The digitalization of sick notes: The "yellow slip of paper" is now retired.

The electronic certificate of incapacity for work (eAU) was implemented as a mandatory digital procedure for employers in the Federal Republic of Germany on January 1, 2023. All relevant information such as the start and expected duration of the incapacity for work, initial or follow-up certificate and the identification as a work or commuting accident are recorded digitally and transmitted in encrypted form. Employees are only given one copy for their personal documentation. This process optimization leads to a significant simplification, as the physical transport of documents is eliminated and manual data entry becomes obsolete. This digital transformation aims to substantially reduce the bureaucratic burden for everyone involved.

The eAU can be used by all employees with statutory health insurance whose health insurance provider supports the procedure and who have agreed to the electronic transmission of their certificate of incapacity for work. The system is mandatory for all panel doctors, panel dentists and hospitals that treat patients with statutory health insurance. Private practices, which only treat privately insured patients, as well as rehabilitation facilities and physiotherapists are exempt. Special regulations apply to incapacity for work abroad, as electronic transmission is not yet possible in this case.

The eAU enables faster and simpler processing compared to the conventional paper certificate of incapacity for work. The administrative workload is considerably reduced as manual entries are no longer necessary. Data protection is increased thanks to encrypted transmission. In addition, digital processing results in better statistical evaluation of sickness data, which is extremely valuable for company health management. Automatic integration into existing personnel management systems simplifies documentation and archiving. The planning of substitutions and the calculation of continued remuneration payments also become more efficient.

As a company that employs staff, you are legally obliged to accept the eAU. It has the same legal status as the conventional sick note. Retrieving the eAU has been mandatory for all employers in Germany since January 1, 2023. In order to comply with this obligation, employers must create the technical requirements and register with the health insurance companies. This applies regardless of the size of the company. In the event of technical problems or system failures, transitional arrangements are in place to ensure that operations can continue smoothly.

The health insurance fund transmits the eAU electronically to the employer after the treating doctor has sent the data digitally to the health insurance fund. The employer can retrieve the data in various ways: either via their payroll accounting program, a special eAU program or the employer portal of an employee's health insurance fund. The transmission is encrypted and meets the highest data protection standards. During transmission, only information relevant to employment law is passed on, but not diagnoses or other medical details.

The employer can register with their health insurance fund to accept the eAU. This is done either via the health insurance fund's employer portal or by contacting the responsible contact person directly. The company number and other identification features are required for registration. The health insurance funds offer comprehensive support and provide detailed instructions. Technical advice on integration into existing systems is also offered. Larger companies can also have system-side interfaces set up.

Since January 1, 2021, all statutory health insurance funds in Germany have been obliged to offer the electronic procedure for the transmission of certificates of incapacity for work (eAU). This applies to both the large nationwide health insurance funds and regional health insurance funds. The technical implementation is carried out via the telematics infrastructure of the healthcare system. Each health insurance fund must comply with the specified technical standards and guarantee secure data transmission. The health insurance funds offer their policyholders and their employers appropriate information and support during implementation.

No, it does not apply to all employees. All privately insured employees, those voluntarily insured in a statutory health insurance fund (GKV) and marginally employed persons in private households are exempt. The old paper procedure also continues to apply in the event of incapacity to work abroad, treatment by private doctors or in certain rehabilitation facilities. For these exceptions, employers must maintain the previous processes in parallel with the electronic system. Special regulations also apply to civil servants and the self-employed who are not compulsorily insured under the statutory health insurance scheme.

The costs for the eAU are borne by the health insurance fund in terms of the technical infrastructure and operation of the system. However, employers must bear the costs of adapting their own systems and integrating the eAU into their HR management software themselves. This can vary depending on the size of the company and its existing IT infrastructure. Smaller companies can use cost-effective solutions via their health insurance fund's employer portal, while larger companies often invest in their own software solutions.

The eAU is transmitted in encrypted form and therefore meets the highest data protection requirements. Transmission takes place via the secure telematics infrastructure of the healthcare system, which was specially developed for the exchange of sensitive medical data. Access is logged and can be traced. The encryption technologies used comply with current security standards and are regularly updated. Additional security measures such as two-factor authentication and strict access controls guarantee the protection of sensitive healthcare data.