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HEALTH

EXPLAINED: The changes around doctor’s notes in Germany you should know

Now the temperature has dropped we're more likely to pick up infections. If you need to take time off work, you should be aware of Germany's doctor's note procedure and some important recent changes.

A woman lies on the sofa with medicine for a cold
A woman lies on the sofa with medicine for a cold. Germany is in the process of digitising sick notes. Photo: picture alliance/dpa/dpa-tmn | Christin Klose

If you feel ill or pick up an infection like the common cold or flu, you’ll think about calling your doctor. It could be to find out if you need any treatment, or you might need to get a sick note which can be given to your employer for time off work.

Some employers ask their employees to submit an incapacity to work certificate (the Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung) on the first day of illness.

Most companies, however, are more accommodating and do not require the certificate (also known as a gelbe Schein or Krankschreibung) until on or after the third day. Your employment contract clarifies what applies in the case of each employer. The rule should be listed under “sickness” or “continued payment of remuneration in the event of sickness”.

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What’s changed about sick notes from the doctor?

Germany is in the process of digitising the sick note procedure as a way of minimising bureaucracy (something we can all get on board with).

Previously, three copies of the sickness certificate were given to the patient from a doctor. But since October 1st, the doctor issues only two documents – one for the patient to keep as a record and one for the employer.

The health insurance company should now be informed automatically by the doctor. 

A doctor signs an incapacity to work slip in Germany.
A doctor signs an incapacity to work slip in Germany. Photo: picture alliance/dpa/dpa-Zentralbild | Paul Zinken

And from July 2022 at the latest, the health insurance organisation will be responsible for informing the employer about the sick note. Patients can therefore concentrate entirely on getting well – and don’t have to worry about submitting certificates to their boss. 

Germany had originally planned to fully digitise sick notes at the start of this year, but this was pushed back to allow medical practices and insurers time to prepare. 

READ ALSO: How Germany plans to ditch paper sick notes for digital ones

Some health insurance firms, such as Techniker Krankenkasse (TK), have been running pilot projects for sick notifications to be transmitted digitally to employers so you may have already come across this procedure. 

Should I be aware of anything else?

This rule is fairly new so patients should double check with their doctor to find out if they plan to forward your sick notification to the health insurer. 

As we are in the transitional phase, it might not yet be practised by all doctors. If the doctor has not got a system in place yet for sending the sick note to the health insurance firm, then you can ask for a copy and send it yourself. Some insurance firms allow people to upload it via an app. 

Those who have statutory health insurance must forward the sick note to their insurer quickly so as not to lose any entitlement to sick pay.

When reporting that you’re sick, it’s important to inform the boss by e-mail or telephone (depending on the procedure in your work place) as soon as possible. This is called a Krankmeldung or notification of sickness.

The sick note should  be forwarded to the HR department or your manager. In many cases, a mobile phone photo of the sick note is sufficient; larger companies have a separate postal address where the sick leave certificates must be sent.

If you feel ill or unwell, you should generally avoid the office or your workplace to protect other colleagues from infection. If you are able to work, check with your boss whether you can work from home during that time. 

If you suffer from fever, cough or cold, it’s probably best to consult a doctor. If they suspect that it is Covid-19 you will be offered a PCR test free of charge and advised to self-isolate.

Is the AU certificate also available via video consultation?

Since July 2020, doctors have also been able to issue sick notes via video consultation (Videosprechstunde)

But there are some rules to keep in mind. For instance, the sick note is valid for a maximum of seven days when first issued through the video consultation. If an extension is needed, the patient has to go to the doctor’s office. If the patient first received the sick note in person from the practice, he or she can extend the sick note via a video consultation once.

The National Association of Statutory Health Insurance Physicians (KBV) emphasises that an important prerequisite for issuing the sick note via video consultation is that the patient is “personally known to the practice through previous treatment”. So you can’t access this service with a new doctor. 

Meanwhile, doctors can also give sick notes for respiratory illnesses such as Covid-19, flu or the common cold over the phone due to the pandemic. This rule is in place until at least the end of 2021. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

In Germany, the number of patients who are requesting a video appointment with a doctor is growing.

According to a representative Allensbach survey commissioned by the medical technology group Fresenius, 46 percent of those surveyed were open to video consultations at the end of last year, compared to only 22 percent four years earlier. In the same period, the proportion of those who ruled out video consultations with their doctor fell from 70 to 41 percent.

Acceptance of online consultations has also increased among doctors in Germany. In the second quarter of 2020, patients consulted a doctor or psychotherapist by video almost 1.2 million times – more than ever before, an analysis by the the National Association of Statutory Health Insurance Physicians (KBV) found earlier this year. 

The numbers have skyrocketed during the pandemic. While there were just under 3,000 video consultations nationwide in 2019, there were almost 1.4 million in the first half of 2020. 

