Digital health The electronic sick leave notice (eAU)

Anyone who is ill and unable to work needs a medical certificate of incapacity for work (AU) in order to receive further salary payments or sickness benefit. This proves to the health insurance provider and employer that they are unable to work. An AU can also be issued if there is a risk that continuing to work will cause a condition to deteriorate to a point that causes an incapacity for work.

In the past, patients had to send the certificate of incapacity for work – also known as a sick note or simply the “yellow note” – to their statutory health insurance provider and employer themselves.

In most cases, this has no longer been necessary since early 2023 as the electronic sick leave notice (eAU) is transmitted digitally via the telematics infrastructure, the secure network for exchanging medical data.

If a doctor determines that a patient is unable to work, the practice sends the eAU to the patient’s statutory health insurance provider electronically.

The following data is transmitted:

• name of the insured person
• date on which the incapacity to work was determined by the doctor
• whether it is an initial or follow-on notification
• whether there is any evidence that an (occupational) accident or occupational disease caused the incapacity to work
• diagnosis

Insured persons receive proof of their incapacity to work in paper format for their own records. This printout does not have to be signed by the doctor.

Since the start of 2023, health insurance providers have made the information reported by doctors available to employers via a secure and encrypted data connection. The employer or authorized representative must independently access the electronic sick leave notice (eAU). No information about the diagnosis is provided. 

Employers must only access the data from the eAU from the health insurance provider if they are entitled to do so. This is the case:

• if an employment contract existed during the period in question
• if the employee has already informed the employer about the incapacity to work and its expected duration

This transition to the electronic sick leave notice (eAU) offers advantages to all involved parties – patients, doctors, health insurance providers and employers.

• The eAU is sent to health insurance providers and employers securely and quicker than the old paper form.
• Insurance holders no longer need to transmit the sick leave notice themselves. They solely have to inform their employer about their incapacity for work.
• The eAU reduces costs compared to using postal mail.
• The eAU provides health insurance providers with complete documentation on an insured person’s sick leave. This makes it easier to pay sickness benefit correctly and on time.

Digital certification is not currently possible in the case of:

• child sickness (child sickness benefit)
• private insurance holders and private medical practices
• sick leave notices from outside Germany
• employment bans
• rehabilitation and reintegration into working life
• “minijobs” (marginal employment) in private households

In these cases, employees receive multiple copies – one each for their health insurance provider, employer and themselves.

In the event of technical problems, the eAU can be substituted for a hard copy version.