In Germany, employees who fall ill are entitled to up to six weeks of continued full pay from their employer for each new illness, under the Entgeltfortzahlungsgesetz (EntgFG). After six weeks, statutory health insurance pays Krankengeld at around 70% of gross pay (capped) for up to 78 weeks per illness within a three-year period.

Statutory entitlement

Six weeks of continued full pay (Entgeltfortzahlung) from the employer per illness. After six weeks, statutory health insurance pays Krankengeld of approximately 70% of gross pay (max 90% of net) for up to 78 weeks per illness in any three-year period.

Eligibility

Employees with at least four weeks of continuous service. The four-week qualifying period applies once at the start of employment.

Employer obligations

  • Continue paying full salary (Entgeltfortzahlung) for up to six weeks per illness.
  • Accept the medical certificate (Arbeitsunfähigkeitsbescheinigung, eAU) transmitted electronically by the doctor from day four (or earlier if the contract requires).
  • Not pressure the employee to return to work before the certificate expires.
  • Restart the six-week entitlement only when the new illness is unrelated, or after a six-month interval and at least 12 months since the original.
  • Continue social insurance contributions during the Entgeltfortzahlung period.

Employee rights

  • Right to six weeks of full pay per illness, restarting after qualifying conditions.
  • Right to Krankengeld from statutory health insurance from week seven.
  • Right to keep accruing annual leave during sickness (BUrlG and ECJ case law).
  • Right to recover annual leave that overlapped with certified sickness.

Common pitfalls

  • Restarting the six-week clock for the same illness without the required interval (six months + 12 months).
  • Treating sick days as a deduction from annual leave — German law explicitly protects accrued leave.
  • Failing to report sickness to the health insurer in time, which can delay Krankengeld.
  • Using the discontinued paper Krankenschein process — since 2023 most certificates are transmitted electronically (eAU).

Six weeks of Entgeltfortzahlung

For each new illness, the employer pays the employee's full salary for up to six weeks (42 calendar days). The right starts once the employee has completed four weeks of continuous service. If the employee becomes ill again with the same condition before a six-month break and a fresh 12 months from the start of the original illness, no new entitlement arises.

Krankengeld from week seven

From week seven, statutory health insurance (gesetzliche Krankenversicherung, GKV) pays Krankengeld at 70% of gross pay, capped at 90% of net, up to a contribution ceiling. Krankengeld is payable for a maximum of 78 weeks per illness within any three-year period.

Sickness certificate (eAU)

Employees must inform the employer immediately of any incapacity for work. By the fourth calendar day at the latest a medical certificate is required, transmitted electronically by the doctor to the health insurer and made available to the employer (eAU procedure).

Frequently asked questions

How long is paid sick leave in Germany?

The employer continues to pay full salary for up to six weeks per illness. From week seven, statutory health insurance pays Krankengeld at around 70% of gross for up to 78 weeks within three years.

Do I keep accruing holiday during sick leave in Germany?

Yes. Annual leave continues to accrue during sickness, and any holiday that coincided with certified illness can be reclaimed.

When do I need a doctor's note in Germany?

The employer must be notified immediately. A medical certificate is required from the fourth day, although the contract or works agreement can require it from day one.

Sources

This page is provided for general guidance and does not constitute legal advice. Always check the cited primary source for current law before making employment decisions.