Sick Leave in Germany [How High is The Sick Pay in 2025?]

Learn about sick pay in Germany. Receive up to 90% of your net salary for 72 weeks if you’re on sick leave due to the same medical condition. Find out how the self-employed can insure sick pay voluntarily.

Key Takeaways

• Your statutory health insurance pays sickness benefits if you’re on sick leave for more than six weeks due to the same medical condition. Before that, you will receive a full salary from your employer.
• You will receive a maximum of 90 percent of your net salary as sick pay – as an employee for a maximum of 72 weeks.
• The self-employed can voluntarily insure sick pay.
• In German culture, employers and doctors recommend staying at home until recovered.

How can you apply for sickness benefits in Germany?

• Send the sick note immediately to your insurance company and your employer.
• You should file an objection if your health insurance refuses to pay you for the time you were sick.

Table of content

After a severe injury like a broken arm or a car accident, work is the last thing you think about. But still, you need money to put food on the table.

Lucky you, you are in Germany.

In Germany, as an employee or self-employed, you don’t have to worry about your finances during your recovery time.

Your employer continues to pay you a full salary for the first six weeks. After that, the health insurance company steps in with the sick pay.

Germans prefer to stay at home when they are sick. They believe it’s better to recover 100% than drag the sickness for long.

Also, when you are sick, you cannot work efficiently and risk infecting your colleagues. Thus, stay home until recovered.

Who is entitled to sick pay in Germany?

To get sickness benefits in Germany, you must fulfill two conditions.

• You are a member of the German statutory health insurance (Gesetzlichen Kran­ken­ver­si­che­rung (GKV))
• You have acquired a right to sick pay.

You’ll get sick pay from your health insurance company in the following situations (§ 5 Para. 1 No. 1 SGB V).

• You do not receive a salary from your employer and are getting treatment as an inpatient in a hospital or rehabilitation facility.
• You are unable to work for more than six weeks due to the same illness, and your employer no longer pays.
• You started a new job and got sick in the first four weeks. In this situation, your employer does not have to pay your salary. Instead, the health insurance company pays you sick pay.
• You receive unemployment benefit 1 (Ar­beits­lo­sen­geld 1) and are ill for more than six weeks. The Employment Agency (Agentur für Arbeit) continues to pay unemployment benefits for the first six weeks. After that, the health insurance company takes over to pay sickness benefits.
• You accompany your sick relative during a hospital stay for medical reasons. To claim paid sick leave, you require a certificate from the doctor stating that an accompanying person is necessary. 

You must get a certificate of incapacity for work (Ar­beits­un­fä­hig­keits­be­schei­ni­gung) from a doctor within a week. Otherwise, the health insurance company will not pay the sick pay.

And worst, you may lose your entitlement to sick pay (Section 49 (1) No. 5 SGB V).

Who doesn’t receive paid sick leave in Germany?

The following people are not entitled to sickness benefits in Germany.

• Spouses and children who are co-insured with statutory family health insurance.
• Interns
• Students
• Recipients of an old-age pension or a full disability pension
• Recipients of unemployment benefit II (Ar­beits­lo­sen­geld II). If you draw unemployment benefit II (aka Hartz IV), you’ll continue to receive basic security during your sick days.
• Self-employed persons who haven’t expressly declared they want sick pay. As a self-employed individual, you must declare to your health insurance company that you want sick pay. You can do so by filling out and submitting the “Wahlerklärung Krankengeld” document. Here is the document for TK customers.

In certain cases, the health insurance company can suspend your entitlement to sick pay. The pause is for a certain period only.

For example, you won’t receive sick pay during parental leave. Instead, you will get parental benefits.

Do self-employed people receive sick pay in Germany?

Yes, self-employed are also entitled to sick pay in Germany. However, it depends on their health insurance policy.

