School, training, higher education and employment with a care grade

More than 20 percent of people who are supported by long-term care insurance are younger than retirement age. In most cases, the reason for their care need is a disability or chronic illness.

This doesn’t necessarily have to present a barrier to pursuing a career or attending school, university or training facilities. People with a care grade are entitled to claim long-term care insurance benefits (Eleventh Book of the German Social Code) and participation benefits (Ninth Book of the German Social Code) to enable them to participate in education and in the workforce. They need to apply for these benefits.

The personal situation of the applicant determines where they need to apply for the relevant benefits. Without any guidance, it can be difficult to know where to start. For example, people may be entitled to claim benefits from their long-term care insurance fund, accident insurance fund, health insurance fund, integration assistance or pension insurance. Social insurance agencies and rehabilitation funding organizations are obliged to forward any claims sent to the wrong cost bearer to the correct cost bearer. If a claim for benefits is rejected, it is possible to lodge an appeal.

While this entitlement is enshrined in the legislation, it is still often difficult to implement in practice in Germany. Support is available, for example, from social associations and self-help organizations.

Advice on all questions relating to school attendance, vocational training, higher education and employment is available in the form of complementary independent participation counseling (Ergänzende unabhängige Teilhabeberatung, EUTB).

It is mandatory for children with an assigned care grade to attend school. Every child has the right to attend a mainstream school, regardless of their underlying disability or illness.

If the support offered by the school is inadequate, children are entitled to benefits such as personal assistance, assistive aids and therapeutic pedagogy (special education) if these are essential to enabling them to attend school. 

Further information about inclusion and how it works in school is available from the Federal Ministry of Labor and Social Affairs (Bundesministerium für Arbeit und Soziales) on its Einfach teilhaben participation information portal.

Who supports children with a care and support need in school? 

A school escort or school support assistant (“Schulbegleiter” in German) is a personal assistant to help a child with tasks they cannot complete independently due to health impairments. As every school pupil will have their own individual capabilities and limits, the tasks involved in this role can be very varied.

They may include, for example, pushing a wheelchair, preparing materials, taking notes and transcribing, as well as helping the child resolve conflicts and communicate effectively with peers and teachers. The role may also involve care tasks, such as assistance with using the toilet, dressing and undressing or eating and drinking.

For more information about school escorts and about the prerequisites, claims and costs, refer to the Aktion Mensch e.V. inclusion funding organization.

What assistive aids can be used in school?

School boards are responsible for special room layouts and setup, furnishings and equipment and special learning materials. Other technical aids (assistive technologies) that are needed to meet the support needs of a child with a disability or illness are paid for by statutory health insurance within the framework of compulsory education. The duration of compulsory education (between 9 and 12 years) is regulated differently in different federal states in Germany. 

When should a special needs school be considered? 

In special schools, daily routines and lessons are tailored more to cater to the additional needs of the children who attend them. Care support and assistive aids are provided as standard in these schools. If children have a particularly high support need, they may also be supported by an assistant in a special school. 

More information about attending a special school is available from the Aktion Mensch e.V. inclusion funding organization.

What therapeutic support is available? 

If a child is not medically able to cope with a full day of school, child and adolescent rehabilitation services may be beneficial. There they learn to manage their disability or illness and cope with everyday life.

Therapies such as occupational therapy and speech and language therapy can also be helpful.

Further information about rehabilitation for children and adolescents can be obtained from the German Pension Insurance Organization (“Deutsche Rentenversicherung”).

Who offers advice on school attendance for children with health impairments? 

Information and advice about school attendance for children with a disability or chronic illness are available from: 

• Online education authorities
• Youth welfare services and health insurance funds (integration assistance) 
• Self-help organizations and parents associations 
•  Centers offering EUTB – complementary independent participation counseling

You can find self-help organizations and parents associations near you through the National Contact and Information Point for Encouraging and Supporting Self-Help Groups (Nationale Kontakt- und Informationsstelle zur Anregung und Unterstützung von Selbsthilfegruppen – NAKOS).

