Disability and Migration Help for disabled people and their family members This presentation was created in connection with the bvkm project Living with one another It is available in Turkish, Arabic, English, and French. Information current as at August 2014. The author is Katja Kruse, bvkm.
Federal Association for People with Physical and Multiple Disabilities an organisation providing self-help for people with physical and multiple disabilities coalition of 240 regional self-help organisations approx. 28.000 members www.bvkm.de Category Law and Politics Guide My child is disabled here s where you can get help available for download at no charge since 2011 in Turkish-German since 2012 in Arabic-German since 2014 in Vietnamese-German 2
Living with one another Project of bvkm to initiate groups of parents with disabled children with a migratory background Project goals: To ensure that people with disabilities and, in particular, parents have access to services of parent self-help organisations and to encourage them to take part To train multipliers to inform families with a migratory background about the rights of disabled people and their family members and to support them in exercising their rights www.bvkm.de à Work areas à Migration and disability 3
Breakdown of the presentation I) Benefits by health insurers (German Social Code [SGB] V) II) Benefits by long-term care insurers (SGB XI) III) Integration assistance benefits (SGB XII) IV) Basic security in old age and in the case of reduced earning capacity (SBG XII) V) Disability identification card (SGB IX) VI) Tax relief (German Income Tax Act [EStG], German Vehicle Tax Act [KraftStG]) VII) How do I get further information? 4
Part I: Benefits by health insurers (SGB V) Health insurers provide benefits for early recognition and treatment of diseases. The scope of the benefits provided by statutory health insurance (gesetzliche Krankenversicherung) is set down in Social Code V. A person needs to belong to a statutory health insurer (gesetzliche Krankenkasse) in order to receive these benefits. 55
Benefits by health insurers (SGB V) Information for foreign residents: Foreigners who live in Germany and belong to a statutory health insurer may also claim the benefits defined in SGB V. Foreigners who work in Germany at a job with mandatory social insurance contributions are automatically insured by a statutory health insurer. Without work, it is impossible for most foreigners who come from countries outside of the European Union (EU) to obtain statutory health insurance. 6
Benefits by health insurers (SGB V) Medication Everyone with insurance is entitled to prescription medications. The health insurer pays for over-the-counter medications only in the following cases: for children, up to the age of 12 for young people with developmental disorders, up to the age of 18 for insured people regardless of age, if the medication is a standard therapy that is necessary for treating a serious illness 7
Benefits by health insurers (SGB V) Therapy e.g. physical therapy, ergotherapy, and speech therapy Therapeutic aids e.g. hearing aids, prosthetics, and wheelchairs In general, insured individuals can obtain therapeutic aids only from medical supply companies and pharmacies, as well as from manufacturers who are contract partners of their health insurer. Where there is a justified interest (e.g. because there a specific need for adaptation), insured individuals can, by way of exception, choose another service provider. 8
Benefits by health insurers (SGB V) In-home care e.g. injections provided by a caregiver in the person s home or at school or kindergarten. prerequisite: care may not be provided by a person living in the household Travel costs for outpatient treatment e.g. for insured people with the following codes in the disability identification card: ag, Bl, H and for care recipients with care level II or III 9
Benefits by health insurers (SGB V) Hospital escort The costs for engaging an escort are covered if this is necessary for treatment for medical reasons. Household assistance is granted to insured individuals when they are unable to continue to maintain the household, e.g. due to hospitalised treatment A child must be living in the household who is younger than 12 or is disabled and reliant on assistance. There must be no other person in the household who could continue to maintain it. 10
Benefits by health insurers (SGB V) Sickness benefits when the child is ill Parents are entitled to sickness benefits if a physician s certificate confirms that they need to care for their sick child and for this reason are unable to go to work. The sick child must be younger than 12 or be disabled and reliant on assistance. There must be no other person in the household who is available for providing care. Benefits are payable 11
