EXPLAINED: The changes around doctor's notes in Germany you should know

If you feel ill or pick up an infection like the common cold or flu, you'll think about calling your doctor. It could be to find out if you need any treatment, or you might need to get a sick note which can be given to your employer for time off work.

Some employers ask their employees to submit an incapacity to work certificate (the Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung) on the first day of illness.

Most companies, however, are more accommodating and do not require the certificate (also known as a gelbe Schein or Krankschreibung) until on or after the third day. Your employment contract clarifies what applies in the case of each employer. The rule should be listed under "sickness" or "continued payment of remuneration in the event of sickness".

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What's changed about sick notes from the doctor?

Germany is in the process of digitising the sick note procedure as a way of minimising bureaucracy (something we can all get on board with).

Previously, three copies of the sickness certificate were given to the patient from a doctor. But since October 1st, the doctor issues only two documents - one for the patient to keep as a record and one for the employer.

The health insurance company should now be informed automatically by the doctor. 

A doctor signs an incapacity to work slip in Germany. Photo: picture alliance/dpa/dpa-Zentralbild | Paul Zinken

And from July 2022 at the latest, the health insurance organisation will be responsible for informing the employer about the sick note. Patients can therefore concentrate entirely on getting well - and don't have to worry about submitting certificates to their boss. 

Germany had originally planned to fully digitise sick notes at the start of this year, but this was pushed back to allow medical practices and insurers time to prepare. 

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

Some health insurance firms, such as Techniker Krankenkasse (TK), have been running pilot projects for sick notifications to be transmitted digitally to employers so you may have already come across this procedure. 

Should I be aware of anything else?

This rule is fairly new so patients should double check with their doctor to find out if they plan to forward your sick notification to the health insurer. 

As we are in the transitional phase, it might not yet be practised by all doctors. If the doctor has not got a system in place yet for sending the sick note to the health insurance firm, then you can ask for a copy and send it yourself. Some insurance firms allow people to upload it via an app. 

Those who have statutory health insurance must forward the sick note to their insurer quickly so as not to lose any entitlement to sick pay.

When reporting that you're sick, it's important to inform the boss by e-mail or telephone (depending on the procedure in your work place) as soon as possible. This is called a Krankmeldung or notification of sickness.

The sick note should  be forwarded to the HR department or your manager. In many cases, a mobile phone photo of the sick note is sufficient; larger companies have a separate postal address where the sick leave certificates must be sent.

If you feel ill or unwell, you should generally avoid the office or your workplace to protect other colleagues from infection. If you are able to work, check with your boss whether you can work from home during that time. 

If you suffer from fever, cough or cold, it's probably best to consult a doctor. If they suspect that it is Covid-19 you will be offered a PCR test free of charge and advised to self-isolate.

Is the AU certificate also available via video consultation?

Since July 2020, doctors have also been able to issue sick notes via video consultation (Videosprechstunde)

But there are some rules to keep in mind. For instance, the sick note is valid for a maximum of seven days when first issued through the video consultation. If an extension is needed, the patient has to go to the doctor's office. If the patient first received the sick note in person from the practice, he or she can extend the sick note via a video consultation once.

The National Association of Statutory Health Insurance Physicians (KBV) emphasises that an important prerequisite for issuing the sick note via video consultation is that the patient is "personally known to the practice through previous treatment". So you can't access this service with a new doctor. 

Meanwhile, doctors can also give sick notes for respiratory illnesses such as Covid-19, flu or the common cold over the phone due to the pandemic. This rule is in place until at least the end of 2021. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

In Germany, the number of patients who are requesting a video appointment with a doctor is growing.

According to a representative Allensbach survey commissioned by the medical technology group Fresenius, 46 percent of those surveyed were open to video consultations at the end of last year, compared to only 22 percent four years earlier. In the same period, the proportion of those who ruled out video consultations with their doctor fell from 70 to 41 percent.

Acceptance of online consultations has also increased among doctors in Germany. In the second quarter of 2020, patients consulted a doctor or psychotherapist by video almost 1.2 million times - more than ever before, an analysis by the the National Association of Statutory Health Insurance Physicians (KBV) found earlier this year. 

The numbers have skyrocketed during the pandemic. While there were just under 3,000 video consultations nationwide in 2019, there were almost 1.4 million in the first half of 2020. 

Here's a roundup of some useful vocabulary:

Incapacity to work certificate - (die) Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung

Sick note - (die) Krankschreibung

Notification of sickness - (die) Krankmeldung 

Video consultation - (die) Videosprechstunde

Cold - (die) Erkältung

Sick day - (der) Krankheitstag

Sick leave –(der) Krankenstand (KS)