Calling in sick: the Arbeitsunfähigkeitsbescheinigung

Germany has a formal sick-note culture that protects both your income and your employer's interests. Whether you're starting your first job or managing an unexpected illness, understanding the Arbeitsunfähigkeitsbescheinigung (AU) — the certificate of incapacity to work — is essential to keeping your paycheck flowing without legal complications.

The first 24 hours: notifying your employer

The moment you realize you cannot work, you must notify your employer immediately on your first day of absence. This obligation exists regardless of whether you'll need a doctor's certificate later. Do this before your shift starts if possible — a simple phone call, email, or even WhatsApp message is sufficient, depending on your workplace's preferred communication method. You are not required to disclose your diagnosis or the nature of your illness; a brief statement that you are taking sick leave is enough.

Ask your HR department during your first week of employment what their preferred notification method is. Some workplaces expect a call to a direct supervisor; others are happy with an email to HR. There is no standard form to fill out, and you do not need to provide medical details at this stage. The key is that your employer knows you will not be coming in and that you are unable to work due to illness.

Understanding the Arbeitsunfähigkeitsbescheinigung (AU) deadline

Under German law, if your illness lasts longer than three calendar days, you must present an Arbeitsunfähigkeitsbescheinigung to your employer by the fourth day. Calendar days include weekends and public holidays — so if you fall ill on a Monday, you must have your doctor's certificate by Thursday. However, many employers have stricter requirements in their employment contracts or collective agreements. Always check your individual contract, because some employers can legally demand the AU from day one.

The German government is currently planning reforms that would change the standard rule to require a medical certificate from the first day of illness, but as of 2026, the three-day threshold remains the legal default. Your specific contract terms take precedence, so do not assume the three-day rule applies to you without checking your paperwork.

What counts as the AU deadline

• Calendar days, not working days — weekends and public holidays count toward the deadline
• The fourth calendar day means if you fall ill on Monday, you must submit by Thursday
• Your employment contract may impose an earlier deadline — check before you need it

How the electronic AU (eAU) works

Since 2023, the Arbeitsunfähigkeitsbescheinigung is transmitted electronically as the eAU (elektronische Arbeitsunfähigkeitsbescheinigung) and no longer issued on paper. When you visit your doctor and they determine you are unable to work, they send the eAU directly and securely to your statutory health insurer, the Krankenkasse. You no longer receive the old yellow slip (gelber Schein) to hand to your employer.

Instead, your employer retrieves the certificate data directly from your health insurance company's secure system. You simply inform your employer when you visit the doctor and provide them with the start date and expected duration of your illness. Your employer can then request the eAU data from your Krankenkasse using this information. You will receive one copy of the eAU for your own records, usually within a day of your doctor's visit.

This electronic system saves time and eliminates the risk of a lost piece of paper, but it only works if you give your employer the correct dates. Simply telling your employer that you have seen a doctor is generally not sufficient — they need to know when your incapacity began and when it is expected to end so they can retrieve the certificate from your insurer.

Your income during illness: the first six weeks

Germany offers one of the world's most generous sick-pay systems. If you have been employed for at least four weeks, your employer is legally required to pay you your full regular salary for the first six weeks (42 calendar days) of any illness. This is called Entgeltfortzahlung — continued remuneration — and is set by the Entgeltfortzahlungsgesetz (EFZG), the Continued Remuneration Act. There is no waiting period, no deductible, and no maximum — you receive 100 percent of your usual gross salary as if you had worked.

This protection applies to all employees regardless of whether you work full-time, part-time, or in a Minijob (mini job, a form of marginal employment). The six-week period runs per illness — if you recover and return to work, then fall ill with a new condition, you get another full six weeks. If you catch the same illness again within six months of returning to work, the days count toward the same six-week total, not a fresh period.

Special rule for new employees

If you fall ill during your first four weeks of employment, you do not yet have a right to Entgeltfortzahlung from your employer. Instead, your statutory health insurer pays you Krankengeld (sickness benefit) from day one at a reduced rate of approximately 70 percent of your gross salary. This is why it is crucial to have your health insurance properly set up before your start date.

