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Do you really need to see a doctor to stay off work in Germany?

In Germany, workplaces require employees to provide a sick note from a GP when they are ill. But do you really need to visit a doctor for the certificate? A court case is raising these questions.

Do you really need to see a doctor to stay off work in Germany?
Should you have to visit a doctor to stay off work in Germany? Photo: DPA

The process of getting a Krankschreibung (doctor's note) signed by a GP when you are off sick from work is under the spotlight after watchdogs questioned the validity of a service that delivers sick notes without a medical examination and via Whatsapp.

Last year Hamburg startup AU-Schein started offering people who have a short-term illness, such as a cold, menstrual pain, back pain or a migraine, the chance to buy a sick note without actually visiting a GP.

Users can fill out an online form on the company's website and answer a comprehensive set of questions about their symptoms. They are then connected with a doctor via the messaging service WhatsApp.

If the doctor is satisfied that the person is sick, they will issue a sick note that allows the patient to take paid leave from work.

The online certificate costs around €14 or the user can pay €5 extra to receive it by post. The certificate is “100 percent valid,” says the company, and is issued by a private doctor. 

However, the Centre for Protection against Unfair Competition (Wettbewerbszentrale) has launched legal action against the startup in a bid to prevent employees from being able to get a medical certificate in this way.

READ ALSO: How Germany plans to ditch paper sick notes for digital ones

The Centre filed a test case at the Regional Court in Hamburg at the beginning of October, Spiegel reported.

“This type of sick leave deceives both the employee and the employer,” said Christiane Köber, a lawyer at the Wettbewerbszentrale.

An 'Arbeitsunfähigkeitsbescheinigung', or sick note, which the employee submits to their employer after receiving it from a doctor. Photo: DPA

According to the Centre for Protection against Unfair Competition, the system is easy to manipulate. During a test, two employees on sick leave who used the service didn't even have to talk to a doctor on the phone but were still given the signed sick note, the Centre said.

The watchdog believes the startup's statement that it gives a “100 percent valid certificate” to be misleading.

Why? Because it gives the impression that the sick note applied for fulfils all legal requirements for a certificate of incapacity for work. This may formally be the case, but the Centre said it is “doubted by a number of lawyers”.

“The law prescribes high standards for an employee's certificate of incapacity for work,” says Köber. It could be that in a legal dispute with an employer, an 'online sicknote' is not considered sufficient – and the employee could bear the damage.

In addition, the startup advertises remote treatment, which the Centre argues is a violation of the law.

The founder of AU-Schein.de, Can Ansay, defended his startup. “We issue legally valid certificates with the original signature of a doctor,” Ansay told Spiegel. “These sick notes do not differ from medical certificates issued during a doctor's visit.”

In a previous interview, Ansay said the AU-Schein doctor is based in Lübeck and issues around 80 certificates a day. The company advertises online that it has already issued more than 20,000 sick certificates.

“People who pull sickies are not the problem,” Ansay said at the time. “It is more problematic when employees come to work while sick and infect others there.”

When do I need a doctor's note to stay off work in Germany?

If you’ve decided to stay off work, firstly you need to give your boss a Krankmeldung (notification of sickness) before the start of work on the first day. Legally, you need to have informed your employer that you're sick before your start time – otherwise you are breaking the terms of your contract.

READ ALSO: The 10 rules you need to know if you get sick in Germany

After three days of being off work you are legally required to get a a Arbeitsunfähigkeitsbescheinigung (incapacity for work certificate) known as a Krankschreibung, gelbe Schein or AU-Schein from a GP. 

However, in many workplaces, the Krankschreibung is needed sooner – sometimes on the first day of sickness.

To get this sick note, you have to make an appointment with a GP, explain your symptoms and the doctor will decide if it's right for you to stay off work and for how long. After you have the signed note, you can then pass this onto your employer.

Isn't there an easier way?

Well, that's why AU-Schein set up their business.

READ ALSO: Don't use new Whatsapp sick note service, German doctors advise

The startup took advantage of a law passed last year that loosened the ban on doctors assessing patients without actually being in the same room as them.