As a self-employed person in Germany, you have five options:

1. Option 1: You pay a reduced contribution of 14 percent to the statutory health insurance plus an additional contribution (Zusatzbeitrag), which is 1.7 percent (average). In this case, you don’t receive any paid sick leave.
2. Option 2: You pay the standard contribution rate, i.e., 14.6 percent of gross income plus the additional contribution. In this case, you’ll get sickness benefits after 6 weeks of illness.
3. Option 3: You took an optional sickness benefit tariff (Wahltariff) with your public health insurance company. You can take this as an add-on to your existing health insurance. In this case, you get sickness benefits without waiting for six weeks. Your tariff decides when and how much sick pay you will receive.
4. Option 4: You take out private daily sickness benefits insurance (Kran­ken­ta­ge­geld­ver­si­che­rung).
5. Option 5: You take private health insurance. Good private health insurance plans offer better medical coverage than public health insurance in Germany. However, you must consult a health insurance expert before opting for private health insurance. The reason is once you enroll in private health insurance, returning to public health insurance is tough.

What should you consider when applying for sick leave in Germany?

• You must get a sick note (Arbeitsunfähigkeitsbescheinigung) from the doctor and submit it to your employer. For the first six weeks, your employer continues to pay your salary. After six weeks, you become eligible for sick pay by the health insurance company.
• The entitlement to paid sick leave begins when your doctor determines you cannot work ( Section 46 sentence 1 no. 2 SGB V ). So, even if you get a back-dated doctor’s certificate, your entitlement to sick pay starts the day you visit the doctor. This is because, on that day, the doctor determined you were incapable of working.
• You may lose the entitlement to sick pay from your health insurer if there is a gap between the two sick leave certificates. Weekends don’t count as a gap. Thus, you must visit your doctor in time to get a new sick note.

The gap in sick leave

As a rule, your doctor cannot give you a backdated sick leave certificate. However, there may be exceptions.

For example, you contacted your doctor well in time and booked an appointment. But the doctor postponed the meeting.

Then, the doctor can write you a sick leave certificate for up to three days in the past.

Don’t know when you’ll be able to work?

There is a field on the medical certificate in which the doctor must enter how long you will be unable to work. The doctor usually issues the sick leave certificate for no more than two weeks.

But if the end of the disease is not yet foreseeable, some doctors leave this field empty. And others write “until further notice (bis auf Weiteres).“

The best part is that health insurance companies must continue paying the sickness benefits.

What do you have to do to get sick pay in Germany?

You do not have to submit a separate application to receive sick pay.

Here is what the process looks like:

1. You receive a questionnaire from the health insurance company

As soon as your employer stops paying the wages (after 6 weeks of sick leave), it informs the health insurance company about the same. Your health insurance company will then send you a questionnaire.

You must fill out this questionnaire to start getting the sick pay.

2. The employer sends proof of earnings to your health insurance company

Your health insurance company will request an “earnings certificate”(Verdienstbescheinigung) from your employer at the end of six weeks.

It uses the earnings certificate to calculate your sick pay.

Under German law, the employer must send all the required information to your health insurer to calculate your sick pay.

3. Get a sick note from your doctor

Since 2016, there is a single document, sick note (Ar­beits­un­fä­hig­keits­be­schei­ni­gung (AU)), that you can use for both sick leave and sick pay from the employer and health insurer.

The doctor certifies your incapacity to work on the document. Then, you submit this document to your employer and health insurer.

Your employer pays you for six weeks. Afterward, the health insurance company steps in.

4. Who submits the incapacity for work certificate?

The short answer is you are responsible for making sure that your insurer gets the certificate on time.

But, since October 2021, your doctor should send the certificate of incapacity to work to your statutory health insurance company electronically. Your employer can request a sick note from your health insurer.

This is called eAU (Electronic Arbeitsunfähigkeitsbescheinigung).

However, many medical practices do not have the necessary technology. Thus, they continue to give the certificate in paper form.

If your doctor cannot submit the certificate to your health insurance, you must send it yourself. You can submit the certificate online, via mobile app, or by registered mail.

NOTE: eAU is only applicable to publicly insured individuals. If you have private health insurance, you must submit the sick note yourself to your employer and health insurer.

