Electronic sick note in Germany: what the employer sees and when it may ask which doctor signed

What data does the employer receive with the electronic sick note?

The employer receives five items from the health insurer: the employee’s name, the first and the last day of the incapacity for work, the day on which the doctor determined it, whether the certificate is a first certificate or a follow-up, and an indication of whether anything points to an accident at work or another accident (section 109 (1) sentence 1 SGB IV). The doctor’s name, speciality and practice location, the diagnosis and the way the examination was carried out are not part of it.

The statute introduces the list with the word “insbesondere” (in particular), so the catalogue is not exhaustive. What is actually transmitted is laid down in the reporting principles of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), which the Federal Ministry of Labour has to approve (section 109 (4) SGB IV). The current version (3.0 of 28 January 2026, applicable from 1 January 2027) still contains no field for the issuing doctor. The only additions are feedback on hospital stays, rehabilitation and special cases, and a flag showing whether an accident insurance doctor (Durchgangsarzt) was assigned.

The change applies only to employees with statutory health insurance. They no longer have to hand in a paper certificate (section 5 (1a) sentence 1 EFZG), but they must still have their incapacity determined by a doctor in time and collect the certificate (section 5 (1a) sentence 2 EFZG). Employees with private health insurance, mini-jobbers in private households and patients of doctors outside the statutory system keep handing in the paper certificate as before (section 5 (1) sentence 2 and (1a) sentence 3 EFZG), as does anyone who falls ill abroad (section 5 (2) EFZG). For a privately insured colleague the employer therefore sees the doctor, the speciality, the practice address and the signature. For a colleague with statutory insurance it sees none of this.

Why the identity of the doctor can decide whether sick pay is owed

A properly issued certificate of incapacity for work carries high evidential value before the labour court, but it does not create a statutory presumption. The employer can shake it by setting out, and if contested proving, facts that raise serious doubts about the incapacity (Federal Labour Court, BAG, judgment of 8 September 2021 – 5 AZR 149/21, paras 12 et seq.). Because the employer usually does not know the causes of the illness, its pleading must not be held to excessive standards (para 14). The individual categories are explained in our article Employer refuses sick pay: when a sick note can be challenged.

Many of these grounds for doubt relate to the doctor: a repeated change of practice with ever new first certificates without a medical reason (Regional Labour Court of Cologne, LAG Köln, judgment of 13 May 2020 – 6 Sa 663/19, para 100), a doctor who has become conspicuous by the number of certificates issued (section 275 (1a) sentence 1 lit. b SGB V), or an unusual closeness between doctor and patient, for example a practice several hundred kilometres away. A single change of family doctor is not enough, it is permitted and is not “doctor hopping” (Labour Court of Cologne, ArbG Köln, judgment of 16 January 2025 – 8 Ca 4803/24, para 76).

The second group concerns how the incapacity was determined. If the doctor breaches the medical requirements of the Incapacity for Work Guideline of the Federal Joint Committee (Arbeitsunfähigkeits-Richtlinie, AU-RL), that too can shake the evidential value. The Federal Labour Court gives as examples a determination without a personal examination and a certificate covering too long a period (judgment of 28 June 2023 – 5 AZR 335/22, paras 13 to 17). Under section 4 (5) AU-RL incapacity may only be certified after a medical examination, in person, by video consultation or, within narrow limits, after a telephone consultation (section 4 (5a) AU-RL). Under section 5 (4) AU-RL a certificate should not be issued for more than two weeks in advance, or for at most one month where there is a specific reason. Backdating to days before the visit is provided for only by way of exception and as a rule for at most three days (section 5 (3) AU-RL).

Four decisions of the regional labour courts show how concrete this becomes:

• Certificates issued after telephone contact only, plus a follow-up certificate for more than two weeks without special justification: evidential value shaken, the employee lost most of her claim (LAG Niedersachsen, judgment of 18 April 2024 – 6 Sa 416/23).
• A follow-up certificate for “the next 20 days” ending exactly with the notice period, plus a handball match during the sick leave: the employer recovered the sick pay it had already paid (LAG Berlin-Brandenburg, judgment of 5 July 2024 – 12 Sa 1266/23).
• Two of four certificates had been signed not by the treating doctor but by a colleague in the practice who had never seen the patient. The court found a gross breach of section 4 (5) AU-RL and held that a reliable determination of incapacity was impossible (LAG Niedersachsen, judgment of 19 November 2025 – 8 SLa 372/25).
• A certificate obtained from a website by questionnaire without any contact with a doctor, submitted to the employer as a sick note: the dismissal without notice was valid (LAG Hamm, judgment of 5 September 2025 – 14 SLa 145/25).

