The Digital Sick Note as an Alternative

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Anyone who is ill must report this to their employer. The sick note from the doctor must be submitted by the fourth day of illness at the latest. Until now, this has been done using the classic yellow slip from the doctor, which shows the start and duration of the sick leave.

In future, this sickness certificate will automatically inform employers as a digital sick note. The digital certificate of incapacity for work or the online sick note is intended to relieve employers and employees alike. You can find out here when the digital sick note will be valid, as well as everything you need to know about its concrete implementation.

Electronic Sickness Certificate - Less Bureaucracy

The issuing and sending of several paper copies resulted in an enormous expenditure of time for all parties involved. The doctor's office, the patient and also the employer should be significantly relieved by the introduction of the digital sick note.

This is possible because the online sickness certificate is automatically sent to the health insurance companies and, in a later step, also automatically to the employers. Paper certificates will no longer be sent. Among other things, this should also avoid a too late submission to the employer. The basis for the new introduction of the eAU is the third law to reduce bureaucracy.

When Will the Digital Certificate of Incapacity for Work Arrive?

But when is the digital sick note actually valid? The classic certificate of incapacity for work (AU) will soon be obsolete and is to become an eAU through the electronic transmission of the AU. The transmission of the electronic sick note by medical practices was originally planned for the beginning of 2021.

Since the practices lacked the necessary technical equipment and should not be burdened with additional acquisition costs during the pandemic, the whole thing could only be implemented on the new start date of January 1st 2022. For all practices that do not yet meet the technical requirements for digital sick leave, there is also a transition period until June 30th 2022.

The eAU replaces the "yellow certificate" and is now printed for patients on normal white paper. If practices have not yet been equipped with the necessary format templates, the old templates are still permitted.

Digital Transmission of Sickness Notification - Advantages and Disadvantages

There are advantages and disadvantages to the digital transmission of the sick note or an electronic sick note. In the old sickness absence procedure, the sick note was issued in 4 copies. The original was sent to the health insurance company and a carbon copy to the patient, employer and the doctor's office that issued it. The big disadvantage was that the patient was responsible for forwarding it to the health insurance company, which only really happened in very few cases. The slip was forgotten, lost or simply thrown away. The online sick note is supposed to simplify these processes. How well it works will only be seen in practice.

The following advantages and disadvantages are offered by the online sickness notification procedure:


  • Saves time
  • Easy and fast data transmission
  • No more sich notes are lost
  • Health insurance companies can process sick pay and other benefits
  • Directly improves work processes in the practice through the digital signature


  • Possible problems/disruptions in the transmission process
  • Possible loss of data
  • Acquisition costs for practices
  • Only planned for SHI-insured patients
  • Does not apply to children's sick notes

How Does the Digital Sick Note Work?

You ask yourself: How does digital sick leave reporting work? The electronic reporting of sick days is to be implemented in two steps:

Step 1

As of the 1st of January 2022, the original will no longer be required for the online sickness notification and will instead be sent digitally directly from the doctor to the health insurance fund. This saves time and no data is lost. There will still be a printout for the patient and the employer, but on white paper.

Step 2

In the next step, which is to be implemented on the 1st of January 2023, the forwarding of the sickness notification online to the employer will also be digitalised. The forwarding of the data to the employer will then take place directly from the health insurance fund to the employer - but only on request. The certificate of sick leave can then still be requested at any time on paper and in signed form for the employer.

Insured persons of the statutory health insurance should be able to collect the eAUs in their electronic patient file after the introduction of the 2nd step and retrieve them for the digital sickness notification for the employer if required.

Does the Certificate Still Have to be Presented to the Employer?

After the second step of the introduction of the eAU procedure, the aim is that the health insurance fund will provide the employer with information about the duration of the sickness notification online upon request. In the first step, however, a carbon copy for the employer is still issued and also in the second step, patients can have a paper medical certificate of incapacity for work printed out on request.

Report on the first day of your absence and inform your employer that you are ill and that you will have a doctor issue you with a digital sick note. If this is extended, the employer must also be informed promptly.

Different Signature Methods Are Possible

In order to confirm the authenticity of the eAU, an electronic sickness certificate must first be electronically signed by the practice before it is sent to the health insurance fund. It is possible to sign each sick note individually, but also to batch process several sickness certificates.

The comfort signature for processing is much more efficient and takes less time when there is a high volume of patients. This means, for example, that at the end of each day in the practice, all sick notes can be signed or signed collectively and sent directly to the health insurers.

Up to 250 signatures for electronic sick leave are possible per day in one step. If there is an error in the data transmission, the system sends a feedback message.

And What if the Technology Stops Cooperating?

As with other technical systems, it can happen that the digital data transmission of the sick note fails. In this case, various substitute procedures are to take effect. The sickness certificate data can be saved in the practice software until the problem is solved. Once the problems have been solved, the data can be sent later.

If the problems are expected to last longer than 24 hours, the doctor can also give the patient the carbon copy for the health insurance company as well as the digital sick note for the employer. Alternatively, the practice can take care of sending it to the health insurance company for its patients to ensure that it is received promptly.

In the Doctor's Office - This is How it Works Step by Step

When you go to the doctor, the procedure for electronic sick leave could look like this in the future.

Treatment at the Doctor

You go to the doctor, get treated and get the prospect of a sick note.

Issue of the Sick Note

The practice staff use the data on your health insurance card to electronically fill out the sickness absence form with the practice software. The diagnosis as well as the beginning and duration of the incapacity for work are entered.

Prepare for Shipping

Now the electronic sick note is created and prepared for dispatch.


The electronic signature is entered using the eHBA procedure.


After saving the data including the signature, the electronic sickness notification is sent to the health insurance fund.


Finally, the copy can be printed out for the patient as well as the employer (optional).


If the illness lasts longer than expected, the digital sick note can be extended and submitted in the same way.


The digital sick note is a significant relief for patients, doctors' offices as well as health insurance companies. Employers also benefit because they can request the current electronic sick note from the health insurance fund at any time and do not have to wait for the employee's paper printouts to arrive by post. Sick notes that are submitted too late and the associated labour law problems are now a thing of the past.

Florian Kassel

Florian Kassel

Online marketing expert

Florian Kassel is the founder of the online marketing agency Digitale Trends and has been dealing with all topics related to digital marketing for more than 10 years now. Whether search engine optimization (SEO), social media or brand building.

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