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Full name Required Date of birth Required Format: DD/MM/YYYY Home address (street, postcode, city) Required Statutory health insurance fund (Krankenkasse) Required Main diagnosis / main impairment Required ICD-10 code or plain text. Treated as confidential and shared only with the Versorgungsamt. 🔒 Stored encrypted; only used to generate your draft. Other diagnoses / impairments Optional 🔒 Stored encrypted; only used to generate your draft. Treating doctors (names + medical specialty) Required With your consent, we obtain the medical records on your behalf. Your own estimate of the degree of disability (GdB) Required Requested feature codes (Merkzeichen) Optional E.g. G (walking-disabled), aG (severely walking-disabled), B (companion required), H (helpless), Bl (blind), Gl (deaf), RF (broadcasting fee). Phone number for queries Required

Private Buronia help — not a government service. Versorgungsamt / Landesamt für soziale Dienste ↗

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