If you've ever woken up too sick to work in Germany, you've probably heard the term Arbeitsunfähigkeitsbescheinigung , usually shortened to "AU" , thrown around by HR, colleagues, or your health insurance fund (Krankenkasse). Understanding Germany's sick leave rules isn't just bureaucratic trivia. Miss a deadline or skip the paperwork, and you could lose your right to paid sick leave entirely, even if you were genuinely too ill to work.
This guide breaks down what an Arbeitsunfähigkeitsbescheinigung in Germany is, when you legally need one, how the new electronic system (eAU) changes things, and how much sick pay you can expect. We'll also cover the situations most guides skip: getting a valid sick note remotely if you're an expat, freelancer, or traveler, and what happens with your child gets sick instead of you.
What Is an Arbeitsunfähigkeitsbescheinigung (AU)?
An Arbeitsunfähigkeitsbescheinigung , literally "certificate of incapacity to work" , is Germany's official sick note. A licensed doctor issues it to confirm that a patient is medically unable to perform their job for a specific period. Most people just call it an "AU" or "Krankschreibung" (sick note).
The AU serves two separate audiences at once:
- Your employer needs it as proof you were genuinely unwell, protecting your job and your right to continued pay.
- Your Krankenkasse (statutory health insurance fund) needs it to calculate benefits, especially if your illness stretches beyond six weeks.
An AU typically states the first and last day you're unable to work, but not your diagnosis , your employer never sees the medical details, only the dates. This protects your privacy under German data protection law and, for digital certificates, under GDPR as well.
Any licensed physician can issue an AU: your general practitioner (Hausarzt), a specialist, an on-call weekend doctor, or , increasingly , a licensed telemedicine provider offering a valid online consultation. The certificate only counts if it's issued by a doctor registered to practice in Germany (or, for statutory insurance purposes, one who works within the German healthcare system).
Employer Notification & Deadlines: When You Must Report Sick
Germany's sick leave rules run on strict timing. Missing a deadline can technically justify a warning or, in repeated cases, disciplinary action , so it's worth memorizing two numbers: immediately and day three .
Rule 1: Tell your employer the same day
You must inform your employer that you're sick and roughly when you expect to return , before your shift starts, or as soon as possible that morning. A quick phone call, email, or message to your manager is enough. You don't need to explain your symptoms or diagnosis, just confirm you're unfit to work.
Rule 2: Submit the AU by the fourth day of illness
By German law (§ 5 of the Entgeltfortzahlungsgesetz, the Continued Wage Payment Act), you must have a sick note in hand no later than the fourth calendar day of your illness, including weekends. In plain terms: if you're still sick on day three, see a doctor by then so the certificate reaches your employer on day four.
Here's the important part many people miss: your employment contract or company policy can shorten this window. Plenty of German employers require an AU starting from day one. Always check your contract , if it's silent on the issue, the statutory four-day rule applies.
| Step | Deadline | Action Required |
|---|---|---|
| Notify employer | Before your shift starts (day 1) | Call, email, or message your manager |
| Get an AU | By day 4 (or sooner if contract states) | See a doctor or licensed telemedicine provider |
| Submit AU to employer | Immediately after issue (paper copies) or automatically via eAU | Confirm your employer received it |
| Extended illness | Before current AU expires | Request a Folgebescheinigung (follow-up certificate) |
If your illness continues past your original AU's end date, you need a follow-up certificate (Folgebescheinigung) before the first one expires. Gaps between certificates can jeopardize your sick pay, so book that follow-up appointment early.
Sick Pay in Germany: Lohnfortzahlung and Krankengeld Explained
Germany's sick leave rules are generous compared to many countries, but the compensation structure changes depending on how long you're out.
The first six weeks: Lohnfortzahlung (continued wage payment)
Under the Entgeltfortzahlungsgesetz, your employer must continue paying your full salary , 100% of your normal pay , for up to six weeks per illness. This applies to full-time and part-time employees alike, as long as you've been with the company at least four consecutive weeks. Apprentices and most working students qualify too.
