title: [Case management for maintaining occupational status of handicapped patients. A model trial by the Bavarian federal district office].
abstract: Under the German social security system, medical benefits and services fall under the health insurance system, while vocational ones are the responsibility of the employment offices. In seamless transition cases, health funds almost exclusively rely on the relevant provisions of Book three--employment promotion--of the Social Code. Notwithstanding, sickness benefits frequently extend over the maximum period possible, i.e., 18 months, although the presence of disablement has been confirmed much earlier, and transition into unemployment certainly is no perspective either. Case Managements targeted at keeping disabled persons in employment have now been set up in several Bavarian employment offices. In close cooperation with the health funds' medical services, as well as in a number of other instances, they undertake early interventions to maintain employment, thus seeking to stem the traditional further course of disabled people still employed into the long waiting lines faced with at the rehabilitation agencies, or into unemployment and subsequent costly occupational reorientation, with continued joblessness awaiting them afterwards. The Case Management approach set out and analyzed in this article is intended as a model to be taken up elsewhere, having proven its benefit for people with disabilities while being cost-effective from an overall economic perspective due to its preventing the need to grant unemployment benefits and costly retraining. Guided by rehabilitation counsellors, the Case Managements are directed at rehabilitees and companies alike, and may take action through technical work aids, integration allowances, or skills adjustment programmes. For speedier, focussed implementation of the services offered, they "purchase" support and back-up from experienced agencies in the field, drawing on so-called "free" funding resources available under book three of the Social Code. Very good results using the model outlined have already been reported by the Nuremberg, Traunstein and Würzburg employment offices.
authors.affiliation: Landesarbeitsamt Bayern, Nürnberg.
authors.forename: J
authors.initials: J
authors.lastname: Göbel
mesh_terms: D019090:Case Management; D003362:Cost-Benefit Analysis / Q000331:legislation & jurisprudence; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence / Q000534:rehabilitation*; D005858:Germany; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence; D012050:Rehabilitation, Vocational / Q000191:economics; D012943:Social Security / Q000191:economics / Q000331:legislation & jurisprudence