A court in Germany has ruled that health insurance companies must pay out sickness benefit (Krankengeld) even if insured people miss the deadline to submit a doctor’s note.

Krankenkassen must pay out long-term sick pay despite delays

Germany’s Federal Social Court (Bundessozialgericht) has ruled that even if statutory health insurance companies do not receive patients’ sick notes (Arbeitsunfähigkeitsbescheinigung) within one week of the note being issued by the doctor, they do not risk losing out on long-term sickness benefit.

If you have worked at a company in Germany for more than four weeks, then your employer is obliged to pay you statutory sick pay for up to six weeks of absence. If your sick leave is extended beyond these six weeks, your health insurance provider then assumes these costs.

If you are unwell, doctors in Germany will write you a sick note to show your employer that you are unfit for work. Your doctor will send one copy of your sick note directly to your health insurance provider and you will be given another copy to show your employer. Only in 2021 did it become doctors’ responsibility to submit sick notes to their patients’ insurance provider within one week, rather than a responsibility which could be assumed by either the patient or doctor.

Now, the BSG has ruled that if patients do end up being off work for more than six weeks, they are entitled to receive Krankengeld regardless of whether their sick note has been submitted within the one-week window since this responsibility now lies with doctors, not patients. However, the new rules will not apply to practices that exclusively care for patients with private health insurance coverage. 

Doctors' practices had not been kitted out with technology for note submission

The new BSG ruling was made based on a specific case, which concerned a patient who had been denied Krankengeld after their doctor failed to submit their sick note within the one-week deadline. It was ruled that the patient should not be penalised for a delay at the doctor's practice.

The court said these rules should apply regardless of whether practices have been kitted out with the services required for them to send a sick note to health insurers, since it became their responsibility in 2021.

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