EAU Certificates in Germany: All You Need To Know

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The electronic certificate of incapacity for work (eAU) is intended to reduce bureaucracy both in the healthcare system and for companies in Germany. The eAU will replace the yellow paper slip much sooner than planned. 

Read below to learn when the process starts for health insurance companies and employers and what tasks are associated with it for HR professionals.

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What Is the Electronic Certificate of Incapacity for Work?

The electronic certificate of incapacity for work (eAU) is also known as electronic sick certificate. It is the digital version of the old sick leave certificate, known as the "yellow slip".

Electronic sick leave was introduced as part of the Bureaucracy Relief Act III from 2019 to reduce administrative bureaucracy and act sustainably. 

It’s a sensible idea because with around 77 million sick notes per year, the eAU saves 308 million paper forms. The electronic AU also prevents possible conflict about the timely  notification of sickness.  

AU certificate so far


Paper form: with original copy for the health insurance company, copy 1 for the doctor, copy 2 for the patient and copy 3 for the employer.

Electronic form: with an electronic signature from the doctor and a printed version for the patient (legally required evidence).

Transmission of the sick note: To the health insurance company and to the employer.

Transmission of the sick note: To medical practices, health insurance companies provide data and then the employer retrieves the data.

Digitisation of the AU is a huge procedure. In a pilot project by the Techniker Krankenkasse (TK) in 2017, it was proven suitable for everyday use. More than 600 medical practices involved entered data for a certificate of incapacity for work into their existing practice software and sent it to TK. The transmission to two test employers also worked perfectly.

Fun fact:  In the old AU procedure, the data was entered into the computer (i.e. digitised) in the doctor’s office. The printouts of these sick notes were then digitised again by health insurance companies and companies - and the original paper notification was destroyed.

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Employees used to need to call in sick and if necessary, upload certificates: Employees do this themselves in Personio – the manager only confirms. This minimises administration for everyone.

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How Does the EAU Work?

The key participants in electronic sick leave are:

  • the medical practices

  • the health insurance companies

  • the employers

The basic process of digital sick leave involves four steps:

Step 1: 

A sick employee is examined in the doctor's office and determined unable to work.

Step 2:

The doctor's office reports this electronically to the employee's health insurance company.

Step 3: 

After the doctor's appointment, the employee informs their employer by telephone, email or instant message that they are sick. This reporting obligation remains with the employee.

Step 4:

The employer now retrieves the following five items from the certificate of incapacity for work. They do this from the responsible health insurance company:

1. the name of the employee 2. the beginning and end of their incapacity to work 3. the date of the doctor’s determining of their incapacity to work 4. identification as initial or follow-up notification 5. information as to whether there are indications that the incapacity to work is due to an  accident at work or another accident or is the consequence of either.

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When Is the EAU Coming?

The introduction is planned in phases. The first phase includes the mandatory transmission of the eAU from medical practices to health insurance companies. This should be possible as early as October 1, 2021, but has not yet been implemented due to a lack of comprehensive software. 

Until December 31, 2022, in addition to the digital transmission, practices will continue to issue a paper sick note, which then has to be sent by the employee to the employer as before.

Who Is Not Involved in the EAU Process?

  • private doctors

  • doctors abroad

  • physiotherapists

  • psychotherapists

According to the initial schedule, employers should be integrated into the eAU process in phase 2 on July 1, 2022. The new official deadline for this is now January 1, 2023.

Attention, HR: Since the beginning of 2022, all employers who already have appropriate software have been able to access eAU information as part of a pilot process.

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What Employers Need To Do About Electronic Sick Leave

The electronic certificate of incapacity to work is intended to relieve companies of complex administrative tasks. But until the digital process runs smoothly, the introduction of the eAU will initially present HR and employers with new challenges. Existing HR processes must be considered and re-evaluated.

This offers HR a great opportunity for more digitisation and automation of HR processes through the introduction of holistic HR software. For example, this would enable employees to upload medical certificates themselves. It would also support the HR department with automatically generated reports in relation to sick leave.

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What Does the Introduction of the EAU Mean for HR?

From January 1, 2023, employers must do two things:

  • accept the employee's sick note (as before)

  • actively retrieve the data on sick leave for their employees from their health insurance companies

From this date onwards, employees are no longer obliged to present the company with a certificate of incapacity for work. Their obligation to submit this will no longer apply once the eAU procedure has been fully implemented. 

But beware: HR may only request an eAU after the employee has been informed accordingly - a blanket request, for example for all employees, is not permitted.

Additional Tasks for HR 

It’s not possible to introduce the eAU without a suitable IT infrastructure. Numerous companies urgently need to improve this, in particular because strict data protection regulations must be observed when retrieving the data. 

According to a survey by the German Society for Personnel Management, 76% of companies in Germany are still in the starting stages of implementation - obviously there is still a lack of information on systems.

HR must continue to ensure that in the case of an electronic certificate of incapacity for work, the corresponding information about absences is also sent to the payroll accounting department quickly and digitally if possible. 

If companies use time tracking software, this must be expanded in order to be able to digitally record periods of incapacity to work.

In addition, HR departments must continue to receive the AU on paper for their privately insured employees and be able to process it, since the eAU procedure has not yet applied to privately insured employees.

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