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How to take sick leave and protect your pay in Germany

Report illness correctly, maintain medical evidence and understand how continued wages, Krankengeld and special absence situations connect.

A complete German sick-leave guide covering Arbeitsunfähigkeit, eAU, employer pay, Krankengeld, work accidents, child sickness, BEM, return, and disputes. Work through the guidance to compare the relevant options, prepare evidence, track timing and costs, and recognise the points that need confirmation with the responsible authority or service.

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Guide details

  • 13 min read
  • 7 chapters
  • 13 sources
  • Updated Aug 26, 2026

Key checks: sick leave Germany, Arbeitsunfähigkeit, eAU, Krankengeld

Protect pay and records during sick leave in Germany

Covers sick leave Germany, Arbeitsunfähigkeit, eAU in Germany, with practical detail on the route, evidence, timing and remedies.

Tell the employer immediately that you cannot work and the expected duration, without waiting for the eAU. Obtain medical assessment by the required date, keep a personal copy, verify health-fund transmission, and renew certification without gaps. Identify whether the cause is ordinary illness, work accident, sick child, rehabilitation, or another insured event because the payer and evidence differ.

Key points

  • Notification and medical proof are separate duties.
  • The eAU does not notify the employer for you.
  • Employer pay is normally limited to six weeks per statutory illness calculation.
  • Krankengeld is lower than ordinary net pay.
  • Work accidents use the accident-insurance route.
  • Dismissal deadlines continue during illness.

Rights Map

Map Notification, eAU, Employer Pay, Krankengeld, Accidents, Child Care, and Return

Choose the correct evidence and payer for the reason, duration, insurance status, and employment stage.

Every incapacity starts with immediate notice to the employer and an estimate of duration. Medical certification is a second requirement. The employer can require it earlier than the general statutory default, and the contract or collective agreement may set a day-one rule. For ordinary statutory cases, the practice sends eAU data to the health fund and the employer retrieves limited information. The employee still has to notify the absence and obtain assessment on time (eAU guidance).

Choose the route

SituationMain pay or benefit routeCritical action
Ordinary employee illnessEmployer continued remuneration, then statutory Krankengeld where coveredNotify immediately and maintain continuous AU
First four employment weeksStatutory fund may pay where covered, then employer from day 29 if incapacity continuesTell fund and employer the start date
Private insuranceContractual daily sickness allowance, if purchasedCheck waiting period, amount, and proof
MinijobEmployer continued pay can apply, but minijob alone normally creates no Krankengeld coverCheck other health-insurance status
Work or commuting accidentStatutory accident insurer, including possible VerletztengeldDocument and report accident, attend D-doctor where required
Caring for sick childEmployer pay only if applicable; otherwise Kinderkrankengeld where eligibleObtain first-day child-care certificate
RehabilitationContinued pay or transition benefit according to timing and payerCoordinate employer, fund, and rehabilitation body
Gradual reintegrationEmployee normally remains unfit for full contractual work and receives replacement incomeAgree medical staged plan and payer

The Continued Remuneration Act normally provides up to six weeks of employer pay after a four-week employment waiting period, but repeat incapacity from the same illness uses aggregation and reset rules (continued-pay law). A new diagnosis arising during an existing continuous incapacity does not safely create a fresh six weeks without the statutory test.

Statutory Krankengeld generally follows employer pay and can also bridge the initial employment waiting period. Work accidents are decided by the Berufsgenossenschaft or public accident fund, not the health fund alone. Gradual reintegration is voluntary and medically planned; the benefit payer depends on whether it follows health-funded absence, rehabilitation, or another route (gradual reintegration).

Illness does not itself prevent dismissal, end a fixed term, or suspend immigration and court deadlines. It can, however, engage general or special dismissal protection, disability accommodations, BEM, and evidence questions.

Who Is Covered

Test Employment Length, Insurance, Same Illness, Job Type, and Policy Coverage

Continued wages and replacement benefit have different eligibility rules and can change during one absence.

Continued employer pay generally covers employees, including many part-time, fixed-term, marginal, and vocational workers, once the four-week uninterrupted-employment waiting period is met and the employee is unable to work through illness without relevant fault. Citizenship and work-permission category do not decide whether already earned statutory rights exist. Genuine self-employed people do not have an employer to continue wages.