The relaxation of the so-called Fernbehandlungsverbot (ban on remote treatment) was meant to provide a reliable alternative to “doctor Google” for people who would rather research their symptoms online than go to a doctor.

Photo: DPA

But AU-Schein believed the change in the law had other applications and decided to launch a startup which reduces bureaucracy and streamlines the process.

However, some medical associations have accused the service of attempting to make money on people's desire to pull sickies.

Does visiting a doctor every time you're off work put pressure on the German health system?

Yes, we imagine so. According to a recent health report by OECD, Germans consult doctors in the outpatient sector more frequently than people in most other countries.

The report also found that although Germany has a high availability of doctors and nurses (there are 4.3 practising physicians – OECD average is 3.5 – and 12.9 nurses – OECD average is 8.8 – per 1,000 population), medics are under a lot of stress.

With 255 hospital discharges per 1,000 people, Germany has the highest rate of inpatient activity among all OECD countries – more than 60 percent above the OECD average.

There are also regional differences and rural areas in Germany are less well served. When it comes to doctors, Germany has a relatively low and decreasing proportion of GPs who “play a key role in addressing the needs of an ageing population,” the report said.

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WORKING IN GERMANY

EXPLAINED: The 25 most in-demand jobs in Germany

For those considering relocating to Germany - or looking for a new profession - here are the most in-demand jobs out there, according to a study by LinkedIn.

EXPLAINED: The 25 most in-demand jobs in Germany

Germany is desperate to fill jobs. In autumn last year, authorities said there was a shortage of 390,000 skilled workers. 

The new government plans to ease red tape and overhaul immigration policies to make it easer for non-EU nationals to come to the country. 

READ ALSO: What Germany’s coalition proposals mean for citizenship and immigration

But many people already within Germany might also be thinking about a change of career, or pivoting to a related sector, especially after the Covid pandemic changed the world of work. 

For those who are curious, international job search engine LinkedIn has published a list of jobs that are in-demand in Germany. Although lots of positions in Germany require that you speak German, many companies are international and encourage English speakers to apply.

What is the list?

The so-called LinkedIn Jobs in Trend 2022 list shows the 25 occupations that have grown the most over the past five years compared to other other positions. 

The list “allows insight into how the job market is evolving and the long-term opportunities it presents – whether you’re looking to change careers, re-enter the workforce or upskill for future challenges,” said LinkedIn. 

It’s based on LinkedIn data between January 2017 and July 2021. 

READ ALSO: How to boost your career chances in Germany

Here is the list of the top 25 positions, including the core skills required for each and the desired amount of experience for candidates according to LinkedIn.

In some of the descriptions below we haven’t translated the job name  to German – that’s because it is usually advertised in Germany with the English name.

1. Consultant for the public sector (Berater*in für den öffentlichen Sektor)

Responsibilities: Advising public and government institutions on the modernisation and digitalisation of administration and infrastructure

Most common skills: Public Policy, Management Consulting, Policy Field Analysis

Top regions hiring in: Berlin, Hamburg and Munich areas

Average years of experience: 2.8 

2. Product analyst (Produktanalyst*in)

Responsibilities: Product analysts use metrics to evaluate a company’s products to determine whether they meet current and future market needs

Most common skills: Tableau, Google BigQuery, SQL

Top regions hiring in: Berlin, Hamburg and Munich areas

Average years of experience: 3.7 

A man at his home office desk.