Benefits by health insurers (SGB V) Co-payment rules In general, health insurers charge a co-payment of 10% of the costs for all provided benefits, with at least EUR 5 and at most EUR 10 being due per benefit. Starting 1 January 2013, the so-called office visit fee (Praxisgebühr) of EUR 10 was done away with. Children and young people under 18 are exempt from co-payments, other than for travel costs. Starting at age 18, an insured individual s co-payments are capped at 2% of his or her annual gross income per year. With regard to chronically ill and disabled individuals who are receiving constant treatment for the same serious disease, the threshold is 1% of their annual gross income (so-called chronic rule ). 12
Part II: Benefits by long-term care insurers (SGB XI) Long-term care insurers provide certain benefits when a person is in need of long-term care. The scope of the benefits provided by statutory long-term care insurers is set down in Social Code XI. A person needs to belong to a statutory long-term care insurer (gesetzliche Pflegekasse) in order to receive these benefits. 13
Benefits by long-term care insurers (SGB XI) Information for foreign residents: Foreigners who live in Germany and belong to a statutory long-term care insurer may also claim the benefits defined in SGB XI. Foreigners who work in Germany at a job with mandatory social insurance contributions are automatically insured by a statutory long-term care insurer. Without work, it is impossible for most foreigners who come from countries outside of the European Union (EU) to obtain statutory long-term care insurance. 14
Benefits by long-term care insurers (SGB XI) Long-term care insurance is broken down into three levels of need for long-term care: Care level 1 Need for daily assistance of at least 1.5 hours Care level 2 Need for daily assistance of at least 3 hours Care level 3 Need for daily assistance of at least 5 hours Cases of hardship: e.g. end-stage cancer 15
Benefits by long-term care insurers (SGB XI) In determining the need for long-term care for disabled children, the following applies: Decisive for the level of care is only the additional need for care that exceeds the need for care for a child of the same age (e.g. more frequent meal times, additional personal hygiene, etc.). The degree of the need for care is determined by the Medizinischer Dienst der Krankenkassen (MDK). It pays a visit to the home and ascertains the need for care using a questionnaire. ADVICE: In order to prepare for this visit, it is recommended that a daily care log be kept. 16
Benefits by long-term care insurers (SGB XI) Starting 1 January 2013, benefits for people with significantly impaired daily living skills now receive greater benefits as a result of the German Long-Term Care Restructuring Act (Pflegeneuausrichtungsgesetz, PNG) This group of persons includes, e.g., people with a mental disability. Examples of significantly impaired daily living skills: tendency to wander away, aggressive behaviour, failure to recognise dangerous situations If they are in care level 1 or 2, individuals with these types of impairments receive a greater amount of long-term care money and non-cash benefits. Also newly introduced is the ability of individuals in care level 0 to draw long-term care money and non-cash benefits. The level of benefits remains unchanged for people without impaired daily living skills. 17
Benefits by long-term care insurers (SGB XI) Non-cash benefits this benefit is provided when a long-term care service provides the care. Care level Without impaired daily living skills up to With impaired daily living skills up to 0 no benefit 225 1 450 665 2 1.100 1.250 3 1.550 1.550 Individuals in need of long-term care in level 3 receive up to 1,918 in cases of hardship. 18
Benefits by long-term care insurers (SGB XI) Long-term care money is provided when the individual in need of long-term care is cared for by a family member or volunteer caregivers. Care level Without impaireddaily living skills monthly Without impaireddaily living skills monthly 0 no benefit 120 1 235 305 2 440 525 3 700 700 19
Benefits by long-term care insurers (SGB XI) Substitute care is provided if the caregiver is unavailable to provide care, e.g. due to illness or holiday. Parents can use the money, e.g. to pay for hourly care of their disabled child by a family-support service. The benefit is limited to an annual maximum amount. Since 2012: 1,550 NOTE: Since 1 January 2013, individuals with impaired daily living skills in care level 0 may receive substitute care. 20
Benefits by long-term care insurers (SGB XI) Long-term care therapeutic aids and home renovations Therapeutic aids For the use of certain therapeutic aids (for example, diapers, bed protection inserts) Monthly maximum: EUR 31 Technical therapeutic aids (for example, hospital beds, bath lifts) Co-payment: up to EUR 25 Care-related home renovations For example, widening doorways, installing a stair lift Subsidy of up to EUR 2,557 per renovation NOTE: Since 1 January 2013, persons with impaired daily living skills in care level may also receive these benefits. 21
Benefits by long-term care insurers (SGB XI) Short-notice care is provided if care is unable to be given at times in certain crisis situations Children, young people, and young adults under the age of 25 may also receive this in facilities of integration assistance agencies. The benefit is limited to an annual maximum amount. Since 2012: 1,550 22
