HR-Glossar
Elektronische AU-Bescheinigung (electronic sick note)
How the German electronic sick note works, what employees still have to do and where the retrieval reaches its limits in practice.
1. What is Elektronische AU-Bescheinigung (electronic sick note)?
The electronic incapacity certificate – eAU for short – has replaced the paper "yellow slip". The doctor's practice transmits the finding of incapacity for work electronically to the health insurance fund; the fund creates a notification for retrieval under Section 109 SGB IV, and the employer retrieves it there instead of being handed it.
Retrieval happens from the payroll program or through the social security reporting portal – the same certified procedures as for the rest of social security reporting. The response contains the start and end of the incapacity, the marker for a first or follow-up certificate and an indication of whether there was an accident at work. No diagnosis is transmitted.
What has not changed is the employee's duty: incapacity must still be notified without delay under Section 5(1) EFZG, and the medical finding must be obtained within the period provided for by contract or statute. Only handing over the paper has fallen away.
The procedure applies to people with statutory health insurance. Privately insured people, marginal employees in private households and certificates from doctors without statutory accreditation stay outside it – paper is still circulating there.
Two points are worth taking out for an employer coming from elsewhere: the direction of travel is retrieval, not presentation, and the privately insured exception is not a marginal one in a company whose senior staff are often privately insured.
2. Origin and development
The yellow slip consisted of three carbon copies for three recipients and was a paper process with three sources of error. Digitalisation happened in two steps: first the transmission from the practice to the health insurance fund, then the retrieval by employers, which has been mandatory since 2023.
The changeover did not run smoothly – transmission problems in practices, incomplete data records and delays were widespread at the start. That explains a feature of the procedure that still holds today: retrieval is not a one-off act but a query that may have to be repeated.
3. Core principles and how it works
Retrieval instead of presentation
The employer collects the certificate from the health insurance fund. The employee's duty is limited to notifying and seeing a doctor.
The duty to notify remains
Without notification the business knows nothing of the absence and cannot retrieve anything. The duty to give notice without delay is unchanged.
No diagnosis
Only periods and markers are transmitted. That was already the case on paper and remains so – the diagnosis is none of the employer's business.
Only for the statutorily insured
The procedure does not apply to privately insured people and some further constellations. There, the paper certificate must still be presented.
Repeat retrieval where there are gaps
Where nothing is available yet, query again. An empty first retrieval does not mean there is no incapacity.
4. Who is Elektronische AU-Bescheinigung (electronic sick note) relevant for?
- All employers with statutorily insured employees – participation is mandatory. - HR and managers – the sickness notification reaches them. - Payroll teams – the retrieval is the precondition for calculating continued pay correctly. - Employees – less changes for them than is often assumed.
5. How it differs from related terms
- eAU and the sickness notification – the notification is what the employee tells the employer; the eAU is the medical evidence. - eAU and continued pay – the eAU evidences the period; the entitlement follows from the Continued Remuneration Act. - eAU and a certificate for a sick child – the certificate for caring for a sick child runs through a procedure of its own. - eAU and reporting an accident at work – an accident at work is marked in the eAU; the report to the statutory accident insurer is not replaced by it.
6. Variants and adaptations
- First certificate – the first finding of incapacity. - Follow-up certificate – an extension; decisive for the continued pay period. - Certificate during a hospital stay – also made available electronically. - Paper certificate – still used for privately insured people, private doctors and treatment abroad. - Retrieval through the reporting portal – for businesses without their own payroll program.
7. Advantages and challenges
Advantages
- No paper route, no lost carbon copies
- The period is established reliably and supports the payroll calculation
- Less chasing after missing certificates
- The data feed directly into payroll
- Data-minimal – no diagnosis is transmitted
Challenges
- Retrieval only works where the incapacity was notified at all
- Delays in practices lead to empty retrievals and require repetition
- Privately insured people and special cases stay on paper – two routes in parallel
- Without a certified procedure or the reporting portal, no retrieval is possible
- Employees frequently believe the eAU removes their duty to notify as well
8. Best practices for implementation
Communicate the duty to notify clearly
The most common misunderstanding of the changeover. One sentence in an internal notice saves many queries and late retrievals.
Build the retrieval into the process
Automated after the sickness notification, with a repeat where the result is empty. A manual retrieval at month-end comes too late for payroll.
Keep the special cases separate
Privately insured people and cases abroad still need paper. Not mapping that leaves gaps that surface only in payroll – and in a company with many higher-paid staff, those gaps are not rare.
Document the responses
The retrieval and its result belong filed traceably – as evidence for continued pay.
9. Tips for employers and employees
For employers
- **Retrieval does not replace the sickness notification** – without notice you do not know you should be retrieving
- **Repeat an empty retrieval** – practices sometimes transmit late
- **Plan for two procedures side by side** – privately insured people stay on paper
- **Keep checking for recurring illness** – the eAU supplies periods, not information about earlier illness
For employees
- **Keep notifying without delay** – the eAU changed nothing about that
- **See a doctor in good time** – the medical finding is subject to a deadline
- **If you are privately insured, keep presenting paper** – the procedure does not apply to you
- **Your diagnosis stays your business** – only periods are transmitted
10. Conclusion
The eAU has replaced the paper route, not the duties. For employees almost nothing changes – notify and see a doctor remains; only handing something over has gone. For businesses the retrieval is now mandatory and works reliably as long as two things hold: the sickness notification reaches the right place, and an empty retrieval is repeated rather than read as an all-clear. Two procedures remain side by side, because privately insured people are not included.
For an international group that last sentence deserves more weight than it first appears to. Employees above the income threshold are frequently privately insured, and in a company with a high proportion of senior and specialist roles that is a substantial part of the workforce. The paper route is therefore not an edge case to be handled ad hoc but a second process that needs owning – and it tends to fail quietly, showing up as a gap in continued pay.
A note on sources: there is no official English version of the Continued Remuneration Act or SGB IV (checked on 2026-09-27); the German texts are cited below and their wording governs.
Sources
- Section 109 SGB IV – Notification for retrieval of incapacity data (German original; no official English version) (opens in a new tab)
- Section 5 EFZG – Duties to notify and to provide evidence (German original) (opens in a new tab)
- Section 3 EFZG – Entitlement to continued pay in case of illness (German original) (opens in a new tab)
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