Policies for recipients of basic income support for jobseekers in Germany focus on activation and quick labour market integration. Yet, the majority of benefit recipients report severe health impairments. Against this background, the article investigates implications of health impairments for benefit recipients’ jobcentre relationship and employment opportunities. The analyses show that 63 per cent of non-employed benefit recipients report health restrictions on their employment capabilities, 51 per cent report severe health impairments, and 25 per cent that they cannot work at all. The most frequent types of health impairments are musculoskeletal and mental health impairments. Health impairments significantly reduce entry rates into socially insured employment, but do not seem to inhibit taking up uninsured minijobs. Counselling frequency increases job entry rates for benefit recipients without health impairments in the short-term. For those with health impairments, no short-term effects are found over a one-year follow-up period. Policy responses could include a more explicit acknowledgement of health impairments as a central issue for benefit recipients. Greater investments in rehabilitation and subsidised employment could be part of a strategy to improve opportunities for benefit recipients with health impairments to find better-quality (part-time) employment instead of uninsured minijobs. The analyses are based on linked longitudinal PASS survey and administrative data.