Benefits by long-term care insurers (SGB XI) Additional support benefits Individuals with significantly impaired daily living skills (e.g. people with mental disabilities) are entitled to an additional support amount. up to 100 per month where there is a low need for support up to 200 per month where there is an increased need for support NOTE: In addition, since 1 January 2013, this group of persons is entitled to a greater amount of long-term care money and non-cash benefits. 23
Benefits by long-term care insurers (SGB XI) Additional support benefits Care level 0 Individuals who do not meet the requirement for a care level may also assert the claim if they have significantly impaired daily skills. What can the payment be used for? For example, for special services of general instruction and support (e.g. being read to, playing games, taking walks) but not for basic care or household assistance. 24
Benefits by long-term care insurers (SGB XI) Social security for caregivers Definition of caregiver Unpaid care, at least 14 hours per week Pension claim The long-term care insurer pays contributions for statutory pension insurance, provided the caregiver does not work in a paid position for more than 30 hours per week. Accident insurance The long-term care insurer adds the caregiver to the relevant accident insurance policy. Coverage exists for work-related accidents and occupational illnesses. 25
Benefits by long-term care insurers (SGB XI) German Long-Term Care Leave Act (Pflegezeitgesetz) Since July 2008, caregivers are entitled to unpaid leave from work. Up to 10 working days Provided this is necessary in an acute care situation in order to organise long-term care for a close family member consistent with needs. Up to six months If a close family member is being cared for at home and the caregiver is working for a company with at least 15 employees. 26
Part III: Integration assistance benefits (SGB XII) Integration assistance benefits are paid by the social welfare office. They are intended to help disabled people take part in community life or make it possible for them to work in a suitable job or other activity. The requirements and the scope of integration assistance benefits are set down in sections 53 et seq. of Social Code XII. Individuals are entitled to benefits if they have significantly limited options to participate due to their disability. 27 27
Integration assistance benefits (SGB XII) Information for foreign residents: EU citizens and foreigners with a solid residency status may also claim integration assistance benefits Asylum seekers are not entitled to integration assistance benefits. All other foreigners can receive integration assistance benefits where justified on a case-by-case basis. 28
Integration assistance benefits (SGB XII) As a social assistance benefit, integration assistance benefits are generally dependent on income and assets. The so-called principle of subordination is applicable. Some integration assistance benefits are free. These include benefits in a workshop for disabled people (WfbM). For other benefits, disabled individuals or their parents must pay a share of the costs in accordance with their income and asset circumstances. However, there are certain income and asset limits. Parents of disabled individuals over the age of 18 pay a maximum of EUR 31.06 per month for integration assistance benefits. In this case, there is no review of income and assets. 29
Integration assistance benefits (SGB XII) Benefits for disabled people under the age of 18/Examples: Early support Early support is intended to help disabled children as early as possible with learning and therapeutic (e.g. ergotherapy) support. It is usually provided by social-paediatric centres (SPZ) and early support agencies. It consists of benefits provided by health insurers and integration assistance benefits (so-called combined benefit ). Applications can be filed with the social welfare office or the health insurer. Parents are not required to share in the costs of early support. 30
Integration assistance benefits (SGB XII) Benefits for disabled people under the age of 18/Examples: Kindergarten Therapeutic kindergarten: Social welfare office covers the costs in connection with integration assistance benefits Normal/integrated kindergarten: Parents can be charged the normal cost contribution School Integration assistant for attending a normal school this benefit is free for parents Boarding school the social welfare office pays the costs for schooling as such in connection with integration assistance benefits; parent s share of the costs is limited to the living costs charged by the boarding school 31
Integration assistance benefits (SGB XII) General social integration assistance benefits/examples: Assistance in acquiring practical skills e.g. support measures that help with spatial orientation Assistance in supported living options e.g. learning assistance for support in daily activities Assistance for taking part in social and cultural life e.g. escort for going to the cinema Note: These benefits depend on income and assets. Parents of children over the age of 18 pay a maximum of EUR 31.06 per month. 32
