Sick Leave in Germany: eAU, Krankengeld, and Filing Rules

Sick leave in Germany is called Arbeitsunfähigkeitsbescheinigung, or AU for short. For employees, the main rule is simple: inform the employer about the illness and the expected duration of the absence immediately, and then obtain confirmation from a doctor if required. For employees with statutory health insurance, the AU is usually transmitted electronically as eAU, but the duty to notify the employer still remains with the employee.

What to do if you get sick

Inform your employer that you are unable to work and state the expected duration of the illness.
Check your employment contract, Betriebsvereinbarung, or the company’s internal rules: they may specify from which day an AU is required.
See a doctor if the illness lasts longer than the period allowed without a certificate or if the employer requires confirmation from the first day.
Confirm whether the practice has sent the eAU to the Krankenkasse if you are insured with a statutory fund.
Keep a paper printout for yourself: it may be useful in case of a system failure, a dispute with the employer, or a long illness.

The employer must be informed about the illness without delay, usually before the start of the working day or shift. A phone call, email, message in the company chat, or another channel accepted in the company is fine. The important thing is not just to send a message, but to make sure it reaches the responsible person.

When you need a sick note from a doctor

As a general rule, an employee must provide proof of incapacity for work if the illness lasts longer than three calendar days. In practice, the employer may demand an AU earlier, even from the first day. So do not rely only on the law; also follow the contract, company rules, and instructions from your manager.

The notification procedure is often laid out in the German employment contract. If the company has a separate instruction for Krankmeldung, it is better to save it in advance instead of looking for it on the day you are sick.

If an employee does not notify the employer or does not arrange the AU in time, this may lead to an Abmahnung, a dispute over salary for the days of absence, and, in serious cases, dismissal. It is especially risky to simply not show up for work and explain the situation later.

Can you leave the house while on sick leave

Sick leave does not always mean bed rest. The employee must behave in a way that does not interfere with recovery. If the doctor recommended staying in bed at home, it is better not to plan trips or meetings. If it is a minor illness, a walk, a trip to the pharmacy, or shopping for groceries usually does not conflict with sick leave as long as it does not worsen the condition.

If in doubt, ask the doctor directly whether you may go outside, travel to see relatives, do sports, or handle household tasks. For the employer, what matters is not the fact that you left home, but whether your behavior is compatible with the declared incapacity for work.

What an AU looks like and what information it contains

In paper form, the Arbeitsunfähigkeitsbescheinigung contains the patient’s details, the Krankenkasse, the doctor’s details, the date the incapacity for work was established, the sick-leave period, and an indication of whether it is an initial AU or a continuation. The medical part may include a diagnosis or ICD code, but the employer does not receive the diagnosis.

If the paper version is used, there are usually different copies:

for the Krankenkasse, where medical information may be included;
for the employer, without the diagnosis;
for the patient and the medical records.

The doctor marks:

Erstbescheinigung - the first certificate for this illness case;
Folgebescheinigung - an extension of an already opened sick leave.

It is important to arrange the extension without a gap. If the first AU is valid until September 17, the next one for the same illness must begin on September 18. A gap may create problems for Krankengeld.

Electronic sick leave eAU

For employees with statutory health insurance, eAU has been the standard procedure since 2023. The doctor’s practice sends the data to the Krankenkasse, and the employer requests confirmation from the fund through a secure electronic channel. The employee usually does not need to send a paper certificate to the employer, but they do need to report the illness and the period of absence.

The employer does not see the diagnosis, only administrative information: the period of incapacity for work, the date the AU was established, whether it is an initial case or a continuation, as well as separate technical markers, for example a connection to an accident if that is indicated. The medical reason for the illness is not passed on to the employer.

When eAU does not apply

Paper documents may still be needed if:

the employee has private health insurance;
the AU was issued by a private doctor or abroad;
it concerns a child’s illness and Kinderkrankengeld;
it is a Minijob in a private household;
it is a Beschäftigungsverbot, rehabilitation, or Wiedereingliederung;
there was a technical failure in the system.

In such situations, ask the practice for the required printouts and clarify who needs to receive them and by when.

How to get a sick note from a doctor

People usually go to a Hausarzt for an AU. If the reason for the illness is specific, such as an injury, a dental problem, or a mental health issue, the doctor may refer you to a specialist or issue the AU directly if they can assess your incapacity for work.

It is not always easy to book a doctor’s appointment in Germany on the day you are sick. That is why it is worth finding a Hausarzt in advance and checking whether the practice sees patients without a Termin for acute complaints.

In some cases, a doctor may issue an AU after a phone or video consultation. This is not an automatic right of the patient: the doctor must decide that a remote assessment is sufficient and that there are no signs of a serious condition.

