The electronic sick leave system (e-Sick Leave) has officially been implemented within Serbia’s healthcare system, marking a major step forward in the digitalization of one of the key areas of healthcare administration. The new model allows sick leave to be opened and closed entirely electronically, eliminating the need for physical delivery of medical certificates of temporary incapacity for work to employers.
Deadlines for Software Compliance and Implementation
e-Sick Leave is part of a broader healthcare digitalization project led by the Ministry of Health, in cooperation with the Republic Health Insurance Fund (RFZO) and the Office for IT and eGovernment, with support from the National Alliance for Local Economic Development (NALED). This important initiative represents one of the priority recommendations for improving the business environment in Serbia.
As of January 1, 2026, all employers will be required to use the software solution “e-Sick Leave – Employer”, while entrepreneurs who employ one or more individuals will be required to comply starting from January 1, 2027.
How Does the e-Sick Leave System Work in Practice?
The digitalization of this process brings numerous benefits for employees, physicians, employers, and the healthcare system. The procedure starts at the selected doctor’s office, who, after examining the patient, enters all relevant information into the healthcare institution’s information system. The sick leave certificate is then automatically forwarded to the eHealth portal, where it becomes accessible to registered patients.
The eHealth portal is becoming the central hub for digital communication between patients and the healthcare system. By registering on the portal, users can:
- Track their sick leaves and durations
- Schedule appointments
- Access their electronic medical records
- Download e-prescriptions and medical certificates
For those who are not registered on the portal, the certificate can still be obtained in physical form at the clinic and delivered to the employer manually.
Patients retain the choice of whether to use the digital system or continue receiving paper-based certificates, providing flexibility and accommodating varying levels of digital literacy among the population.
In the final phase of implementation, full integration with employers and real-time automated data exchange is planned, which will further streamline and accelerate the entire process.
What Challenges Do Employers in Serbia Face?
In labor & employment law practice so far, one of the more serious issues employers in Serbia have encountered is the abuse of the right to temporary incapacity for work. In certain cases, medical certificates were used without legitimate medical grounds, making it difficult for employers to verify and control the justification for employee absences. Paper-based certificates, which could be delivered through third parties, further complicated oversight and created opportunities for misuse.
The lack of direct communication and integration between healthcare institutions, employers, and the Republic Health Insurance Fund (RFZO) has often resulted in delayed notifications, lost documentation, and abuse of the sick leave extension process. These shortcomings have contributed to a breakdown of trust between employers and employees.
In Serbia, sick leave is regulated by the Labour Law and the Law on Health Insurance:
- In the case of “standard” temporary absence from work due to illness, the employer is obligated to pay the employee a salary compensation for the first 30 days of leave. The amount is determined by law or collective agreement, but cannot be less than 65% of the employee’s average salary in the previous 12 months. After this period, the cost of compensation is covered by the competent Health Insurance Fund.
- In the case of sick leave due to a workplace injury or occupational disease, the employer bears the full cost of salary compensation, both for the first 30 days and beyond.
- For pregnancy sick leave, the employee is entitled to 100% salary compensation. In such cases, the employer pays the compensation for the first 30 days, after which the cost is transferred to the competent Fund, provided the necessary documentation is submitted and approved by the relevant medical commission (where applicable).
This system creates additional financial pressure on employers, particularly in cases where there is reasonable doubt about the legitimacy of the sick leave. A growing trend in practice is the use of sick leave based on claims of workplace harassment (mobbing), which further complicates matters. Employees experiencing workplace conflicts or dissatisfaction with working conditions increasingly invoke mobbing as grounds for temporary incapacity for work. This often leads to extended absences and strained communication between employees and employers.
While employees’ rights to protection from workplace harassment and access to medical treatment are undeniable and legally guaranteed, such misuse undermines trust in the system and makes it more difficult to address genuine cases of abuse at work. In the absence of objective oversight and digital tracking, abuses are difficult to prove, leaving employers to bear the financial consequences with limited legal protection.
This is precisely where the e-Sick Leave system can play a key role By digitalizing the input, duration control, and documentation related to sick leave, the possibility of arbitrarily opening or extending sick leave without medical grounds is reduced. This enables better protection of rights for genuinely ill employees while also safeguarding employers from unwarranted absences and financial burdens. Ultimately, it promotes a balanced and transparent system that serves the interests of all parties involved.
Pros of the New System
Besides reducing administrative burdens, the e-Sick Leave system also enables better control over the duration of sick leave – if a patient does not come for a check-up by the scheduled date and does not request an extension, the sick leave is automatically closed. In case an extension is needed, the doctor can prolong the certificate and enter a new check-up date. For sick leaves longer than 30 days or in special cases, the system automatically generates a referral for the medical commission of the Republic Health Insurance Fund (RFZO), and all documentation is exchanged electronically.
Along with the introduction of e-Referrals and e-Sick Leave, work is also underway on developing the electronic medical record (e-Karton), which will consolidate the patient’s entire medical history and enable doctors at all levels of healthcare to access relevant data. This will further improve the quality of healthcare services, eliminate the need for repeating tests, and reduce costs in the healthcare system.
One of the strategic goals is also to connect the public and private healthcare sectors through integration of information systems, ensuring continuity of healthcare regardless of the place where the service is provided.
Possible Obstacles During Implementation
While digitalization is welcomed as a solution, there are practical challenges to overcome:
- Uneven levels of digital equipment in health centers
- Insufficient public awareness of the eHealth portal
- Technical unreadiness of some employers to access the system
- The need for additional training of doctors and administrative staff
Full functionality of the e-Sick Leave requires not only technical readiness but also a change in awareness about the importance of digitalization, as a means to a more transparent, fairer, and faster healthcare and labor protection system. With the timely resolution of these challenges, this model can become one of the key pillars of the modern healthcare system in Serbia.
We conclude that the implementation of electronic sick leave represents an important step forward in the digital transformation of healthcare in Serbia and is part of a broader reform aimed at making the healthcare system more efficient, accessible, and sustainable, in accordance with the needs of modern society.
Frequently Asked Questions
1. Can an employee open an e-Sick Leave if they are not registered on the eHealth portal?
Yes, the doctor can issue the certificate in paper form as well.
2. Can the employer access the employee’s diagnosis?
No. The employer only sees the data necessary for calculating and tracking the duration of the sick leave, not the illness itself.
3. What happens if the employee forgets to see the doctor for a follow-up check?
The sick leave is automatically closed unless otherwise agreed with the doctor.
4. How long can an employee be on sick leave before the Republic Health Insurance Fund takes over salary compensation?
The employer pays the compensation for the first 30 days of sick leave. After that, the RFZO takes over payment of the salary compensation, with approval from the medical commission (for “ordinary” sick leave and sick leave due to pregnancy maintenance).
For sick leave due to work injury or occupational disease, the employer covers the full cost even after the first 30 days of temporary incapacity for work.
5. Can e-Sick Leave be opened at a private clinic?
For now, e-Sick Leave can only be issued by selected doctors within the public healthcare system (health centers). Private institutions do not have access to the system, but the Ministry of Health plans to integrate the private sector as well.
6. How can an employee check if their sick leave has been entered into the system?
If you are registered on the eHealth portal, you can immediately see your sick leave status. If you are not registered, you can check with your selected doctor.
7. Can e-Sick Leave be opened retroactively?
In exceptional cases and only with justification, a doctor may open sick leave retroactively, usually for no more than three days. This decision is made by the doctor based on medical documentation.
