Sick leave in Germany: rules, pay and sick notes

Waking up sick in Germany can feel stressful, especially if you are still learning the local rules about sick pay, leave and reporting requirements. The good news is that the system is quite protective, as long as you report your absence quickly and follow the certificate rules that apply to your job.

Germany does not usually give employees a fixed bank of sick days. Instead, sick leave depends on whether you are medically unfit for work, with separate rules for notice, sick notes, salary continuation, and later sickness benefit. Read on to learn more about sick notes, sick pay, child leave, mental health cases, and current rule changes.

Key takeaways

• Tell your employer as soon as you know you cannot work.
• A sick note may only be needed after more than three calendar days, but your employer can legally ask for one from day one.
• Most employees get full pay from their employer for up to six weeks for the same illness.
• After that, statutory health insurance may pay Krankengeld, sickness benefit, if the legal conditions are met.
• Child sickness is separate from your own sick leave and has its own day limits and payment rules.

How sick leave works in Germany

In Germany, there is usually no annual allowance of sick days for employees. If you are unfit for work, you stay off work for as long as your doctor certifies and the legal conditions are met.

German terms at a glance

• Krankschreibung: the everyday term for being signed off sick
• Arbeitsunfähigkeitsbescheinigung (AU): the certificate of incapacity for work
• eAU: the electronic sick leave notice used in the statutory system
• Entgeltfortzahlung: continued salary payment by your employer
• Krankengeld: sickness benefit paid by a statutory insurer

The legal baseline comes from the Continued Remuneration Act and sits within wider German labor law and employment rights. In practice, that means you report your absence, get an AU if needed, and move from employer pay to insurer pay only if the illness lasts longer.

A common question is whether Germany works like the UK or US. It does not. For many expats, the surprise is that the system is not based on using up a yearly pot, but on medical incapacity and the right paperwork.

Example: Sam wakes up with a high fever on Monday, tells their employer before work starts, and visits a doctor when needed. If the illness continues and the conditions are met, Sam first gets employer pay and may later move to Krankengeld if the same illness lasts beyond six weeks.

When to tell your employer and when to get a sick note

Contact your employer as soon as you know you cannot work. Say that you are unfit for work and, if you can, give a rough idea of how long you may be off. You do not need to share your diagnosis.

Under the standard legal rule, you usually need a certificate if the illness lasts more than three calendar days. But employers can lawfully ask for a note earlier, including from day one, so never assume the fourth-day rule applies automatically.

If you need medical proof, start with a GP or another treating doctor. If you are still learning the system, Expatica’s guide to German doctors and GPs explains how to find one and what to expect.

Check this in practice:

• your employment contract
• the staff handbook
• any collective agreement
• manager or HR instructions
• whether first-day certification is already standard at your workplace

Content Specialist in Germany

Philipp Spitzenpfeil

Insider tip: 

Many expats assume the doctor sends everything automatically, but you still need to tell your employer yourself on day one even if the eAU is later transmitted digitally.

If you are searching for sick leave in Germany without a medical certificate, the key point is this: a short absence may not always need a note under the national baseline, but your employer can set stricter proof rules.

Who pays for sick leave in Germany?

Who pays depends on the stage of the illness. Once the legal conditions are met, your employer usually pays first. After that, statutory health insurance may take over.

One thing worth knowing is that employer paid sick leave does not start on day one of every brand-new job. Under the law, the entitlement to employer continued pay starts after four weeks of uninterrupted employment, so very new starters should check their insurer and HR process.

The official rule on Krankengeld is that it can follow employer pay and is time-limited for the same illness. If you are privately insured, the process can differ and may depend on whether you have separate sickness daily allowance cover.

A common mistake is to assume every new certificate restarts the six-week clock. It may not. For the same illness, a full new six-week period generally only returns after six months without that illness, or once 12 months have passed since the first period began.

What changes with private health insurance?

Employer-paid sick leave normally follows the same employment rules whether you have statutory or private health insurance. The important difference may come after your employer stops paying. Statutory Krankengeld does not automatically apply to privately insured workers: income replacement may instead depend on separately arranged sickness daily allowance insurance, known as Krankentagegeld.