Run separate employer and insurer tests

For employer pay, identify the legal employer, employment start, incapacity start, cause, medical proof, earlier absences from the same underlying illness, and any collective improvement. The statutory maximum is generally six weeks per the repeat-illness calculation. If employment began less than four weeks earlier, a covered statutory fund can pay Krankengeld from the first day; if incapacity continues, employer pay can begin on day 29 (sickness-benefit rules).

For statutory Krankengeld, confirm membership includes that benefit. Ordinary employees above marginal-employment status commonly qualify; minijob-only workers, family-insured people, and some students do not acquire it through that job. Voluntarily insured self-employed people need an eligible declaration or optional tariff. Recipients of Arbeitslosengeld I can have a route. Private health insurance does not automatically include daily sickness allowance; the policy sets waiting period, insured daily amount, exclusions, proof, coordination, and maximum lost-income rule.

A same-illness decision can join medically related absences even if the diagnostic wording changes. Ask the health fund for its recorded block period and employer-pay calculation rather than exchanging detailed diagnoses with payroll. A later additional illness during existing continuous incapacity normally does not extend the 78-week maximum for the first illness.

Child sickness benefit in 2026 normally requires a statutorily insured caring parent and child, a child generally under 12 or qualifying due to disability, need for care, no other household carer, and first-day medical evidence. The temporary 2026 allowance is up to 15 workdays per child per parent or 30 for a single parent, capped at 35 or 70 across multiple children (2026 child sickness).

A work or commuting accident uses statutory accident-insurance scope, causal connection, route rules, and provider decision. For rehabilitation, identify whether health, pension, or accident insurance is responsible. Students, agency workers, multiple-job workers, people abroad, and cross-border workers must notify every relevant employer and insurer and verify which system is competent.

Evidence Record

Preserve Notice, AU Continuity, Hospital, Foreign, Accident, and Insurer Evidence

Prove incapacity dates and required communications without disclosing the diagnosis more widely than necessary.

Keep a private chronology with symptoms only as needed for medical care, first day unable to perform the job, employer notification time and channel, expected duration, each doctor or hospital assessment, every certified period, practice transmission status, health-fund receipt, employer retrieval problem, pay transition, and return date. Save the contract and sickness policy, payslips, bank credits, insurer forms and decisions, and any Medical Review communication.

Use the correct document for each event

For ordinary German statutory cases, the doctor issues medical evidence and transmits eAU data to the health fund. Keep the patient copy and ask the practice to correct errors. The employer retrieves incapacity start, end, initial or follow-up status, and permitted data, not the diagnosis. A technical failure can require paper submission to the fund; private insurance, foreign certification, rehabilitation, hospital, and child-care cases can remain outside the normal eAU path.

A hospital supplies an admission or stay certificate and, where needed, discharge and follow-up incapacity documentation. Do not assume the hospital record covers the next week. Arrange the next assessment before coverage ends. For a foreign illness, notify the employer immediately, give the expected duration and address abroad, notify the statutory fund as required, obtain a certificate that clearly establishes incapacity rather than only treatment, and retain travel and delivery proof. Translation can be necessary; legalisation is not a universal requirement.

For a work accident, record exact time, place, activity, mechanism, injury, witnesses, first aid, supervisor notice, and photographs lawfully taken. Even small first-aid events should enter the workplace accident record. If incapacity exceeds three calendar days, the employer normally files the Unfallanzeige within three days after learning of it; serious events are immediate. Keep the report copy, D-doctor record, insurer case number, and decision (work accident).

For child sickness, retain the first-day medical care certificate, child and parent insurance, household-care facts, employer release, dates used, and fund application. For gradual return, preserve the medical plan, hours, duties, restrictions, parties' agreement, payer, reviews, and changes. For BEM, keep the invitation, purpose and data notice, consent choices, participants, measures considered, and outcome separately from broad personnel records.

Share diagnosis and treatment data only with the doctor, fund, Medical Review, accident insurer, rehabilitation body, or authorised adviser where legally necessary. Give the employer functional limits and required incapacity evidence, not an open medical file. Never surrender the only original foreign or private-policy record.

First Action

Notify, Certify, Maintain Coverage, Start Benefit, and Plan Return in Order

A gap-free sequence protects both employment duties and income replacement.

Use seven steps. First, stop work if medically unable and obtain urgent care when needed. Second, notify the employer immediately through the required channel, stating inability to work and expected duration but not diagnosis. Third, obtain medical assessment by the contractual or statutory date. Fourth, keep the patient record and verify eAU transmission or send an exception document. Fifth, calendar the certificate end and arrange follow-up no later than the next working day. Sixth, contact the payer before employer pay ends. Seventh, plan safe return, accommodation, BEM, or rehabilitation with the relevant parties.