Whether the certified period keeps within the limits, the employer can check against the data set. Which doctor issued the certificate and whether the patient was examined at all cannot be read from it. In the case before the LAG Niedersachsen the missing examination only came to light on appeal, when the doctor gave evidence as a witness.

Does the electronic sick note carry the same evidential value as the paper certificate?

The Federal Labour Court has not decided this question. The legislator deliberately kept the paper certificate: the employee is to collect it so that a statutory piece of evidence with the high evidential value recognised by the courts remains available, for instance where the transmission fails or where the matter goes to court, and that for as long as no electronic equivalent of equally high evidential value exists (Bundestag printed paper 19/13959, p. 37). The Federal Labour Court has adopted this wording (judgment of 13 December 2023 – 5 AZR 137/23, para 12) but has not ruled on the evidential value of the data set itself.

The prevailing view in legal literature is that the bare retrieval data weigh less than the certificate, precisely because they lack the details the courts rely on. The opposing view treats both forms as equivalent. At first instance the Labour Court of Kassel has held that the data set retrieved from the health insurer has lower evidential value once the employer sets out justified doubts (judgment of 27 January 2026 – 9 Ca 262/25). Whether this line prevails remains to be seen. Employees should therefore keep the paper certificate and produce it in a dispute. Anyone who sends a photo of it to HR unprompted, however, discloses more than necessary, because the employee’s copy carries the diagnosis code.

Can the employer ask the health insurer who the doctor was?

Not in the standard procedure. The health insurer transmits only the fields provided for in the reporting principles, and there is no field for the doctor. Whether the employer could demand the information separately because of the open wording of section 109 (1) SGB IV is disputed and has not been clarified by the courts. What it can demand is an assessment by the Medical Service (Medizinischer Dienst): where it doubts the incapacity, it can require the health insurer to involve the Medical Service (section 275 (1a) sentence 3 SGB V). The insurer must in any event review cases where insured persons are off sick conspicuously often or conspicuously briefly, or where a doctor stands out by the number of certificates issued (section 275 (1a) sentence 1 SGB V). The route is slow, however: the employer has to decide on sick pay by the payroll date and on a dismissal without notice for feigned illness within two weeks of learning the facts (section 626 (2) BGB). An expert opinion that arrives weeks later rarely helps with that.

May the employment contract require the employee to name the doctor?

A general contractual clause under which every employee names the doctor’s name, speciality and practice location with every sick note carries a serious risk of being void. The notification and evidence duties of section 5 EFZG cannot be extended to the employee’s detriment, not even by collective agreement or works agreement (section 12 EFZG), and a duty that applies regardless of any reason and with every illness can place an unreasonable burden on the employee (section 307 (1) sentence 1 BGB). Whether a bare information clause falls within this rule is assessed differently in legal literature. Then there is the works council: if the employer regularly demands a particular form of proof of illness from all employees or from a group, that is subject to co-determination (section 87 (1) no. 1 BetrVG), whereas a demand based on the particular circumstances of one employment relationship remains free of it (Federal Labour Court, order of 15 November 2022 – 1 ABR 5/22, para 25). Our recommendation is therefore to do without such clauses. A clause that applies only in a suspicious case repeats what already applies and merely adds a risk of invalidity.

May the employer ask the employee directly which doctor it was?

Whether the employer may, where there is a concrete reason, require the employee to state who determined the incapacity and how has not been decided by the courts. Legal literature derives such a claim from the duty to have regard for the other party’s interests under the employment relationship combined with the principle of good faith (section 241 (2), section 242 BGB), while some authors reject it. The yardstick would be the general requirements the Federal Labour Court has set for information claims: the party asking must, through no fault of its own, be unsure whether and to what extent it has a right. The other party must be able to give the information without significant effort. And the allocation of the burden of pleading and proof in the proceedings must not be shifted in an impermissible way (judgment of 27 May 2020 – 5 AZR 387/19, para 31). The Federal Court of Justice additionally requires proportionality (BGH, judgment of 27 September 2023 – IV ZR 177/22, para 30).

