✊Klassenbewusst.deen
Back to English overview
Labor law · EFZG, SGB V

Being sick is not a failure. It is your legal right.

EFZG · German Continued Remuneration Act·8 min read·Deutsche Version
The essentials
  • →6 weeks of full pay when you are ill, from the first day of illness (after 4 weeks with your employer).
  • →After that, your health insurance pays Krankengeld (sickness benefit), roughly 70 % of gross pay, for up to 78 weeks.
  • →A doctor's certificate (AU-Bescheinigung, the German sick note) is normally only required once you are ill for more than 3 calendar days (§ 5 Abs. 1 EFZG), unless your employer demands it earlier, which is allowed (Federal Labor Court, BAG 14.11.2012, 5 AZR 886/11).
  • →Report sick as early as possible, before your shift starts.
  • →Your employer may not ask what illness you have. Only whether you are fit to work.
The guilt is a tool of your employer

In care work, calling in sick is often framed as betraying your colleagues. That is structural control: you are worked until you get ill, and then made to feel guilty when you cannot go on. Being sick is not a weakness. It is a biological fact, and German law has rules for it.

Continued pay: the basic principle

The Entgeltfortzahlungsgesetz (EFZG, Continued Remuneration Act) says: if you are unfit for work because of illness, your employer continues to pay your full wage for up to 6 weeks (42 calendar days).

Requirements:

  • You have been employed at the company for at least 4 weeks.
  • The illness is not self-inflicted (a leisure accident without gross negligence does not count as self-inflicted).
  • You have a doctor’s certificate (AU) whenever one is required.

Full wage means: what you would normally have earned, including the regular bonuses and shift supplements you would have worked during that time.

The sick note: when and how?

§ 5 Abs. 1 Satz 2 EFZG is clear: you only have to present a doctor’s certificate (AU) once your inability to work lasts longer than three calendar days. It must then be submitted no later than the following working day. Calendar days means: weekends and public holidays count.

Example: you fall ill on a Friday. The three calendar days are Friday, Saturday, Sunday. From Monday (the 4th calendar day) you need an AU, at the latest on the working day you would otherwise return.

But: under § 5 Abs. 1 Satz 3 EFZG your employer may demand the AU earlier, even from the first day of illness, without giving any particular reason (BAG 14.11.2012, 5 AZR 886/11). This can be written into your employment contract or ordered case by case. Check your contract.

Since 2023 the AU is electronic: your doctor transmits it directly to your health insurance fund. For you, nothing changes with regard to the employer: you report sick, the rest runs digitally.

What you have to do
  • 1.Report sick to your employer before your shift starts (phone, not just WhatsApp).
  • 2.See a doctor and have the AU issued.
  • 3.If you stay ill longer than the certificate covers: get a new AU in time and report again.
In short:

No sick note needed up to and including the 3rd calendar day of illness; submission at the latest on the following working day. Your employer may demand the AU earlier, but your right to continued pay applies from the first day of illness regardless.

What may your employer do? And what not?

Your employer may:

  • Ask when you expect to be back at work.
  • Demand an early sick note (if regulated by contract or company practice).
  • Have the Medical Service (Medizinischer Dienst, MD) involved via your health insurance fund if there are doubts about your inability to work. This is rare and tied to strict conditions (§ 275 SGB V).

Your employer may not:

  • Ask what illness you have (your diagnosis is protected).
  • Call you in to work or pressure you to come anyway.
  • Dismiss you simply because you are ill, at least not without meeting strict legal requirements (see the German article on dismissal protection, Kündigungsschutz).
  • Ignore or refuse to accept your sick note if it was issued correctly.
In short:

Your employer may not ask what you have. Only whether you are fit to work. That also applies to return-to-work conversations.

After 6 weeks: Krankengeld (sickness benefit)

If your inability to work lasts longer than 6 weeks, statutory health insurance takes over. Krankengeld amounts to:

  • 70 % of your gross pay, but at most
  • 90 % of your net pay

Krankengeld is paid for a maximum of 78 weeks within 3 years for the same illness. A new illness starts a new period.

Important: there must be no gap between the end of continued pay and the start of Krankengeld. Make sure your sick notes connect seamlessly, including beyond day 42.

More than 6 weeks ill in a year: your right to BEM

If you were unable to work for more than 6 weeks within 12 months, continuously or in several episodes, your employer must offer you a Betriebliches Eingliederungsmanagement (BEM, workplace reintegration process), § 167 Abs. 2 SGB IX. Its purpose: to clarify together how your inability to work can be overcome and prevented in the future.

Important: taking part in BEM is voluntary. But under Federal Labor Court case law, a properly offered BEM is a precondition for an illness-related dismissal to be proportionate at all. An employer who fails to offer BEM undermines a later dismissal. You have the right to bring a person you trust (works council or MAV, union, representative for severely disabled employees).

Frequent short illnesses: what is the employer allowed to do?

If you are frequently ill for short periods, you may be confronted with talk of your “absence rate”. What is legally permitted?

  • Frequent short illnesses can, under high hurdles, justify a dismissal on personal grounds. But the employer must prove a negative health prognosis and show that the absences place a substantial burden on the business.
  • Before that: employers regularly use so-called return-to-work interviews (Krankenrückkehrgespräche). These are not unlawful as such, but you never have to disclose diagnoses.
  • If you suspect that illness is being used as a pretext for dismissal: involve the works council, inform your union.

Made ill by the job: occupational disease and burnout

Care workers fall ill more often than average: backs, mental illness, burnout. If the illness is causally linked to the job, additional claims can arise:

  • Occupational disease: must be reported to the statutory accident insurance (BGW for health professions). Better benefits than ordinary illness.
  • Work accident: psychological trauma caused by care situations can also count as a work accident.
  • Gefährdungsanzeige (hazard report): if you know that working conditions are making people ill, document it before it gets that far.

Legal note: This page is general information, not legal advice. This translation is provided for orientation; the German version is authoritative. For concrete questions about Krankengeld or continued pay, contact your health insurance fund, your works council or your union (ver.di).