A list of centers offering EUTB complementary independent participation counseling in your area is provided on the website of the Fachstelle Teilhabeberatung agency for participation counseling.

Training in a recognized trade is open to people with a care need. Work placements are a useful way to try out different areas and get a taste for what type of job would best suit. Career entry mentors (“Berufseinstiegsbegleiter” in German) and rehabilitation advisors from the Federal Employment Agency (Agentur für Arbeit) provide career guidance support.

There are various training options that can meet your support needs and allow you to participate in the primary labor market.

Examples include: 

• Mainstream training: Assistants, assistive aids and equality measures enable people with support needs to complete mainstream training programs. 
• Part-time training: Daily or weekly working hours are reduced, which increases the duration of the training program. This type of training is open to people with health impairments and to people who are carers for others. 
• Skilled practitioner training (“Fachpraktiker-Ausbildung” in German): This option comes into consideration if the options listed above are not possible. It comprises a simplified training program in recognized occupations for people with a disability or a special support need.  
• Extra-company vocational training (“außerbetriebliche Berufsausbildung” in German): The theoretical and practical parts of the training program take place in a special educational facility, such as a vocational training center for disabled peopled, rather than in a company. 

In addition, those who have completed their schooling can claim various support benefits:

• Training supports (“ausbildungsbegleitende Hilfen”): Special tuition, learning support for exam preparation and help resolving problems when completing in-company training 
• Assisted training (“assistierte Ausbildung”): Support is provided, for example, when searching for a placement as a trainee and during preparation for training

Further information about career orientation, the various training options available and career entry is available from the Federal Employment Agency (Bundesagentur für Arbeit), the “REHADAT Education” portal operated by the Cologne Institute for Economic Research (Institut der deutschen Wirtschaft Köln e.V.) and the Federal Council of Vocational Training Centers (Bundesarbeitsgemeinschaft der Berufsbildungswerke e.V.).

Adaptations and assistive aids in the workplace 

A wide range of assistive aids and assistive technologies is available for various occupations, such as magnifiers, Braille keyboards, modified desks or modified tools. The costs of aids for use in the workplace and during training are covered by rehabilitation funding organizations (“Reha-Träger”). These also cover the costs of adaptations such as ramps if these are needed to facilitate access. 

Further information about assistive aids for training and employment is available on the Assistive Products portal operated by the Cologne Institute for Economic Research (Institut der deutschen Wirtschaft Köln e.V.).

Who offers advice on job training for people with health impairments? 

Information and advice about training and employment for people with a disability or chronic illness are available from: 

• The Federal Employment Agency  
• Specialist integration services 
• Integration Offices 
•  Centers offering EUTB – complementary independent participation counseling

Local advice centers operated by the Federal Employment Agency can be found on the Federal Employment Agency portal.

The Federal Association of Integration Offices and Central Welfare Offices (Bundesarbeitsgemeinschaft der Integrationsämter und Hauptfürsorgestellen, BIH e.V.) allows you to search online for the relevant specialist integration service or Integration Office.

A list of centers offering EUTB complementary independent participation counseling in your area is provided on the website of the Fachstelle Teilhabeberatung agency for participation counseling.

Students with a disability or a care need can choose to pursue any course of study that appeals to their personal interests and meets their requirements. Long-term care benefits don't reduce a person's entitlement to financial supports for education and training (BAföG).

How do assistants provide support in higher education? 

Assistants help meet the support needs of students with health impairments during their studies. Study assistants can, for example, provide assistance and support with lectures and seminars, library use and course-work preparation and follow-up. They don’t write exams for students or attend lectures and seminars. This type of assistance is often provided by other students.

It can be useful to have one permanent assistant to take care of multiple tasks and perform care tasks if necessary. This can be achieved by employing a personal assistant. Personal assistants help students respond with greater flexibility to the requirements of third-level education.

What assistive aids can be used in higher education?

