Back to work after extended sick leave in Germany- BEM

It can happen to any of us – we fall ill for a long time, possibly many months. Returning to work after extended sick leave can be difficult (not only in Germany): On the one hand, you are still weakened by the illness you have just overcome. On the other hand, you may no longer be used to the work processes. It takes time to get back into your old routine.

To make this phase easier, there is a special instrument in Germany designed to facilitate this return – the so-called Workplace Integration Management (in German: „Betriebliches Eingliederungsmanagement“ - BEM).

different components of workplace health

But what exactly is Germany's BEM?

Workplace integration management (BEM) is a specifically German instrument for occupational health and safety. It is regulated in the German Social Code ( Sozialgesetzbuch SGB IX) – more precisely in § 167 (2) SGB IX – and concerns how employers deal with employees who have been ill for a long time.

The BEM is a procedure that employers should use to clarify the following issues with the employee concerned:

• How the incapacity to work can be overcome

• How a recurrence of incapacity to work can be prevented

• How the job can be retained

The company integration management (BEM) process can take place both during the period of incapacity to work and after the employee returns to work, depending on the situation and the objective of the procedure.

A BEM must (!) be offered if an employee has been unable to work for more than 6 weeks continuously or repeatedly within 12 months – regardless of whether the person is still on sick leave or has already returned to work.

Employers should offer the BEM promptly after the 6-week limit has been reached – even during sick leave. Whether the actual BEM meeting takes place before or after the return to work depends on the individual case, the state of health, and the willingness of the employee(s).

It is important to note that participation in the BEM is voluntary, but recommended. The employer must protect data privacy. And the employee can bring along a person they trust. A missing or inadequate BEM can lead to disadvantages for the employer in dismissal protection proceedings, especially if they wish to terminate the employment relationship.

Who is involved?

• Employer (often represented by the HR department or a manager)

• The employee concerned

• Works council or staff council (if available)

• Representative for severely disabled persons, if applicable

• Company doctor or external experts (e.g., rehabilitation provider), if applicable

Typical BEM procedure:

1. Offer of BEM by the employer (in writing)

2. Consent of the employee (BEM is voluntary!)

3. Meeting to clarify the situation

4. Analysis of stresses or barriers

5. Development of measures (e.g., adjustment of working hours, technical aids, transfer, etc.)

6. Implementation & follow-up

Objectives of the BEM:

• Protect health

• Preserve jobs

• Prevent long-term illness

• Legally compliant duty of care

Is the BEM only common in Germany?

Yes, in this form, the BEM is specific to Germany. Other countries have similar rehabilitation or reintegration measures, but:

• Most are not legally binding

• Often not structurally anchored in the company

• In some cases, more the responsibility of social security or doctors

Examples of similar approaches abroad:

•Australia: “Return to Work” programs (mandatory for certain injuries)

•UK: Fit Note & Occupational Health Support

•Sweden: Rehabilitation coordination by health services

•Canada: Work reintegration by professional associations

Have you ever heard of the “Hamburg model”?

The Hamburg model is a concrete tool for gradually returning to work after a long period of illness—and can be used as a measure within the framework of a BEM.

What is the Hamburg model?

The "Hamburg Model" is a form of gradual reintegration after a long period of incapacity for work. It allows employees, in consultation with doctors, employers, and health insurance companies, to gradually return to work—e.g., first 2 hours a day, then 4, later 6—until they have reached their original number of daily working hours.

Features of the Hamburg model:

• Voluntary for all parties involved

• Basis: medical certificate & reintegration plan

• Employees are still considered unable to work

• They receive sick pay (not salary)

• No entitlement under labour law to a specific duration or implementation

Example: An employee was on sick leave for 3 months due to a slipped disc. On medical advice, he begins a gradual reintegration over 6 weeks. This measure is coordinated and supported within the framework of the BEM.

In short:

The BEM is the framework, and the Hamburg model is one possible measure within it. So you could say: “A BEM can take place without the Hamburg model – but ideally, the Hamburg model should be part of a BEM.”

Is the Hamburg model a German invention?

Yes, it is! Yes, the Hamburg model is a German “invention” – more precisely, a form of practice developed in Germany for the gradual reintegration of people after a long illness. It was developed in Hamburg in the 1970s – hence the name. The aim was to gently and carefully reintegrate people into working life after a long illness. The idea was developed jointly by doctors, rehabilitation experts, and social insurance providers.

Although the model was originally a regional pilot project, gradual reintegration is now enshrined in law throughout Germany, namely in:

• § 74 SGB V (for those with statutory health insurance)

• § 28 SGB IX (for people with disabilities or rehabilitation needs)

The procedure is not directly referred to as the “Hamburger Model” in the law, but in practice the term is widely used – especially in the medical, labour law, and rehabilitation contexts.

What is occupational health management (BGM) as opposed to occupational integration management (BEM)?

Occupational health management (Betriebliches Eingliederungsmanagement - BGM) combines various operational tasks such as occupational safety, occupational integration management (BEM), and workplace health promotion.

BGM is the systematic organization and design of measures within a company to promote and maintain the health of its employees. The aim is to optimize workplaces, organization, and behaviour in such a way that they promote health, maintain performance, and prevent work-related illnesses and accidents.

BGM covers various areas, which are often regarded as three pillars:

• Occupational safety and health protection: Compliance with legal regulations and the design of safe workplaces.

• Workplace health promotion: Activities that directly promote employee health, such as back training, healthy canteens, or sports programs.

• Workplace integration management: A structured process for employees who have been absent from work for more than six months.

It is, so to speak, the big umbrella that holds all three areas together.

I publish interesting questions about German employment law judgements on this blog regularly. If you need special advice tailored upon your individual case, don't hesitate to get in contact with me.

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