If you are an employee in Germany, you probably already know that sick leave is paid here. However, it can sometimes be difficult to figure out: how long an employee can be off sick in Germany, who pays for it and how much, what exceptions apply to sick pay in Germany, and what you should bear in mind to avoid financial surprises if your illness is prolonged. We will cover all of this in our article.
the Entgeltfortzahlungsgesetz (EFZG) establishes the right of an employee (who has already worked at the company for more than four weeks) Section 3(3) of the German Act on Continued Remuneration (EFZG)) to the retention of earnings in the event of illness and provided that the employee is not at fault for the onset of the illness (Section 3(1) of the German Act on Continued Remuneration (EFZG)).
Contents
Who pays for sick leave in Germany
We’d like to add straight away that it’s extremely unwise to take sick leave during the first four weeks after starting a new job. This is because sick pay is covered by the Krankenkasse at a rate of 70% of your previous gross salary. To claim this, you’ll need to provide your health insurance fund with a doctor’s certificate and proof of your salary. You’ll have to wait 1–2 weeks. During this time, it’s worth having your own funds to cover your living expenses.
During the first four calendar weeks following employment:
- Sick pay is paid by the health insurance fund in the form of sick pay — 70% of the average gross earnings, but not exceeding 90% of the previous net income § 3 para. 3 EFZG + Section 44 SGB V
After 4 weeks from the start of employment, the general rules apply:
- For the first 1–6 weeks of illness, the employer pays 100% of the employee’s usual gross earnings (including any allowances, for example, if these would have been paid whilst at work);
- Weeks 7–78 of sick leave are paid by the health insurance fund at a gross rate of 70% (from which pension and social security contributions are deducted), but not exceeding 90% of the previous net income. And only on that part of the salary which does not exceed the Beitragsbemessungsgrenze (in 2026 = 5812,50 euros per month). In other words, the maximum amount of sick pay will be 70% of 5,812.50 euros = 4,068.75 euros per month Section 47(1) of the Fifth Book of the Social Code (SGB V).
An employer can compensate an employee for the difference between sickness benefit and net salary. However, they are not obliged to do so.
- The sickness benefit fund pays for a single diagnosis only from the 7th to the 78th week within a three-year period (the count runs continuously, starting from the first day of incapacity for work for the same diagnosis while the fund is paying the benefit). After the 78th week (only days for which Krankengeld was paid are counted), payments cease and you need to look for other sources of income. This restriction is lifted after three years and the count starts again from the first week. The employer starts paying again, and then the health insurance fund steps in.
After 78 weeks of sickness and other benefits:
- Options for financial support, if the 78 paid weeks have ended and the three-year period has not yet expired, may include Krankentagegeld (KTG). These payments, approximately from 30 to 150 euros per day, private insurance provides.
- If a person is recognised as disabled as a result of an accident or a serious illness, the employer pays 100% of their usual gross income from weeks 1 to 6; from the 7th to the 78th week of illness, the health insurance fund (Krankenkasse) pays 70% of gross earnings; after this period, long-term care insurance (Pflegeversicherung) – compulsory insurance for long-term care in Germany – comes into effect. It covers costs where a person, due to illness, disability or old age, is in constant need of assistance from others (with dressing, eating, personal hygiene and household tasks);
It is designed to cover costs that are not reimbursed by mandatory state care insurance.
- Transitional allowance 65-67% (during rehabilitation);
- Reduced earning capacity pension 30-40%: if the prognosis is permanent, a pension from the pension insurance scheme (DRV) that replaces income when a person has partially or completely lost their ability to work in any occupation;
- ALG I under Nahtlosigkeit 60-67% – receiving unemployment benefit whilst a person is still unable to work, but a decision on a disability pension (Erwerbsminderungsrente) or the outcome of rehabilitation is not yet available;
- Citizen's Allowance (Bürgergeld) / unemployment benefit II (ALG II) is an unconditional basic income and housing allowance for those whose income is below the subsistence level or who have no income at all, provided that all previous avenues of assistance have been exhausted and the subsistence level is still not covered.
Is the first day of sickness paid — the Karenztag question
A topic that caused a great deal of anxiety in 2025 and 2026: Germany was debating the Karenztag — an unpaid first day of sickness. The direct answer: it was not introduced, there is no bill, and the topic is off the agenda. The first day of sickness is paid in full, as are all the other days of the first six weeks.
| When | What happened |
|---|---|
| January 2025 | The head of Allianz publicly proposes bringing back the Karenztag, citing around 20 sick days per employee per year |
| June 2025 | Techniker Krankenkasse survey: those opposed to cutting the benefit were 65 % of business leaders themselves |
| 29 April 2026 | The chancellor publicly rules out both cuts to sick pay and Karenztage: the earlier attempt, in his words, “ended in a spectacular failure” |
| 1–2 July 2026 | The coalition committee rejects the Karenztag. Instead a different decision was taken — to abolish the telephone sick note and to require a certificate from the first day |
| 10 July 2026 | In the Bundestag the SPD states that it blocked the Karenztage demanded by the employers' associations |
What may actually change is the obligation to see a doctor from the first day instead of the current fourth day. But even that is so far only an agreement within the coalition: the Bundestag has not voted, no date of entry into force has been announced, and changes are needed both to the law and to the medical committee's guideline. More on this in the section on the telephone sick note below.