5. Verification and payment of sickness benefits

You’ll receive sick pay as soon as your health insurance company receives and processes the “incapacity for work” certificate.

6. Send a sick note to your employer

You should continue informing your employer after six weeks about your illness.

Even if the employer no longer pays the salary, they need to know if and when you can work again.

If you are unemployed and receive unemployment benefits I (ALG I), you must inform the employment agency.

How much is the sick pay in Germany?

German law regulates sickness benefits. According to the law, sick pay is 70 percent of gross earnings but no more than 90 percent of net earnings (Section 47 SGB V ). So, the lower of these two values is the gross sick pay.

The health insurance company deducts social security contributions from the gross sick pay and pays the rest.

Tip: Here is a sick pay calculator by T.K. You can use it to calculate the net sick pay you will receive.

Example of sick pay calculation

Item	Amount (Monthly)
Gross Salary	3000 €
Net Salary (Income tax class III, 1 Child)	1977 €
70% of the gross salary	2100 €
90% of the net salary	1779 €
Gross sick pay	1779 €
Social Security	​
Pension Insurance (9,3 %) (Ren­ten­ver­si­che­rung)	165 €
Unemployment Insurance (1,20 %) (Arbeitslosenversicherung)	21 €
Long-term Care Insurance (1,525 %) (Pfle­ge­ver­si­che­rung)	27 €
Net sick pay	1557 €

The insurance company also considers one-time payments like Christmas (Weinachtsgeld) or Holidays (Uralubsgeld) allowance while calculating the sick pay (Section 47 (2) sentence 6 SGB V).

These one-time payments increase the amount of sick pay you will get.

Sick pay for high earners

The law limits the amount of sick pay to 70 percent of the contribution assessment ceiling (Beitragsbemessungsgrenze). As a result, you can get a maximum of 120.75 € gross sick pay per day in 2024 or 3622.5 € per month.

The contribution assessment ceiling will increase to 5512.5 € per month in 2025. Thus, the sick pay will increase to 3858.75€ per month or 128.6€ per day in 2025.

Net sick pay is not enough to cover your expenses.

You may need more than the sick pay if you are a high earner and have high monthly expenses. In this situation, you can take private sick pay insurance (Krankengeldversicherung) to cover the difference.

Another option is to ask your employer. Some employers in Germany supplement sick pay to cover the difference in your net salary and net sick pay.

How long is the paid sick leave period in Germany?

You can avail of sickness benefits for 78 weeks within three years per illness (§ 48 SGB V). In the first six weeks, you will receive your salary as usual. 

So, you can get sick pay for 72 weeks from your health insurance provider.

You don’t have to be on continuous sick leave. The health insurance company adds the periods you were ill for the same sickness within three years.

NOTE: The waiting period of six weeks occurs only once in these three years. If you get sick again within three years with the same illness, your health insurer starts paying the sick pay immediately.

Here are some rules that apply when you are on paid sick leave

• The health insurance company will not extend the sickness benefit period if you catch another illness during your sick leave. The benefit period will remain the same, i.e., 78 weeks ( § 48 Para. 1 Sentence 2 SGB V ).
• 78 weeks of sickness benefit period includes the sick leave paid by your employer. That means the first six weeks; your employer pays you the wages. And the health insurance company covers the rest of the period, i.e., 72 weeks (§ 49 Para . 1 No. 1 SGB V, § 146 Para . 1 Clause 1 SGB III ).
• You don’t get sick pay during parental leave, as you get parental allowance during that period.

What happens if you catch the same sickness after three years?

After three years, everything starts anew.

So, if you catch the same illness in a new three-year period, your sickness benefits start over again.

But, you must fulfill the following conditions to receive sickness benefits.

• You must be in the statutory health insurance scheme.
• No doctor gave you sick leave for the same disease for at least six months.

Is sick pay tax-free in Germany?

Yes, sick pay is tax-free. You don’t pay any taxes on it. However, your sick pay is added to the total taxable income when determining your tax rate for that year.

