Severe disability card and degree of disability for autism

Legal status: 08.10.2026 (federal law; responsibilities under state law). The versions in force at the time of your application are decisive. Legal terms are translated here for understanding; the German wording of the law is what counts.

Disability, GdB, severe disability – the terms

• Disability: Under the law, people with disabilities have physical, mental, intellectual or sensory impairments. In interaction with barriers in their environment, these can “with high probability” prevent them from participating on an equal footing for longer than six months. ^[1]
• Degree of disability (GdB): It describes how strongly an impairment affects participation. It is determined in steps of ten, and only if it is at least 20. ^[3]
• Severe disability: It exists from a GdB of 50 if one lives, usually stays or works in Germany. ^[1]
• Equivalent status: People with a GdB of 30 or 40 can, on application, be treated as equivalent to severely disabled people. The requirement is that without equivalent status they cannot obtain or keep a suitable job. ^[1] The Federal Employment Agency is responsible. Equivalent status takes effect on the day the application is received and can be time-limited. ^[2] More on this in the article Benefits for participation in working life.

Which GdB comes into question for autism

The authority follows the “Principles of Medical Care” (Versorgungsmedizinische Grundsätze), an annex to the Ordinance on Medical Care. There, autism is still listed under the older term “pervasive developmental disorders”, with the examples childhood autism, atypical autism and Asperger syndrome. ^[4]

Social adjustment difficulties	GdS according to the ordinance (guideline value)
none	10–20
mild	30–40
moderate	50–70
severe	80–100

^{[4; 5]}

GdS and GdB: The ordinance gives the values as “degree of damage consequences” (GdS); the determination procedure under section 152 SGB IX speaks of the “degree of disability” (GdB). The ordinance itself makes clear that both terms are assessed by the same principles and that in the parts not yet revised the abbreviation GdS is used throughout; the values given in Part B are guideline values. ^[4] In this article, the table values are therefore labelled GdS according to the ordinance.

What “social adjustment difficulties” means: According to the ordinance, they exist in particular when a person cannot cope in areas of life such as mainstream nursery, mainstream school, the open labour market, public life or home life without special support or assistance, for example without integration assistance. They also exist when someone needs more supervision than is usual at their age. ^[5]

The following also applies: ^[5]

• A disability exists only from the start of the participation impairment. A flat determination from a certain age is not possible.
• Comorbid, that is, additional mental disorders, are according to the ordinance to be taken into account separately. ^[5] For the overall GdB with several impairments, under the common principles of the ordinance: the starting point is the impairment with the highest individual GdB; it is examined whether a further impairment substantially increases the overall impairment, that is, causes an increase of at least 10. Calculation methods such as adding or averaging are not permitted. ^{[4, Part A no. 3]}
• The ordinance requires that the criteria of ICD-10-GM, version 2011 are met, that is, the version of the disease classification used in Germany at the time.
• The table values are guideline values. The decision is made in the individual case. ^[7]

For the classification, what is therefore decisive is how autism actually affects everyday life – at home, in nursery, school or work and in public life. The diagnosis alone is not enough for this.

The application: how it works

1. Submit the application to the responsible authority. Under the law, these are the authorities responsible for implementing the Fourteenth Book of the Social Code; state law can provide otherwise for responsibility. ^[3] Which authority this is in your federal state, you can find out from the municipality, the district or an advice centre. For children, the parents represent the child, because parental custody includes representing the child; the parents generally represent the child jointly. ^[6]
2. Attach documents: the assessment findings and current reports that describe the effects in everyday life, for example from doctors, therapists, nursery or school.
3. Retroactive determination: On application it can be determined that a GdB or health characteristics already existed at an earlier point in time, if a special interest in this is made credible (section 152 para. 1 sentence 2 SGB IX). ^[3] How pension offices and courts handle this for autism is inconsistent, according to the Federal Association autismus Deutschland. ^[7] Get advice on this in the individual case.
4. Check the decision notice: Anyone who disagrees with the decision can file an objection. See Applying and filing an objection.

Practical tip: Describe concretely and with examples what support is needed for and what does not work without it. General wording such as “has autism” helps the authority little with the classification.

Marks (Merkzeichen)

In addition to the GdB, the authority can determine further health characteristics, the so-called marks (Merkzeichen). They are entered in the card. ^[3] For people with autism, according to the Federal Association autismus Deutschland, the marks H (helpless), B (accompanying person) and G (significantly impaired mobility in road traffic) often come into question. ^[7] On helplessness (mark H), the ordinance contains a special rule for children and adolescents: for pervasive developmental disorders that alone cause a GdS of at least 50, and for other equally severe behavioural and emotional disorders beginning in childhood with long-lasting significant difficulties fitting in, helplessness is regularly to be assumed up to the 18th year of life. ^{[4, Part A no. 5 letter d bb]} The exact requirements are explained in the article Marks for autism.

What the card brings – and what it does not

The severe disability card serves as proof for claiming benefits and other help to which severely disabled people are entitled. The validity period of the card is to be time-limited. ^[3]

Important: some forms of help do not require a GdB, for example integration assistance. More on this in Integration assistance. Whether an application is worthwhile depends on the personal situation. Some people deliberately decide against it, for example out of concern about stigma. Independent advice can help with weighing this up.

Sources and literature

1. § 2 SGB IX – Begriffsbestimmungen. Sozialgesetzbuch Neuntes Buch. – Statute (German federal law, in German)
2. § 151 SGB IX – Geltungsbereich. Sozialgesetzbuch Neuntes Buch (www.gesetze-im-internet.de/sgb_9_2018/__151.html). – Statute (German federal law, in German)
3. § 152 SGB IX – Feststellung der Behinderung, Ausweise. Sozialgesetzbuch Neuntes Buch (www.gesetze-im-internet.de/sgb_9_2018/__152.html). – Statute (German federal law, in German)
4. Versorgungsmedizin-Verordnung (VersMedV), Anlage zu § 2 „Versorgungsmedizinische Grundsätze“, Teil B Nr. 3.5.1 Tief greifende Entwicklungsstörungen. – Ordinance (in German)
5. Dritte Verordnung zur Änderung der Versorgungsmedizin-Verordnung vom 17.12.2010, BGBl. I S. 2124, und Vierte Verordnung zur Änderung der Versorgungsmedizin-Verordnung vom 28.10.2011, BGBl. I S. 2153 (Nr. 3.5.1, ICD 10-GM Version 2011). – Ordinance, official amending text (in German)
6. § 1629 BGB – Vertretung des Kindes (www.gesetze-im-internet.de/bgb/__1629.html). – Statute (German federal law, in German)
7. autismus Deutschland e.V. – Bundesverband: Rechte von Menschen mit Autismus (Vortragsfolien Recht, 20.11.2025). https://www.autismus.de/fileadmin/RECHT_UND_GESELLSCHAFT/Folien_Recht_20_11_2025.pdf – Professional association (website in German)