When should I go to rehab?

Rehab entitlement

"Reha" is the abbreviation for "rehabilitation" (recovery) and generally includes all forms of social, occupational and medical rehabilitation. In a narrower sense, however, “rehab” only refers to the period of a measure for which certain conditions must be met so that patients can take advantage of them. The most important medical requirement is that at least one of the following factors must be present: physical or mental illness with the potential of permanent restrictions, chronic illness or stressful environmental influences that contribute to permanent illness.

A rehab is usually done after clinical treatment recommended to treat symptoms developed by the disease as well as any sequelae or side effects of therapies. The aim is to restore long-term health or to promote the abilities and skills of the patients in order to cope with the illnesses in their everyday life as independently as possible. Each rehabilitation clinic has its own approvals. This means that it is only responsible for certain indications and not every rehabilitation clinic is available for all forms of treatment.

What is rehab?

Medical rehab aims to provide holistic care, support and support for patients. That is why interdisciplinary teams work in the clinics, i.e. specialists from various areas of health and medicine. These are various programs and measures to alleviate or completely remedy a physical or psychological damage to health.

The focus is on patients whose ability to work is threatened by their state of health in order to avert a disability pension. In addition, the offers are aimed at people who are not, not yet or no longer able to work. A specialty is that Follow-up treatmentin which rehab is used within a short time after a hospital stay. The advantage of this form of rehab is that there are no long waiting times.

Who is entitled to rehab - and how often?

First of all, everyone who is subject to German law is entitled to rehab. Section 4 of the Social Security Code I gives everyone the right to take the necessary measures to protect, maintain, improve or restore health and performance. Those who are insured with social security are also entitled to rehab in order to be economically covered in the event of illness or reduced earning capacity. The rehab is considered Compulsory health insurance benefits. The responsible cost bearers are usually the statutory health insurance, the statutory pension insurance or the private health insurance.

This results in the following prerequisites for entitlement to rehab:

  • medical necessity,
  • Rehabilitation ability of the patient,
  • positive rehabilitation prognosis,
  • Approval by the insurance provider,
  • possibly significant or partial endangerment of the ability to work.

As a patient, you can apply for rehab at any time. It is usually approved immediately if you have recently received clinical treatment (follow-up treatment). Once you have completed your rehab, you may first apply for a new rehabilitation after four years. Earlier times are only possible in urgent medical cases. The clinical pictures can make rehabilitation possible after about 2 years, but also after a few months after the end of the first rehabilitation.

Rehab refused - what now?

Follow-up treatment after a stay in hospital is usually not refused. The situation is different when those affected independently submit an application for rehab because it is then checked very carefully whether and what requirements exist.

The most common reasons for rejections are decisions about that

  • an outpatient rehab is sufficient.
  • the waiting time had not passed since the last rehab.
  • a rehab ability is not given.
  • insurance law conditions are not met.
  • there would be inadequate cooperation.

Put in any case Contradiction and justify it as detailed as possible. You should of course also yours Duty to cooperate always comply appropriately in order to prevent this reason for rejection. Explain your clinical picture, your impairments and the possible consequences for you, your family and your work life in order to be able to show how serious it is about you. Do you collect Evidence and Findings by specialists and thus underpin your argument. If new medical complications have occurred, please present them and point out that in this case the 4-year period would not apply.

Applying for rehab correctly

Follow-up treatment is the easiest and fastest form of rehabilitation. Because it takes place directly after the hospital stay, there are no long waiting times and the therapies are seamlessly linked. If you request rehab at a later date, it is best to explain the need as precisely and comprehensively as possible.

Last changed on: 01/18/2018

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