Integration assistance benefits (SGB XII) Work-promoting integration assistance benefits/examples: Training assistance e.g. study helper for attending lectures at university Workshop for disabled people (WfbM) The workshop for disabled people (WfbM) offers a job or the opportunity to carry out a suitable activity to disabled individuals who, because of the nature or severity of their disability, are unable or not yet able to take work on the general job market. The costs for occupational training are paid for by the German Federal Employment Agency (Bundesagentur für Arbeit). The costs associated with job placement are covered by the social welfare office as an integration assistance benefit. 33
Part IV: Basic security in old age and in the case of reduced earning capacity (SGB XII) Basic security is paid by the social welfare office. It serves to secure an individual s subsistence (lodging, food, clothing) The requirements and the scope of benefits are set down in sections 41 et seq. of Social Code XII. Individuals are entitled to benefits if they are at least 18 years of age, are in need, and have a permanent and full reduction in their earning capacity. 34
Basic security (SGB XII) Information for foreign residents: Foreigners who maintain their customary place of residence in Germany may also claim basic security (Grundsicherung). However, asylum seekers are not entitled to these benefits. 35
Basic security (SGB XII) Full reduction of earning capacity exists when a person, because of illness or disability, is unable for an unforeseeable period of time to work for at least three hours a day under the customary conditions of the general job market. Disabled individuals who work at a workshop for disabled people or at a vocational rehabilitation facility are considered to have a full reduction of earning capacity. 36
Basic security (SGB XII) covers the following benefits: normal rates applicable to the individual entitled to benefits: Single persons: 391 Euro Spouses: 353 Euro Household members: 313 Euro reasonable, actual expenses forlodging, heating, and centralised provision of hot water, an added need of 2.3% of the applicable normal rate, where hot water is generated by appliances installed in the housing (decentralised provision of hot water) 37
Basic security (SGB XII) covers the following additional benefits: an added need of 17% of the applicable normal need level where the individual has a disability identification card with the code G or ag, a reasonable added need for people who are ill or disabled and require a costly diet, coverage of contributions for health insurance and long-term care insurance. 38
Basic security (SGB XII) In addition to the above-mentioned regular benefits, individuals entitled to basic security also receive benefits for the following one-time needs: initial outfitting of an apartment, including appliances, initial provision of clothing, initial outfitting in the event of pregnancy and birth, and since 2011 the purchase and repair of orthopaedic shoes, repair of therapeutic devices and furnishings, and rental of therapeutic devices. 39
Basic security (SGB XII) Income and assets of individuals entitled to basic security: Individuals are entitled to basic security only if they have a need. If the need for basic security is able to be covered by the individual s income and assets, the social welfare office does not provide basic security. Assets are protected up to an amount of EUR 2,600. Income of parents: Individuals are not entitled to basic security if the annual total income of one of their parents exceeds EUR 100,000. 40
Part V: Disability identification card (SGB IX) The disability identification card is normally issued by the pension office. In some German states, the responsibilities of the pension offices have been taken over by cities and districts. The disability identification card entitles holders to claim certain types of compensation for being disadvantaged (e.g. tax relief or free use of public transportation). The requirements for the issuance of the card and some of the types of compensation for being disadvantaged are set down in sections 68 et seq. of Social Code IX. Individuals are entitled to a disability identification card if their degree of disability (GdB) is at least 50%. 41
Disability identification card (SGB IX) Information for foreign residents: Foreigners can receive a disability identification card if they reside or work in Germany lawfully. This applies, e.g. to EU citizens and to foreigners who have a visa, a renewable residency permit, or a permanent residency permit. Asylum seekers who have a temporary residency permit may also receive a disability identification card. 42
Disability identification card (SGB IX) The pension office ascertains the degree of disability (GdB), which is measured according to the German Pension Medical Ordinance (Versorgungsmedizinverordnung, VersMedV) If the GdB is at least 50%, this is considered to be severe disability, and a disability identification card is issued. It is also examined whether the requirements for certain codes have been met. 43