It is worth knowing separately: the employer is already entitled today to require a certificate from the first day — under the employment contract or by direct instruction, without giving reasons. This is a long-standing rule, not a novelty, and the place to check it is your own contract, not the news.
How to get a sick note
- The illness must be reported to the employer immediately in accordance with Section 5 paragraph 1 of the EFZG.
- Incapacity to work must be certified by a doctor (medical certificate) no later than the fourth day from the beginning of the illness § 5 Abs. 1 S. 2 EFZG.
- The employee must not be at fault for the illness. Only unintentional illnesses are paid for (sporting activity with equipment: fell off a bicycle, broke a leg playing football, flu). If the employee lost their ability to work as a result of breaking an arm in a fight, failing to observe health and safety regulations at work, or undergoing a risky operation without medical indication and encountering complications (§ 3 Abs. 1 EFZG), the employer will not pay sick leave in these cases.
How long can you be ill and receive sick pay
The employer pays the 100% salary for a single illness. Different illnesses are not combined.
For example: The person first had tonsillitis for four weeks, then broke their arm and stayed at home for a further three weeks. These are two separate illnesses. Neither of them lasted longer than six weeks. The periods do not add together, and the employer pays 100% both during the sore throat and during the sick leave due to the broken arm.
If more than 6 calendar months have elapsed between two periods of incapacity for work due to the same diagnosis, the employer will once again pay 100% of the employee’s salary from the first to the sixth week of sick leave.
For example: The man had the flu in September. His employer paid his sick pay for the two weeks he was off work. Having contracted the flu in April (more than six months having passed between the two instances of the same illness), he will again receive 100% of his gross salary from his employer from the first to the sixth week of his illness.
Following this, from week 7 to week 78, i.e. up to one and a half years, the health insurance fund pays sickness benefit.
How much actually arrives in your account
The figure “70 % of gross” sounds tolerable until you work out what is deducted from it and where it hits the ceiling. Both limits apply at the same time, and together they produce a result that many find unexpected.
The ceiling is the same for everyone
Krankengeld (statutory sick pay) is calculated only on income up to the contribution ceiling, the Beitragsbemessungsgrenze — €5,812.50 per month in 2026. Anything a person earns above that amount is not counted at all. That is why the maximum is the same for someone earning €6,000 and for someone earning €12,000.
| 2026 figure | Per day | Per month |
|---|---|---|
| Maximum Krankengeld, gross | 135,63 € | ≈ €4,069 |
| Maximum net in hand | ≈ €116.41 | ≈ €3,492 |
No health insurance contribution is taken from Krankengeld, but pension, unemployment and long-term care contributions are — together around 12.4 %, plus a 0.6 % surcharge for childless people over 23.
🔴 And here is the detail that half the calculators online get wrong: the contributions are calculated not on the benefit itself but on 80 % of previous earnings — that is, the assessment base is higher than what is actually paid to you (§ 345 SGB III, § 166 SGB VI, § 57 SGB XI). As a result the real deduction is not 12.4 % but about 14.2 %. The difference is small, but calculators that apply the percentages directly to the Krankengeld overstate the result by roughly two euros a day.
The tax trap almost nobody writes about
Krankengeld is tax-free — but it falls under Progressionsvorbehalt (§ 32b EStG), the progression proviso. This means that the benefit itself is not taxed, but it raises the tax rate on all the rest of your annual income. At the end of the year this turns into a tax back-payment, and people find out about it in retrospect, once the money has already been spent.
A payment from private Krankentagegeld (daily sickness benefit) does not fall under the Progressionsvorbehalt — this is set out directly in the rules and confirmed by a ruling of the Federal Fiscal Court (BFH, 13.11.2014, III R 36/13). Over a long illness the difference between the two types of payment becomes substantial.
Who really needs to close the gap
- Employees on a high salary. The higher the income, the bigger the gap between €3,492 and your usual net pay, and there is nothing to close it with except Sick pay.
- The self-employed. In a statutory Krankenkasse (health insurance fund) they pay the reduced contribution rate of 14.0 % by default and receive no Krankengeld at all. Even after switching to the general rate of 14.6 %, the fund only starts paying from day 43.