One nuance: if you fall sick with a new, unrelated illness after your six weeks run out, the clock resets. But if it's a continuation or recurrence of the same condition within a set period, the six-week entitlement doesn't automatically renew , this is where things get legally complex, and an employment lawyer or your Krankenkasse can clarify your specific case.
After six weeks: Krankengeld (statutory sickness benefit)
Once Lohnfortzahlung ends, your Krankenkasse takes over and pays Krankengeld , roughly 70% of your gross salary , capped at 90% of your net income, whichever is lower. Krankengeld can continue for up to 78 weeks within a three-year period for the same illness.
| Period | Who Pays | Amount |
|---|---|---|
| Weeks 1–6 | Employer (Lohnfortzahlung) | 100% of salary |
| Week 7 onward | Krankenkasse (Krankengeld) | ~70% gross / max 90% net |
| Maximum duration | , | Up to 78 weeks per illness, per 3-year window |
Freelancers and self-employed workers in Germany don't automatically qualify for Krankengeld unless they've opted into that coverage tier with their statutory or private insurer. If you're self-employed, double-check your policy , this is one of the most commonly misunderstood gaps in German sick leave rules.
The eAU: Germany's Electronic Sick Note System
Since 2023, Germany has rolled out the elektronische Arbeitsunfähigkeitsbescheinigung (eAU) , an electronic transmission system that's quietly changed how sick notes move between doctor, Krankenkasse, and employer , yet it's still widely misunderstood.
Here's how it actually works:
- Your doctor transmits the AU data electronically directly to your Krankenkasse.
- Your employer no longer receives a paper copy from you in most cases. Instead, they request your AU data digitally from the Krankenkasse once you've reported sick.
- You still must notify your employer yourself, the same day, that you're unfit to work , the eAU only handles the certificate transmission, not the notification requirement.
So when does a paper AU still matter? A few situations still require the old-school paper certificate:
- You're covered by private health insurance instead of statutory insurance , the eAU system currently applies only to statutorily insured employees.
- You visited a doctor abroad, where the eAU infrastructure doesn't apply.
- Technical outages or system errors occasionally require a temporary paper backup, which your doctor's office can issue on request.
- Some smaller employers haven't fully integrated with the eAU retrieval system yet, so a paper copy may still be requested as a backup during the transition period.
If you're unsure whether your employer uses the eAU system, ask HR directly , and always keep a personal copy or screenshot of any certificate you receive, digital or paper, just in case.
Sick Leave for Children: Kinderkrankengeld
Germany's sick leave rules extend beyond your own illness. If your child gets sick and needs care at home, you can take paid time off under Kinderkrankengeld (children's sickness benefit), rather than using your own sick days.
parents need to know:
- Each parent covered by statutory health insurance can claim up to 15 paid days per child, per year (30 days for single parents), with a household cap regardless of how many children you have.
- Your child must be under 12 years old (no age limit if the child has a recognized disability).
- You need a doctor's certificate confirming your child is sick and needs supervision , this is a separate document from your own AU, sometimes called a "Kind-krank" note.
- Kinderkrankengeld is paid by the Krankenkasse, generally at a similar rate to Krankengeld (around 90% of net pay, subject to caps), not by your employer directly.
Privately insured parents should check their individual policy, since Kinderkrankengeld is a statutory insurance benefit and isn't automatically included in private plans the same way.
The Real Cost of Sick Leave for German Employers
Understanding the employer's side of Germany's sick leave rules helps explain why the paperwork matters so much , and why deadlines are enforced fairly strictly.
Employers absorb the full cost of Lohnfortzahlung for six weeks per employee, per illness, with zero government subsidy for most companies. For a mid-sized business with dozens of staff, even a handful of long-term sick leaves can represent a meaningful payroll expense , one reason HR departments are often firm about receiving valid AU documentation on time.
