If a sick note is submitted late, sick pay must still be paid. The Federal Social Court decided this. Since 2021, medical practices have had to report incapacity to work to the health insurance company.
The entitlement to sick pay may not be suspended if a subsequent sick note is submitted late to the statutory health insurance company. This was decided by the Federal Social Court (BSG) in Kassel. Since 2021, it is no longer the insured persons, but the contracted doctors who are obliged to submit the certificate of incapacity for work.
Doctors’ offices have to incapacity for work report
According to legal regulations, employees are entitled to sick pay after an illness of more than six weeks.
For this purpose, the incapacity for work (AU) must be reported not only to the employer, but also to the health insurance company. In this case, late notification resulted in a temporary loss of sick pay.
The plaintiff is entitled to sick pay
In the case of the dispute, the plaintiff’s incapacity for work was certified without any gaps from March 31, 2021 to July 21, 2021. However, the follow-up certificates were received by the health insurance company too late.
From May 12th to July 21st, 2021, the health insurance company therefore refused to pay sick pay. The BSG decided that the plaintiff was entitled to sick pay despite the delayed notification from the AU.
Since the beginning of 2021, contracted doctors have been obliged to transmit sick notes electronically to the statutory health insurance companies, explained the BSG. Therefore, if an AU certificate sent by the doctor is received by the health insurance company too late, this should not be to the detriment of the insured person and the sick pay should not be withheld from him.
Ruling does not apply to private doctors and rehabilitation facilities
Something different could only apply to doctors and facilities that do not take part in statutory health care, such as private doctors and rehabilitation facilities.
The highest social justice judges decided that the fact that the technical requirements for electronically sending the AU certificates in the practices were sometimes not present during the disputed period was irrelevant to the insured person’s entitlement to sick pay.
AZ: B 3 KR 23/22 R