Various assistive aids may be required depending on the chosen course of study –for example, laptops with Braille and audio output or tactile globes for students with a vision impairment, specially equipped PCs for students with motor impairments or stethoscopes for medical students with a hearing impairment. As a rule, students need to procure the aids themselves and apply to have the costs covered.

Some universities and colleges make assistive aids available free of charge for shared use by multiple students – for example, specially equipped computer workstations, portable access ramps or hearing induction loops for students with hearing impairments. 

What limitations apply to assistive aids in higher education? 

Students are generally entitled to claim participation benefits for their initial course of study (primary degree) and a subsequent master's degree. The same age limits that apply to financial supports for education and training (BAföG) apply here also – students must normally be younger than 45 years of age when beginning their studies.

More information about entitlements to support with higher education is available from the Information and Advice Centre for Students with Disabilities (Informations- und Beratungsstelle für Studium mit Behinderung und chronischen Krankheiten, IBS).

Who offers advice on attending higher education with health impairments?

Information and advice about attending higher education for students with a disability or chronic illness are available from: 

• The Information and Advice Centre for Students with Disabilities (Informations- und Beratungsstelle für Studium mit Behinderung und chronischen Krankheiten, IBS)
• Advice centers for students with support needs at the individual college or university
• Social advice centers provided by local student services
• Centers offering EUTB – complementary independent participation counseling

A list of centers offering EUTB complementary independent participation counseling in your area is provided on the website of the Fachstelle Teilhabeberatung agency for participation counseling.

People in need of care can choose to pursue any career that appeals to their personal interests and suits their personal skill set. In principle, they can access employment in the primary labor market. Self-employment is also an option.

Being assigned a care grade doesn't present a barrier to employment. There is no obligation to report a care need to an employer. In addition, being in employment doesn't reduce a person’s entitlement to long-term care benefits. However, their long-term care insurance fund may regard a new job as a reason to repeat the person's care assessment, as their level of independence may have increased.

The conditions under which a care assessment is repeated and a care grade is decreased are explained by consumer advice centers.

People with a disability are entitled to benefits that enable them to participate in working life so that they can pursue a career. These include workplace assistance, assistive aids, workplace adaptations and professional development and training. 

Information about eligibility for benefits to enable participation in working life and how to apply for these is available from the Aktion Mensch inclusion funding organization.

Training and employment in workshops for people with disabilities and in inclusive companies 

Training and employment can also take place in workshops for people with disabilities and in inclusive companies.

Workshops for people with disabilities, also known as sheltered workshops, are organized in way that is tailored to the health requirements of the employees and also includes care support. Workshops are facilities that enable reintegration into working life – employees don't pay mandatory social security contributions and rely on social welfare to subsidize their wages.

In inclusive companies or inclusive enterprises, people with and without disabilities work side by side. Employees with disabilities pay mandatory social security contributions and are paid regular wages. The work they do is suited to their needs and the company makes certain allowances for potential fluctuations in output and days off due to illness.

For more information about these opportunities, refer to the German Federation of Sheltered Workshops (Bundesarbeitsgemeinschaft Werkstätten für behinderte Menschen, BAG WfbM) and the Federal Association of Inclusive Enterprises (Bundesarbeitsgemeinschaft Inklusionsfirmen e.V.).

Who offers advice on employment with health impairments? 

Information and advice about training and employment for people with a disability or chronic illness are available from: 

• The Federal Employment Agency 
• Specialist integration services 
• Integration Offices 
• Centers offering EUTB – complementary independent participation counseling 

Local advice centers operated by the Federal Employment Agency can be found on the Federal Employment Agency portal.

The Federal Association of Integration Offices and Central Welfare Offices (Bundesarbeitsgemeinschaft der Integrationsämter und Hauptfürsorgestellen, BIH e.V.) allows you to search online for the relevant specialist integration service or Integration Office.  

A list of centers offering EUTB complementary independent participation counseling in your area is provided on the website of the Fachstelle Teilhabeberatung agency for participation counseling.