This way, the tax office ensures fair tax calculation for people who received sick pay and those who didn’t.

Resolving trouble with your health insurance company?

It is your right to receive paid sick leave. But your health insurance company can get in the way.

So, it’s essential to know how you can defend yourself against common problems:

Unsolicited calls from health insurance

Patient advice centers (Beratungsstelle) report that many insured people feel pressured by their health insurance company on the phone.

Sometimes, health insurance companies advise their customers to quit their jobs and apply for unemployment benefits.

One of the motivations behind this suggestion is that health insurers don’t have to pay sickness benefits if you register as unemployed.

But you should never respond to such suggestions.

In principle, the health insurance company can call you for individual advice on sick pay. But only if they have your written consent.

And you can revoke your consent at any time ( § 44 Para. 4 SGB V ).

If you feel harassed by your health insurance company, feel free to tell them that you do not want telephone advice.

Also, mention that you are happy to answer any necessary questions in writing only.

Please note that you have certain obligations to cooperate ( § 60 to 67 SGB I ) with the health insurer. So you cannot refuse to provide information.

However, you can provide the required information in writing instead of by telephone.

Get your health checked by “Medizinischen Dienst.”

Your health insurance company can request “Medizinischen Dienst” to check your incapacity to work. However, in this check, your insurer can ask only these two questions (in writing):

1. Is it possible to know when you can work again? If yes, what is the tentative date?
2. Are there any treatments planned that prevent you from returning to work?

You can also agree to provide this information by telephone. However, in this case, the health insurance company must create a protocol for the call.

There could be situations when you are unsure what to tell the health insurance company. You can contact an advice center (Beratungsstelle) for guidance in such scenarios.

Every city has multiple advice centers run by NGOs or the government. You can find them by searching “Beratungsstelle” on Google.

The health insurance company issues a letter to stop paying sickness benefits.

The health insurance company can tell you they’ll stop paying the sick pay as you are healthy and can work. Many people in Germany have received such a letter.

However, to issue this letter, the insurance company needs to have an expert opinion of the medical service (Medizinischen Dienst).

The Medical Service (M.D.) judges your health based on your medical reports. However, they may also ask for a personal examination in exceptional cases.

However, an assessment based on medical records alone does not always hold in court. Thus, the health insurance company should conduct your examination before concluding anything.

What can you do if the health insurance company wants to stop paying sick pay?

If the insurer wants to stop paying sick pay, you should do the following.

• Request the M.D.’s report as soon as possible.
• File an objection within one month to the health insurance company. Add the note that you will submit the reason for the objection later, for example, within 14 days after you have received the M.D.’s report. You can use our sample letter to file an objection.
• Ask your physician to apply for a second opinion from the health insurance company ( § 6 Disability Directive ).

But your doctor might refuse to apply for a second opinion. In this case, list all the doctors who are treating you in your objection letter and add a note:

“for the medical justification of the objection, please contact the doctors mentioned in the list.”

If the health insurance company contacts any of the doctors from your list for an opinion, doctors are legally bound to answer. Of course, they can bill the health insurance company for their service.

Many times, the second opinion changes the decision of the health insurer. And you continue to receive the sickness benefits.

Learn more about how to object to the health insurer’s decision in our guide.

You should apply for rehab.

The health insurance company may ask you to apply for rehabilitation via your pension insurance. The German law allows health insurers to do this if they believe you are at risk of disability ( § 51 Para. 1 SGB V ).

Here are a few things that you should know about applying for rehab.

• As per law, you have ten weeks to submit your rehab application. And the health insurance company cannot set a shorter deadline.
• You should send the rehab application by registered mail, as it proves that you applied on time.
• It’s vital to send the rehabilitation application within ten weeks, as the insurance company may stop paying sick pay.
• You have the right to appeal against the request for rehabilitation.
• If in doubt, contact an advice center near you for guidance.
• You have the freedom to choose the rehab center.
• During rehabilitation, you will not receive sick pay but a transitional allowance (Übergangsgeld in German).
• Transitional allowance is paid by your pension insurance when you are in rehab. It is 68 percent of the last net salary if you have no kids and 75 percent if you do.
• The paid sick leave continues if you are unable to work after rehab.

