Care level refused or too low — objecting to the MD assessment
The long-term care insurer almost always follows the assessment of the Medical Service — if you object, you should check it module by module.
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Quick check: what should you do?
3 short questions — no sign-up required.
Deadline at a glance
1 month from notification
§ 84 SGG
The objection (Widerspruch) must be lodged within one month of notification of the decision; the grounds (e.g. a care diary) can be submitted later.
It is an AI, not a person: nobody looks at your individual case, and we do not know who signs up or for what reason. That is why we give pointers, but no legal advice on the individual case. Guidelines and playbooks in the platform are only guardrails: the AI relies on the available sources and your information. AI can make mistakes — check important results, and if in doubt, ask a lawyer.
What we pay special attention to
Curated from real cases. The AI review flags exactly these points in your document.
Individual modules are often rated lower in the assessment than the actual need for help.
Without a care diary, concrete evidence from everyday life is often missing.
The objection deadline is easily missed when the family is under strain.
What you can do here in 5 minutes
If the long-term care insurer (Pflegekasse) grants no care level (Pflegegrad) or one that is too low, this is almost always based on the assessment of the Medical Service (MD, formerly MDK) or of MEDICPROOF (private long-term care insurance). The assessment rates 6 modules under § 15 SGB XI — each of them can be checked against the actual need for assistance.
Upload the decision + assessment — we compare the module ratings with the need for assistance you describe and prepare the objection.
Results in three steps
Request the assessment
Request the MD/MEDICPROOF assessment from the long-term care insurer.
Compare the modules
Check each of the 6 modules against actual everyday life — a care diary kept over 1–2 weeks helps.
Lodge the objection
Objection lodged in time, with a care diary and a statement from a doctor or care professional.
- Request the assessment – Request the MD/MEDICPROOF assessment from the long-term care insurer.
- Compare the modules – Check each of the 6 modules against actual everyday life — a care diary kept over 1–2 weeks helps.
- Lodge the objection – Objection lodged in time, with a care diary and a statement from a doctor or care professional.
- No on-site care assessment.
- No substitute for a medical or nursing assessment.
- No representation before the social court.
Transparency
What the AI checks — and what only a lawyer can decide
An AI is only as good as the question. We show openly where your answer is reliable and where you should speak with a lawyer.
If the claim is refused again after the objection — an action before the social court (Sozialgericht) with a court-appointed expert opinion is then usually advisable.
More letters & checks
- Fine noticeAccused of a regulatory offense? At 2 weeks, the objection period is considerably shorter than for most other official decisions.
- Check T&C clausesExclusion of liability, notice period, automatic contract renewal — not every clause in standard terms and conditions is valid.
- Health insurer refusesTherapy, medical aid or rehabilitation refused? Often the insurer has missed its own response deadline — in which case the benefit is already deemed approved.
- Road traffic accidentAfter an accident, the other party’s insurer often settles too little — complete heads of damage and the correct liability ratio are worth a close look.