- The privately insured. Krankengeld from a statutory fund is not available to them by law — only the benefit under their contract.
The independent Stiftung Warentest study of 16 June 2026 gives an idea of the price range: for a 35-year-old employee a policy paying €20 a day from day 43 costs €7–23 a month, and for a self-employed person €150 a day from day 29 — it costs €76–150. At identical parameters the spread between insurers is two- to threefold, and this is a case where comparing really pays off.
Honestly about the product's main limitation: if during a long illness a person is classified as unable to work in their occupation (Berufsunfähigkeit, occupational disability), Krankentagegeld payments stop. This is the classic gap between two policies, and it is closed with occupational disability insurance (Berufsunfähigkeitsversicherung).
How it works in practice: eAU and calling the doctor
Employees no longer need to hand paper certificates to their employer
In force since 2023 electronic fit note — electronic note for incapacity for work. The doctor sends it to your health insurance fund, and the employer retrieves the data from the fund themselves. You no longer need to carry or send the yellow form to the employer.
But one duty remains, and it is violated most often: you are obliged to inform your employer about your illness yourself and immediately — on the very first day, before the start of the working day. An electronic sick note does not replace this: the cash register transmits data, not warns your manager. A call or message according to company rules is up to you.
The doctor will still print a copy of the certificate for themselves. Keep it: if something fails in the transfer chain, this is your only proof.
Sick note by phone
Since 7 December 2023 this is a permanent rule, not a temporary Covid measure. The conditions are strict:
- maximum 5 calendar days;
- you must be known to this practice — you can't make an appointment at the new clinic by phone;
- the symptoms must not be severe;
- you cannot extend a sick note by phone — initial certificate only. You must attend in person for a renewal.
You have no right to demand a sick note over the phone: the doctor decides.
And the rule is in question. On 1–2 July 2026 the coalition agreed to abolish the telephone sick note and to require a certificate from the first day of illness. But so far this is only a coalition decision: the Bundestag has not voted, there is no date of entry into force, and on 30 August 2026 the Grüne (Greens) called for the first-day certificate to be dropped. Until the law is passed, the telephone sick note works under the rules above. For scale: it accounts for less than 1 % of all sick notes, and the family doctors' association (Hausärzteverband) puts the cost of abolition at 30 million additional visits a year.
If a child falls ill
This is a separate payment — child sickness benefit, and it is not calculated from the parent on sick leave. Days for 2026:
- 15 working days per parent per child;
- 35 days per parent per year, if there are multiple children;
- 30 days for the child and 70 days a year for single parents.
These increased entitlements have applied since 1 January 2024 and have been extended for 2026. An important caveat: this is a temporary rule, not a permanent one. The law of 29 December 2025 extended it only until 31st December 2026. If no new law is passed, from 1 January 2027 the basic rule returns — 10 days per child and 25 days a year, and for single parents 20 and 50. The child must be under 12 (there is no age limit for children with disabilities), and there must be no other person in the household who could look after them.
The «child is ill» note can also be obtained over the phone — as of 1 July 2024 this is a permanent rule, until 5 calendar days and only if the child is known to the practice.
Amount of payment is calculated differently from ordinary Krankengeld: it is 90 % of the net earnings lost, within the contribution ceiling (§ 45 SGB V). In other words, a day spent caring for a child is paid noticeably better than your own sick leave.
Benefits of such a system for the employee
- Retention of the full 100% gross income during the first 42 days.
- In the event of a prolonged illness, the Krankenkasse continues payments for up to a year and a half.
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Dismissing someone on the grounds of ill health is difficult. To do this, the employer must:
1) a medical report from doctors stating that the person will be incapacitated for a long time/permanently, with no prognosis for improvement. There will be no improvement in work capacity within two years or the employee will be incapacitated for more than six weeks a year;
2) confirm that the absence of the employee results in significant additional costs (hiring additional personnel, changing working shifts, paying overtime, disrupting the delivery or production schedule);
3) to prove that the employee's interests have been respected and other settlement options (a new schedule, lighter duties, the chance to find employment in other company departments, retraining) have already been exhausted or are impossible. The employee's age, length of service, and marital status have been taken into account. - Regarding dismissal, the recognition of a disability in itself does not give the employer the automatic right to dismiss an employee. As with illness, evidential steps must be followed and all the above-described measures taken to preserve the job for the employee.
Disadvantages for the employee
- Loss of part of earnings during illness for more than 42 days.
- The health insurance fund strictly checks the connection between diagnoses and can suspend Krankengeld payments.
- Remember to get the sick note issued by the doctor, submit it to your employer and send the details to your health insurance fund to avoid any delay in payments.
Practical advice for an employee
- Report incapacity for work immediately: phone the employer + send an electronic fit note to the employer within three days.