A man works at his ‘home office’ desk. Photo: picture alliance/dpa | Sina Schuldt

3. Business development specialist or consultant (Beschäftigte in der Geschäftsentwicklung)

Responsibilities: Business development employees develop companies, enter new markets and evaluate sales opportunities

Most common skills: salesforce, account management, inside sales

Top regions hiring in: Berlin Munich and Frankfurt areas

Average years of experience: 3.3

4. Sustainability manager (Nachhaltigkeitsmanager*in)

Responsibilities: Sustainability management employees are based in corporate social responsibility (CSR) departments and look after the social, environmental and economic aspects of a company

Most common skills: Sustainability reporting, corporate social responsibility, life cycle assessment management

Top regions hiring in: Munich, Berlin and Hamburg areas

Average years of experience: 3.8

5. Cyber Security Specialist (Cyber Security Spezialist*in)

Responsibilities: Unlike IT security, cyber security is not limited to the environment of your own company, but also keeps an eye on wider threats from the internet in order to ward off viruses, Trojans or ransomware

Most common skills: ISO 27001, Security Information and Event Management (SIEM), vulnerability assessment

Top regions hiring in: Munich, Frankfurt and Cologne-Bonn areas

Average years of experience: 7.1

6. Developer for machine learning (Entwickler*in für maschinelles Lernen)

Responsibilities: Machine learning developers create so-called artificial intelligence. They research and design models and algorithms that enable machines to recognise patterns in large volumes of data, among other things

Most common skills: TensorFlow, Python (programming language), Keras 

Top regions hiring in: Berlin, Munich and Cologne-Bonn areas

Average years of experience: 3.3 

READ ALSO: Working in Germany – 7 factors that can affect how much you’re paid

7. User Experience (UX) Researcher

Responsibilities: User experience researchers find out what users need and want and prepare these findings for developers, marketers, designers and others

Most common skills: Usability testing, design thinking, human-computer interaction

Top regions hiring in: Berlin, Munich and Cologne-Bonn areas

Average years of experience: 4.6

8. Real estate finance specialist (Spezialist*in für Immobilienfinanzierung)

Responsibilities: Real estate finance specialists accompany and advise clients from the initial property enquiries stage to closing the deal and agreeing on financial arrangements

Most common skills: Construction financing, finance, sales

Top regions hiring in: Munich, Frankfurt and Hamburg areas

Average years of experience: 5.3

9. Head of Public Affairs (Leiter*in Public Affairs)

Responsibilities: Public affairs is the strategic aim to integrate the interests of the employer into political decision-making processes. Also known as lobbying, the job description should not be confused with public relations (corporate communications)

Most common skills: Politics, international relations, strategic communication

Top regions hiring in: Berlin, Munich and Cologne-Bonn areas

Average years of experience: 7.2

10. Information security officer (Beauftragte*r für Informationssicherheit)

Responsibilities: Information Security Officers protect data in analogue and digital form. To do this, they ensure that sensitive data is only accessible to authorised persons at all times.

Most common skills: ISO 27001, Information Security Management System (ISMS), data protection management

Top regions hiring in: Frankfurt, Munich and Berlin areas

Average years of experience: 10.2

11. Specialist in talent acquisition (Spezialist*in für Talentakquise)

Responsibilities: Talent acquisition specialists identify suitable job candidates and take care of the strategic development of the Talent Acquisition department

Most common skills: Employer branding, sourcing, talent management

Top regions hiring in: Berlin, Munich and Frankfurt areas

Average years of experience: 3.8

12. Expansion manager

Responsibilities: Expansion managers accompany the growth of companies and take care of things like the purchase or leasing of business space in optimal locations

Most common skills: Business development, marketing, strategic planning

Top regions hiring in: Berlin, Düsseldorf and Munich areas

Average years of experience: 5.7

13. Test engineer (Prüfingenieur*in)

Responsibilities: Cars, wind turbines, lifts, amusement park rides and countless other technical constructions must be regularly checked for safety. This is where test engineers come into play

Most common skills: LabVIEW, Matlab, electrical engineering

Top regions hiring in: Munich, Hamburg and Tübingen areas

Average years of experience: 4 

14. Marketing (Marketingmitarbeiter*in)

Responsibilities: Marketing employees (Associates) support the planning and implementation of marketing activities for companies and organisations

Most common skills: Social media marketing, online marketing, content marketing

Top regions hiring in: Berlin, Hamburg and Munich

Average years of experience: 2.7

15. Data engineer (Dateningenieur*in)

Responsibilities: Data engineers deal with the collection, processing and checking of data

