Sitting for long periods of time and back problems of various kinds go hand in hand these days. It only sounds logical to apply for an office chair from your health insurance provider to avoid long-term problems, doesn't it?
Find out below what this looks like in practice and what steps you need to take to get an ergonomic office chair.
Important: Acceptance by the health insurance company is always a case-by-case decision that depends on various factors. A positive decision can therefore not be guaranteed.
Requirements for cost coverage by the health insurance company
If you work as an employee, your employer is obliged to provide you with an ergonomic workstation. However, the legal framework is based on a general standard and any need beyond this is not covered by law and therefore does not have to be financed.
Your health insurance comes into play if there is a medical necessity. You must therefore be able to prove that you need a special office chair over and above the standard in order to ...
... compensate for an existing disability,
... ensure the success of medical treatment or
... prevent an impending disability.
Accordingly, you can apply for an office chair from your health insurance provider if, for example, you have a slipped disc, chronic back pain or musculoskeletal disorders (e.g. arthritis). However, if you are above the weight for a standard chair due to a medical condition or require a wider seat, you can apply for an office chair for overweight people.
Addition for employees: You should speak to your employer before applying. Even if they do not pay for the chair, they must authorise the equipment to be used in the work environment.
You have to pay these costs despite the cost coverage
The statutory co-payment regulations stipulate that every policyholder must pay a co-payment when a prescription is filled.
This corresponds to 10 % of the selling price, but at least 5 euros and at most 10 euros.
This does not apply to you if you are exempt from this regulation because the payments would exceed your living expenses limit.
How can I increase my chances when applying?
Basically, the burden of proof is on you and you have to prove why you think your health insurance company is justified in covering the office chair.
If possible, appeal to the insurer that it is also in their interest to avoid long-term treatment costs. After all, a healthy posture on an office chair adapted to your stature can, in the best case, effectively prevent subsequent complaints.
You should therefore talk to your doctor at length and ask him or her to document the reason explicitly on the prescription. It should clearly state why the requested chair is medically relevant for you.
If you have already taken advantage of rehabilitation measures due to your illness or disability, you should also submit the relevant reports to support your argument.
It is very important for the cost coverage that you only apply for the office chair and purchase it after (possible) approval.
How to apply for your office chair from your health insurance company in 5 steps:
- Speak to the person in charge at your health insurance company and obtain all the necessary information.
- Visit your attending (specialist) doctor and have a prescription issued certifying that you need it.
- Were you in rehab because of your complaints? Then enclose the notification of your discharge.
- Ideally, you should obtain a quote for an office chair model that suits your disability.
- Submit the relevant documents to the health insurance company.
What if my health insurance doesn't cover my office chair?
The reasons for a rejection can be varied and must always be assessed individually. If this happens, you have one month from receipt of the rejection notice to lodge an objection in writing with your health insurance company.
If this is also unsuccessful and you feel you have been treated unfairly, you can appeal to the social court.
However, depending on your individual case, you may also have other options for taking over an office chair. It is best to enquire in advance whether your individual case is eligible for an application with the following contacts:
- German Pension Insurance (DRV)
- Statutory accident insurance
- Employer's liability insurance association
- Employment Agency
- State welfare organisations