- Track the days: keep a sickness calendar to remind the health insurance fund in advance about upcoming Krankengeld.
- If the doctor makes a new diagnosis, check whether the health insurance fund considers it related to the previous illness in order to understand the further payment plan.
- Keep your documents: certificates, bank statements, and correspondence with the health insurance fund. These are your evidence in the Social Court.
- If the Krankenkasse has refused, check the reason for the refusal immediately, submit a Widerspruch (no later than 1 month from the date the refusal was served), and wait for a response from the insurance fund. If there is no response after 3 months, you can go to the Sozialgericht.
The German sick pay system operates on a clear structure: initially, the employer bears the responsibility — full salary for up to six weeks, followed by the Krankenkasse, which pays Krankengeld for up to 78 weeks within a three-year period. The right to these payments only arises after four calendar weeks of employment and provided there is no intent or gross negligence on the part of the employee.
To receive the payment from the Krankenkasse into your account without delay, it is necessary to:
1) continuously confirm incapacity for work with doctor's notes and not allow a gap of even a single day;
2) to provide the current bank details to the health insurance fund;
3) to submit the necessary documents (a copy of the employment contract, application forms, application) at the very first request;
4) make sure that the accounts department has forwarded the necessary data (Entgeltbescheinigung) regarding your sick leave to the health insurance fund.
It is important to observe the formalities: report the illness immediately, submit the e-AU on time, keep all notifications from the health insurance fund and, if necessary, promptly lodge an objection. Then even a prolonged incapacity for work will not turn into a financial crisis.
Frequently asked questions
Who pays for sick leave in Germany
For the first six weeks of one and the same illness the employer pays — 100 % of normal earnings (§ 3 EntgFG). From the seventh week the Krankenkasse pays: Krankengeld, 70 % of gross, but no more than 90 % of net. Entitlement to payment from the employer only arises after four weeks of employment at the company; before that the fund pays.
Is the first day of sickness paid?
Yes, in full. An unpaid first day — the Karenztag — was discussed in Germany in 2025 and 2026, but it was never introduced: on 29 April 2026 the chancellor publicly ruled out both benefit cuts and Karenztage, and on 1–2 July 2026 the coalition rejected the idea for good.
For how many days is a sick note issued?
A single certificate usually covers anything from a few days to two weeks, after which the doctor extends it. The overall limit for one and the same illness is 78 weeks within three years, of which the employer pays the first six and the fund pays the remaining roughly 72 weeks. Another illness that arises during the period of incapacity does not extend this limit.
How much money arrives in your account while on sick leave?
The maximum Krankengeld in 2026 is €135.63 a day gross, about €4,069 a month. After pension, social insurance and long-term care contributions are deducted, roughly €116.41 a day remains, that is about €3,492 a month. The fund pays no more than this, whatever the salary.
Can you get a sick note for stress and burnout?
Yes. Mental health diagnoses are the second most common cause of incapacity for work in Germany and the only growing category: 3.81 days per employee in 2025 against 3.75 in 2024 (TK data). The procedure is the same as for any other illness: a certificate from the doctor, six weeks from the employer, then the Krankenkasse.
What do the self-employed get while off sick?
By default — nothing. A self-employed person in a statutory Krankenkasse pays the reduced contribution rate of 14.0 % and has no entitlement to Krankengeld at all. To create one, you must opt in writing for the general rate of 14.6 % under § 44 Abs. 2 SGB V — the fund then pays from day 43, and the choice is binding for three years. The first six weeks are without income in any case, and only Krankentagegeld can close them.
What else to read
- State health insurance — who pays sick pay and how the social security fund works.
- Sick pay — how to bridge the gap between salary and sick pay, especially for the self-employed.
- incapacity for work — what to do if the 78 weeks have ended and you still cannot work.
- Social contributions — where does the limit of €5,812.50 per month come from?.
Sources: G-BA and BMG on the telephone sick note (regulation from 07/12/2023), Techniker Krankenkasse — Kinderkrankengeld days for 2026. Checked in August 2026. The material is for informational purposes only.
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Good day. Please help me understand what to do. I am a person with a category III disability from childhood in Ukraine, having received my disability status in 2018 (at which age terrible pains appeared), and I am now 24. I arrived in Germany on 01.09.2023, and on 19.12.23 I had spinal surgery (congenital vertebral defect) where a vertebra was removed and a metalwork structure was installed; the pain has not gone away, and I have been to rehabilitation twice with no help. I cannot sit for longer than 20 minutes, I cannot stand for long either, and I have been on narcotic painkillers for the second year already. I cannot work, I have been registered with the Jobcenter all this time, and I am now going through the assessment process to be transferred to social assistance (Sozialamt). I need outside help for daily life at home because I cannot do everything myself. Will I be able to get a disability status (Schwerbehinderung) with such problems? If so, what payments will there be, and is it even worth doing?
