Sick Leave in Germany: pay, Krankengeld, and the rules

Sick leave in Germany is built around two rules: the employee must inform the employer quickly about their inability to work, and income during illness is first protected by the employer and then by public health insurance. In the standard case, the employer pays the first six weeks for the same illness as continued salary payment (Entgeltfortzahlung). If the illness lasts longer, people insured in the public system usually start receiving Krankengeld from their Krankenkasse.

This system matters not only for serious illness. In Germany, it is normal not to go to work when your condition prevents you from working or creates a risk for colleagues. But it is important to follow the formalities carefully: notification deadlines, eAU rules, and insurance conditions all affect your money.

Who is entitled to paid sick leave

Employees in Germany are entitled to paid sick leave if they cannot work because of illness and are not responsible for causing their inability to work. This usually includes full-time and part-time employees, as well as mini-job workers.

The main rules are:

in the first four weeks of a new employment contract, the employer usually does not yet have to pay Entgeltfortzahlung;
after four weeks of employment, the employer pays salary for up to six weeks for the same illness;
if the illness lasts longer, the public Krankenkasse usually pays Krankengeld;
with private health insurance, there is no Krankengeld from the public system, so you need a separate Krankentagegeld tariff or add-on;
freelancers and self-employed people need to plan their sick-leave protection in advance because they do not have an employer who continues paying their salary.

If the illness returns for the same reason, the six weeks do not always start again automatically. In such cases, the Krankenkasse and the employer look at the periods of incapacity and the medical cause.

Read also: Private and public health insurance in Germany

How much you get paid during illness

The first six weeks: salary from the employer

Entgeltfortzahlung means that the employer keeps paying the normal salary as if the employee were working. This is not a bonus or a voluntary benefit, but a basic labor right if the legal conditions are met.

The employer does not learn the diagnosis. They only need to know that the employee is unable to work, from which day, and roughly until what date.

After six weeks: Krankengeld

If incapacity for work due to the same illness lasts more than six weeks, employees with public health insurance usually become entitled to Krankengeld. In 2026, the basic formula remains the same: the benefit equals 70% of regular gross income, but not more than 90% of net income. Social security contributions are deducted from it.

There is also an upper limit. Because the calculation is capped by the Beitragsbemessungsgrenze in health insurance, the maximum gross Krankengeld in 2026 is about 135.63 euros per calendar day. The net amount depends on contributions and personal circumstances, so it is best to calculate it through your Krankenkasse or an official insurer calculator.

For the same illness, Krankengeld is paid for a maximum of 78 weeks within a three-year period. Since the first six weeks are usually already covered by the employer, people often refer in practice to up to 72 weeks of payments from the Krankenkasse after Entgeltfortzahlung ends.

How many sick days you can take per year

In Germany, there is no simple limit like “10 sick days per year.” If you are genuinely unable to work and notify your employer correctly, sick leave can last as long as your doctor confirms.

At the same time, frequent or very long absences can become an employment issue, especially if the employer believes the health prognosis is negative and work will be disrupted regularly. Dismissal because of illness is possible only under strict conditions, so these situations are best discussed with a lawyer, Betriebsrat, union, or advisory service.

When you need a doctor’s note

As a general rule, an employee must inform the employer immediately about the illness and the expected duration of the absence. If the incapacity lasts longer than three calendar days, medical confirmation is required no later than the next working day. The employer may demand the certificate earlier, even from the first day, if this is stated in the contract, internal rules, or a separate instruction.

In practice, check these three documents:

your employment contract;
company rules or the intranet/HR policy;
instructions from your manager or HR for Krankmeldung and eAU.

How to arrange sick leave: step by step

1. Inform your employer immediately

Do not wait for the doctor’s appointment. As soon as it is clear that you cannot work, notify your employer about the illness and the approximate length of your absence. The company may require a specific channel: a call to your manager, an email to HR, a message in the time-tracking system, or a combination of these.

You do not need to disclose the diagnosis. It is enough to say that you are arbeitsunfähig, from which day you are absent, and when you expect to return or send an update.

2. See a doctor

If the illness needs confirmation, contact your Hausarzt, Facharzt, or another suitable medical practice. The doctor decides whether there is Arbeitsunfähigkeit and issues confirmation for the required period.

If the condition continues, it is important to get the follow-up certificate without a gap. A gap between certificates can create problems with Krankengeld payments or with proving a continuous illness.

3. Check how the eAU is transmitted

For employees with public health insurance, the paper “yellow slip” has been replaced in most standard cases by the electronic eAU (elektronische Arbeitsunfähigkeitsbescheinigung). The doctor sends the data to the Krankenkasse, and the employer retrieves it from the insurer.

But the employee’s duty to inform the employer about the illness has not disappeared. The eAU does not send the first notification to your manager or HR for you.

Ask the doctor for a paper copy for yourself. It is useful if the data does not arrive, the employer cannot retrieve the eAU, or there is a dispute about dates.

Example of the former paper sick note in Germany

Paper documents may still be needed in exceptional cases: with private insurance, treatment abroad, some child sick leave cases, technical failures, or if the doctor does not participate in the eAU process.

Example of an insurer interface for sick leave documents

If you are asked to send a paper certificate by post, this guide may help: how to send a letter in Germany.

What you can do while on sick leave

While on sick leave, the rule is not that you must stop living a normal life, but that you must not do anything that interferes with recovery. Whether a specific activity is allowed depends on the diagnosis and the doctor’s advice.

Usually, activities that support recovery or do not worsen the condition are not a problem:

a short walk;
going grocery shopping or to a pharmacy;
visiting a doctor or therapist;
a calm trip, if it is compatible with treatment and does not contradict medical advice.

It is risky to do things that look incompatible with the stated illness: working another job, doing intensive sports with an injury, going to parties while having an illness that requires rest, or publicly showing behavior that undermines trust in the sick note.

You can return to work before the date on the certificate if you have genuinely recovered. But if there is any doubt, it is better to discuss it with your doctor and employer first.

What if you get sick while on vacation

If an employee gets sick during annual leave and confirms the illness with a doctor, those days should not be counted as vacation days. You need to notify the employer quickly and provide proof of incapacity according to company rules.

The legal minimum vacation is 24 working days with a six-day workweek. For a five-day week, this corresponds to 20 working days. Employment contracts often give more, for example 28 to 30 days, but that is a contractual or collective agreement condition.

Common mistakes

Telling your employer about the illness only after seeing the doctor, even though the employer should be informed immediately.
Thinking that eAU fully replaces the Krankmeldung to the employer.
Not checking whether the company requires a certificate from day one.
Allowing a gap between the initial and follow-up sick note during a long illness.
Telling the employer the diagnosis even though they usually do not need it.
Not arranging Krankentagegeld when you have private insurance or are self-employed.

In short

Sick leave in Germany protects an employee’s income, but it works only if the procedure is followed. First inform your employer, then get medical confirmation, check the eAU or paper exceptions, and keep track of deadlines. If the illness drags on, contact your Krankenkasse in advance and clarify how Krankengeld will be calculated.