Beyond six weeks: Krankengeld from your health insurance

If you are still unable to work after six weeks, your employer's obligation ends and your statutory health insurance (Krankenkasse) takes over with a benefit called Krankengeld. This benefit is approximately 70 percent of your gross salary, capped at 90 percent of your net salary after deductions. In 2026, the maximum daily rate is €135.63 per day, which works out to roughly €4,069 per month gross before social insurance deductions.

Krankengeld continues for up to 78 weeks over any three-year period for the same illness. Combined with the initial six weeks of full employer pay, this means you can receive income for up to 84 weeks (roughly 19 months) while recovering from the same condition. If you fall ill with the same condition again within three years after the 78 weeks expire, a new 78-week period begins.

Privately insured employees: different rules

If you have private health insurance (Private Krankenversicherung, PKV) rather than statutory insurance, the eAU system does not apply to you. Your doctor will issue a paper sick note instead. More importantly, what happens to your income after six weeks depends entirely on your individual insurance policy. Some private policies include sickness benefit coverage (Krankentagegeld), while others do not. You should contact your private insurer directly to ask specifically whether your policy covers Krankentagegeld and for how long. This is a gap that some expats overlook, and it can result in no income after the six-week employer period ends.

Common mistakes and how to avoid them

Failing to notify your employer in time is the most frequent error. Always report sick before your shift starts. Late notification can lead to warnings or even disciplinary action. Similarly, missing the deadline to submit your AU can cost you pay even if you are genuinely ill, so check your contract immediately and mark the deadline on your calendar.

Another common pitfall is not obtaining follow-up certificates in time. Once your first sick note expires, you must visit your doctor again to obtain a continuation if you are still unable to work. Gaps in documentation can delay or interrupt your Krankengeld payments. If your Krankenkasse does not receive a new certificate within the required timeframe, they may suspend payments until you submit one, and suspended days are not paid retroactively.

Finally, if your illness extends beyond six weeks, you must notify your Krankenkasse directly, not just your employer. This notification must be made within one week of the start of incapacity. If you miss this deadline, your Krankengeld entitlement may be suspended.

What happens if you disagree with the diagnosis?

Your employer must accept a properly issued AU as evidence that you are genuinely unable to work. Employers cannot simply reject a sick note because they doubt your illness. However, if an employer has concrete facts suggesting fraud — not just suspicion — they can request that your employer's occupational health service (Betriebsarzt) or the health insurance's medical service examine you. A doctor's signature on an AU carries strong legal weight, and employers bear the burden of proof if they want to challenge it.

Practical steps: your sick-leave checklist

1. Day 1: Notify your employer immediately before your shift starts. No diagnosis needed.
2. Check your contract: Confirm the AU deadline — it may be sooner than the legal four-day rule.
3. Days 2–3: If illness persists and your contract requires it, book a doctor's appointment.
4. By deadline day: Ensure your doctor issues the eAU, which will be sent electronically to your Krankenkasse. Confirm the dates with your employer so they can retrieve it.
5. Week 2: If still ill, obtain a follow-up sick note before the first one expires.
6. Week 6: If you are still unable to work, ensure your Krankenkasse has been notified of continued incapacity.
7. Ongoing: Keep your doctor's certificate current every two weeks for as long as needed.
8. Return to work: Notify both your employer and your Krankenkasse when you are able to return.

Key terms you'll encounter

Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung: the certificate of incapacity for work, now transmitted electronically as the eAU. Elektronische Arbeitsunfähigkeitsbescheinigung (eAU): the digital version of the AU, sent directly from your doctor to your health insurer. Entgeltfortzahlung: continued remuneration — the legal obligation of your employer to pay your full salary for the first six weeks of illness. Krankenkasse: your statutory health insurance provider, which pays Krankengeld after week six. Krankengeld: sickness benefit paid by the health insurer, approximately 70 percent of gross salary, for weeks 7–78 of illness. Gelber Schein: the old yellow paper slip, now obsolete, replaced by the eAU. Krankmeldung: your notification to your employer that you are taking sick leave.