Hello.
You need to speak to a social caseworker about this topic.
And depending on the degree of disability, check which Pflege payments you are entitled to.
Hello, what happens if I have an accident at work? Is this reported everywhere – at work and to the doctor? It’s just been six weeks, and even if it was a work-related accident, will I then receive payment under code 70-90% from the insurance company? I’m due to return to work in January, but only for four hours a day – in that case, how will I be paid for that?
Hello!
During my sick leave, I travelled outside of Germany and the EU, as this was not forbidden by my doctor, and I really needed a rest due to my medical condition. During the trip, I experienced complications related to my pregnancy and had to cancel my flights, as this was forbidden by a doctor due to a threatened miscarriage. In total, more than 6 weeks have now passed since the illness began in Germany, and the TK health insurance fund is refusing to pay sick pay, citing the fact that I am outside the EU. I am not asking for compensation for doctor visits or medical treatment, but I need my statutory sick pay (Krankengeld), as I am employed by a German company and insured with TK. Could you please tell me whether it is lawful for TK to refuse Krankengeld? Please could you give me your commentary?
Your situation relates to the specifics of receiving sickness benefits in Germany (Krankengeld), and it is worth looking closely at the details to assess the legitimacy of the insurance company's refusal.
Rules for receiving Krankengeld
Sickness benefit (Krankengeld) is paid in Germany after 6 weeks of sick leave (when the employer is no longer obliged to pay salary) for insured persons who remain ill. However, the following important rules apply to receiving these payments:
1. Continuation of employment: You must remain employed and keep your employment contract with a German company.
2. Confirmed sick note: The doctor must continue to confirm your incapacity for work.
3. Location in Germany or the EU: Krankengeld is paid on the basis of German law, and it generally only covers cases where you are in Germany or the EU. If you travel outside the EU, payments may be restricted, as the health insurance fund may consider that the conditions for monitoring your condition become more difficult.
Why might sick pay (Krankengeld) be refused?
The health insurance fund (TK) is refusing to pay you Krankengeld because you are outside the EU. This may be due to the fact that:
Outside the EU, the insurance company cannot effectively monitor your condition and the validation of sick leave (especially if the sick note is issued by a foreign doctor).
Insurance companies can argue their refusal on the grounds that staying outside the EU violates the conditions for receiving Krankengeld, if this was not agreed in advance.
Important points for your situation:
1. Doctor's decisionYour inability to fly due to pregnancy has been confirmed by a doctor, and this is an important factor. In this case, if you provide the necessary medical documents, it may be possible to appeal to the insurance company on the grounds that you found yourself in this situation through no fault of your own, but for medical reasons.
2. Checkout decisionOften Krankengeld is not paid if you are not in the EU, even if the sick leave continues. Some insurance companies allow the possibility of payment if their permission for the stay outside the EU was obtained in advance. Check whether this point was discussed with the TK before your departure.
What can be done:
1. Appealing the decision: Send a written complaint to the TK describing your situation and providing medical documents confirming the necessity of staying outside the EU. The health insurance fund may reconsider its decision.
2. Legal consultation: If the TC continues to refuse, it is worth seeking legal help. In Germany, there are many lawyers who specialise in social benefits and insurance issues who can help protect your rights.
3. Clarification with health insurance (TK): If your doctor did not ban travel outside Germany and the EU at the start of your sick leave, check with the TK whether you have breached any conditions for receiving sickness benefit (Krankengeld) or if the insurance company is basing its decision solely on the fact that you were outside the EU.
Conclusion:
The situation regarding the refusal of Krankengeld payments outside the EU is quite common, but if you have all the necessary medical documents confirming the need to be abroad, there is a possibility to appeal the decision. However, you may need the help of a lawyer if the health insurance fund does not change its position.
Hello, I am 22 weeks pregnant. Since April, I have hardly been working for health reasons. Initially, there was a threat of an ectopic pregnancy, and I was on sick leave for a week. Then, after working for a week, the pain had not gone away and a cyst was detected that was growing rapidly and caused pain. I was monitored in several clinics, and this lasted for almost 5 weeks. Then I went back to work for 1.5 weeks in the hope that management would be understanding and I wouldn't have to run 8 km a day and lift heavy objects as before (I work in a warehouse/im Lager), but no, zero understanding and I couldn't work because my stomach still hurt, plus morning sickness and migraines, and now I am on sick leave again, but with a different diagnosis. I was on sick leave for 2 weeks, and then I had 3 weeks of holiday. I chose not to take sick leave during that time so that management wouldn't think I was trying to save my holiday this way, but after the holiday nothing changed. I am constantly lying in bed, catching colds, suffering from a terrible cough, back and stomach pain. I go to the hospital and they tell me I have premature contractions (vorzeitige Wehen), and another 3 weeks of rest. I cannot afford to live on sickness benefit (Krankengeld). My gynaecologist refuses to give me an employment ban (Beschäftigungsverbot / BV), saying that the company doctor (Betriebsarzt) should do this (whom we don't have) or I should sort it out with a lawyer (whom I have no money for). Her plan is simply to keep me on sick leave... There are 2 months left until maternity leave. I cannot work because the pain doesn't go away, plus my mental health can't take it anymore. This long-awaited pregnancy has turned into a living hell for me, where I am constantly in pain, crying a lot, and hardly leaving the house...((( Please tell me what I should do next??? And is there a likelihood that my pay will be reduced because I haven't been working for 13 weeks now, but with different diagnoses???? Thank you
Hello.
