Diese 5 Punkte sollten Sie im Bescheid ihres gesetzlichen Unfallversicherungsträgers prüfen
Ein Bescheid der gesetzlichen Unfallversicherung enthält mehrere wichtige Elemente:
- Recognition of the occupational accident: Wird der Unfall überhaupt als Arbeitsunfall anerkannt?
- Anerkannten Unfallfolgen: What injuries and damage to health were identified?
- Benefits granted: What medical treatments, rehabilitation measures and financial support are available?
- Rejections of claims: Which benefits were rejected and why?
- Notice of legal remedies: Informationen zu Ihren Rechten
Recognition of an accident at work
Ein zentraler Punkt sollte im Bescheid kontrolliert werden, ob der Unfall als Arbeitsunfall anerkannt wird. Nur wenn der Unfall anerkannt ist, besteht die Möglichkeit auf Entschädigungsleistungen. Prüfen Sie genau, ob die Begründung nachvollziehbar ist. Eine Ablehnung der Anerkennung kann erhebliche Auswirkungen auf Ihre Ansprüche haben.
Identified injuries and damage to health
Der Bescheid sollte alle durch den Unfall verursachten Gesundheitsschäden auflisten. Vergleichen Sie diese Liste mit Ihren eigenen Erfahrungen und den Diagnosen Ihrer behandelnden Ärzte. Fehlen Unfallfolgen oder werden sie falsch dargestellt, ist dies ein wichtiger Grund für einen Widerspruch. Die Art und Höhe der Ansprüche, die Ihnen zusteht, hängt bereits von kleinen Details ab.
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Benefits granted
Check carefully which benefits are granted by the employers' liability insurance association. These can be medical treatment, rehabilitation measures, injury benefits or pensions. Compare the benefits awarded with your actual needs and the recommendations of your doctors. Pay particular attention to whether the employers' liability insurance association offers a one-off payment instead of a monthly pension. A monthly pension is often more financially advantageous than a one-off payment.
One-off payments vs. monthly injury pension
The employers' liability insurance association often offers one-off severance payments instead of a monthly pension. These one-off payments can seem attractive at first glance, but are often the worse deal. A monthly pension offers long-term financial security and may adjust to changes in your earning capacity. Before accepting a lump sum payment, you should carefully consider the long-term financial implications and seek legal advice if necessary.
Refusal of benefits
You should pay particular attention to rejections of benefits. The employers' liability insurance association must give reasons for every rejection. Check whether these reasons are comprehensible and correct. It is often worth appealing against rejections. A rejection could be based on missing or insufficiently documented information, which can be refuted by additional evidence or medical reports.
Reduction in earning capacity (MdE)
In the case of long-term consequences of the accident, the decision may contain an assessment of the reduction in earning capacity (MdE). This assessment is decisive for any pension entitlements. Compare the assessed MdE with your personal assessment and the opinions of the doctors treating you. An underestimated MdE can significantly reduce your pension entitlement, which is why it is important to obtain an accurate and fair assessment.
Right of appeal and objection
You will find the information on legal remedies at the end of the notification. It informs you about your options for appealing against the decision. The appeal period, which is usually one month, is particularly important. Make a note of the end of this period and plan accordingly. A late appeal will generally not be considered and the decision will become legally binding.
Procedure for appealing against the BG decision
- Timely objection: The objection must be submitted in writing to the Employer's Liability Insurance Association in due time.
- Justification: The appeal should contain a detailed explanation of why you consider the decision to be incorrect. Include all relevant evidence, such as medical reports and witness statements.
- Inspection by the BG: After the objection has been submitted, the Employer's Liability Insurance Association will review the case again and may arrange for additional investigations.
- Decision: The employers' liability insurance association will issue a notice of objection. If the objection is rejected, you have three months to lodge a complaint with the competent social court.
Template: Objection against employers' liability insurance association
If you wish to lodge an appeal against a decision by the employers' liability insurance association, you should note the following:
- Address and subject: Enter the full address of the employers' liability insurance association and the subject "Objection to the decision of [date]".
- Introduction: State your personal details (name, address, insurance number) and briefly explain that you are appealing against the decision.
- Justification: Explain in detail why you consider the decision to be incorrect. Include relevant evidence, such as medical reports, reports from treating doctors, accident reports and witness statements. Clearly state which points of the decision you are disputing.
- Summary: At the end, summarise again which changes you are requesting and why you believe they are justified.
- Signature: Finalise the objection with the date and your signature.
Check BG decision: Common mistakes
- Incomplete or late reporting of the accident: May result in the accident not being recognised as an accident at work.
- Missing or insufficient documentation of the injuries: Can lead to an incorrect assessment of the MdE and thus to lower benefits.
- Failure to meet the objection deadline: This means that the decision becomes legally binding and your claims are permanently restricted or lost.
Use our digital & free notification check
As those affected, we know how opaque the notifications and the reasons for a rejection in the BG notification can be. That's why, together with our partner law firm from Berlin with 17 years of experience, we have developed the digital decision check. You can check how high your claim might be free of charge and in just a few minutes. Afterwards, our partner experts are also available to you and can advise you on the next steps to take against the employers' liability insurance association if you do not want to take them alone.
