🤒 Continued pay during illness

Six weeks of full pay if you are unfit for work, then sickness benefit from your health insurer – and what you must report to your employer.

Continued pay (Entgeltfortzahlung) EFZG Certificate of incapacity for work eAU (electronic sick note) Sickness benefit (Krankengeld) Waiting period

In brief

If you fall ill through no fault of your own and are therefore unfit for work, your employer continues to pay your full salary for up to six weeks – provided that the employment has already lasted four weeks without interruption at that point. After that, the health insurer takes over with the lower sickness benefit (Krankengeld).

You must report your incapacity for work without delay; since 2023, for most people with statutory health insurance the medical certificate is transmitted electronically (eAU) directly to the health insurer and, on request, to the employer – but a duty of your own to submit it may still exist.

Step by step

Report your incapacity for work without delayInform your employer on the first day of incapacity for work, if possible before work starts (§ 5 Abs. 1 EFZG).
Get a medical certificateYou must have a medical certificate available at the latest on the fourth calendar day of incapacity for work, if the employer does not require it even earlier.
Enable the employer to retrieve the eAUFor people with statutory health insurance, the employer usually retrieves the incapacity data electronically from the health insurer; a paper copy is mostly only needed for people with private insurance or in technical exceptional cases.
After six weeks: apply for sickness benefitApply to your health insurer for sickness benefit in good time before the six weeks end, so that there is no gap in payment.

Deadlines

4 weeks

Waiting period: the employment must have lasted four weeks without interruption for the entitlement to continued pay to arise.§ 3 Abs. 3 EFZG

up to 6 weeks (42 calendar days)

Duration of full continued pay by the employer for the same illness; for a new, different illness the entitlement can arise again.§ 3 Abs. 1 EFZG

at the latest on the 4th calendar day

Submission of a medical certificate of incapacity for work, unless the employer has already required it earlier.§ 5 Abs. 1 EFZG

Watch out – common mistakes

If you report sickness late or not at all, you risk a warning letter – the six-week duty to continue paying remains legally unaffected at first, provided the incapacity for work itself is proven.
In the case of repeated incapacity for work due to the same illness, the six-week period does not automatically start again – special rules on the so-called "continuation connection" (Fortsetzungszusammenhang) apply (§ 3 Abs. 1 Satz 2 EFZG), and applying them can be complex in an individual case.
After the 2023 reform of sick notes, the eAU applies only to people with statutory health insurance towards statutory health insurers; for people with private insurance and in certain exceptional cases a paper certificate is still needed.
Announced but not yet decided change: in July 2026 the coalition committee announced a requirement for a certificate from the first day of illness and the abolition of sick notes by telephone, with options for exceptions at workplace level. A law passed by the Bundestag and Bundesrat with final wording did not yet exist as of this page; according to available sources, passage is to be expected at the earliest at the end of 2026.

In depth · legal basis, figures and practice – for advisers and professionals

Conditions for the entitlement

There is an entitlement to continued pay if an employee is prevented from working by illness through no fault of their own and the employment has already lasted four weeks without interruption at that point (§ 3 Abs. 1 and 3 EFZG). "Through no fault of their own" means that there is no grossly irresponsible breach against one's own interest – an everyday sports accident does not usually count as fault.

Duration and amount

Continued pay is made at the full previous pay for up to six weeks (42 calendar days) per illness. After that, the statutory health insurer pays sickness benefit of 70 % of gross pay, limited to at most 90 % of net pay (§ 47 SGB V), regularly for up to 78 weeks within three years for the same illness (§ 48 SGB V).

Duties to report and prove

The employee must notify the employer of the incapacity for work and its expected duration without delay (§ 5 Abs. 1 Satz 1 EFZG). Since 1 January 2023, doctors contracted to the statutory health insurance scheme record incapacity for work electronically for people with statutory insurance (eAU); the employer retrieves the data from the health insurer instead of requiring a paper certificate. A separate, direct duty of the employee to inform the employer of the start and expected duration of the incapacity for work continues to exist independently of this.

Announced reform (as of September 2026, not in force)

As part of the reform package presented by the coalition committee in July 2026, it is planned to introduce a requirement for a medical certificate from the first day of illness and to abolish sick notes by telephone, with the possibility of workplace exceptions by individual agreement or works agreement. According to available sources, this has so far been a political decision of the coalition leaders; the legislative procedure in the Bundestag had not yet been completed as of this page.

Who is responsible

Employer (continued pay)
Statutory health insurer (sickness benefit, eAU)
Local labour court in case of dispute

Quick questions

Worum geht es bei „Continued pay during illness“?

Six weeks of full pay if you are unfit for work, then sickness benefit from your health insurer – and what you must report to your employer.

Which deadlines and figures matter?

4 weeks: Waiting period: the employment must have lasted four weeks without interruption for the entitlement to continued pay to arise. (§ 3 Abs. 3 EFZG)
up to 6 weeks (42 calendar days): Duration of full continued pay by the employer for the same illness; for a new, different illness the entitlement can arise again. (§ 3 Abs. 1 EFZG)
at the latest on the 4th calendar day: Submission of a medical certificate of incapacity for work, unless the employer has already required it earlier. (§ 5 Abs. 1 EFZG)

What should I do first?

Report your incapacity for work without delay: Inform your employer on the first day of incapacity for work, if possible before work starts (§ 5 Abs. 1 EFZG).
Get a medical certificate: You must have a medical certificate available at the latest on the fourth calendar day of incapacity for work, if the employer does not require it even earlier.
Enable the employer to retrieve the eAU: For people with statutory health insurance, the employer usually retrieves the incapacity data electronically from the health insurer; a paper copy is mostly only needed for people with private insurance or in technical exceptional cases.

What do I need to watch out for?

If you report sickness late or not at all, you risk a warning letter – the six-week duty to continue paying remains legally unaffected at first, provided the incapacity for work itself is proven.
In the case of repeated incapacity for work due to the same illness, the six-week period does not automatically start again – special rules on the so-called "continuation connection" (Fortsetzungszusammenhang) apply (§ 3 Abs. 1 Satz 2 EFZG), and applying them can be complex in an individual case.
After the 2023 reform of sick notes, the eAU applies only to people with statutory health insurance towards statutory health insurers; for people with private insurance and in certain exceptional cases a paper certificate is still needed.

Evidence

Entgeltfortzahlungsgesetz (EFZG), gesetze-im-internet.de
Sozialgesetzbuch V (SGB V) §§ 47, 48, gesetze-im-internet.de
Deutsches Ärzteblatt, "Koalitionsausschuss: Abschaffung der Telefon-AU und Krankschreibung ab erstem Tag geplant"
ecovis-kso.com, "Krankschreibung ab Tag 1: Alles zur geplanten Reform 2026"

As of

September 2026 · Sources and method

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