Sick Leave in Germany: Your Complete Rights Guide

Germany has one of the most employee-friendly sick leave systems in the world. If you are unable to work due to illness, you have strong legal protections and guaranteed income continuation. This guide explains every aspect of sick leave in Germany for English-speaking expats.

Frequently Asked Questions about Sick Leave

What is a sick note?

A sick note (Arbeitsunfähigkeitsbescheinigung, commonly called Krankschreibung or AU) is a certificate from your doctor confirming that you are unfit for work. Since January 2023, Germany uses the electronic sick note (eAU) system — your doctor submits the certificate electronically to your health insurance, who forwards it to your employer.

You do not need to physically hand a paper certificate to your employer anymore. However, you should still confirm with your employer that they received it.

What is present in a sick note?

The sick note contains:

• Your name and date of birth
• The date you visited the doctor
• The start date of your inability to work
• The expected end date
• Whether it is an initial certificate (Erstbescheinigung) or a follow-up (Folgebescheinigung)
• Your doctor's stamp and signature

Importantly: The sick note does not contain your diagnosis. Your employer has no right to know what illness you have.

Things to do when you fall sick in Germany

When you fall sick, follow these steps in order:

Inform your employer

On the first day of your illness, notify your employer as soon as possible — ideally before your normal working hours begin. A phone call, email, or message to your manager is sufficient. You do not need to disclose your diagnosis or any details about your illness.

Tip: Send a short email or message saying something like: "I am feeling unwell today and won't be able to come to work. I will keep you updated on my recovery." That is all you need.

Submit a Sick Note

Since the introduction of the electronic sick note (eAU), your doctor sends the certificate directly to your health insurance, who forwards it to your employer. You do not need to physically deliver anything, but make sure your employer is aware you visited a doctor.

How is it counted over weekend?

Sick days include weekends and public holidays. If you fall sick on a Friday, Saturday and Sunday count as sick days too. This matters for the 3-day rule and for calculating the 6-week employer payment period.

Getting a sick note

You can get a sick note from:

• Your Hausarzt (general practitioner / family doctor)
• Any doctor you visit
• Since 2024, doctors can also issue sick notes via video consultation for certain conditions

You can also get a sick note retroactively — your doctor can backdate it by up to 2 days if they believe you were genuinely sick before the appointment.

Who pays my salary on sick leave?

Your sick pay works in two phases:

First 6 weeks (Entgeltfortzahlung): Your employer pays your full salary, mandated by the Entgeltfortzahlungsgesetz (EFZG). This applies from day one of employment — even during your probation period.

Key rules for the 6-week employer payment:

• The 6 weeks restart for each new, unrelated illness
• For the same illness, the 6 weeks reset only after you have been healthy for at least 6 months, OR 12 months have passed since the first sick day
• Applies to all employees, including part-time and mini-job workers

After 6 weeks (Krankengeld): Your statutory health insurance (GKV) takes over and pays Krankengeld.

Can I take a sick leave for mental health reasons?

Yes. Mental health conditions — depression, anxiety, burnout, panic attacks — are treated exactly the same as physical illnesses in Germany. You have the same rights to sick leave and sick pay. Your employer cannot penalize you for mental health sick leave, and the diagnosis is not disclosed to them.

In fact, mental health is now the number one cause of long-term sick leave in Germany, accounting for over 17% of all sick days.

Sick leave in the first month of a job

You are entitled to sick leave and full pay from day one of employment. There is no waiting period. Even during your probation period, your employer must pay you for up to 6 weeks of sick leave.

However, be aware that during probation, your employer can terminate your contract with just 2 weeks' notice without giving a reason. While they cannot explicitly fire you for being sick, frequent absences during the first months can influence their decision.

Returning early from sick leave

You can return to work before your sick note expires. The end date on a sick note is a forecast, not a binding contract. If you feel better, you can go back to work. You do not need a separate "fit for work" certificate.

Your employer cannot refuse your early return unless there is a legitimate safety concern (e.g., a contagious illness in a healthcare setting).

Can I get a sick note over phone?

Since 2023, you can get a sick note via telephone consultation for up to 5 days if:

• You are already a patient of the doctor
• The illness does not require a physical examination
• It is the initial sick note for that illness

This is particularly useful for common colds, migraines, and similar conditions.

Can I get a sick note over the internet?

Some telehealth providers offer online consultations where a doctor can issue a sick note via video call. This has been allowed since 2024 and is increasingly common, especially through apps like TeleClinic or Kry.

What can I do if my doctor is unavailable?

You can visit:

• Any other doctor (you do not need to go to your registered Hausarzt)
• An urgent care clinic (Bereitschaftspraxis)
• The hospital emergency room (for serious conditions)
• Call 116 117 (the medical on-call service) for guidance

I fell sick on a weekend, what do I do?

If you fall sick on a weekend, you should:

1. Notify your employer on Monday morning (or Sunday evening)
2. Visit a doctor on Monday or go to a weekend urgent care clinic
3. Your sick leave can be backdated by up to 2 days

Krankengeld

If you are sick for longer than 6 weeks with the same illness, your statutory health insurance pays Krankengeld:

• Amount: ~70% of your gross salary, capped at ~90% of your net salary
• Maximum: approximately €3,400/month (2026)
• Duration: Up to 78 weeks within a 3-year period for the same illness
• Eligibility: Only for members of statutory health insurance (GKV), not private insurance (PKV)

Important: If you have private health insurance (PKV), you do not receive Krankengeld. You need to have a separate Krankentagegeld policy. This is something to discuss with your health insurance provider.

To receive Krankengeld, you must submit your sick note to your health insurance within one week of it being issued. Late submissions can result in delayed or reduced payments.

Can You Be Fired for Being Sick?

During Probezeit: Your employer can terminate with 2 weeks' notice for any reason — they do not need to state the reason.

After Probezeit: Termination due to illness is very difficult and requires all three conditions:

1. A negative health prognosis (the illness is expected to continue)
2. The absences significantly impact business operations
3. A balance of interests favors the employer over the employee

In practice, short-term illnesses rarely lead to termination. Courts generally side with employees in these cases.

What You CAN and CAN'T Do While Sick

You CAN:

• Go grocery shopping
• Go for walks (in fact, fresh air is often recommended)
• Visit a pharmacy
• Do light household chores
• Pick up children from school

You should AVOID:

• Heavy physical activity (if related to your illness)
• Going on vacation or traveling
• Working a second job
• Posting activities on social media that contradict your illness (e.g., partying while on sick leave for back pain)

Rule of thumb: You must do everything that promotes your recovery and avoid everything that could delay it.

Sick While on Vacation

If you get sick during your vacation, those days do NOT count as vacation days. You need to:

1. See a doctor and get a sick note
2. Notify your employer immediately
3. Those vacation days are credited back to you

This applies even if you are on vacation abroad — but you must get a doctor's certificate from a local doctor and submit it promptly.

Related Resources

• Probation Period in Germany — How sick leave works during Probezeit
• Health Insurance for Expats — GKV vs PKV explained
• Resigning Your Job in Germany — How to quit properly
• Salary Calculator — Understand your net salary
• Explore English-speaking jobs in Germany with companies that prioritize work-life balance