WG 4: Rehabilitation Capacity

In addition to the need for rehabilitation and a positive rehabilitation prognosis, a prerequisite for participation in medical rehabilitation under pension and health insurance is the so-called rehabilitation capability. The rehabilitation capability is operationalized by a high degree of independence and mobility (e.g. being able to wash independently and move around the ward) as well as the ability to participate in therapeutic measures. As a result, people with more severe functional impairments or with a greater need for care despite a possible high need for rehabilitation (e.g. people with mental and/or multiple disabilities) fall through the existing care grid, also or above all because there is a lack of appropriate services.

The concept of rehabilitation capability has no basis in social legislation. According to §§4 and 42 SGB IX, it is exclusively a question of whether the services are likely to lead to an improvement in participation, i.e. whether relevant participation goals can be achieved. Rejections of rehabilitation applications on the grounds of a lack of rehabilitation capacity in the above sense also contradict the principles of the Convention on the Rights of Persons with Disabilities (2009) and the resolution on rehabilitation of the World Health Assembly of 27 May 2023, according to which people with disabilities or impairments should have access to rehabilitation services and rehabilitation programs that meet their needs. The construct of rehabilitative capacity is based on the care possibilities of rehabilitation facilities (e.g. lack of personnel and structural equipment of the respective rehabilitation clinic) and apparently does not refer to the quality of the person.

The working group discusses whether the application of the construct of rehabilitation ability systematically denies participation in medical rehabilitation to patient groups in need of rehabilitation, thereby systematically excluding these patient groups, and publishes this discussion. In addition, suggestions are made as to how a differentiated definition of the care capacity of rehabilitation facilities can enable access to rehabilitation based on the needs and actual rehabilitation potential of rehabilitants.

Speaker: Dr. phil. Christoph Egen