Complete the handoffs

Tell the manager or designated absence line before the shift starts where possible, then retain the timestamp. Do not assume a colleague, doctor, or eAU system notified the employer. If the employer demands first-day certification, comply or challenge the demand later with advice. If a practice cannot transmit electronically, ask what paper copy must reach the fund and employer.

During the first weeks, compare payslips and bank payments. Give the health fund any income or status form it requests and ensure the employer sends the earnings statement and last continued-pay date. Krankengeld usually begins automatically through fund coordination, but the member must cooperate and correct missing data. It is 70 percent of contribution-liable gross pay, capped at 90 percent of net and the daily statutory maximum, with further social contributions deducted (Krankengeld).

If the event is a work or commuting accident, say so to the employer and clinician immediately and use the D-doctor route where required. If caring for a sick child, obtain the special first-day certificate and file with the fund rather than using your own AU. If illness begins abroad, send the additional location and insurer notices without waiting to return.

Do not work for the employer while drawing Krankengeld for full incapacity. Activities compatible with recovery are not automatically prohibited, but avoid conduct that materially delays recovery and seek medical or fund approval for travel where required. EU travel during benefit needs prior fund approval under the official guidance.

When capacity returns, tell the employer and resume normal work if medically fit; an AU is not a blanket legal ban on earlier return, but safety and insurance facts matter. For reduced capacity after long illness, propose a medically supported gradual plan. During staged reintegration the employee normally remains unfit for full contractual work and replacement benefit continues under the responsible payer. Confirm hours, tasks, monitoring, and stop rules before starting.

Money and Deadlines

Calculate Six-Week Pay, Krankengeld, Private Allowance, and Hidden Costs

Model the change from ordinary remuneration to capped benefit and protect every payroll and insurer claim.

Calculate employer continued remuneration using the statutory and contractual basis, normal working time, regular salary, variable components, supplements, commissions, and any collective rule. The usual period is up to six weeks, but a four-week employment waiting period and same-illness history can change who pays and when. Record calendar days of incapacity, not only missed shifts, and ask for the employer's calculation when dates differ.

Model the income step-down

Statutory Krankengeld is normally 70 percent of contribution-liable regular gross pay but no more than 90 percent of net earnings and the annually adjusted maximum. Pension, unemployment, and care contributions are generally deducted, so the bank amount can be materially lower. Relevant one-off remuneration enters through statutory rules, while non-contributory night or weekend overtime supplements can be excluded. The fund pays by calendar day, commonly treating a full month as 30 days (benefit calculation).

The same-illness entitlement is limited to 78 weeks within a three-year block, counting the employer-pay and rehabilitation periods. A later additional diagnosis during continuous incapacity does not extend the block. Ask the fund for the exact block start, periods counted, maximum date, daily gross benefit, deductions, and payment intervals. Plan the next income route months before Aussteuerung.

Private daily sickness allowance follows the policy's waiting period, occupation, insured daily amount, reporting, medical evidence, review, and coordination clauses. Total benefit generally cannot exceed lost net income. Self-employed people should model business fixed costs separately. A cheap health policy without adequate daily allowance can leave a large income gap.

Add doctor, medicine, therapy, hospital, rehabilitation, transport, childcare, home help, translation, foreign-certificate, and advice costs. Statutory co-payments and exemption limits may apply; accident insurance can cover necessary accident treatment and aids. Lost shift supplements, bonus metrics, meal or commute benefits, and employer pension contributions require their exact terms.

Keep payroll due dates, insurer forms, follow-up certificates, objection dates, and contractual or collective Ausschlussfristen. A benefit objection does not preserve an employer wage claim, and a payroll discussion does not challenge an insurer decision. If a statutory fund issues an adverse notice, an objection normally must arrive within one month (health-insurance objection). Calculate professional advice, union membership, legal insurance, translation, and social-court travel before escalation, while noting that statutory social-court proceedings are generally court-fee free for covered members.

Escalation Timeline

Manage Certificate Gaps, Pay Transition, BEM, Rehabilitation, and Benefit End

Work backward from every certificate end, six-week point, insurer decision, return review, and 78-week maximum.

Calendar employer notice on day one, required first certificate, every covered end date, next-working-day follow-up, four-week employment point, six-week employer-pay transition, insurer income statement, benefit payment, Medical Review contact, travel approval, rehabilitation review, BEM trigger, staged-return reviews, 78-week maximum, and every objection or wage-claim deadline. Keep proof for each submission.