Disability identification card (SGB IX) Codes G the cardholder is substantially impaired in his or her mobility in public ag the cardholder is extremely impaired in his or her mobility H the cardholder is helpless, in that he or she requires constant assistance from others B the cardholder is entitled to take along an escort Bl the cardholder is blind Gl the cardholder is deaf or substantially hard of hearing, accompanied by severe speech impediments RF the cardholder is generally excluded from public gatherings 44
Disability identification card (SGB IX) Overview of several types of compensation for being disadvantaged: Free public transportation for cardholders with code G, ag, H, or Gl by purchasing a ticket costing EUR 72 annually; the ticket is free for codes H and Bl Free transportation for an escort for cardholders with code B Parking in disabled-only parking spaces for cardholders with code ag or Bl 45
Disability identification card (SGB IX) Reduction of or exemption from the radio and television licence fee Legal situation until 31 December 2012: Until that time, cardholders with code RF and individuals drawing class II unemployment benefits or basic security under Social Code XII were fully exempt from the radio and television licence fee. Legal situation since 1 January 2013: The fee for each home is 17.98 per month. Full exemption can be applied for by: deaf-blind individuals and recipients of assistance for the blind, as well as recipients of class II unemployment benefit or basic security under Social Code XII Reduction to one third ( 5.99 per month) can be applied for by: blind or visually impaired individuals with a GdB of at least 60, and hearing-impaired individuals who are deaf, and disabled individuals whose GdB is at least 80 and who, on account of their affliction, are not able to take part in public events 46
Part VI: Tax relief (German Income Tax Act [EStG], German Vehicle Tax Act [KraftStG]) Tax relief is granted by the tax office. It serves to compensate for special burdens related to disability. Tax relief for disabled people is dealt with, in particular, in the German Income Tax Act (EStG) and the German Vehicle Tax Act (KraftStG). Normally, a certain degree of disability or a certain code in the disability identification card is required in order to obtain tax relief. 47
Tax relief (EStG, KraftStG) Information for foreign residents: Foreigners who maintain their residence in Germany are obligated to pay income tax. If they own a vehicle, they must also pay vehicle tax. If they have a disability identification card with the necessary codes, they can obtain tax relief under the same requirements as for German citizens. 48
Tax relief (EStG, KraftStG) Flat-rate allowance for disabled individuals (EStG) Purpose: Simplified assertion of impairments that are typically associated with a disability (e.g. increased need for laundry) Amount: from 310 to 1,420, depending on GdB 3,700 for blind and helpless individuals In addition to the flat-rate allowance, the following is also deductible: Costs for private travel Illness costs Assignability: The flat-rate allowance for a disabled child can be assigned to the parents if they are drawing child benefits for the child. 49
Tax relief (EStG, KraftStG) Flat-rate care allowance (EStG) Purpose: Simplified assertion of impairments that are associated with the domestic care of a helpless individual Requirements: domestic care care must be given by family members care must be given at least 36 days per year the individual in need of care must be helpless (code H or care level III) caregiver may not receive any income for the care Note: long-term care money that parents receive for their disabled child does not count as income! Amount: 924 50
Tax relief (EStG, KraftStG) Vehicle tax relief (KraftStG) Exemption from tax fully exempt are vehicles of severely disabled individuals who are helpless ( H ) or blind ( Bl ) or extremely impaired in their mobility ( ag ) Tax relief tax is reduced by 50% for severely disabled individuals who are substantially impaired in their mobility ( G ), or deaf ( GI ), provided they have waived the right to free public transportation The vehicle may be used only for travel that serves the disabled individual s movement, or household maintenance 51
Part VII: How do I get further information? www.bvkm.de Legal guides available for free download on the following topics: My child is disabled here s where you can get help My child is disabled here s where you can get help in Turkish-German My child is disabled here s where you can get help in Arabic-German My child is disabled here s where you can get help in Vietnamese-German Turning 18 with a disability what changes occur upon reaching full age? Tax information sheet for families with disabled children Child benefits for adult individuals with a disability Information sheet on basic security Testamentary bequests in favour of disabled individuals www.bag-selbsthilfe.de Legal guide The rights of disabled people and their family members www.lebenshilfe.de Information is available here for people with mental disabilities 52
Thank you for your attention!