Here’s a roundup of some useful vocabulary:

Incapacity to work certificate – (die) Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung

Sick note – (die) Krankschreibung

Notification of sickness – (die) Krankmeldung 

Video consultation – (die) Videosprechstunde

Cold – (die) Erkältung

Sick day – (der) Krankheitstag

Sick leave –(der) Krankenstand (KS)

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For members

WORKING IN GERMANY

Five things to know about salaries in Germany

Finding a job is typically a top priority when planning a move to Germany. The country boasts the third largest economy in the world and a continuing need for skilled professionals. 

Five things to know about salaries in Germany

If you are moving to Germany, you might soon start looking for a job in the country. However, like many other aspects of living abroad, there are several cultural differences and specificities when it comes to job hunting in Germany – especially when it comes to salaries.

Here are five things to know about salaries in Germany.

There is a minimum wage in Germany

Germany’s minimum wage of €12.41 per hour, pre-tax came into effect at the start of this year. This amounts to a monthly salary of €2,054 which ranks ninth in the world. The minimum wage will rise again in 2025 to €12.82 per hour before tax deductions.

There have been calls recently to hike the salary up higher to €14 per hour.

READ ALSO: Millions of workers in Germany ‘earning less than €14 per hour’

Find out salary expectations

Germany does not require companies to list salary ranges for listed positions. But that may be changing soon. The EU parliament passed a wage transparency law to require companies to publish annual reports detailing wage and wage discrepancy information. The rules, which are set to go into effect in 2027, are intended to help close the gender pay gap. 

In the meantime, employees can utilise online resources to find industry averages and expectations for different roles:

  • Gehalt.de offers users access to salary information on more than 800 professions
  • Online platform, Kununu provides compensation information and employer reviews to users in the DACH region  
  • Berlin residents can utilise REDSOFA’s salary survey for an overview of salary averages in the country’s capital city

As of April 2023 the average gross monthly salary was €4,323 according to Germany’s Federal Statistical Office.

Two-thirds of full time workers make less than this average monthly salary and one-third of workers earn more than this average monthly salary.

While wages after deductions may be less than similar roles in other countries, it is also important to take into consideration what other benefits come with a salary. Paid holiday leave, pension contributions, long notice periods and annual bonuses can help make up some of that difference. 

READ ALSO: How much do employees in Germany typically earn?

Check your payment schedule

Internationals can usually expect their salary once a month when working in Germany. Many German companies choose to pay employees either on the 1st or 15th of the month. It is also important to note that most employees can expect to receive their first pay check within 30 or 45 days of starting. 

For positions that offer yearly bonuses, these payments are included in a 13th pay check which are subject to income tax.  

A person works on a laptop.

A person works on a laptop. Image by Bartek Zakrzewski from Pixabay

How many hours do you work?

When looking for a job, don’t forget to check how many hours you can expect. Job descriptions will include expectations for time commitments. 

Mini-jobs, as expected from the name, are limited in hours and pay. Employees can expect up to €538 per month. Mini-jobs do not provide social security because they do not require social security contributions. Employees are also not automatically covered by health and nursing care insurance. 

Teilzeit, or part time jobs, are defined as any job where working hours are less than a full time position.

A common misconception is that part-time work requires working 20 hours or less a week. But an employee working five days a week for 30 hours, at a position that is typically 40 hours when full time can also be defined as a part time worker. 

READ ALSO: The rules in Germany around ‘mini’ and ‘midi jobs’

In fact, Germany has a term for workers who work between 28 and 36 hours a week. Vollzeitnahe Teilzeit, or nearly full time part time workers, can be a popular choice for some people, including parents. These positions can give employees more flexibility to balance work and family responsibilities. It is important to note that these workers are paid according to their time worked, so it will still amount to less than full time.

Depending on the work schedule, part time employees can earn the same amount of vacation as their full-time counterparts. That’s because holiday leave is calculated based on days worked, not hours. If a part time worker comes in five days a week, they will be eligible for at least 20 days of holiday. If that same part time worker comes in three days a week, they will be legally entitled to twelve days of vacation, even if they worked the same hours as the other employee. 

In most companies, weekly working hours between 35 and 40 hours are considered full-time employment or Vollzeitbeschäftigung

Watch out for the gross v. net difference

Before you sign the dotted line, it will be important to check how much of your gross salary you’ll be able to keep come pay day. Companies that include salary expectations in descriptions include gross salary (Bruttoeinkommen) – not the net income after taxes and deductions (Nettoeinkommen). The amount deducted will depend on how much you earn, the tax class you’re in and on other factors such as how much you’re paying for healthcare but it is usually around 40 percent. 

Salaried employees can find information on the deductions on their pay slip. Some to expect to see include:

  • Taxes are deducted directly from the gross pay. The amount is based on the tax bracket your salary falls within 
  • A percentage of your gross salary is also deducted for your pension / retirement contributions
  • Church taxes between eight and nine percent of your salary will also be due if you are affiliated with a religion
  • Unemployment insurance amounts to a 2.5 percent deduction from your gross salary. It is important to note that the insurance covers a salary up to €90,600 
  • Health insurance contribution rates are typically split between employers and employees. The rate depends on the provider. In 2024, the TK contribution rate to health insurance is 15.8 percent of the gross income

READ ALSO: What you need to know about your payslip in Germany 

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