From when do I need a sick note?
At the latest from the fourth day — unless otherwise agreed. If you're ill you must notify your employer without delay. A doctor's incapacity certificate (AU) must, under the Continued Remuneration Act, be presented at the latest on the 4th sick day — but the employer may, by contract or in an individual case, require it from the first day. The AU is now transmitted electronically (eAU) from the practice to the health insurer; your employer retrieves it there. For mild illnesses, since the end of 2023 a telephone sick note (up to 5 days) is possible for known patients.
📋 The rules
- AU at the latest on the 4th sick day (§ 5 EntgFG)
- The employer can require the AU from day 1
- Immediate sick notice to the employer is mandatory
- The AU runs electronically (eAU) via the health insurer
- Telephone sick note for mild illness (up to 5 days, known patients)
🔓 Exceptions
- Privately insured people still get the AU on paper
- For employment bans/pregnancy, own evidence applies
- Longer/renewed illness: a follow-up AU is needed, often an in-person visit
⚠️ Penalties & fines
If you present no AU or don't report sick in time, the employer may withhold continued pay, and a warning up to dismissal can follow. Anyone who fakes a sick note (e.g. provably working/travelling despite a certified incapacity in a way that contradicts recovery) risks a termination without notice. The AU has high evidential value — shaking it is the employer's job.
📎 Official sources
- § 5 EntgFG · Notification and proof duties →
- GKV / G-BA · Telephone sick note →
- Verbraucherzentrale · Electronic sick note (eAU) →
❓ Frequently asked
From when do I need a sick note?
At the latest from the fourth sick day you must present a doctor's incapacity certificate. But your employer can, by contract or in an individual case, require it from the first day — then that applies.
Do I still have to hand in the sick note?
For statutory-insured people, not on paper: the practice transmits the AU electronically to the insurer (eAU), and your employer retrieves it there. You should still report sick in time. Privately insured people still get a paper certificate.
Can I get a sick note by phone?
For mild illness, yes. Since the end of 2023 the telephone sick note is permanently possible for patients known to the practice — for up to five days, if there's no suspicion of a serious illness.
Do I have to see a doctor at once?
First report sick to your employer without delay. Whether you must see a doctor at once depends on from when an AU is required. At the latest for the fourth sick day you need the certificate.
What happens if I don't present an AU?
The employer may then withhold continued pay, and a warning or, on repetition, dismissal can follow. Anyone who fakes a sick note even risks a termination without notice.
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