Returning to full-time work immediately after a long illness can be overwhelming. Phased return to work (also known as the "Hamburg Model") offers a structured path back into professional life: gradually, step by step, and with medical support. But how does it work exactly? Who is eligible? What happens to your salary during the process? And what obligations do employers have? This article answers all of these questions.
What Is Phased Return to Work? Definition
Phased return to work (§ 74 SGB V, § 28 SGB IX) is a procedure that allows employees to gradually return to working life after a prolonged illness – with progressively increasing workloads – while they are still officially classified as unfit for work. The process is guided by a step-by-step plan drawn up by the treating physician or a rehabilitation facility.
The procedure is also referred to as the Hamburg Model, as it was developed and piloted in Hamburg.
When Is Phased Return to Work Appropriate?
Phased return to work is particularly suitable in cases of:
- Prolonged illness (approximately 6 weeks or more of incapacity for work)
- Mental health conditions (burnout, depression, anxiety disorders)
- Serious physical illness or surgery
- Rehabilitation following an accident or cardiac event
- Chronic conditions with fluctuating capacity to work
How Does Phased Return to Work Function?
Step 1: Create a Step-by-Step Plan
The treating physician or rehabilitation facility draws up a reintegration plan that gradually increases working hours. Example:
- Weeks 1–2: 2 hours per day
- Weeks 3–4: 4 hours per day
- Weeks 5–6: 6 hours per day
- From week 7: Full working hours
The plan must be signed by all parties involved: the employee, the physician, and the employer. Phased return to work cannot take place without the employer's consent.
Step 2: Employer Consent
The employer must voluntarily agree to the phased return – there is no legal entitlement to compel their participation. In practice, employers typically agree, as it helps them retain valuable employees and can pre-empt a formal occupational reintegration management (BEM) process.
Step 3: Notification of Health Insurance or Pension Insurance
Responsibility for the phased return to work lies with either:
- The statutory health insurance fund (if the employee is receiving sick pay)
- The German Pension Insurance (within the framework of rehabilitation)
- The statutory accident insurance (in the event of a workplace accident)
What Happens to Salary During Phased Return to Work?
This is one of the most common misconceptions: during phased return to work, the employee is still officially classified as unfit for work. This means:
- The employer pays no salary
- The employee continues to receive sick pay from their health insurance fund (approximately 70% of gross salary)
- There is no entitlement to continued pay – phased return to work is a medical measure, not employment in the legal sense
Many employers nonetheless voluntarily pay a supplement or ensure continued remuneration – this is not mandatory, but it supports the return to work and strengthens employee loyalty.
Rights and Obligations During Phased Return to Work
Employee Rights
- Protection against dismissal: Any termination on grounds of illness during the phased return is subject to the same strict legal requirements as dismissal for illness generally
- Adjustment of the step-by-step plan: If the workload proves too demanding, the plan can be amended with medical support
- Right to discontinue: The employee may end the measure at any time without any impact on their entitlement to sick pay
Employer Obligations
- Assign reasonable tasks: During the phased return, employees must not be assigned duties that could jeopardise their recovery
- Provide an adapted workplace: This may include ergonomic adjustments or relief from physically demanding activities
- Confidentiality: The employee's illness must not be disclosed to colleagues without their consent
Phased Return to Work and Occupational Reintegration Management (BEM)
Phased return to work is not the same as Occupational Reintegration Management (BEM), though the two complement each other. BEM (§ 167 SGB IX) must be offered whenever an employee has been unfit for work for more than six weeks within a twelve-month period. It is a broader process aimed at sustainably securing an employee's ability to work. Phased return to work can form part of a BEM process or take place following its conclusion.
Frequently Asked Questions (FAQ)
Is the employee entitled to phased return to work?
Employees are entitled to support from their health insurance fund for phased return to work. However, the employer must agree – they cannot be compelled to participate in the measure.
Can phased return to work fail?
Yes – if the employee's health deteriorates, the workload proves too high, or the step-by-step plan cannot be maintained. In such cases, the employee reverts to full incapacity for work and continues to receive sick pay.
What happens after phased return to work concludes?
Once full fitness for work has been regained, the phased return ends and the normal employment relationship resumes. The treating physician issues a certificate of fitness for work.
Conclusion: Phased Return to Work as an Opportunity for Both Sides
Phased return to work is a win-win solution: employees return to their professional role in a health-conscious and sustainable way, while employers retain experienced staff and demonstrate a genuine duty of care. A professional return-to-work interview, a well-adapted step-by-step plan, and open communication between all parties are the keys to a successful reintegration.