Sick Leave in Germany: The Krankmeldung Explained

Germany has a well-structured system for sick leave that provides significant income protection — but it comes with specific procedural requirements that employees need to know from day one. Missing a step can complicate things quickly.

What to Do on the First Day of Illness

When too unwell to work, the first obligation is simple: notify the employer on the morning of the first day, before normal working hours begin if possible. This can be done by phone, email, or WhatsApp (check company norms), but it must be timely. A message sent at midday explaining absence since morning is not ideal.

Notify the immediate manager or HR, whichever the company requires — find this out during onboarding, not during illness.

The AU-Schein: Doctor's Certificate

The Arbeitsunfähigkeitsbescheinigung (AU-Schein) is the official doctor's certificate confirming inability to work due to illness. It is issued by any registered general practitioner (Hausarzt) or specialist.

When Is It Required?

The legal rule: an AU-Schein is required if illness extends beyond 3 calendar days. So if sick on Monday, Tuesday, and Wednesday, the certificate is technically required from Thursday. In practice, most German employers now require the certificate from the first day of absence — this is permitted by law and increasingly standard. Check the employment contract or company handbook.

Some employers — particularly startups and international companies — have shifted to more flexible self-certification policies (3-7 days without a certificate), but this remains the exception in Germany.

Getting an AU-Schein

Visit the Hausarzt to receive the certificate. Since 2022, sick notes have been issued electronically (eAU — elektronische Arbeitsunfähigkeitsbescheinigung). Since January 2023, employers retrieve the sick note directly from the health insurer's system — the employee no longer needs to hand a paper copy to HR. However, the employee must still visit the doctor to have the note issued.

Many GP practices also issue AU-Scheine via video consultation through telehealth apps (AU24, Kry, etc.) for minor, non-contagious illnesses. This is legal and widely used.

Employer Pays: The First 6 Weeks

German law guarantees continued salary payment during illness for up to 6 weeks per illness episode. This is called Entgeltfortzahlung (continued remuneration). The employer pays the full gross salary — there is no reduction.

The 6-week clock resets for each separate illness (with separate causes). However, if the same illness returns within 6 months of the previous episode, the original 6-week clock continues from where it left off.

Entgeltfortzahlung applies from the fourth week of employment. In the first 4 weeks of a new job, an employer is not legally required to pay continued salary during illness — a gap typically covered in part by the health insurer.

From Week 7: Krankengeld

If illness continues beyond 6 weeks, the health insurance fund (Krankenkasse) takes over payment. This is called Krankengeld (sickness benefit):

• Amount: approximately 70% of gross salary (capped at 90% of net salary)

• Duration: payable for up to 78 weeks within a 3-year reference period for the same illness

• Eligibility: requires membership in the statutory health insurance system (gesetzliche Krankenversicherung, GKV)

Employees in private health insurance (private Krankenversicherung, PKV) need a separate Krankentagegeld (daily sickness allowance) policy if they want income protection beyond the employer's 6 weeks — PKV does not automatically provide Krankengeld.

For Freelancers and Self-Employed

Freelancers and the self-employed have no employer to pay Entgeltfortzahlung and are not entitled to Krankengeld through GKV by default. Income protection during illness requires:

• Voluntary Krankengeld coverage added to statutory health insurance (elective, costs extra)

• A private Krankentagegeldversicherung (daily sickness allowance insurance) policy

• Some GKV policies for self-employed include Krankengeld from week 7 if opted into the higher contribution tier

Without planning, a freelancer with a prolonged illness faces income loss from day one.

Key Takeaways

• Notify the employer on the morning of the first sick day; many employers require an AU-Schein from day one (not just from day 4)

• Since 2023, sick notes are issued electronically (eAU) and retrieved directly by the employer — no paper needed

• Employers pay full salary for up to 6 weeks per illness episode (Entgeltfortzahlung)

• From week 7, GKV pays Krankengeld at approximately 70% of gross salary, for up to 78 weeks

• Freelancers and self-employed must arrange separate income protection insurance, as statutory sick pay does not automatically apply