If your doctor gives you different diagnoses, you can generally continue to receive 100% of your income for a long time.
However, if you have a single diagnosis, the health insurance fund will pay you around 70% of your income until you reach 78 weeks.
And since you only have 2 months left until maternity leave, you can rest assured that you won't be left without pay.
We wish peace and good health to you and your unborn baby.
Hello! My husband has been ill since October 2022, with intermittent breaks. Since 30 May 2023, he has been ill continuously, spending almost all his time in hospital with the same diagnosis. He is unfit for work. The diagnosis is G32.2. All this time, health insurance has been paying sickness benefit (Krankengeld). He has a permanent employee contract under the TVöD (public service collective agreement). How much longer can he remain on sick leave? And what happens next if he is still unable to work? Thank you for your reply!
Hello.
I am very sorry that your husband is in such a difficult situation. Let us look at a few aspects that might help you.
Duration of sick pay benefits in Germany
In Germany, there are certain rules and restrictions associated with the payment of sick pay:
1. Sick notes (Krankengeld)The employer is obliged to pay wages for the first 6 weeks of illness (42 days). After that, sickness benefit (Krankengeld) is paid by the Krankenkasse (health insurance).
2. Sickness benefit paid by medical insurance for a maximum of 78 weeks (18 months) over a three-year period for the same diagnosis.
If your husband has been ill since October 2022 without a break, he is already receiving sickness benefits from the Krankenkasse. As soon as the payment period for benefits reaches 78 weeks within a 3-year period, the Krankenkasse will stop paying them to you.
Next steps if he cannot return to work
1. Rehabilitation and Wiedereingliederung: You can discuss with your husband's doctor the possibility of a rehabilitation programme or returning to work through the «Hamburger Modell», which allows a gradual return to work on a part-time basis.
2. Income protection insurance (occupational disability pension): If your husband's condition does not allow him to return to work even after the Krankengeld period has expired, he can apply for a disability pension. This includes applying for an Erwerbsminderungsrente (partial or full incapacity pension) from Deutsche Rentenversicherung.
3. Disability pension (Schwerbehindertenrente): If your husband has been granted a high level of disability, he may be entitled to an early disability pension.
Hospitals usually have a social worker who can help you deal with administrative and legal issues related to a long-term illness.
Could you please tell me, if my annual leave was agreed with my employer, but it so happened that I've been scheduled for an operation and am being given a sick note—the leave was from 4/04 to 19/04 and the sick note is from 1/04 to 9/04—the doctor said there is no problem with flying off on holiday on 4/04 as planned, but the employer says I have no right to travel anywhere. Tell me, is it legal to go away during a sick leave, and upon its expiry, take the previously agreed annual leave?
Hello.
In Germany, the rules regarding whether you can travel during sick leave depend on several factors, including your doctor's recommendations and the terms of your health insurance. In general, if the doctor considers that a trip elsewhere will not hinder your recovery (and perhaps even contribute to it) and does not impose restrictions on movement, technically, you are allowed to leave.
However, there are a few points you need to take into account:
1. Doctor's recommendations: If your doctor has indicated that you are able to travel, make sure you have this in writing. In some cases, the doctor may state in the fit note that travel is not contraindicated.
Message to employer: It is important to clearly and transparently communicate with your employer about your health and plans. Even though you may feel you have the right to leave, if your employer expresses concern, this could affect your employment situation. Ideally, you should reach an agreement with your employer and find a compromise.
Insurance policy terms: Make sure your health insurance covers treatment if needed during your trip. Some insurance companies may have restrictions on travelling while on sick leave.
Legal aspects: In practice, if you breach medical advice or insurance terms, this can lead to issues with sick pay or even disciplinary action from your employer.
If you have any doubts regarding your specific situation, it is recommended that you consult a lawyer specialising in employment law. It is important to obtain professional advice in order to avoid potential misunderstandings and legal problems.