Sick notes by phone and online

A telephone Krankschreibung is possible for minor illnesses without severe symptoms if the patient is already known to the practice. An initial AU by phone can be issued for a maximum of five calendar days. An extension is also possible, but the doctor may require an in-person visit if the condition is not improving or diagnostics are needed.

For video consultations, the rules depend on the medical assessment and on whether the patient is known to the doctor. Online services and apps such as TeleClinic can be convenient for a consultation, but the decision is always made by the doctor, not by the app itself.

A remote AU is not suitable for serious symptoms, suspected complications, the need for an examination, or prescription treatment that requires a full in-person assessment. In such cases, it is safer to go to the practice, the Bereitschaftsdienst, or, if life is at risk, the Notaufnahme.

Sick leave to care for a child

If a child becomes ill, a parent can receive leave from work and apply for Kinderkrankengeld from their Krankenkasse. In 2026, the limit for parents with statutory health insurance is 15 working days per parent for each child insured under statutory health insurance, and 30 days for a single parent. If there are several children, the total limit is 35 working days per parent and 70 days for a single parent.

Main conditions:

the child is under 12 or has a disability and needs assistance;
the child is insured with a statutory Krankenkasse;
a doctor confirms the need for care;
there is no other person in the household who can look after the child;
the parent cannot work because they are caring for the child.

Kinderkrankengeld is usually 90% of the lost Nettoarbeitsentgelt. The application is submitted to the Krankenkasse. If one parent and the child are insured with a statutory fund, while the other parent has private insurance, the right to Kinderkrankengeld belongs to the parent who is in the GKV together with the child. If the child is privately insured, there is normally no GKV entitlement to Kinderkrankengeld.

Unused child sick days cannot be transferred between parents by law as an automatic right. In practice, a transfer is only possible if the employer of the parent who has already used up their limit agrees.

For Minijobs, an important limitation applies: the employee may have a right to time off work, but Kinderkrankengeld is usually not paid if there is no insurance with an Anspruch auf Krankengeld.

Who pays your salary while you are ill

The first six weeks of the same illness are usually paid by the employer as Entgeltfortzahlung. The employee receives their normal salary if the conditions for continued payment are met. If the employment relationship has only just begun, special rules may apply during the first four weeks: the Krankenkasse may step in earlier instead of the employer.

After six weeks for the same illness, employees with statutory health insurance may start receiving Krankengeld from the Krankenkasse. The amount is 70% of regular gross income on which social contributions are paid, but no more than 90% of net income. Contributions to pension insurance, unemployment insurance, and Pflegeversicherung are deducted from Krankengeld.

Krankengeld for the same illness is paid for a maximum of 78 weeks within three years. This period also includes the first six weeks of Entgeltfortzahlung. That is why, in the case of a long illness, it is especially important that continuation certificates follow without gaps.

Voluntarily insured self-employed people receive Krankengeld only with the corresponding tariff or Wahlerklärung. If a long illness turns into questions of long-term care, a separate assessment of the Pflegegrad may be needed. With private insurance, Krankentagegeld usually has to be selected separately: standard PKV does not mean automatic payments in the event of long-term incapacity for work.

Common problems

If an employee is often absent without clear proof, colleagues may see it as macht Blau, meaning pretending to be sick or skiving off. Legally, however, what matters is not rumors but documents, notification deadlines, and medical confirmation.

The employer cannot find the eAU

First check whether you correctly told the employer the dates of the illness and which Krankenkasse is listed in the system. Then contact the doctor’s practice and the Krankenkasse. In the event of a technical failure, ask for a paper printout and pass it on to the employer or the fund in the agreed way.

The employer demands a paper certificate

If you are insured in the GKV and the case falls under eAU, the employer normally has to request the data from the Krankenkasse themselves. But if there is a failure, private insurance, an AU from abroad, or Kinderkrankengeld, a paper document may be necessary. Do not argue in the abstract: clarify why it is being requested and ask the practice for the appropriate printout.

The payment was calculated incorrectly

If the mistake occurred during the first six weeks, contact the employer’s payroll department. If it concerns Krankengeld after six weeks, the Krankenkasse decides questions about the amount and the period. It is useful to keep copies of all AUs, letters from the employer, and pay slips.

The employer doubts that you are sick

The employer may inform the Krankenkasse about their doubts. The Medizinischer Dienst checks the medical justification. In this situation, it is important for the employee to keep documents, follow the doctor’s recommendations, and avoid actions that clearly contradict the declared incapacity for work.

Short checklist

Inform your employer about the illness immediately, even if the eAU is sent automatically.
Check from which day your company requires an AU.
Keep a printout for yourself.
Extend the Folgebescheinigung without gaps in dates.
If a child is ill, obtain a separate medical certificate and submit an application to the Krankenkasse.
With private insurance, AU issued abroad, and technical failures, clarify the paper procedure in advance.