In favour of the claim it is said that the employer is in the dark through no fault of its own, because the change of procedure took away information it still receives for privately insured employees, and that the employee can provide the details without any effort. The case law on default of acceptance (Annahmeverzug) is cited as well, under which a dismissed employee must tell the employer about the job offers made by the employment agency and the job centre, because only the employee knows them (Federal Labour Court, judgment of 27 May 2020 – 5 AZR 387/19). Against the claim it is argued that section 5 EFZG regulates the evidence duties exhaustively, that section 12 EFZG prohibits extending them, and that the employer already has the Medical Service at its disposal.

Those who accept the claim require a concrete reason in any event. A routine question to all sick employees has no basis in section 242 BGB. What comes into consideration are circumstances which on their own do not yet shake the evidential value but could gain weight together with the information requested: a sick note immediately after a conflict meeting, a written warning (Abmahnung) or a rejected holiday request, a conspicuous series of first certificates, or a sick note that runs exactly to the end of the notice period. The strict standard for surveillance by a private detective, which comes into consideration only once the evidential value is shaken and only where an assessment by the Medical Service is ruled out (Federal Labour Court, judgment of 25 July 2024 – 8 AZR 225/23, para 23), does not readily fit a mere question: it observes nobody and does not touch the diagnosis.

What might the employer then want to know?

An information request could cover the doctor’s name, the location of the practice and the way the incapacity was determined, that is whether the doctor examined the patient in person or whether the incapacity was determined by video or telephone. The speciality could be asked for only where it matters for the suspicion itself. The diagnosis is out of the question in any case.

The reason for this gradation lies in data protection. Who treats an employee is personal data that the employer may collect only where this is necessary for the employment relationship (Article 88 (1) GDPR in conjunction with section 26 BDSG, Article 6 (1) GDPR). The name and practice address allow no inference about the illness, the speciality does: an employee signed off by a psychiatrist or an oncologist reveals health data within the meaning of Article 9 (1) GDPR. Processing is not prohibited, because Article 9 (2) lit. f GDPR permits it to establish or defend legal claims, and the Federal Labour Court even holds it permissible that an employee with a recurring illness (Fortsetzungserkrankung) must disclose individual diagnoses (judgment of 18 January 2023 – 5 AZR 93/22, paras 10 et seq.). The principle of data minimisation (Article 5 (1) lit. c GDPR) nevertheless requires not asking for more than the concrete suspicion needs.

The way the incapacity was determined is the more important point in practice, because the courts do not treat a certificate not preceded by an examination as a reliable medical determination. Whether the limits for video and telephone were kept is known only to the employee. The employer cannot, by contrast, demand that the paper certificate be handed over, because the employee’s copy carries the diagnosis code.

What happens if the employee does not answer?

The employer may not withhold sick pay merely because the information was refused. The right to refuse performance under section 7 (1) no. 1 EFZG is, by its wording, tied to the employee failing to hand in the certificate to be submitted under section 5 (1) EFZG or breaching the duties that apply to an illness abroad. The provision no longer fits employees with statutory insurance, who need not hand in anything, and whether it applies by analogy is assessed differently. It certainly cannot be stretched to cover an ancillary duty under section 242 BGB. An employer who wants to enforce the information has to sue, in a dispute over sick pay typically by way of a counterclaim.

The refusal is more effective at the level of evidence. The general rules of evidence apply to the shaking of the evidential value (section 286 ZPO). Under the settled case law of the Federal Court of Justice, a party cannot rely on prima facie evidence if it culpably prevents the other side from rebutting it. Refusing information that could have been given without any effort can therefore work in two ways: as a point the court weighs against the employee in its overall assessment, and as a reason to allow the employer to deny, for lack of knowledge, that the certificate was properly issued (section 138 (4) ZPO). The courts do not accept a bare denial for lack of knowledge, but they say so in relation to a properly issued certificate (Federal Labour Court, judgment of 28 June 2023 – 5 AZR 335/22, para 12). It is precisely this propriety that the employer cannot know without the information.

Once the evidential value is shaken, the employee has to plead in detail what complaints he or she had and how the doctor established them, and has to release the doctor from medical confidentiality as a witness. An employer who withholds sick pay without well-founded doubts, by contrast, risks a claim for the pay plus default interest and, where social security contributions are withheld, the accusation under section 266a of the Criminal Code (StGB).

For employees: what you should answer and what you should not

If the employer asks about the doctor with a concrete reason, there is much to be said for answering: the doctor’s name and practice location and whether you were examined in person or the sick note was issued by video or telephone. You owe no more. You need to state the speciality only if the reason is connected with it, and never the diagnosis. Blanket questions addressed to all sick employees or asked without any reason may be refused, in that case ask in writing for the reason. You do not have to hand over the paper certificate, which shows the diagnosis code, but keep it, because in court it is your strongest piece of evidence. If you change doctors, note the reason: lack of trust, a wrong diagnosis, a referral to a specialist. If in doubt, have yourself examined in person, because a sick note by video or telephone is fully valid but gives the employer an angle of attack. If the employer has doubts, you can point it to the Medical Service, which clarifies the question without your employer learning any details.

