Request a certificate for your occupational disease | Federal agency for occupational risks

Form

Do you need a certificate relating to your occupational disease, for example to prove the degree of incapacity for work or the amount of your compensation? You can request the certificate via this form.

Please fill in all mandatory fields (*). The document will then be sent to you by post.

You can read how Fedris uses your personal data in our privacy notice (GDPR).

First name

Last name

National Register Number

11 digits, without spaces or hyphens

Street

House number (and box, if applicable)

Postal code

City

Country

Phone number

E-mail

I would like a certificate as proof of:

the degree of incapacity and the relevant periods

the gross amount

the net amount

the taxable amount

Other

File number

Comments

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