for a maximum of 78 weeks within a three-year period. The employer's continued payment of wages during the first six weeks is offset against this.
What happens if my private disability insurance pension is approved retroactively, but I have already received sickness benefits?
In this case, the income protection insurer may request the repayment of benefits already provided, as many policies exclude coverage for occupational disability. Check your income protection insurance terms.
Is a disability clause in occupational disability insurance always advisable?
An AU clause can be very useful as it often provides benefits faster than the actual disability pension. It bridges the period of sick leave until disability is confirmed. It is especially worth considering for self-employed individuals without entitlement to sick pay.
What role does the Trier Social Court play regarding disability pension and sick pay?
The Social Court of Trier ruled in 2011 (Case No. S 5 KR 40/11) that the private occupational disability pension should not be deducted from statutory sickness benefits. This ruling is an important reference.
Ideally, how much should my private disability pension be?
Your disability insurance pension should cover at least eighty percent of your net income to maintain your standard of living, as well as deductions for health insurance and taxes.
What can nextsure do for me?
nextsure provides comprehensive advice and tailored insurance solutions as a digital insurance portal. We help you optimize your contracts and close coverage gaps, including private occupational disability pensions and sickness benefits.
