WORK & CAREERS
| When | What to do |
|---|---|
| As soon as you cannot work | Notify your employer and give the expected duration. |
| Certification deadline | Check workplace rules; your employer may require evidence from day one. |
| Usually up to six weeks | Qualifying employees normally receive continued salary. |
| When continued salary ends | Eligible statutory-insured employees may receive Krankengeld. Keep follow-up certification continuous. |
Sick leave in Germany
Sick notes, salary and longer absences
Feeling unwell is stressful enough without trying to understand an unfamiliar system. Here is what to do when you cannot work, how electronic sick notes work and what to check if your absence lasts longer.
Updated 4 October 2026 · A practical guide for employees
First, tell your employer
Report that you cannot work and how long you expect to be away as soon as possible, ideally before your shift starts. Follow your employer’s reporting process and update them if your absence continues. An electronic sick note does not make this call or message for you.
If you are off for more than three calendar days, the usual legal deadline for medical certification is the next working day. Weekends count in those three days. Your employer can require a certificate earlier, including from day one, so check your contract and workplace rules.
The sick note is digital. The reporting is still yours.
The electronic certificate is called an eAU—short for elektronische Arbeitsunfähigkeitsbescheinigung. For most employees with statutory health insurance, the doctor sends the certificate to the health provider. Your employer then retrieves the absence details electronically. This has been the standard employer process since January 2023.
You normally do not upload the eAU yourself. Keep your own copy and tell your employer the certified dates. The electronic employer record does not include your diagnosis.
Exceptions still matter. Privately insured employees, certificates from abroad and certificates from doctors outside the statutory system generally require you to provide the employer with the appropriate proof yourself. Technical problems can also mean a paper backup is needed. If unsure, ask the practice and your employer which document to send; avoid sending the copy containing your diagnosis.
Source: TK: how the eAU reaches employers.
Source: Federal health portal: private insurance and certificates.
Do you always have to visit the practice?
Sometimes a telephone or video consultation is possible. The doctor decides whether your illness can be assessed safely this way; you cannot demand a remote sick note.
By telephone
If the practice already knows you, symptoms are not severe and a video consultation is not possible, an initial telephone sick note can cover up to five calendar days. If you remain unwell after that telephone assessment, the extension normally requires a visit to the practice.
By video
An initial video sick note can cover up to three calendar days for patients unknown to the practice, or seven for known patients. A video extension is allowed only when the previous sick note followed an in-person examination.
What happens to your pay?
Usually, salary first
Employees generally receive continued pay from their employer for up to six weeks of qualifying sickness. The statutory entitlement normally starts after four uninterrupted weeks of employment. Repeated absences for the same illness can count towards the same six-week period; a new certificate does not automatically restart it.
Source: Continued-pay entitlement, § 3 EntgFG.
Then, statutory sickness benefit
Eligible statutory-insured employees generally move to Krankengeld when continued salary ends. It is normally 70% of qualifying gross pay, capped at 90% of net pay and subject to the statutory maximum. Social-insurance deductions can reduce the payment further, so plan for an income gap.
For the same illness, the limit is generally 78 weeks within three years, including the employer-paid period—not another 78 weeks after it. Contact your health provider before salary stops and complete any forms they request.
Source: Federal Health Ministry: sickness benefit.
Private insurance and self-employment
Private health insurance does not automatically replace lost earnings. Check whether you have Krankentagegeld, its daily amount and when payments begin. Freelancers do not have an employer paying six weeks of salary; their statutory or private sickness-benefit arrangements need checking separately.
Source: Federal health portal: sickness benefit and self-employment.
If your absence lasts longer
Arrange follow-up appointments before your certificate ends and keep your employer informed. For uninterrupted statutory sickness-benefit entitlement, further incapacity due to the same illness should normally be medically confirmed by the next working day after the previous certificate ends; Saturday does not count as a working day for this rule. Booking before expiry is the safest practical approach.
Source: Follow-up certification, § 46 SGB V.
Keep a simple record of certified dates, employer messages and benefit correspondence. Before the 78-week limit approaches, ask your health provider and the Agentur für Arbeit about your next steps; further support depends on your circumstances.
Your practical checklist: notify work promptly, check the certification deadline, confirm the eAU process, book extensions in time and understand the income you can rely on.
This guide explains the general system. Your employment terms, insurance status and individual circumstances can affect the result.
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