{"id":102801,"date":"2026-10-15T14:52:00","date_gmt":"2026-10-15T12:52:00","guid":{"rendered":"https:\/\/ru.law\/?p=102801"},"modified":"2026-10-12T14:57:50","modified_gmt":"2026-10-12T12:57:50","slug":"berufsunfaehigkeit-depression-nachweise","status":"publish","type":"post","link":"https:\/\/ru.law\/en\/berufsunfaehigkeit-depression-nachweise\/","title":{"rendered":"Disability due to depression \u2013 what proof does the disability insurance company need?"},"content":{"rendered":"

What the Higher Regional Court of Saarbr\u00fccken has decided regarding proof of mental illness in occupational disability insurance<\/strong><\/h2>\n\n\n\n

Depression can lead to occupational disability, but the diagnosis alone does not automatically entitle someone to an occupational disability pension. This was confirmed by the Higher Regional Court of Saarbr\u00fccken in its ruling of December 10, 2025 (Case No. 5 U 80\/24). The decisive factor is how the illness specifically affects the individual's professional duties. Rogert & Ulbrich can help you build a solid case for this.<\/p>\n\n\n\n

The case: CEO with depression fails in his lawsuit<\/strong><\/h2>\n\n\n\n

The plaintiff was the commercial director of a family-owned gas station and automotive business. Following a stay in a psychosomatic clinic in 2016, he was continuously on sick leave for over two years. He stated that he suffered from moderate to severe depression, dysthymia, somatoform disorders, lack of motivation, and anxiety. He later took up internships and employment at other companies.<\/p>\n\n\n\n

He claimed benefits from four supplementary occupational disability insurance policies with two insurers. They rejected his claims, arguing that the required occupational disability had not been proven and pointing to a possible reorganization of his business and his ability to perform other commercial tasks. The regional court dismissed the claims after obtaining a psychiatric expert opinion. The Higher Regional Court of Saarbr\u00fccken upheld this decision.<\/p>\n\n\n\n

Is your disability insurance company questioning the impact of your depression? Have them review what evidence is missing in your case.<\/p>\n\n\n\n

Why diagnosis alone is not enough<\/strong><\/h2>\n\n\n\n

According to Section 172 Paragraph 2 of the German Insurance Contract Act (VVG), a person is considered occupationally disabled if, due to illness, injury, or a decline in physical or mental capacity exceeding that expected for their age, they are wholly or partially unable to perform their most recently held occupation, as it was structured before any health impairment, and this inability is expected to be permanent. Many contracts additionally require a specific degree of occupational disability, often 50 percent.<\/p>\n\n\n\n

The Higher Regional Court of Saarbr\u00fccken emphasized that occupational disability requires a medically sound prognosis indicating that the insured person is likely to be permanently prevented from working. While the expert witness confirmed a moderate depression, insufficient treatment data and a lack of evidence of specific functional impairments meant that no reliable conclusions regarding occupational disability could be drawn.<\/p>\n\n\n\n

Even the sick notes from the family doctor were of no help. Incapacity for work and occupational disability are different terms. The requirements for occupational disability are stricter.<\/p>\n\n\n\n

A diagnosis describes the illness, not its consequences in the workplace. It is precisely these consequences that you must document.<\/p>\n\n\n\n

Treatment and proof: What the court clarified<\/strong><\/h2>\n\n\n\n

The court also clarified that the existence of occupational disability does not depend on whether the illness is treated professionally. Insured persons are therefore not obligated to undergo a specific therapy in order to retain their entitlement.<\/p>\n\n\n\n

In practice, however, treatment plays a crucial role. Without conclusive findings, therapy reports, or specialist assessments, it becomes difficult for the expert to determine the occupational limitations. This is precisely where the plaintiff failed in the case at hand. Without a documented course of events, it is almost impossible to ascertain when, how frequently, and to what extent the symptoms impacted daily work.<\/p>\n\n\n\n

Those suffering from mental illness should therefore ensure that treatments and symptoms are medically documented. This applies particularly to specialist medical or psychotherapeutic treatments.<\/p>\n\n\n\n

Without conclusive medical findings, proving occupational disability due to depression is extremely difficult. Ensure you have complete and thorough documentation from the outset.<\/p>\n\n\n\n

This is the evidence required by disability insurance in cases of mental illness.<\/strong><\/h2>\n\n\n\n

For a successful disability insurance claim due to depression, medical documents should describe as specifically as possible which abilities are impaired. The following are particularly helpful:<\/p>\n\n\n\n