For employers: how to proceed safely

Document the reason before you ask: when the sick note arrived and how it relates to a conflict meeting, a dismissal or a rejected holiday request, how many first certificates were submitted and in what sequence, and whether the certified period exceeds the two-week limit of section 5 (4) AU-RL. Phrase the request in tiers and in writing: always the doctor’s name and practice location and the way the incapacity was determined, the speciality only where your suspicion is connected with it, and do not demand the certificate itself. Document the answer or the refusal and apply in parallel to the health insurer for an assessment by the Medical Service (section 275 (1a) sentence 3 SGB V). Do not withhold sick pay without well-founded doubts, do without general contractual clauses and instructions to the whole workforce, and when you analyse how often particular doctors sign off your employees, observe the limits of section 26 BDSG.

Frequently asked questions

Does my employer see which doctor signed me off with the electronic sick note?
No. Under section 109 (1) SGB IV the health insurer transmits only your name, the first and last day of the incapacity, the date of the medical determination, whether it is a first certificate or a follow-up, and indications of an accident. The doctor’s name, speciality and address and the diagnosis are not included.

Do I have to tell my employer which doctor issued my sick note?
There is no settled duty, the courts have not decided the question. If the employer asks with a concrete reason, for example because the sick note followed directly on a conflict, there is much to be said for naming the doctor, the practice and the way the incapacity was determined. You need not answer a blanket question without a reason, and you never have to state the diagnosis.

May the employer demand the paper certificate?
No. Since 2023 employees with statutory insurance no longer have to hand in a certificate (section 5 (1a) EFZG). The employee’s copy also carries the diagnosis code. You should keep the certificate, though, because in court it is the strongest piece of evidence.

May the employer withhold sick pay if I do not name the doctor?
Not for that reason alone. The right to refuse performance under section 7 (1) no. 1 EFZG requires a breach of a duty to hand in the certificate, which no longer exists with the electronic sick note. The refusal can, however, count against you in court if the employer had a concrete reason to ask.

Is a sick note issued by telephone or video worth less?
It is valid within the AU-RL but subject to limits: video for unknown patients at most three calendar days, for known patients at most seven, telephone only for known patients without severe symptoms and at most five days (section 4 (5) and (5a) AU-RL). Exceeding those limits can shake the evidential value.

What can the employer do if it has doubts?
It can demand an assessment by the Medical Service from the health insurer (section 275 (1a) sentence 3 SGB V), ask about the doctor and the way the incapacity was determined where there is a concrete reason, and plead circumstances in court that raise serious doubts. Surveillance by a private detective is permitted only once the evidential value is already shaken.

Analysis based on sections 5, 7 and 12 EFZG, section 109 SGB IV, section 275 SGB V, sections 241 (2) and 242 BGB, section 87 BetrVG, section 26 BDSG, Articles 6, 9 and 88 GDPR, the Incapacity for Work Guideline of the Federal Joint Committee (AU-RL) as in force since 21 February 2024, the reporting principles of the GKV-Spitzenverband (version 3.0 of 28 January 2026) and the case law: BAG, judgments of 8 September 2021 (5 AZR 149/21), 28 June 2023 (5 AZR 335/22), 13 December 2023 (5 AZR 137/23), 27 May 2020 (5 AZR 387/19), 25 July 2024 (8 AZR 225/23) and 18 January 2023 (5 AZR 93/22), order of 15 November 2022 (1 ABR 5/22), BGH, judgment of 27 September 2023 (IV ZR 177/22), LAG Niedersachsen, judgments of 18 April 2024 (6 Sa 416/23) and 19 November 2025 (8 SLa 372/25), LAG Berlin-Brandenburg, judgment of 5 July 2024 (12 Sa 1266/23), LAG Hamm, judgment of 5 September 2025 (14 SLa 145/25), LAG Köln, judgment of 13 May 2020 (6 Sa 663/19), ArbG Köln, judgment of 16 January 2025 (8 Ca 4803/24), ArbG Kassel, judgment of 27 January 2026 (9 Ca 262/25). Legal position as of November 2026. This article is for general information and does not replace advice in an individual case.

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