Hello, I have another question: I will still have a year and 2 months left until my pension after Krankengeld. What should I do since I cannot work for health reasons? Should I apply to the Arbeitsamt or somewhere else?
Good afternoon.
Yes, first to the Arbeitsamt.
Hello, I have been on sick leave since 2 January 2023. First, the employer paid for 6 weeks, and then AOK started paying Krankengeld. I read that Krankengeld is paid for 78 weeks. My question is, do these 78 weeks include the 6 weeks paid by the employer or not?
In Germany, the healthcare system provides for the employer to pay wages in full during the first 6 weeks of an employee's incapacity to work. After that, the insurance company (in your case AOK) begins to pay sickness benefits (Krankengeld), provided that the incapacity to work continues.
According to German legislation, Krankengeld is paid for up to 78 weeks (approximately 1.5 years) over a 3-year period for the same illness. The 6-week period during which the employer paid wages is not included in these 78 weeks. This means that after the employer stops payment, the insurance company can pay sickness benefits for up to a further 72 weeks.
Hello, could you please tell me how sick pay is calculated for a mini-job when I only work weekends, so that after returning from sick leave I don't work extra hours and consequently have to pay tax.
Hello! In Germany, sick pay for employees working on a mini-job basis (with an income of up to €538 a month) has its own specific features. It is important to know the following:
— Sick pay calculation: Sick pay is usually calculated on the basis of average earnings for the last 12 calendar days before the illness (for hourly workers) or on the basis of fixed monthly earnings (for those with a regular income). In the case of a mini-job, if your income does not exceed 538 euros a month, your sick pay will be calculated based on your average earnings.
— Taxation: Since mini-job income is tax-free up to a certain threshold (€538), sick pay will also not be subject to tax as long as the total income does not exceed this threshold.
— Working hours: If you only work at weekends, it is important to notify your employer of your sick leave as early as possible so that they can correctly calculate your sick pay. To avoid overworking and potentially exceeding the tax threshold after returning to work, you should discuss your work schedule with your employer and the possibility of adjusting your hours to comply with the conditions of a mini-job.
- Sick pay claim: You need to provide a doctor's sick note to your employer as soon as possible. The employer uses this information to calculate and pay sick pay.
Hello, if I am currently on sick leave, but in addition to this I have also developed an illness unrelated to the current one, and the doctors do not want to help even with an emergency application, what should I do?
Hello.
You cannot be refused medical treatment if you are ill.
You should consult another doctor or go to the hospital accident and emergency department.
Good afternoon! I have been on sick leave since 29.11.23 and so far until 23.02.24. If I worked a Minijob and a part-time job (Teilzeit), does the AOK pay for both of these jobs? And what should I do next? The doctor said that they cannot give me sick notes for half a year. But I am sure that I won't be able to work under a heavy workload. I worked as a cleaner. I had hand surgery. At home, cutting bread is a problem.
Good afternoon! Your situation requires careful consideration, especially given the duration of the sick leave and the type of your employment relationship (Minijob and Teilzeit, i.e. part-time work). In Germany, the healthcare and social security system provides support for workers in such situations, but there are certain nuances and rules.
Sick pay
1. First 6 weeks: Usually, for the first 6 weeks (42 days) of sickness absence, the employer continues to pay the salary (Entgeltfortzahlung im Krankheitsfall). This applies to both part-time employment (Teilzeit) and mini-jobs.
2. After 6 weeks: Following this period, sickness benefit (Krankengeld) is usually paid by your health insurance fund, for example, AOK. The benefit amounts to approximately 70% of your regular earnings, but may not exceed the maximum set limit.
Your situation
As you have been on sick leave for more than 6 weeks, payments must be made through your health insurance (AOK). This applies to both of your jobs, provided you are insured and have made the relevant social security contributions. You should contact the AOK to clarify the conditions and procedure for payment of the benefit in your specific case.
What to do next
1. Contact the AOK: Check the information regarding the continuation of payments and possible next steps. You will need to provide all necessary documents, including sick notes.
2. Medical rehabilitation: If your doctor considers that you cannot return to work due to your state of health, you may be offered a medical rehabilitation or vocational retraining programme, which can help you with future employment.
3. Legal advice: In complex cases, especially when it involves long-term absence from work and potential changes to employment status, it can be useful to seek advice from a social security specialist or a lawyer specialising in employment law.
Remember that it is important to consult your GP regularly and follow their advice, as well as to keep in touch with your insurance company and employer regarding your condition and plans for returning to work or other social security matters.
Good afternoon. I have been working for 4 months, but for health reasons I need an operation. The doctor says that, under favourable circumstances, I will need to stay in hospital for 10-12 days, followed by rehabilitation. Can my employer dismiss me before the operation, sick leave, or during sick leave? And after sick leave?
Hello.
