Injury Benefit (Verletztengeld)

Requirements and commencement

Injury benefit is paid to insured persons who are unable to work as a result of an insured event or who cannot pursue full-time gainful employment because of a medical treatment measure, and who immediately beforehand were entitled to pay, earned income or certain social benefits (§ 45 para. 1 SGB VII). The entitlement arises on the day on which incapacity for work is medically certified (§ 46 para. 1 SGB VII). Since employees are entitled to continued salary payment by the employer during the first six weeks and this pay is offset (§ 52 SGB VII), injury benefit is in practice usually paid from the seventh week. It is calculated and paid out by the health insurance fund on behalf of the accident insurance carrier (§ 189 SGB VII).

Amount and duration

Injury benefit amounts to 80 percent of the regular pay – the regular gross pay before the onset of incapacity, limited to the contribution ceiling of accident insurance – and may not exceed net pay (§ 47 para. 1 SGB VII); the calculation follows the rules on sickness benefit under § 47 SGB V, and one-off payments are taken into account. It is thus higher than the 70 percent sickness benefit of statutory health insurance. Contributions to pension, unemployment and long-term care insurance are deducted from the benefit; injury benefit is tax-free but subject to the progression clause. It ends on the last day of incapacity for work, on the start of transitional allowance during vocational rehabilitation, or at the latest after the 78th week from the onset of incapacity, but not before the end of inpatient treatment (§ 46 para. 3 SGB VII). If a reduction in earning capacity of at least 20 percent persists thereafter, the injury pension follows.

Country comparison

The Swiss UVG daily allowance starts as early as the third day after the accident, likewise amounts to 80 percent of insured earnings and has no maximum duration. Austria grants no daily allowance to employees from statutory accident insurance; after continued salary payment, sickness benefit from health insurance applies until, where relevant, the disability pension (Versehrtenrente) begins. The German combination of six weeks of continued salary payment and a maximum of 78 weeks of injury benefit is thus more limited in time than the Swiss model but more generous than the Austrian one.