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Source: BUS Sachsen-Anhalt (Linie6PLus)

Applying for aids for persons with statutory accident insurance

Description

If you need aids due to an accident at work or an occupational disease, the accident insurance covers the costs. Only doctors authorised by the accident insurance institutions, the so-called transit doctors, can prescribe aids. Exception: visual and hearing aids. The respective specialists are responsible for this.

Aids are, for example:

  • prostheses
  • orthopaedic aids including fitting, such as orthoses, splints, bandages and the like.

The costs for maintenance or replacement are also borne, as well as for training in the use of the aids.

In principle, additional payments are not to be made in the statutory accident insurance. However, fixed amounts apply to some aids. If something more expensive is prescribed or you prefer a different model yourself, you must be informed by your doctor about the assumption of the additional costs.

If the goal of the medical treatment cannot be achieved with a "fixed amount" (medical justification required), the responsible accident insurance institution will cover the actual costs.

Accident insurance institutions are:

  • Trade associations, broken down by sector
  • Accident insurance institutions of the public sector (municipal accident insurance associations, state accident insurance funds, fire brigade accident insurance funds)
  • Agricultural employers' liability insurance associations

In the event of accidents at work or an occupational disease, accident insurance covers the costs of aids instead of health insurance according to specified fixed amounts. If the fixed amount is exceeded, you pay the additional costs.

An accident at work that leads to an incapacity for work of more than three calendar days must be reported by the company to the responsible employers' liability insurance association or accident insurance fund.

Those affected must consult a transit doctor. These are particularly qualified for the treatment of accident injuries.

  • The competent accident insurance institution must have recognised the damage to health as a result of an accident at work or an occupational disease.
  • The aid must have been prescribed by a transit doctor.

The accident insurance institution shall bear the costs, but only up to the amount of any fixed amount. If a more expensive drug or dressing is prescribed, the doctor must inform you of the additional costs. You have to wear them yourself.

The text was automatically translated based on the German content.

Lower Saxony Ministry of Social Affairs, Health and Equality

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