Antrag auf Leistungen zur Teilhabe für Versicherte – Rehabilitationsantrag Completed Form Examples and Samples
Explore practical examples of the 'Antrag auf Leistungen zur Teilhabe für Versicherte' (G0100). See how to correctly fill out your Rehabilitationsantrag with our detailed samples and automated processing guides.
Automated Processing of Rehabilitationsantrag (G0100)
How this form was filled:
This example demonstrates how an AI agent extracts structured data from a patient's informal clinical narrative to populate a complex 'Antrag auf Leistungen zur Teilhabe' (G0100). By parsing unstructured physician dictation and patient background information, the system eliminates manual data entry, ensuring high accuracy for critical social security forms.
Source document used: Medical Referral Letter / Physician Dictation
Dear Dr. Schmidt, my patient Marcus Weber (born 15.03.1978 in Berlin, VSNR: 12150378W001) is struggling with chronic orthopaedic issues requiring a stay in a rehabilitation clinic. Marcus, who lives at Kastanienallee 42, 10435 Berlin, has been employed as a warehouse manager for the last 15 years. Due to his condition, he is currently unable to work and has been on sick leave since January. He is insured with the Techniker Krankenkasse. Marcus requested this rehab measure himself, without any prior pressure from the Jobcenter or the Employment Agency. He is primarily interested in an inpatient medical rehabilitation program. He has identified three clinics he would prefer for his stay: the Reha-Klinik am See in Bad Saarow, the Kurzentrum Rheinsberg, and the Brandenburg-Klinik Bernau. He is currently married and has no plans to bring a nursing-dependent person with him. He confirms that he is not a civil servant and has not received any pension payments to date. He does not have any ongoing legal claims regarding the origin of his illness, nor has he participated in any other rehabilitation measures in the last four years. I have attached his current health reports to this email for your convenience.
Information used to fill out the document:
- Personal Details: Marcus Weber, 15.03.1978, VSNR: 12150378W001
- Employment: Warehouse Manager, employed for 15 years
- Clinic Preferences: Reha-Klinik am See, Kurzentrum Rheinsberg, Brandenburg-Klinik Bernau
- Insurance: Techniker Krankenkasse, Gesetzliche Krankenversicherung
- Request Status: Self-initiated, no Jobcenter/Agentur-für-Arbeit requirement
- Rehab Type: Medical Rehabilitation, Inpatient (Stationär)
What this filled form sample shows:
- Automatic identification of VSNR and personal identification fields
- Natural language parsing of specific clinic names for wish-list fields
- Classification of employment status based on context
- Mapping of negation logic for institutional requirements (e.g., Jobcenter)
- Extraction of insurance status without explicit form-field labels
Form specifications and details:
| Form: | Antrag auf Leistungen zur Teilhabe für Versicherte (G0100) |
| TargetLanguage: | German |
| Use-Case: | Medical Rehabilitation Application |
| Key-Focus: | Intelligent parsing of unstructured clinical narratives |
| Created: | May 19, 2026 06:01 PM |