🔄 Gradual return to work (Hamburg model)
In brief
After a longer exhaustion illness you do not have to go back to full-time work from one day to the next. The gradual return to work – known as the "Hamburg model" – allows you to increase your working hours step by step while you are formally still signed off sick. For this, the doctor, you yourself and the employer jointly set a reintegration plan that increases working hours and tasks in stages.
The measure is voluntary: neither you nor the employer can be forced to take part. During the gradual return you generally continue to receive sickness benefit or – during ongoing rehab – transitional allowance (Übergangsgeld), not your regular pay.
Step by step
- Discuss with your doctor or clinicThe treating person checks whether and when a gradual return to work makes medical sense and draws up a reintegration plan.
- Involve the employerSubmit the plan to the employer; the employer must agree to its implementation but is not legally obliged to offer it.
- Inform the benefit providerDepending on who is responsible (health insurer while receiving sickness benefit, pension insurance during ongoing rehab), the plan must be submitted and approved there.
- Carry out the stage planWork according to the agreed number of hours, which usually rises weekly; if it becomes too much, the plan can be adjusted or stopped.
- Have the progress medically supervisedRegular consultation with your doctor ensures that the workload is not increased too quickly.
Deadlines
- The gradual return to work is voluntary – the employer can refuse it without this directly causing you legal disadvantage; if the employer refuses without a comprehensible reason, this may be relevant under employment law in an individual case.
- During the gradual return you remain signed off sick – absences due to overload are not an "abandonment through your own fault" but a normal part of the process and should be medically documented.
- How high the payment during the gradual return is exactly (sickness benefit vs. transitional allowance) and whether employer top-ups are added depends on the individual case and is therefore not stated here with an example amount.
- Do not confuse the gradual return to work with a permanent reduction to part-time – it is meant as a transitional measure with the aim of fully restoring fitness for work.
In depth · legal basis, figures and practice – for advisers and professionals
Legal bases
For people with statutory health insurance, the entitlement to a medical prescription of a gradual return to work arises from § 74 SGB V; for rehabilitation patients of the pension insurance and other rehab providers, from § 44 SGB IX. Both provisions essentially regulate the same instrument from different areas of responsibility: during ongoing medical rehabilitation the pension insurance is responsible, otherwise the health insurer.
Process and participants
The treating doctor draws up a reintegration plan that describes the stepwise increase of working hours and workload over an individually set period (in practice usually a few weeks to a few months). The employer, the company doctor and – where one exists – the works or staff council are involved. The employer's consent is required, as the employer must make implementation at the workplace possible; according to the prevailing view there is in principle no statutory entitlement against the employer to carry it out, but this is discussed in employment law literature and has in individual cases already been the subject of labour court proceedings.
Financing during the measure
Since incapacity for work continues during the gradual return, regular pay is generally not paid; instead sickness benefit continues to be paid by the health insurer (§ 74 SGB V cases) or transitional allowance by the rehabilitation provider (§ 44 SGB IX cases). Some employers voluntarily pay a top-up; there is no automatic statutory entitlement to this.
Interplay with BEM
The gradual return to work is often initiated or accompanied within workplace integration management (BEM), but is legally a separate instrument and is also possible without BEM (see separate topic page).
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