Protect continuity and the next payer

If an AU ends Friday and incapacity continues, obtain follow-up no later than Monday where it is a working day. Do not rely on retrospective certification. A short gap may leave the gap days unpaid even where the entire entitlement is not lost. Confirm transmission with the practice and fund if the employer cannot retrieve it. Hospital discharge and rehabilitation end need their own bridge to the next certificate.

Contact the fund before week six to confirm diagnosis grouping, prior same-illness periods, employer continued-pay end, earnings report, daily benefit, contribution deductions, and bank details. Reply to relevant cooperation requests and Medical Review appointments. If the fund proposes rehabilitation or questions incapacity, ask for the written legal basis and preserve the response date.

After more than six weeks of continuous or repeated incapacity within a year, the employer must offer workplace reintegration management. BEM is conducted with the employee's consent and participation to overcome incapacity, prevent recurrence, and preserve the job. The employee can involve a trusted person and must receive advance information about goals and data use (BEM law). Consider ergonomic change, duties, hours, qualification, technical aid, rehabilitation, or gradual return without disclosing unnecessary diagnosis.

A gradual return needs a medical staged plan, employer participation, payer confirmation, review dates, and a safe response if health worsens. Do not let payroll treat the staged hours automatically as ordinary full contractual work without clarifying benefit and pay.

At least several months before the 78-week limit, assess full return, accommodation, rehabilitation, disability recognition, reduced-earning-capacity pension, or the special unemployment-benefit route for continuing incapacity. Maintain health insurance and employment records. A benefit application or pending decision does not automatically extend Krankengeld.

If employment ends, continue medical proof, inform the fund, register with the employment service on time, and notify immigration where job-linked. A fixed term can expire during illness. A written dismissal requires immediate legal review and a court challenge generally within three weeks, regardless of sick leave.

Enforcement and Help

Resolve Missing AU Data, Diagnosis Demands, Suspended Benefit, and Dismissal

Separate employer, health-fund, accident-insurer, privacy, and labour-court disputes and protect each deadline.

If the employer cannot retrieve eAU data, verify the incapacity dates and personal details with the practice and health fund, obtain paper fallback where appropriate, and send the employer a privacy-safe confirmation. Do not assume a system failure excuses absence without notice. If the certificate has a wrong date, ask the issuing clinician to assess and correct it; neither payroll nor the employee should alter medical evidence.

Match the dispute to the decision-maker

For withheld continued pay, provide the employment start, notice proof, AU periods, same-illness calculation, payslips, and requested gross amount. Use HR or payroll, works council, union, labour advice, and labour court as appropriate, complying with all exclusion periods. For an employer demand for diagnosis, ask for the specific legal basis. Ordinary absence management receives incapacity and duration information, while the fund and Medical Review assess medical detail.

For a fund denial, suspension, daily-rate error, diagnosis block, certificate gap, cooperation dispute, or travel issue, request the written Bescheid and file a short timely Widerspruch, usually within one month, with reasons and evidence to follow if necessary. Ask for file access and the Medical Review assessment. A rejected objection can normally go to social court within one month.

For a rejected work accident, preserve the accident sequence, witnesses, first aid, D-doctor evidence, employer report, and causation material. Object to the accident insurer within the notice's deadline, normally one month. Health insurance covers necessary treatment if accident recognition fails, but the benefit and liability route can change.

Do not perform ordinary work while certified fully unfit and drawing Krankengeld. If the employer pressures an early return, seek medical review and propose a safe staged route. If the employee feels fit before the certificate end, discuss safe return and insurance with the doctor and employer. A certificate is evidence, not permission to ignore actual safety.

Illness does not make termination automatically invalid. Employer dismissal and a separation agreement require written form; electronic form is excluded (termination form). General protection depends on tenure and establishment size, while pregnancy, disability, parental status, and other circumstances can add special rules (dismissal protection). Preserve receipt and obtain labour advice immediately.

Qualified help is proportionate for long-term income loss, linked diagnoses, foreign evidence, work accidents, private-policy denial, rehabilitation pressure, medical privacy, disability, or dismissal. Bring one chronology, certificates, decisions, calculations, communications, and deadline list.

Guidance from Federal Ministry of Health health portal

Official Germany sources for sick leave and sick pay

Verify sick leave Germany using Federal Ministry of Health health and other federal and local authorities handling the process.

How sick leave and sick pay fits work in Germany

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