Off sick in Germany: calling in, the sick note and who pays you

1. Call in before your working day starts

The law asks for two things only: that you cannot work, and for roughly how long.

• § 5 (1) sentence 1 EntgFG says "unverzüglich" — without culpable delay. In practice that means before your shift or core hours begin, by phone or in whatever way your contract or works agreement names.
• You do not have to give the diagnosis. The notice covers the incapacity and its expected duration, and the electronic record your employer later retrieves carries no diagnosis either (§ 109 (1) SGB IV).
• Read your contract for one clause: § 5 (1) sentence 3 EntgFG lets your employer demand a certificate from the first day. Many contracts do exactly that, and then the three-day rule below does not apply to you.
• If you fall ill while abroad, tell your employer as fast as possible, including your address there; if you have statutory insurance, tell your fund as well, and report your return to both (§ 5 (2) EntgFG).

2. See a doctor by the fourth day — earlier if your contract says so

If you are still ill after three calendar days, the certificate is due on the following working day (§ 5 (1) sentence 2 EntgFG).

• A sick note by phone is possible only for mild illnesses and only if that practice knows you from earlier treatment — § 4 (5a) sentence 2 AU-Richtlinie excludes everyone else. The first note then covers at most five calendar days.
• By video, a practice that has never seen you can certify up to three calendar days, one that knows you up to seven (§ 4 (5) AU-Richtlinie). There is no right to a video certificate.
• Do not count on a backdated note. § 5 (3) AU-Richtlinie allows backdating only by way of exception and as a rule by no more than three days.
• Go to a panel doctor (Kassenarzt). A private practice without panel admission issues a paper certificate that you must pass on yourself (§ 5 (1a) sentence 3 no. 2 EntgFG).

3. Know which way the certificate travels

Since the electronic sick note, the route depends on how you are insured.

• Statutory insurance: the practice sends the data to your fund, and your employer retrieves it there — start and end date, date of the finding, first or follow-up certificate (§ 109 (1) SGB IV). You still receive a printed copy for yourself; keep it.
• Private insurance: nothing is transmitted. § 5 (1a) EntgFG exempts only people with statutory insurance from handing over the certificate, so you give the paper to your employer.
• Mini-job in a private household: paper as well — § 5 (1a) sentence 3 no. 1 EntgFG excludes it from the electronic route.
• The electronic route replaces the paper, not the phone call from step 1. Your employer only sees the record once it has been retrieved.

4. Check who pays you for the first six weeks

Your employer pays, provided you have been employed for at least four uninterrupted weeks.

• § 3 (1) EntgFG: up to six weeks of pay for an illness that is not your own fault. § 4 (1) and (1a): the pay for your regular hours — overtime pay and expense allowances are not part of it.
• § 3 (3) EntgFG: in the first four weeks of a new job your employer owes nothing. According to DAK, the statutory fund then as a rule pays Krankengeld instead, and from the fifth week your employer pays for up to six weeks.
• A new illness starts a new six weeks. The same illness returning does so only after six months without incapacity for it, or twelve months after it first began (§ 3 (1) sentence 2 EntgFG).
• Your employer may withhold pay for as long as a required certificate is missing through your fault (§ 7 EntgFG). Once it arrives, the pay is due.
• If you fall ill on holiday, certified sick days do not count as holiday (§ 9 BUrlG) — but only with a doctor's certificate.

5. When the six weeks end, claim Krankengeld from your fund

When your employer's six weeks end, your statutory fund takes over, for up to 78 weeks in total for the same illness within three years (§ 48 (1) SGB V).

• Amount: 70 percent of your gross pay, but no more than 90 percent of your net pay, paid per calendar day, 30 days for a full month (§ 47 (1) SGB V).
• Cap: gross pay counts only up to the contribution ceiling of 5,812.50 euros a month in 2026 (Bundesregierung, April 2026). vdek gives the resulting maximum as 135.63 euros per calendar day in 2026.
• The 78 weeks include the employer's six. Krankengeld rests while you receive pay (§ 49 (1) no. 1 SGB V), and § 48 (3) SGB V counts resting periods towards the limit.
• No Krankengeld for people insured as students (§ 44 (2) no. 1 with § 5 (1) no. 9 SGB V) or through a family member. With private insurance, SGB V Krankengeld does not apply at all; you receive only what your own policy provides.

6. Never let the certificates leave a gap

This is the mistake that costs the most money, and it is avoidable.

• If you are still ill, the follow-up finding must be made no later than the next working day after the last certified day. Saturday does not count as a working day (§ 46 SGB V, § 5 (3) sentence 5 AU-Richtlinie). A certificate ending on a Friday therefore needs a doctor's visit by Monday.
• Miss that day and the incapacity is no longer continuous, which § 5 (3) sentence 5 AU-Richtlinie makes the condition for continued Krankengeld. What the gap costs in your case is a question for your fund.
• Your fund must know about the incapacity within one week, or Krankengeld rests (§ 49 (1) no. 5 SGB V). The electronic report from the practice meets that deadline for you; a paper certificate from a private doctor does not, so send it yourself.
• The doctor should not certify more than two weeks ahead (§ 5 (4) AU-Richtlinie). Book the follow-up appointment before you leave the practice.

7. If your child is sick, use Kinderkrankengeld

A sick child under 12 is a separate entitlement, not your own sick leave.

• Days in 2026: 15 working days per child and parent, 30 for single parents, at most 35 and 70 across all children (§ 45 (2a) SGB V). The rule is limited to the calendar year 2026.
• Amount: 90 percent of the net pay you lose (§ 45 (2) SGB V), paid by your statutory fund on a doctor's certificate for the child.
• Leave: your employer must release you without pay for those days, and your contract cannot exclude this (§ 45 (3) SGB V).

8. Register with a Hausarzt before you need one

The honest recommendation of this guide: find a practice in your first weeks, while you are healthy. Every shortcut in step 2 — the note by phone, the seven days by video — depends on a practice that already knows you, and in a new city you have none. How to find one is in the guide to finding a doctor linked below.