Most common skills: Apache Spark, Amazon Web Services (AWS), Apache Hadoop |

Top regions hiring in: Berlin, Munich and Cologne-Bonn areas

Average years of experience: 4.8 

16. Personnel officer recruiting (Personalreferent*in Recruiting)

Responsibilities: Recruiters use job advertisements and various channels to search for suitable candidates for open positions in the company and personally recruit suitable candidates

Most common skills: Active sourcing, e-recruiting, employer branding

Top regions. hiring in: Munich, Berlin and Cologne-Bonn areas

Average years of experience: 3.3 

A woman sits at a desk.

Are you looking for a chance in career? Photo: picture alliance/dpa | Finn Winkler

17. Manager in strategic partnerships (Manager*in Strategische Partnerschaften)

Job Purpose: Strategic partnerships managers are responsible for building and maintaining relationships with business partners to further the development and distribution of their own products and services

Most common skills: Business development, account management, product management

Top regions hiring in: Berlin, Munich and Frankfurt areas

Average years of experience: 6

18. Head of Software Development (Leiter*in Softwareentwicklung)

Responsibilities: Software Development Managers are responsible for all stages of software application development. They control and structure planning, organisation and execution

Most common skills: Agile methods, cloud computing, product management

Top regions hiring in: Berlin, Munich and Frankfurt areas

Average years of experience: 12.2 

READ ALSO:

19. Data science specialist

Responsibilities: Data science experts or data scientists help companies to make data-based decisions. They build a structured database from raw data, analyse data and prepare it with business background knowledge

Most common skills: Python (programming language), R, SQL

Top regions hiring in: Berlin, Munich and Hamburg areas

Average years of experience: 3

20. Robotics engineer (Robotik-Ingenieur*in)

Responsibilities: Robotics engineers develop and programme robots and other intelligent assistance systems, whether for medicine, gastronomy, or future cars.

Most common skills: Robotic Process Automation (RPA), UiPath, C++ 

Top regions hiring in: Munich, Frankfurt and the Hanover-Braunschweig-Göttingen-Wolfsburg areas 

Average years of experience: 3.8 

21. Investment associate (Investmentmitarbeiter*in)

Responsibilities: Which areas are worth investing in, which companies are suitable for takeover? This is checked by investment managers through market observations, financial modelling and due diligence procedures

Most common skills: Private equity, corporate finance, mergers & acquisitions (M&A)

Top regions hiring in: Frankfurt, Munich and Berlin areas

Average years of experience: 2.7 years

22. Chief Information Security Officer

Responsibilities: Many companies are not only urgently looking for information security officers (see position 10), senior positions in this professional field are also in high demand

Most common skills: Information Security Management System (ISMS), ISO 27001, IT Risk Management

Top regions hiring in: Munich, Frankfurt and Berlin areas

Average years of experience: 14.3

23. Manager in strategic sales (Manager*in im strategischen Vertrieb)

Responsibilities: Strategic Sales Managers usually look after selected target and existing customers over a longer period of time. Duties include preparing quotations and negotiating prices

Most common skills: Solution selling, business development, account management

Top regions hiring in: Munich, Stuttgart and Frankfurt areas

Average years of experience: 9.3

24. Communications manager (Kommunikationsmanager*in)

Responsibilities: Communications managers take care of PR work inside and outside a company – this includes planning communication strategies as well as implementing campaigns on social networks or organising press appointments and events

Most common skills: Strategic communication, public relations/PR, internal/external communication

Top regions hiring in: Berlin, Munich and Nuremberg areas

Average years of experience: 5.4 

25. Specialist writer for medicine (Fachautor*in Medizin)

Responsibilities: Medical writers produce documents in a medical context, such as study reports for scientific journals, texts for regulatory authorities and information sheets for medicines – but also journalistic texts for websites or magazines

Most common skills: Clinical studies, scientific writing, life sciences

Top regions hiring in: Frankfurt, Berlin and Munich areas

Average years of experience: 5.2

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