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HEALTH

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

Now the temperature has dropped we're more likely to pick up infections. If you need to take time off work, you should be aware of Germany's doctor's note procedure and some important recent changes.

A woman lies on the sofa with medicine for a cold
A woman lies on the sofa with medicine for a cold. Germany is in the process of digitising sick notes. Photo: picture alliance/dpa/dpa-tmn | Christin Klose

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.
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)

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WORKING IN GERMANY

7 tips for how to survive as a freelancer in Germany

Taking the decision to go it alone and freelance in Germany can be a daunting prospect. But, if you do it right, it can be an exciting and liberating path. Here are some of our top tips on how to survive.

7 tips for how to survive as a freelancer in Germany

1. Get a tax advisor

The German tax system is complicated, even for Germans. All the associated paperwork uses the Amtsprache (authority language) which is more like legalese than ‘normal’ German, and mistakes when filling out tax forms can cause you, at best, a massive headache and, at worst, a costly fine. So it’s best that you employ someone who knows what they’re doing to help you out.

That person is called a Steuerberater (tax advisor) in Germany. They will help you register with the tax office, correspond with them and submit your tax declarations.

Be aware that, in Germany, different deadlines apply for tax returns depending on whether you employ an official tax advisor or not. If you are doing the tax return on your own, the deadline for submitting your annual tax return is earlier than if you use a tax advisor’s services. 

READ ALSO: What NOT to do when you’re freelancing in Germany

When looking for a tax advisor, a top tip is to use your network to get recommendations. Ideally, you want someone who will do more than just fill in the forms for you, but who will actually advise you on how best to manage your business finances so that you can make tax savings.

2. Keep your accounting in order

The better you keep your own accounts in order, the easier it will be for your tax advisor to compile your tax declarations and therefore the cheaper their services will be.

As a freelancer, there are a lot of costs you can deduct from your taxes – from train tickets, working materials, to meals out – so it’s best to keep hold of all your receipts and to keep them in good order.

2 euros and 50 cents lie on a receipt in a beer garden. Photo: picture alliance/dpa | Peter Kneffel

In Germany, you’re obliged to keep hold of receipts for two years, in case of a tax inspection, so it’s a good idea to photocopy the type of machine-printed receipts you get from restaurants so that they stay legible for a long time.

There are also a few things to be aware of when writing your own invoices. Firstly, make sure that you include your tax number. This isn’t the 11-digit Steueridentifikationsnummer that everyone gets when registering in Germany, but the 10-digit Steuernummer you get from the Finanzamt after registering yourself as a freelancer. 

Most companies won’t pay you if you don’t have this on your invoices so make sure you include it.

You should also make sure that you number your invoices properly – ideally in ascending order so that you can easily keep track of them. You are not allowed to issue two invoices with the same number and if you do so and the finance office notices, you could face an inspection of your whole accounting system.

There are numerous great accounting software programmes you can use to help you, such as Lexoffice and Sevdesk and, even if you have to pay for them, the costs will be tax deductible!

3. Find out if you’re eligible for financial support

In Germany, there are several opportunities for freelancers to gain financial support and to cut their outgoings, and its worth finding out if you’re eligible for them.

If you’re claiming unemployment benefits under ALG 1 and are thinking about becoming a freelancer, the employment office offers a special type of financial support to help you to get your freelance business off the ground.

Called the Grundungszuschuss (“foundation grant”) the payment is a six-month grant equalling your monthly entitlement under ALG 1 plus €300 towards your insurance costs can be applied for those in receipt of this unemployment benefit.

READ ALSO: Will freelancers benefit from Germany’s €300 energy allowance?

If you are engaged in some form of artistic profession in Germany – which can include journalism to pottery – you may be entitled to membership to the Kunstlersozialkasse (artists’ social insurance).

Being a member of the KSK means you only have to pay half of your health insurance and pension contributions, and the KSK will pay the rest.

4. Work out how much you think you will earn

As with starting any business, you need to have some idea of your expected earnings from the outset.

If you’re just starting out as a freelancer, or have some freelance gigs on the side of an employment position, then it might be worth considering registering yourself as a Kleinunternehmer (“small business”).

As a Kleinunternehmer, you can currently earn up to €22.000 per year without having to charge VAT and having to submit only yearly tax declarations. 

An income tax declaration form lies on a table. Photo: picture alliance/dpa/dpa-Zentralbild | Hans-Jürgen Wiedl

Be aware that if you are registered as this kind of freelancer, you must include the following sentence in your invoices: ‘Gemäß § 19 UStG wird keine Umsatzsteuer berechnet’ which means ‘In accordance with Paragrah19 of the German VAT law, no VAT has been added to this invoice.’

READ ALSO: Everything you need to know about your German tax return in 2022

If you think you will earn more than €22.000 per year, you will need to pay Umsatzsteuer (VAT) and will have to submit tax declarations in advance and more often. Depending on how much you earn, this could be every month or every quarter. 

5. Get your insurance in order

In Germany, it’s a legal requirement to have health insurance.

If you’ve just made the move from employment to being a freelancer and want to keep the same health insurer, you should get in contact with your health insurance provider straight away to tell them about your change of circumstances. They will ask you to re-register and to tell them your projected freelance earnings for the year, so they can amend your monthly fees.

If you don’t keep your health insurer provider updated, you could continue to be charged the higher rate that you had from your previous salary.

The insurance cards of the health insurance companies DAK, AOK, Barmer and Techniker-Krankenkasse TK lie with euro notes under a stethoscope. Photo: picture alliance / dpa | Daniel Karmann

It’s not just health insurance you need to think about as a freelancer. It’s also wise to think about protecting yourself from any sort of claims that could arise as a result of any working mishaps. 

If, for example, you lose your laptop which contains confidential client information, you need to be protected against claims.

That’s why it’s good to have both Betriebshaftversicherung (business liability insurance) and Rechtschutzversicherung (legal protection insurance).

6. Plan your time wisely

All of these bureaucratic obligations take time. So it’s really important that you take account of that when planning your time. For example, planning half a day a week to deal with your invoices, filing, emails to clients, and conversations with authorities can be really beneficial when scheduling your working time. 

7. Grow your network

As a freelancer, networking is absolutely crucial to success. 

Keep an up-to-date profile on websites like LinkedIn and German equivalent XING and keep in contact with anyone you’ve ever worked with, no matter how brief the contact was. 

Having a network is not only about getting more clients, but also about building a support network in your field to exchange advice, tips and generally for your own enrichment. 

Participating in workshops related to your field, going to seminars, and meet-ups, can be great ways of broadening your network. 

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