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EXPLAINED: How Germany’s new electronic sick note works

Sarah Magill
Sarah Magill - [email protected]
EXPLAINED: How Germany’s new electronic sick note works
A doctor sits behind a computer in an appointment with a patient. Photo: picture alliance/dpa/dpa-tmn | Christin Klose

Since January 1st, 2023, employees in Germany no longer need to pass on paper sick notes to their employers, as these will be sent electronically. Here’s what you need to know.

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What’s going on?

If you're unwell in Germany and need a sick note from your doctor, things should be just a little bit simpler now.

Instead of getting a yellow paper slip from the doctor which you have to pass on to your employer, your public health insurance will transmit the data electronically to your employer as eine elektronische Arbeitsunfähigkeitsbescheinigung (eAU) - an "electronic incapacity for work certificate".

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Previously, employees got three certificates at the doctor's office: one each for their statutory health insurer, for the employer, and for themselves. Now the sickness certificate is completely electronic.

The aim of the new digitisation is to ease the bureaucracy for employees and health insurers, as well as to improve the documentation of sick leave, which is important for possible payment of sick pay.

Who can get the electronic sick note?

Privately insured people should be aware that only statutory health insurers will be forwarding digital sick notes to employers. Those with private insurance will still need to take good care of their little yellow document for now. 

Parents with statutory health insurance who cannot work because their children are sick will also have to keep hold of the paper sick note from the doctor. 

READ ALSO: Colds and flu: What to do and say if you get sick in Germany

Those who fall ill while on holiday and have to stay abroad for a longer period of time will also still have to send their sick note to their employer by mail. 

Does this mean I don't have to tell my boss that I'm sick?

Even though employees no longer have to submit the paper sick note to their health insurer or to their employer themselves, they are still obliged to inform their company immediately of their incapacity for work. They also still have to provide a certificate of incapacity for work from the fourth day of sickness.

What information does the employer get? 

Once an employer knows that a staff member is on sick leave, they can submit a digital request to retrieve the eAU from the health insurance company.

If the doctor's surgery is having technical problems, it sends the printout of the certificate by mail to the health insurance company, where the process is digitised and can then be retrieved by the employer.

READ ALSO: 'It works': Your verdict on the German healthcare system

Just as with the previous "yellow slip" - the employer can't see any information about the diagnosis, or for what reason their employee is off sick - only in the event that the diagnosis is in relation to an accident at work. The certificate from the health insurance company only shows the name of the insured person, the beginning and end of the incapacity for work, and whether or not it is an initial or a follow-on sick note. 

The employer also won't find out which doctor issued the sickness certificate.

Does this mean an end to all paper sick notes?

Not quite.

Firstly, patients themselves will receive a paper printout of the sick note for their own records. In the future, however, it should also be possible to have the sick leave saved in the electronic patient file.

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Also, not all employers - or doctors' surgeries - have upgraded technically and organisationally in time to get on board with the new digital procedure. 

READ ALSO: 7 things to know about visiting a doctor in Germany

The Association of Statutory Health Insurance Physicians in Lower Saxony estimates that around 20 percent of health practices in Germany currently lack the technology needed, while the National Association of Statutory Health Insurance Physicians (KBV) fears that many employers will continue to request paper printouts from their employees.

Patients of practices or employees of companies which are not yet up to speed with the new system will therefore continue with the old system of passing on paper sick notes to their employers for the time being. 

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