E-sick leave is becoming “increasingly the standard” despite criticism from employers

The first evaluation of regular operation shows that the electronic certificate of incapacity for work (eAU) is becoming “increasingly the standard” despite criticism of the mandatory introduction of the employer procedure by various employers’ associations. In the first quarter of 2023, employers called up or had called up around 21.6 million sick notes from their employees.

Last year – during the pilot phase for employers – a total of 5.9 million certificates of incapacity for work were retrieved electronically. In March 2023 alone, doctors who have been obliged to send the eAU since July 2022 sent 12.9 million sick notes electronically. This emerges from a press release by the Central Association of Statutory Health Insurance Funds (GKV-Spitzenverband). For more than 80 percent of doctors, the electronic certificate of incapacity for work works, but there are still some problems when accessing the eAU, especially in small and medium-sized enterprises (SMEs).

So far, the total number of sick leave in Germany “can only be roughly estimated”. Accordingly, there was an unreported number “because some employees, especially in the case of short and acute illnesses, have not submitted proof of their sick leave to the health insurance company”. These sick notes were missing from the statistics. In addition, the eAU procedure also has the advantage that sick leave will be recorded more completely in the future and enables a more realistic view of the sick leave of the employees. So far, around 70 to 80 million annual certificates are assumed. With around three million eAUs sent weekly by medical practices to health insurance companies, the majority of sick leave is already digital.

“Digital sick leave has quickly become a fixture in the health care system. This shows that when electronic procedures work, they are accepted by employers, medical practices and insured persons and advance digitization in Germany,” says Dr. Doris Pfeiffer, Chair of the Board of Directors of the National Association of Statutory Health Insurance Funds. For 2025 there should also be “the extension of the retrieval procedure for employers to stay in preventive and rehabilitation facilities”. From January 1, 2024, employment agencies will also be able to electronically retrieve sick reports from people receiving unemployment benefit.

There are no fundamental difficulties with retrieval. However, the health insurance companies are dependent on the doctors making the electronic sick notes available quickly. The eAU has been mandatory for employers since January 1, 2023. Since then, employers have had to electronically request their employees’ sick leave from the communication servers of the statutory health insurance companies and then retrieve it. That the companies have to proactively retrieve the data from the health insurance companies. For SMEs in particular, this caused additional work and, in some cases, additional costs for the retrievals.

Employees must then contact their employer if they are ill and tell them how long they expect to be ill. The retrieval by the employer works via payroll software or alternatively via “certified filling-in aids on the Internet or time recording systems” – employers can then commission external service providers such as tax consultants to retrieve the eAU. The Tagesspiegel recently reported that, according to various health insurance companies, hundreds of thousands of sick leave “get stuck in the ether”. For data protection reasons, the eAU is not sent directly to the employer. Only a few weeks ago, Federal Health Minister Karl Lauterbach admitted that this was “not a good status” for companies. Know the problem and work on it.


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