But, if the physician determines that you cannot work long-term, your rehab application will convert into a disability pension application.

Once the disability application is approved, you will no longer receive sick pay.

Vacation is allowed when you are on paid sick leave

German law allows you to go on vacation when you are on paid sick leave. But the holiday should not impair your recovery.

You don’t need the health insurance company’s approval to go on a vacation as long as you travel within Germany.

But, if you decide to travel outside of Germany, you will need your insurer’s approval. However, according to the Federal Social Court ruling, health insurance companies must approve the travel if it’s within E.U. ( Az. B 3 KR 23/18 R ).

Things to do if you plan to travel abroad during paid sick leave.

• Get a note from your physician stating the trip will not interfere with your recovery.
• Inform your health insurance company several weeks before the trip.

By applying early, you’ll have the time to file an objection if your insurer does not approve your travel.

Get help from a counseling center.

You can get help from the nearest advice center when in need. They can help you with the following.

• Resolving conflicts with your health insurance company.
• Explain your rights.
• Guide you based on the situation.
• Help you write an objection against the health insurer.

Here are some of the entities that provide counseling.

• Independent patient advice service (UPD)
• Consumer advice centers
• Social organizations such as the VDK.

Take legal action if the objection is unsuccessful.

If your objection is unsuccessful, you can still take legal action before the social court.

German government waived the court fees to make it easier for the general public to take legal action. However, it makes sense to get help from a lawyer specializing in social law.

You have to pay the lawyer’s fee yourself if you lose the case. So, weigh the cost before taking any legal action, especially if you don’t have legal expense insurance (Rechtsschutzversicherung in German).

What happens after paid sick leave ends?

The following applies if you cannot work after 78 weeks of paid sick leave.

• You won’t get sick pay after the 78th week.
• You may be entitled to a disability pension (Er­werbs­min­de­rungs­ren­te in German).
• Your health insurance company will ask you to apply for medical rehabilitation. The insurer must do so no later than three months before your sickness benefits expire.

The doctor checks whether rehab can restore your ability to work within three to six months. If it can’t, your rehabilitation application will be converted into a disability pension application.

German pension bureau may take months to evaluate your application for a disability pension. So, your sickness benefits may expire before you start receiving a disability pension.

Hence, you should register with the employment agency (Agentur für Arbeit) at least three months before your sick leave ends.

This way, you can claim unemployment benefits (§ 145 SBG III) until you get a disability pension.

Claiming occupational disability insurance benefits

Occupational disability insurance is one of the most important insurance policies in Germany. It pays you a monthly pension if you cannot work anymore due to health reasons.

A statutory disability pension is not enough to cover your monthly expenses. Families of high earners and sole earners are affected the most.

Thus, you should consider getting statutory disability insurance sooner rather than later. You should consult an insurance broker to get the right disability insurance for yourself.

Frequently asked questions about sick leave in Germany

How much sick pay is there?

The amount of sick pay is prescribed by law: 70 percent of gross earnings but no more than 90 percent of net earnings (Section 47 SGB V). The employee’s share of statutory social insurance is deducted from the lower of these two values. You will then receive the remaining amount as sick pay.

The maximum sick pay is limited to 120.75€ per day (as of 2024) and 128.6€ per day (as of 2025)

How long is paid sick leave?

Sickness benefits for the same illness runs for 78 weeks or 19.5 months within three years (§ 48 SGB V). You don’t have to be on sick leave in one go. The periods are added together.

What do you have to do to get sick pay?

You do not have to submit a separate application to receive sick pay. Your health insurance company will contact you to coordinate further procedures.

References

• https://www.tk.de/techniker/versicherung/tk-leistungen/weitere-leistungen/krankengeld/selbststaendige/krankengeldanspruch-selbststaendige-2006296
• https://www.finanztip.de/gkv/krankengeld/