The doctor issues a three-part sick note, known as eNeschopenka.

An e-sick note contains the following forms to be filled in by the employee’s treating physician:

• 1st part of an e-sick note – Notification of the beginning of a sick leave (electronic form);
• 2nd part of an e-sick note – Card of an employee unfit for work (printed form), issued in printed form by a doctor automatically until December 31, 2024. From January 1, 2025, the Czech Social Security Administration (ČSSZ) introduced SMS and email notifications for the creation, extension, and termination of e-sick notes. These serve as an alternative to printed forms. If the insured person does not provide contact details for sending the identifier, the doctor must print out the form
• 3rd part of an e-sick note – Notification of the end of a sick leave (electronic form).

Besides these basic forms, doctors can fill in and issue the following additional forms:

• Certificate of a continuing sick leave – on the 14th day of the sick leave and each following month of the sick leave (printed form): only for insured employees from another EU state;
• Treating physician’s notification – notification of any changes concerning the sick leave (electronic form).

The process concerning administration of a sick leave of an employee requires the following steps:

• A sick employee sees his/her doctor who decides that the employee is unfit for work;
• The doctor issues an e-sick note either via his/her certified software or using a web application available at the CSSZ ePortal;
• When the doctor fills in the employee’s insurance registration number, the employee’s data are automatically uploaded from the CSSZ register, including information on the employee’s employer; the employee merely confirms the accuracy of these data;
• The doctor fills in the diagnosis, the date of the beginning of the sick leave and possibly other additional information and send this information electronically to the responsible SSZ branch;
• The doctor sends the employee an ID number for the sickness leave via text message or email. The employee may also choose to request a printout from the doctor or combine both methods. Contact details are provided to the doctor at the clinic for one-time use.
• The doctor also prints out a Card of an employee unfit for work and hands it over to the employee;
• The employee without undue delay informs his/her employer on being unfit for work;
• The employer can access and verify all information about the employee’s sick leave, including its start and duration, the employee’s address of residence, and the end of the sick leave on the CSSZ ePortal;
• Employers who asked to be notified of sick leaves of their employees (at the CSSZ ePortal) are notified via their data mailboxes (or, in an abridged form, via email) as soon as the doctor enters the data into the system.

Thanks to the CSSZ ePortal, employers can immediately receive information on the following:

• The fact that an employee has been found temporarily unfit for work;
• Number of the decision establishing the employee’s temporary unfitness for work;
• Date of the beginning of the sick leave;
• Whether the treating physician’s decision contained any suspicion of an industrial injury, injury caused by another person or by abuse of alcohol, drugs or other psychotropic substances;
• Address of the employee’s residence and the scope and times of outings permitted in the first 14 calendar days of the sick leave, and any changes thereto;
• Treating physician’s name, surname and work address, name and address of the provider of medical services who issued the decision on the beginning or end of the sick leave;
• The fact that the sick leave has been terminated;
• The end date of thesick leave.

Doctor appointment and beginning of sick leave

The employee sees a doctor who, after examining the employee, establishes that the employee is unfit for work.

Doctors have two equally valid options of how to issue an e-sick note since they can use their own medical software or the free online application available at the CSSZ ePortal. The technical solution employed does not require the use of an electronic signature or any other new identifier and doctors can use the system certificate issued by the State Institute for Drug Control which they already use for e-prescription. Regardless of whether the doctor uses his/her special software or the online application, the patient’s personal data, including information on the patient’s employer, upload automatically. The doctor only fills in the diagnosis, the date of the beginning of the sick leave, or possibly other additional information.

The doctor sends the first part of the e-sick note – Notification of the beginning of a sick leave – electronically to the responsible SSZ. At the same time, the doctor sends the employee an ID number for the onset of temporary incapacity for work via SMS or email. If the employee does not provide contact details or requests a paper copy of the decision, the doctor prints out the second part of the eNeschopenka – Certificate of Incapacity for Work of an Insured Person (one page in A5 format). This form is given to the employee and is used for records of checks by the attending physician, by the Czech Social Security Administration, and for marking the confirmation of the duration of incapacity for work and its termination. The employee does not take it anywhere, does not hand it over to the employer, but keeps it for the above purposes. If the employer has requested notifications, a notification is also sent to the employer after the attending physician’s report has been sent to the CSSZ. Otherwise, the notification is sent immediately after the report has been processed in the CSSZ systems (after verification of the data) and any further investigation by the SSZ employee.

Proving sickness to the employer

Employees are required to immediately inform their employer of their temporary incapacity to work, using the method prescribed (customary) by the employer, i.e., by email, telephone, etc. Employers can easily verify the employee’s claim electronically (see below).

Information available to employers via the CSSZ ePortal

Employers have two options to learn about their employees’ sick leave, both available in the CSSZ ePortal client zone.

Registered users can use two types of services:

Service for verification or downloading of information on employees’ sick leaves:

Information is downloaded via data mailboxes. Moreover, employers who want to process e-sick notes in their own software can use a service called “Information on sick leaves for employers”, which works via the VREP (APEP) channel, which is currently used to file electronic submissions. This service allows for regular automated downloading of information on employees’ sick leaves directly into the employer’s payroll or HR software. How exactly this information is processed into the employer’s software depends on the provider of the software.

This channel allows employers not only to obtain information about the beginning, duration and end of a sick leave, but also about the employee’s current address of residence and permitted outings.

It is possible to save the output as a PDF or XML file.

Automatic electronic notifications of employees’ sick leaves:

Employers who file a request via the CSSZ ePortal are sent a notification of the beginning, change or termination of their employees’ sick leaves either by email, as a short report that a change in the status has been recorded, which may be verified as described above, or by a data message sent to the employer’s data mailbox as a PDF or XML file which contains complete information about the sick leave.