Check your policy for:

• whether Krankentagegeld is included or must be purchased separately
• the waiting period before payments begin
• the agreed daily payment
• exclusions and notification requirements
• whether the cover matches your current income and employment status

Expatica’s health insurance partners serving Germany include:

• Allianz Worldwide Care
• Cigna Global
• April International
• Feather Insurance

Their policies and eligibility conditions differ, so do not assume that ordinary medical cover includes income replacement during a long illness. Check the precise terms directly with the provider before choosing or changing a policy.

What expats should check in their contract and health insurance

The national rules are only the baseline. Your day-to-day process can change depending on your contract, probation status, collective agreement, and whether you use statutory or private cover.

Most employees rely on statutory cover, so understanding German health insurance and the wider German healthcare system helps. If you have – or are considering – private or international health insurance, check more than treatment benefits. Ask whether the policy is suitable for residents in Germany, how sick notes must be submitted, and what income protection applies after employer-paid sick leave ends.

Check Expatica’s best expat health insurance quotes in Germany 2026 to compare the top providers for expats, such as Allianz Worldwide Care, Cigna Global, and Feather Insurance.

Healthcare Basics

Guide to getting health insurance in Germany in 2026

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The places you’ll need to check details include:

• Your employment contract
• Any collective agreement
• The HR handbook
• Your Krankenkasse or insurer documents
• The doctor’s office instructions

If your certificate comes from abroad, send notice quickly and ask what form, language, and timing your employer and insurer need.

Probation does not cancel sick leave rights, but it can feel riskier in practice because employers often enforce reporting rules closely.

Mental health, burnout and privacy issues

Mental health conditions can lead to ordinary sick leave if a doctor certifies that you are unfit for work, for example because of a diagnosed burnout. Official health guidance on burnout notes that it is common language, not a precise legal leave category. If you need support beyond the sick note itself, Expatica’s guide to mental health services and support in Germany can help with the next steps.

Your employer usually needs notice of your absence and proof of incapacity, not your diagnosis. If recovery lasts longer, your statutory insurer or private insurer may become involved, so contact your GP early rather than waiting until the situation worsens.

Child sick leave and family care

Child sickness is separate from your own sick leave, so do not treat it as part of your personal absence record. For statutory-insured parents, the current official baseline for 2024 to 2026 is 15 working days per child per parent, or 30 for single parents, with yearly caps of 35 and 70 days across multiple children.

Payment is usually handled through statutory health insurance as Kinderkrankengeld (child sick pay), not through your normal sick pay. The child normally must be under 12, unless they have a disability and need help, and you usually need a medical certificate for the child.

Home working does not automatically remove the right to claim. The official test is whether you can actually do your job while caring for the sick child and whether someone else in the household can take over.

Healthcare Services

Children’s healthcare in Germany

Read more

Prepare this checklist:

• child’s medical certificate
• insurer claim form, if required
• employer notice
• confirmation that no other household carer is available

Online sick notes and Germany’s sick leave changes

For most statutorily insured employees, the eAU process means the doctor sends the sick leave notice digitally to the health insurer and the employer retrieves it from there. You still have to report the absence yourself. Paper handling can still matter for child sickness, private insurance, certificates from abroad, and some other exceptions.

Rules on remote assessment have changed more than once in recent years. If you are hoping to get an online sick leave certificate in Germany, check the current position with your doctor and insurer rather than relying on older news reports or forum advice.

Changes to watch: news coverage still debates stricter first-day certificate practices and the exact scope of phone-based sick notes, but proposed or temporary changes are not the same as settled law. Always check what is in force right now with your employer, doctor, works council, union, or Krankenkasse.

Most employees will rely on statutory health insurance, but some expats may also compare additional international or private cover, depending on eligibility and circumstances, through providers such as Allianz Worldwide Care, Cigna Global, April International, and Feather Insurance.

Useful resources

Checked 12th August 2026

• gesund.bund.de: Electronic sick leave notice (eAU) – Explains the digital sick note flow, employer access, and exceptions
• Federal Ministry of Health: Krankengeld – Sets out the official baseline for sickness benefit after employer pay ends
• Federal Ministry of Health: FAQ on Kinderkrankengeld – Covers child sickness days, single-parent rules, home office questions, and payment basics
• gesund.bund.de: Burnout – Clarifies burnout as common language rather than a precise legal leave type
• Official laws portal for the Continued Remuneration Act – Primary legal source for continued salary payment rules