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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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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

Published: 23 April 2024 12:55 CEST
How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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