Sharing a Medical Certificate: What the Recipient May See
A sick note rarely shows your diagnosis. See what employers in France, Germany, the UK and the US actually receive, and what you can mask yourself.
Your employer almost never needs to know why you are sick. France and Germany leave the diagnosis off the document by design, and the UK leaves it to the doctor's judgment. In the US, the rules work differently, but the goal is the same: proof you need leave, not your medical file.
Why Is Health Data Given Special Protection?
Under EU law, health data sits in a protected group called special category data. Article 9 of the GDPR bans processing it, with narrow exceptions such as your explicit consent or your own doctor's care. That is a stronger rule than the one covering an ordinary email or a name.
This is why sick leave paperwork is built the way it is. Most forms already strip out anything beyond what a recipient truly needs. Most of the time, your job is simply to hand it over as issued.
What Does Your Employer See in France?
A French arrêt de travail (sick leave certificate) comes in three parts, called volets. Volets 1 and 2 go to your health insurance fund, the CPAM, and they do carry the diagnosis. Volet 3 goes to your employer, and it does not.
Ameli, the French health insurance service, states it directly on volet 3. The medical reason is left off. It is covered by medical confidentiality and does not concern the employer. Claire Exemple, a teacher in Lyon, hands her school only volet 3. Her diagnosis stays with her doctor.
What Does Your Employer See in Germany?
Since 2023, most German sick notes travel electronically as the eAU, short for elektronische Arbeitsunfähigkeitsbescheinigung. Your doctor sends it to your statutory health insurer, and your employer retrieves it from the insurer instead of receiving a paper slip from you.
Germany's official health portal, gesund.bund.de, is specific: no diagnosis is transmitted. The employer sees only the incapacity period, whether it is a first or follow-up notice, and whether a workplace accident is involved. You still must tell your employer you are sick. You just no longer hand over paper.
What Does Your Employer See in the UK?
In the UK, a fit note is required once an illness keeps an employee off work for more than seven days. Some people still call it a sick note. Shorter absences can usually be self-certified, with no note at all.
A fit note does have a line for the medical condition. GOV.UK guidance lets the doctor keep that line general if a precise diagnosis could hurt the employee's position. What matters most to the employer is the fit-for-work status, plus any suggested adjustment, such as shorter hours. James Example, an engineer in Leeds, got a fit note naming only a general muscle problem, with a suggestion for lighter duties. His manager saw nothing more specific than that.
What Does Your Employer See in the US?
US federal law works differently. Under the Family and Medical Leave Act, an employer can ask a worker for certification, often form WH-380-E, described by the US Department of Labor. The employer may request only facts tied to the health condition behind the leave, nothing broader.
Once certification arrives, the Equal Employment Opportunity Commission is strict about what happens next. Under the ADA, medical information stays confidential. It sits on separate forms, in a medical file apart from the regular personnel file. Only a short list of people with a real need may see it.
What Can You Mask on a Supporting Document?
The guardrail above only covers the official certificate you must submit. It does not apply to supporting documents you choose to share on top of it. Think of a hospital bill to prove dates, a prescription to justify a purchase, or a specialist's report sent for information.
- Keep the dates of service, so the recipient can match the document to your leave
- Keep the provider or facility name, so the document looks genuine
- Keep the amount billed or paid, if that is why you are sharing it
- Keep any claim or reference number the recipient asked you to quote
- Mask your patient or medical record number, which nobody outside the clinic needs
- Mask the diagnosis line or procedure code printed on an itemised bill
- Mask other patients' names that appear on a shared invoice or shared room
- Mask a drug name if it would reveal a condition you have not disclosed
A diagnosis rarely sits alone. It hides inside a drug name, a procedure code, or a specialist clinic's letterhead. Erika Mustermann, sharing a hospital invoice with her landlord to explain a late rent payment, nearly missed that one line still named her treatment.
For a document like that, ONYRI Sanitize can mask names, ID numbers, dates and ICD-10 diagnosis codes in your browser. You can also search for a diagnosis word and mask every place it appears. It will not catch a diagnosis spelled out in a sentence on its own, so read the preview before you send anything.
Document by Document: What Each Recipient Needs
| Document | Recipient | What they need to see | What you can hide |
|---|---|---|---|
| France: arrêt de travail, volet 3 | Employer | Absence dates, first or follow-up notice | Nothing to add: the diagnosis is already left off |
| Germany: eAU record | Employer | Incapacity period, first or follow-up flag | Nothing to add: the insurer already omits the diagnosis |
| UK: fit note | Employer | Fit or not fit status, suggested adjustments | Never edit it: ask your GP to keep the condition line general |
| US: FMLA certification (WH-380-E) | Employer or HR | Facts supporting the need for leave, expected duration | Nothing: submit as issued, HR files it separately |
| Supporting: hospital bill | Landlord, insurer, school | Dates, provider name, amount | Patient ID, diagnosis code, other patients' names |
| Supporting: prescription | Expense claim, pharmacy proof | Date, amount, item if relevant | Drug name if it reveals a condition |
Frequently asked questions
Can my employer legally ask what illness I have?
In France and Germany, the document your employer receives already leaves the diagnosis out. In the UK, the doctor can choose to keep the condition line general, so there is often little to ask about. Some employers ask anyway, out of curiosity. You are not required to answer, and the paperwork does not obligate you to.
What if the certificate I must submit already shows my diagnosis?
Do not black it out yourself. Ask the doctor, hospital or insurer for the version meant for that recipient, such as the employer's volet in France. Altering a document you must submit can create bigger problems than the exposure itself.
Can a company doctor see more than my employer does?
Often yes. Under GDPR Article 9, occupational health is one of the narrow exceptions, and it must run through a health professional bound by confidentiality. That professional usually reports fitness for work, not the diagnosis itself.
Does my US employer need to know my diagnosis for FMLA leave?
No. The US Department of Labor's certification form asks only for facts tied to the need for leave. Under the ADA, the EEOC requires that information to sit in a separate, confidential file, not your regular personnel record.
I need to send a hospital bill to my insurer. What should I mask?
Keep the dates, the provider's name and the amount, since your insurer needs those to process a claim. You can mask your patient ID number and any diagnosis code printed on the bill. You can also mask other patients' names if the invoice covers a shared room.
Sources & references
- Arrêt de travail maladie du salariéAssurance Maladie (ameli.fr)
- The eAU: electronic certificate of incapacity for workgesund.bund.de (German Federal Ministry of Health portal)
- Taking sick leaveGOV.UK
- Fit note: explaining the form for patients and employeesGOV.UK
- FMLA forms, including WH-380-E medical certificationU.S. Department of Labor
- Enforcement guidance on disability-related inquiries and medical examinationsU.S. Equal Employment Opportunity Commission (EEOC)
- Article 9 GDPR: processing of special categories of personal datagdpr-info.eu