Your employer has no right to dismiss you on the grounds of ill health while you are ill, on sick leave or undergoing treatment. This is guaranteed by the Working Time Framework Agreement, which sets out minimum health and safety standards in the workplace.
Nevertheless, it is worth noting that in some cases, if you are unable to perform your job duties for an extended period due to illness, there is the possibility of terminating the employment contract. However, this must be justified and carried out in accordance with the law.
Good afternoon!
Could you please tell me, if an employee has a Minijob, will they be paid sick leave after 6 weeks by the health insurance (Krankenkasse)? And if so, does the employee have to apply for it themselves or does the employer do it?
And another question: if an employee is going for rehabilitation for 3 weeks, should there be a sick note for this time or just a document indicating the period from and to which the employee was in rehabilitation? And who pays for this period? There is a 3-week gap between the sick leave and the rehabilitation, during which the employee essentially has to work….
Thanks in advance for your reply.
Hello.
In Germany, employees working on a minijob also have the right to receive sick pay after 6 weeks if they are unable to work due to illness. This coverage is provided through the Krankenkasse, which is a medical insurance company.
Regarding the procedure, the employee generally has to submit an application (Antrag) for sickness benefit themselves. The employer can help with this process, but it is not their obligation. It is important that the employee notifies their employer of the illness and provides the sick note as quickly as possible.
If an employee goes for rehabilitation, they will also need to provide relevant documents confirming the rehabilitation period, its purpose and duration. This paperwork must be an official document from the attending physician or rehabilitation facility.
Payment for the rehabilitation period is usually covered by an insurance policy if the rehabilitation is deemed necessary by a doctor and approved by the insurance company. If there is a gap between sick leave and rehabilitation, and the employee is physically capable of working, they must return to work unless a doctor gives other instructions.
For precise information and actions in specific situations, it is always best to contact the insurance company and consult with your employer.
Example. A person has been on sick leave since January. For 6 weeks they received pay from the employer and after that Krankengeld (sickness benefit). In February, they underwent major spinal surgery. Treatment, etc., in May they were offered a REA (rehabilitation) and spent 3 weeks there. Now the health insurance fund (Krankenkasse) is writing that they have decided to contact the Medizinischer Dienst assessor and have asked to fill out a questionnaire about what work they performed and for how many hours before the illness started. I know that Krankengeld is paid for up to 78 weeks. But judging by these letters, it looks like they want to verify the incapacity for work and have them receive [benefits] from the pension insurance. Could this be the case? Has worked in the same place since 1996 as a turner.
Hello.
Yes, that can happen.
When a person is on sick leave in Germany and receives Krankengeld (sickness benefit) from their health insurance company (Krankenkasse) for an extended period, the insurance company may decide to carry out a health assessment of the patient to determine whether they are still genuinely unable to work. This is done through the Medizinischer Dienst der Krankenkassen (MDK), or Medical Service of the Health Insurance Funds.
If, following an assessment, the MDK decides that the person truly cannot return to their work due to their illness or injury, but might be able to do other work, the insurance company may offer rehabilitation measures or other support measures.
If the MDK determines that a person is likely to be unable to return to work for a prolonged period or permanently, the insurance company may suggest applying to the pension insurance scheme (Rentenversicherung) for a disability pension.
It is important to note that the transition from sickness benefit (Krankengeld) to a disability pension is not automatic. To receive a disability pension, you have to go through a separate procedure, which includes an assessment of your state of health and your ability to work.
If you have any doubts or questions regarding your condition or the process, I recommend consulting a lawyer specialising in social security law in Germany or the relevant advisory services.
I have fallen ill with varicose veins, please, my back and legs are swelling, my back is trapping and I can barely stand my shift. In Ukraine, I am a Group 3 lifelong disabled person. Plus, I burned both legs and have poor circulation. In August, I asked for payment but I was underpaid by 338 euros, the manager refused to give me the income statement, but I was underpaid 327 euros towards my salary. What should I do, this is a hotel, my email address has changed because my phone was stolen and I cannot log into the old one, where should I turn? On top of that, we work in conditions where there is no ventilation, only visually, and 5 of us serve 500-700 guests, and at the same time we are told "schnell". And the managers smoke 5 times an hour, and they are young enough to be my children and I have to ask permission to go to the toilet. We are asking to hire more staff so there is at least 2 people at each position, despite working 36 hours [note: likely a typo in original for 36 hours or similar]. Plus, the kitchen ovens have no ventilation or cooling, we are dying while they don't care and sit in the office under air conditioning. Help me, what should I do?!!
Good afternoon,
Thank you for your message.
Due to the difficult working conditions, you need to see a doctor and resign for health reasons. It would be best to look for a job with more flexible working conditions and in an environment that is comfortable for you (according to your state of health).