Objecting to a German care grade: secure the deadline, test the report
When the decision letter gives too low a grade or refuses care altogether: the deadlines, how to build the reasons and what happens next.
Checked by Radif Partners · Editorial policy · How we calculate
What a successful objection pays back
Back payment of allowance
€1,008
| more per month | €252 |
| more per year | €3,024 |
From the month of application if the higher grade applied from the start.
An objection (Widerspruch) against the care fund’s decision must be lodged within 1 month of notification, or within 3 months if the decision was delivered abroad (section 84 of the Social Courts Act, SGG). If the letter lacks correct information on how to appeal, the deadline extends to 1 year (section 66 SGG). The objection must be in writing, in qualified electronic form or recorded in person at the fund; the reasons can follow later. If the fund does not change its mind, a new assessment usually follows by an assessor not involved before, normally in the home and never as a phone interview alone (section 142a SGB XI). If the objection is rejected, there is 1 month to go to the social court (Sozialgericht), which charges insured people no court fees (section 183 SGG). The effort pays: if grade 3 is recognised instead of grade 2, the allowance rises by €252 a month, so after four months of proceedings €1,008 is paid back.
The deadlines
| Step | Deadline | Legal basis |
|---|---|---|
| Objection to the decision | 1 month from notification | s. 84(1) SGG |
| Decision notified abroad | 3 months | s. 84(1) SGG |
| Appeal information missing or wrong | 1 year | s. 66(2) SGG |
| Fund does not decide on the objection | court action after 3 months | s. 88(2) SGG |
| Court action after the objection decision | 1 month, 3 if abroad | s. 87 SGG |
| Deadline missed: review request | back pay up to 4 years | s. 44 SGB X |
The month runs from notification, not from the date printed on the letter. Note when the decision arrived and make sure the objection reaches the fund before the period ends (section 84 SGG). The deadline is also met if the objection reaches another German authority, another insurance agency or a German consulate. If the letter does not tell you the deadline and where to object, you have a year (section 66 SGG).
Secure the deadline first, argue later
A short letter is enough to stop the clock: name and insurance number, date of the decision, the sentence “Hiermit lege ich Widerspruch gegen den Bescheid vom … ein. Die Begründung reiche ich nach.” (I object to the decision of … and will send reasons later) and the signature of the insured person or their attorney. The form is strict: on paper, electronically only with a qualified signature or through an identity-verified portal (section 36a SGB I), or recorded in person. Ask in the same letter for the full report if it was not enclosed; you can request it at any time (section 18c(2) SGB XI) and you have a right to inspect the file (section 25 SGB X).
Testing the report criterion by criterion
Strong reasons do not say “my mother needs more help”. They say which rating on which criterion is wrong and what shows it. Put the report next to your care diary and go through the modules in order. Frequent errors that can be documented:
- Prompting scored as independent. Under the assessment guidelines, someone who must be prompted to wash, dress or eat is at least “mostly independent”; someone who must be guided through the task is “mostly dependent”.
- Behaviour judged on the day only. Module 3 counts frequency over two weeks. Restlessness on four nights a week is “often”, even if the person was calm during the visit.
- Doctor and therapy visits left out. Regular appointments where someone has to accompany count in module 5, as do tablets that have to be prepared or given.
- Incontinence not recorded. Those criteria only count if “mostly” or “fully incontinent” is noted, or there is a catheter or stoma.
For each point add the date, time and type of help from the diary, and enclose new medical or hospital letters. The fund works in German, so a short German summary at the top of your notes helps the case handler. The calculator below shows how many points are missing for the next grade; the care grade calculator lets you rework the whole assessment.
How close is the next care grade?
Points missing for the next grade
5.50
| Grade today | 2 |
| Extra allowance after | €252 |
| Extra services budget after | €701 |
What happens next
The fund passes the objection and your reasons to the Medical Service. First, the original assessor checks whether new points lead to a different result. If not, an assessor who was not involved before prepares the objection report, normally at a new home visit (assessment guidelines). A phone interview is excluded for objections (section 142a(2) SGB XI). The new report must address your reasons and state whether the higher grade already applied at the first assessment or only arose later; that decides how far back the money goes.
If the fund agrees, it issues a revised decision. Otherwise the objections body set up by the fund’s self-governing board sends a written, reasoned objection decision (section 85 SGG), and from notification you have 1 month to take the case to the social court (section 87 SGG). Insured people pay no court fees (section 183 SGG) and may represent themselves (section 73 SGG).
What a successful objection is worth
| From grade to grade | Extra allowance per month | Extra services per month | Extra allowance per year |
|---|---|---|---|
| 1 to 2 | €347 | €796 | €4,164 |
| 2 to 3 | €252 | €701 | €3,024 |
| 3 to 4 | €201 | €362 | €2,412 |
| 4 to 5 | €190 | €440 | €2,280 |
If the higher grade already applied when the application was made, the fund pays the difference from the month of application. For an objection from grade 2 to grade 3 after four months that is €1,008 of allowance, plus higher day care and care home amounts. The calculator at the top works it out for your case.
Objection or new application?
Object when the decision was already wrong at the time of the assessment. If the condition only worsened afterwards, after a fall or a hospital stay for instance, a request for a higher grade is the right route; the two can be combined. If the deadline has passed and the report was demonstrably wrong, there is still the review request (section 44 SGB X). How the first visit works is explained under the Medical Service assessment.