To offset some of this burden, small and medium employers (generally under 30 employees) can participate in the U1 reimbursement scheme , which refunds a portion of Lohnfortzahlung costs through a levy-funded pool. This is one reason employers are motivated to process eAU requests promptly , reimbursement claims depend on accurate records.
From the employee's side, this context matters: a properly issued, correctly timed AU isn't just a formality for your own protection. It's also the document your employer needs to stay compliant and, in many cases, to recover part of their costs. Submitting it late or incompletely can create friction that's easy to avoid with a same-day doctor visit , in person or online.
Getting a Sick Note Remotely: Telemedicine, Expats, and Travelers
Not everyone can walk into a German clinic on short notice. Expats without an assigned GP, remote workers traveling abroad, students far from campus health services, and people simply too sick to leave bed all face the same problem: they need a valid AU fast, without an in-person visit.
This is where licensed telemedicine steps in. A properly regulated online sick note works the same way as an in-person one, as long as:
- The issuing doctor is licensed to practice medicine within the German healthcare framework.
- The consultation involves a genuine medical assessment, not just a form you fill out unchecked.
- The certificate meets the same formatting and legal requirements as a paper AU , correct dates, doctor's signature/credentials, and issuance details.
- Your data is handled under GDPR-compliant processes , meaning your medical information is encrypted, stored securely, and never shared with your employer without your consent.
This matters most for people who fall outside the "walk into your Hausarzt" scenario: freelancers between statutory and private coverage, travelers who fall ill mid-trip, remote employees working from a different city or country, and anyone whose symptoms make an in-person waiting room genuinely unsafe for others (think flu, stomach bugs, or contagious infections).
The key is choosing a provider that's transparent about its medical licensing and its data privacy practices , not every "instant sick note" service abroad meets German legal standards, and an invalid certificate can leave you without pay protection when you need it most.
Frequently Asked Questions
Do I need an AU on the first day I'm sick?
Not always. By law, you have until the fourth calendar day of illness to submit an Arbeitsunfähigkeitsbescheinigung , but many employment contracts require one starting on day one. Check your contract to be sure.
Can I get a sick note over the phone or online in Germany?
Yes, if it's issued through a licensed telemedicine provider following a real medical assessment. A phone or video consultation that meets German medical and documentation standards produces a legally valid AU, the same as an in-person visit.
How long can I stay on sick leave in Germany?
Your employer pays full salary (Lohnfortzahlung) for up to six weeks per illness. After that, your Krankenkasse pays Krankengeld (roughly 70% of gross pay) for up to 78 weeks within a three-year period for the same condition.
What happens if I get sick during my vacation?
If you fall ill during approved vacation and get an AU covering those days, German law lets you reclaim those vacation days for later use , the sick days don't count against your annual leave, as long as you notify your employer and submit a valid certificate.
Do freelancers and self-employed workers get sick pay in Germany?
Only if they've opted into that coverage level with their insurer. Standard statutory or private plans for the self-employed don't automatically include Krankengeld-equivalent benefits , it's usually an add-on you select when signing up.
What is the eAU and does it replace paper sick notes completely?
The eAU (elektronische Arbeitsunfähigkeitsbescheinigung) transmits your sick note data electronically from doctor to Krankenkasse, and employers retrieve it digitally. It applies to statutorily insured employees seeing German-based doctors. Privately insured patients, care received abroad, and occasional system outages still rely on paper certificates.
Can my employer refuse an AU issued through an online consultation?
No , a properly issued AU from a licensed doctor is legally valid regardless of whether the consultation happened in person or via telemedicine, as long as it meets standard certification requirements.
If you're currently sick, traveling, or working remotely and can't easily get to a clinic, you don't have to choose between your health and your paperwork. Get Medical Certificate offers a licensed, GDPR-compliant AU certificate online, issued after a real medical review, so you can notify your employer on time and protect your sick pay without leaving bed.