Sick Leave in Germany: Doctor’s Note and Pay

This guide is for internationals who have recently started working in Germany and want to know what happens when illness keeps them away from work. After reading it, you will understand how to report sick, what the doctor’s certificate is, how your pay continues and when sickness benefit from the health insurer takes over.

• Telling your employer
• The doctor’s certificate
• Electronic sick notes, phone and video
• Continued pay and sickness benefit
• When your child is ill
• Where to get help
• FAQ

Telling your employer

When you are ill and unable to work, you are entitled to rest at home. According to Handbook Germany’s guide to sick leave, you need to inform your employer at the start of the first day you cannot work, at the latest. This applies every time you are ill, however the certificate later reaches your employer.

• How: by phone, SMS or email.
• What to say: you do not have to disclose what illness you have.
• How long: if you can estimate how long you will be ill, the page says your employer should be told.

When a certificate is due can differ from one workplace to the next, as the next section explains.

The doctor’s certificate

Your employer has the right to ask for proof that you are unfit for work. In everyday speech this document is called a Krankschreibung (sick note). Its official name is Arbeitsunfähigkeitsbescheinigung (certificate of unfitness for work), often shortened to AU.

When it is due

An employer can request a sick note from the first day of sickness. If yours does, the certificate must be presented on the first day you miss work. In many workplaces, however, employees only have to submit one from the third day of illness. The employer sets which rule applies, and the page recommends asking them.

At the practice

When you see the doctor, you need to say that you need a sick note. Based on the diagnosis, the doctor decides how many days you will be unable to work. The certificate must cover every day you miss because of the illness.

The three parts

1. A page for your health insurance, which the doctor’s office sends directly to the insurer.
2. A page for your own records.
3. A page for your employer, which shows only the duration of your sick leave, not the diagnosis.

Your employer cannot learn the type of illness from the certificate and has no right to ask you about it.

If your employer has doubts

If your employer does not believe you are really ill, they can inform your health insurance company. The insurer will then commission its medical service, the MDK (medical service of the health insurance), to carry out an examination.

Electronic sick notes, phone and video

For people with statutory health insurance, sick notes are now processed digitally throughout Germany. The doctor’s office sends the certificate electronically to your statutory health insurance company, and your employer receives the notification from there. This does not replace your own duty: you still have to tell your employer directly that you are absent. The page does not describe the process for people with private health insurance.

Sick notes by phone

For a time after the peak of the coronavirus pandemic, a sick note required a visit to the practice in person. That is no longer the case: you can once again call your doctor to get a sick note, provided the practice already knows you personally.

Sick notes by video

Under certain conditions, a doctor can also issue a sick note after a video consultation. Again, you must already be known to the practice. There is no legal entitlement to this service, so whether it is offered depends on the individual practice.

Continued pay and sickness benefit

What you receive while ill depends on the length of your sick leave.

• Less than six weeks: in principle, you continue to receive your salary.
• More than six weeks: if your employer no longer pays your salary, your health insurer pays Krankengeld (sickness benefit) instead.

Krankengeld is lower than your wage. The page does not give the amount or explain how it is calculated; that is for your health insurer to decide.

Staying at home or going out

Sick leave does not automatically mean staying indoors. It depends on the type of illness. If your doctor prescribes bed rest, you are expected to stay at home. Otherwise, you may go out or travel.

If you hold a residence permit and have a specific question about how a long illness or lower income relates to your residence status, the foreigners’ authority (Ausländerbehörde) or a migration advice service can answer it.

When your child is ill

Under the Children’s Sickness Benefits Act, statutory health insurance pays benefits when a doctor confirms that a child is ill and needs supervision, care or nursing. One parent may then stay away from work. Handbook Germany gives these entitlements as of 2025:

• Each parent: 15 days per year for each child, making 30 days for both parents per child.
• Single parents: 30 working days per year for each child.
• Several children: a maximum of 35 working days per parent (70 days for both parents), or 70 days for single parents.

Three conditions apply. Your child must be younger than 12, or need special care because of a disability. You must be able to present a medical certificate confirming that your child needs care during the illness. And there must be no other person in your household who can look after the child.

Where to get help

Handbook Germany points to “Faire Integration”, where you can find a counselling centre nearby for questions on employee rights and working conditions. The Ministry of Employment also offers advice on labour law issues through its Citizen Line on 030-6028 0028.

FAQ

Do I have to tell my employer what illness I have?

No. You have to report that you are unable to work, but you do not have to disclose the illness. The employer’s part of the certificate shows only the duration of your sick leave, and your employer has no right to ask about the diagnosis.

From which day do I need a sick note?

Your employer can request one from the first day of sickness. In many workplaces, employees only have to submit it from the third day. Which rule applies is set by the employer, so the details come from them.

Can I get a sick note without going to the practice?

Yes, by phone, if the practice already knows you personally. Under certain conditions, a video consultation is also possible for known patients, but there is no legal entitlement to it and not every practice offers it.

What happens to my pay if I am ill for a long time?

For sick leave of less than six weeks, you continue in principle to receive your salary. After six weeks, if your employer no longer pays, your health insurer pays Krankengeld (sickness benefit), which is lower than your wage. The insurer decides the amount.

Sources: handbookgermany.de

Last verified: 29 October 2026 against the pages linked above. Rules and fees change; the responsible authority always has the final word.

This is general information, not legal or immigration advice. For your own situation, ask the foreigners’ authority (Ausländerbehörde) of your city, a recognised migration advice service or a lawyer (Rechtsanwalt).