The Czech sick note (neschopenka)
Temporary incapacity for work has been fully electronic since 2020. You no longer carry paper anywhere — your doctor sends it into the ČSSZ system for you.
A neschopenka is a decision on temporary incapacity for work, issued by your treating doctor when your health prevents you doing your job. It is issued electronically as an eNeschopenka: the doctor sends it directly to the Czech Social Security Administration (ČSSZ), your employer sees it in the ČSSZ ePortal, and you carry no forms around. In the first phase your employer pays wage compensation; from the day set by law, ČSSZ takes over paying sickness benefit.
The basics
What a neschopenka actually is
It is not a note excusing you from work. It is a doctor's decision that your health temporarily prevents you doing your job.
The decision rests with your treating doctor — most often a GP, but equally a specialist treating you for that diagnosis, or a hospital doctor during admission. It follows from examination and diagnosis, not from how much time off you would like.
Since 2020 it is issued electronically only. The doctor sends notification of the incapacity into the ČSSZ system, from where both the district social security office and your employer collect it. That ended the carrying of paper counterfoils, which used to be the single most common cause of delayed payment.
Competence
Who may issue a neschopenka
Only a doctor treating you for that condition, and only after an adequate examination.
- The GP you are registered with, or a GP who treated you acutely.
- An outpatient specialist, if they are treating you for that diagnosis.
- A hospital doctor during an inpatient stay.
- Never an employer, an HR officer, a pharmacist or a non-medical member of staff.
Every doctor practising in Czechia is a member of the Czech Medical Chamber. You can verify any doctor's registration in the Chamber's public list — including ours. With our Czech doctors we treat that as a given, not a selling point.
Public register of doctors: Czech Medical Chamber.
Information flow
How your employer finds out
You take nothing to them. You still have to tell them.
Notification of the start, continuation and end of temporary incapacity travels electronically through ČSSZ. Your employer views it through their access to the ČSSZ ePortal and pays wage compensation for the first phase on that basis.
That does not mean your employer learns what is wrong with you. The diagnosis is not disclosed — they are told that you are incapable of work and for what period, not why. A diagnosis is health data and is protected by medical confidentiality.
Overview of your own incapacity: ČSSZ ePortal.
The regime
Permitted outings and checks on the regime
Outings are not an automatic right. The doctor permits them, and only where your condition allows.
The extent of permitted outings is set by the treating doctor and written into the decision. Outside those hours you are expected to be at the address you gave for the period of incapacity — and you must report that address if it changes, for instance if you spend the illness at your parents' home.
- The extent of outings is a medical decision by the doctor, not an arrangement between you and your employer.
- Compliance may be checked by ČSSZ and by your employer; those checks follow rules laid down in law.
- Travel to the doctor, to an examination or to the pharmacy is part of treatment, even outside permitted hours.
- Breaching the regime has consequences for the benefit — which is the whole reason a regime is set at all.
If the permitted range stops fitting because your condition is changing, the answer is a review appointment, not adjusting the regime yourself.
The exception
Can a neschopenka be backdated?
Exceptionally yes, but it is not an arrangement with your doctor — the social security administration is part of the decision.
Temporary incapacity is normally issued as of the day the doctor examined you. Issuing it from an earlier date is an exception the doctor cannot simply grant: it is assessed separately and requires the consent of the relevant district social security office.
In practice that means one thing — if you are ill, contact a doctor now, not after you have worked out how to arrange your week. Sorting it out retrospectively is always more complicated than doing it in time.
Conditions of sickness insurance: ČSSZ — sickness benefit.
Telemedicine
Can a doctor issue it online?
It depends what is wrong with you. A video consultation is a full examination for some conditions and not for others.
A doctor consulting online carries the same professional duties as one in the surgery. A decision on incapacity for work may only follow an adequate examination. For a range of common illnesses — a respiratory infection, a gastrointestinal upset, a migraine, an acute anxiety episode — a well-conducted video consultation is sufficient.
For other conditions it is not. Anything requiring the chest to be listened to, an abdomen palpated, a joint examined, blood pressure measured or bloods taken the same day belongs in a surgery. A responsible doctor will say so and refer you, rather than deciding blind.
- The doctor must be licensed to practise in Czechia and a member of the Chamber.
- The consultation must be detailed enough for the conclusion to be reachable at all.
- If your condition does not justify incapacity for work, the doctor will say so. That is not a failure of the service; it is why the document carries weight.
Safety
When to forget the paperwork and get care now
There are situations in which the administration is the last thing worth dealing with.
- Chest pain or pressure, particularly with breathlessness, sweating, or pain into the arm or jaw.
- Sudden limb weakness, facial droop, difficulty speaking, or a sudden severe headache.
- Breathlessness at rest, or blue lips or face.
- A rash that does not fade under pressure, especially with fever, neck stiffness or confusion.
- Any thought of harming yourself.
In these cases call 155 or 112, or go to the nearest emergency department. The paperwork can follow.
Global Health Czechia
Where to go from here
Our Czech doctors consult online and will assess whether issuing a neschopenka is clinically appropriate in your case.
- eNeschopenka and online consultation with a doctor
- Our doctors in Czechia
- Contact Global Health Czechia
Need your fitness for work assessed?
An online consultation with a Czech doctor establishes whether your health prevents you working, and if it does, the decision is issued electronically.
Official sources
Where the rules actually come from
Benefit amounts, the length of the support period and the rules on checks come from the Sickness Insurance Act and change. Read current figures at the source, not in an article.
Links open on the relevant institution's own website. Global Health is not part of ČSSZ or the Chamber and cannot decide, expedite or guarantee any benefit.
FAQ
Common questions
How does a neschopenka work and what do I have to do with it?
Your treating doctor issues the decision on temporary incapacity electronically and sends it to ČSSZ. You carry nothing anywhere, but you must tell your employer without undue delay that you are unfit for work, and follow the treatment regime including the address you reported.
How does my employer find out?
Through the ČSSZ ePortal, which receives the start, continuation and end of the incapacity electronically from the doctor. Your employer does not learn the diagnosis — only that you are unfit for work and for what period, not why.
How do I check the status of my own sick note?
Through the ČSSZ ePortal, in the service showing information about your temporary incapacity. It displays what the doctor submitted. If something does not match, raise it first with the doctor who issued the decision.
How do permitted outings work?
Their extent is authorised by the treating doctor according to your condition and written into the decision. Outside them you are expected to be at the address you reported. Travel to an examination or the pharmacy is part of treatment. Compliance may be checked.
Can a sick note be backdated?
Only exceptionally. It is normally issued as of the day of examination, and issuing it from an earlier date is assessed separately, with the consent of the relevant district social security office. It is not something a doctor can promise in advance.
Can a doctor issue it during an online consultation?
For conditions where a video consultation is an adequate examination, yes. For problems requiring physical examination, blood tests or observation in the surgery, the doctor will recommend an in-person visit instead. The decision always follows the consultation, never the booking.