🩺 Sick leave and sickness benefit in chronic illness
In brief
If you are unable to work because of a chronic physical illness, your doctor issues an electronic certificate of incapacity for work (elektronische Arbeitsunfähigkeitsbescheinigung, eAU), which is automatically sent to the health insurer; you must still report your incapacity for work to your employer without delay. The employer continues to pay your wages for up to six weeks (Entgeltfortzahlung). After that, the health insurer pays sickness benefit (Krankengeld) – for the same illness for a total of at most 78 weeks within three years (block period, Blockfrist).
Step by step
- Have your incapacity for work certified by a doctorThe practice issues the eAU; it goes electronically to the health insurer.
- Inform your employer without delayYou must tell your employer about your incapacity for work and its expected duration without delay, at the latest on the fourth calendar day, unless your employment contract provides otherwise.
- Check continued pay for 6 weeksThe employer continues to pay wages for up to six weeks in total for the same illness; for a new, unrelated illness the period starts again.
- Apply for sickness benefitFrom the seventh week, you submit the sickness benefit application to the health insurer; the eAU must be available without gaps for this.
- Keep an eye on the block period if relapses recurFor chronic illnesses with recurring relapses, it is worth clarifying with the insurer whether later periods of absence count as "the same illness" towards the 78-week limit.
Deadlines
- Whether recurring relapses of a chronic illness legally count as "the same illness" and are therefore counted together towards the 78-week limit must be clarified medically and legally in the individual case – this can be complex and should be checked with the health insurer or a social law advice service.
- If a further, unrelated illness arises during an existing incapacity for work, this does not in principle extend the period of entitlement under § 48 SGB V.
- This page deals with sick leave and sickness benefit in general for chronic physical illness. For the specifics of mental illness, see the separate Wegweiser Depression (sick leave in depression) and Burnout & Exhaustion (sick leave in burnout).
In depth · legal basis, figures and practice – for advisers and professionals
Continued pay (Entgeltfortzahlung)
Under § 3 EFZG, an employee who is unable to work through no fault of their own due to illness is entitled to continued payment of wages by the employer for up to six weeks. If the same person falls ill again with the same illness within this period, the six-week period is in principle not extended.
Sickness benefit
After continued pay ends, the health insurer pays sickness benefit (§ 44 SGB V), provided the membership includes an entitlement to sickness benefit. The amount is 70% of gross earnings, but at most 90% of net earnings. The entitlement exists for the same illness for at most 78 weeks within three years, counted from the day incapacity for work begins (§ 48 SGB V) – the so-called block period.
Electronic certificate of incapacity for work (eAU)
Since the introduction of the eAU, the certificate of incapacity for work is sent electronically by the doctor's practice to the health insurer; employers retrieve the data from the insurer. The duty to inform the employer of the incapacity for work yourself without delay remains unaffected (§ 5 Abs. 1 EFZG).
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