Electronic certificates of incapacity for work are hesitantly accepted

1660317808 electronic certificates of incapacity for work are hesitantly accepted.jpg
1660317808 electronic certificates of incapacity for work are hesitantly accepted.jpg

Sending the electronic sick note presents many doctors in private practice with “big problems”. This is shown by a survey by the medical news service.


Contract doctors have been able to issue electronic certificates of incapacity for work since October 2021, and electronic dispatch of the eAU to health insurance companies has been mandatory since July 2022. However, according to a survey conducted by the medical news service (Änd) in August, many of the 917 general practitioners and specialists surveyed from all over Germany have “big problems” with the electronic certificate of incapacity for work (eAU).

The majority (59 percent) of survey participants issue eAUs – 31 percent of them exclusively. 28 percent also issue traditional paper sick notes when necessary. For 22 percent of the participants, the dispatch ran smoothly. For another 22 percent, this is not yet the case, but according to the survey, they are confident that this will change in the future.

For the majority (55 percent) of those surveyed, however, the issuing of the eAU still causes “big problems” and for 56 percent the process is too time-consuming. In addition, 21 percent stated that the entire practice staff lacked the necessary knowledge for a smooth process. In addition, the electronic form of the certificate of incapacity for work leads to discussions among patients.

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Nevertheless, 35 percent of the doctors stated that the electronic sick leave was well received by patients – with another 30 percent this was “partly” the case and some patients would still insist on a sick leave in paper form. For 23 percent of the doctors in private practice, not a single patient wanted to be given sick leave with the eAU. 12 percent of the doctors stated that the majority of patients rejected the digital certificate of incapacity for work.

According to survey participants, there is also a lack of fast technical support for IT problems. 43 percent of those surveyed stated that it is often difficult to reach technical support and receive assistance. A good quarter (28 percent) of the doctors stated that support was not long in coming, but that the solution was usually very time-consuming. Only 15 percent were convinced that support had been able to solve their problems quickly and 14 percent were able to take care of technical problems when issuing the eAU.

Overall, the majority of those surveyed (75 percent) consider the digital form of the AU to be a “superfluous application” that must be “abolished”. Only 13 percent thought that the eAU makes sense and is already integrated into their everyday life. According to almost a third of those surveyed (29 percent), it will probably take a while before dealing with the eAU becomes routine. It is interesting that despite the obligation, a full 41 percent of those surveyed do not issue any eAUs at all. The reason given by most of them was that they were not connected to the telematics infrastructure (TI).

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According to the National Association of Statutory Health Insurance Physicians, the obligation to transmit the eAU via the KIM service (communication in medicine) connected to the TI only applies if this is “technically possible”. The Central Association of Health Insurance Funds (GKV-Spitzenverband) also states that so far there have been no sanctions for doctors who do not send the eAU electronically to the health insurance companies. From January 2023, employers will also be involved in the process. The health insurance company then makes the eAU available to employers for retrieval.