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HEALTH

EXPLAINED: How Germany’s new electronic sick note works

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.

Published: 31 January 2023 11:35 CET
A doctor sits behind a computer in an appointment with a patient.
A doctor sits behind a computer in an appointment with a patient. Photo: picture alliance/dpa/dpa-tmn | Christin Klose

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”.

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.

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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FAMILY

How to find mental health resources in Germany for children

As mental illnesses and behavioural disorders among children and teenagers continue to rise, it can be difficult for international parents in Germany to know where to find resources.

Published: 19 April 2024 16:17 CEST
How to find mental health resources in Germany for children

Whether it’s school stress, adjusting to a move abroad, low self esteem, a personal crisis, hormonal changes or family issues, there are plenty of things that may make it hard for young people to cope with everyday life. 

A survey screening child anxiety disorders, found children in Germany ages 11 to 17 with symptoms of anxiety more than doubled over the course of the pandemic from under 15 percent before the pandemic to nearly a third of children surveyed exhibiting symptoms in January 2021. 

And social media has only added to the problem. According to a recent DAK study, media addiction among children and young people in Germany has nearly tripled from numbers before the pandemic. 

Girls and boys with heavy social media use reported more depressive symptoms, anxiety and a higher level of stress than children with less media usage. The parents of the affected children and young people also reported more dissatisfaction with communication within the families.

While Germany has a large capacity to care for mental healthcare patients, it can still be tough to find resources for children, especially if there’s a language barrier. Here’s a guide to finding mental healthcare for children and youth in Germany:

Is mental health care covered by insurance in Germany?

Yes, Germany’s state health care system covers mental healthcare. Statutory health insurance currently covers nearly 90 percent of the population. This insurance gives residents access to consultation with a psychiatrist, therapy, in- and outpatient care, emergency mental health services and medication. 

READ ALSO: How to receive help for a mental health issue in Germany 

Where should you start?

Parents should start by reaching out to their children’s paediatrician or family doctor. After explaining how your child is doing, they will likely refer you to a child psychiatrist to further evaluate treatment options. Treatment can include prescribing mediation, talking therapy, or a combination of both. You can also directly set up a consultation with a mental health professional for your child.

Insurance type, public or private, can also impact the type and availability of services. Public insurance covers fewer practitioners, meaning you may have to cover the cost of therapy for your child upfront and wait to be reimbursed.  

Whether you have public or private insurance can impact the type and availability of services. Public insurance covers outpatient psychotherapy, but patients must meet specific requirements for coverage. Doctors can also write a letter that parents can submit to their health insurance to access up to six therapy sessions, with the possibility of extension. 

Families using public insurance may also have longer wait times. Nearly half of all patients must wait three to nine months before receiving care, according to Germany’s Federal Chamber of Psychotherapy. 

A school girl at a Leipzig school. Photo: picture alliance/dpa | Hendrik Schmidt

This problem is worsened because public insurance does not cover all mental health professionals. Practitioners must have a ‘Kassensitz’ licence to bill public health insurance. These licences are regulated by the government and are limited. The cost of this licence, along with the waiting time for it, is often a deterrent to some practitioners. 

Another option could be to talk to your child’s school. Some schools employ social workers and psychologists who can screen and provide resources to children. These professionals can screen young people who exhibit symptoms of mental and emotional distress or hyperactivity in the classroom. They can also refer you to additional resources for more specialised treatment. 

What mental health resources are available?

As of 2022 there were more than 55,000 child and adolescent psychologists working across the country, according to data from the German society for psychiatry and psychotherapy, psychosomatics and neurology (DGPPN). The majority of these health professionals work in outpatient facilities, and the remaining 15 percent work in inpatient or day-care facilities. 

Germany has 274 mental health hospitals, 401 psychiatric units across general hospitals and 63 mental health outpatient facilities, according to the UN’s 2020 Mental Health Atlas. The country also started granting more specialist titles, including in child and adolescent psychiatry, in 2022.

Germany has also launched a helpline called “Nummer gegen Kummer” (number against grief) to support children facing mental health issues, whether it’s to do with getting bad grades or dealing with unrequited love.

READ ALSO: ‘Being honest helps’: How expats have overcome loneliness

The free help line – which is accessed by calling 116 111 – is active Monday to Saturday from 2pm to 8pm daily. Children can anonymously speak with volunteer consultants who range from the elderly to students ages 16 to 21. It is important to note that this resource is intended for children comfortable speaking German at an elementary level.

Other resources to consider include:

  • Online directory Therapy Route features English-speaking psychologists and social workers across Germany
  • It’s Complicated connects users to in-person or virtual therapeutic care based on your language and insurance type
  • Online directory Therapie.de lists around 600 English-speaking therapists currently working in Berlin, 150 in Frankfurt, around 230 in Hamburg, and 240 in Munich
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