An uncertified informative message is sent immediately after CSSZ receives an electronic message from the doctor that an employee has been found unfit for work.

After processing of individual notifications included in the e-sick note and their examination by a CSSZ employee, extracts from the first and the third part of the e-sick note, certificate of a continuing sick leave and selected data from the treating physician’s notification will be sent to the employer. The processing is a matter of hours or days, depending on the circumstances of the given case, in particular, the accuracy of the data filled in and the potential need for their re-examination.

Due to the protection of privacy, notifications only contain the employee’s name, surname, date of birth and date of beginning of the sick leave.

The employer is notified on an employee’s sick leave only if such an employee participates in the system of sickness insurance and is registered in the insurance sickness register. Recruitment of new employees should therefore be notified to the responsible CSSZ as soon as possible, by a form called “Notification of new employment”. If the data uploaded into the system by the doctor fails to identify an insured employee, the employer receives the notification only after the e-sick note has been manually processed by the CSSZ.

Employers may register for services provided by the CSSZ ePortal either via their data mailboxes or by using one of the methods offered by the National Identity Authority („NIA“ – may be created free of charge at eidentita.cz).

Employers may authorize an employee or another individual or legal entity (e.g. a payroll provider) to use the CSSZ ePortal on behalf of them. Such authorization must be granted via a special service available at the CSSZ ePortal  (available to registered clients) or via an interactive form. The authorized person may then access the services using their data mailbox login or one of the NIA tools. If the authorized person is a legal entity, it must further authorize an individual to act on behalf of it.

The service should contain data on individual employees (based on their birth number) or generate a list of all employees of a given employer who the CSSZ at the given moment registers as being on a sick leave.

Employer’s obligations after receiving an e-sick note

The basis for excusing absence from work and paying wage compensation during the first 14 days of sick leave is information from the Czech Social Security Administration (ČSSZ) in electronic form. If the employee has a “Sickness Insurance Card,” they can prove the existence of sick leave by presenting it.

Data on the onset, duration, and end of an employee’s temporary incapacity for work can be imported into payroll calculation programs either online via the VREP channel or by importing an XML file from eNeschopenka.

Reporting changes in the course of the sick leave

Doctors electronically announce to the OSSZ any changes occurring in the course of the sick leave – e.g. change of address, referral to another doctor, change of permitted outings. Employers may learn about such changes via the CSSZ ePortal.

Employer’s obligations after the end of a sick leave

Sick leave not exceeding 14 days

Should the doctor in the first 14 days of the sick leave establish that the employee is again fit for work, the employer takes steps described below in sec. “End of sick leave”.

If the employer asked to be notified of its employees’ sick leaves (please, see sec. “Information available to employers via the CSSZ ePortal” above), a notification is sent to the employer’s data mailbox or email address immediately after the threating physician sends the notification to the CSSZ.

Certified information on the end of the sick leave is also available at the CSSZ ePortal.

Employers pay compensation of income during the employee’s sick leave on the basis of this information.

Sick leave exceeding 14 days

After 14 days of sick leave, the doctor notifies the CSSZ that the employee’s temporary unfitness for work continues. This information is also recorded in the Card of an employee unfit for work. No other document is issued for the employer(“money vouchers” no longer exists).

Employers who requested sending of notifications also receive this information by a data message sent to their data mailbox. Certified information may be accessed at the CSSZ ePortal.

In this case, the employer is obliged to send, immediately after the first 14 days of temporary incapacity for work, an electronic Employer’s Notification of Employee’s Application for Benefits with the information necessary for calculating sick pay. In this notification, the employer shall also indicate the bank account to which the employee’s wages are paid, or indicate another method of wage payment, in electronic form to the electronic address designated by the district social security administration. Documents for the deduction of sickness insurance benefits may be sent either electronically or in paper form.

Until the 14th day of the sick leave, the sickness benefit is paid to the employee by the employer. From the 15th day on, the benefit is paid by the CSSZ.

After the employee returns to work, the employer is obliged to send an electronic notification of the employee’s conduct of work on the last day of the sick leave or during the sick leave.

Based on the notification received from the doctor and the employer, the OSSZ makes a calculation of the sickness benefit. Sickness benefits are paid to employees by the same method as salary or other remuneration, unless an employee asks for another payment method. If the employee’s salary is paid in cash, by postal service to an address abroad, or by a transfer to a financial institution other than a bank located abroad, the sickness benefit is paid by a payment method indicated by the employee.

End of sick leave

When a doctor establishes that the employee is again fit for work, he/she issues a decision on the end of the sick leave. The doctor may either use his/her medical software or log in to the CSSZ ePortal where he/she selects the case of sick leave he/she intends to terminate and the data on the case uploads automatically. 

The doctor will issue the third part of the sick note – Report on the end of temporary incapacity for work, final diagnosis – and send the report on the end of temporary incapacity for work electronically to the relevant Czech Social Security Administration (ČSSZ). At the same time, the employee will mark this termination in the incapacity for work card of the insured person (if the employee has it available, i.e., has not requested electronic delivery of the decision).

Employers who asked to be notified about sick leaves (see sec. “Information available to employers via the CSSZ ePortal above”), are notified by email or by a data message immediately after the doctor sends the notification to the CSSZ.

At the same time, the doctor records the end of the sick leave in the Card of an employee unfit for work. Employers who asked to be sent notifications are immediately notified that the sick leave has been terminated. Certified information about the end of the sick leave is available at the CSSZ ePortal.