How to Get a Sick Note (Krankschreibung) in Germany: The Expat Guide

Getting sick is stressful enough. The German sick leave system in a foreign language makes it worse. This guide walks you through exactly what to do (from calling your doctor to notifying your employer) so you don’t lose pay or accidentally break any rules.

What Is a Krankschreibung?

A Krankschreibung (also called Arbeitsunfähigkeitsbescheinigung or AU-Bescheinigung) is a doctor’s certificate confirming you are too ill to work. It states the period you are officially signed off sick. In Germany, this document is legally significant, without it, your employer can withhold sick pay after a certain point.

Since January 2023, Germany has switched to a fully digital system called eAU (elektronische Arbeitsunfähigkeitsbescheinigung). Your doctor now sends the certificate electronically directly to your Krankenkasse. You no longer need to physically post a yellow slip, but you still need to tell your employer you are sick.

When Do You Need a Krankschreibung?

The rules depend on your employment contract:

• Most employers: A Krankschreibung is required from the 4th day of illness. The first three calendar days are covered without a certificate.
• Some employers: Your contract may require a certificate from day 1. Check your Arbeitsvertrag (employment contract).
• If you work from home: Same rules apply, remote work does not exempt you from sick leave rules.

When in doubt, get a certificate from day 1. It costs nothing and protects you.

How to Get a Krankschreibung: Step by Step

Step 1: Call your Hausarzt first

Call your registered GP (Hausarzt) as soon as you know you can’t work. You do not need to go in person, many German practices now issue a Krankschreibung over the phone for common illnesses like colds and flu, especially for the first few days. Simply explain your symptoms and ask for an AU-Bescheinigung.

Step 2: Or use a telemedical app

If your Hausarzt is unreachable or fully booked, telemedical services are a fast alternative:

• AU-Schein.de: online consultation, certificate issued within minutes
• Teleclinic: video appointment with a German-licensed doctor
• Kry: available via app, some Krankenkassen cover the cost

These services are particularly useful for expats whose German is limited, many offer English-speaking doctors.

Step 3: Notify your employer immediately

You must inform your employer before your usual start time on the first day you are sick, even if you don’t yet have a certificate. A message or email is fine. You do not need to explain your medical condition, only that you are unwell and cannot work.

Since the switch to eAU, your employer can retrieve the certificate digitally from your Krankenkasse. However, not all employers have fully adopted this yet, if yours hasn’t, you may need to email them a scan or bring a paper copy.

Step 4: Your Krankenkasse is notified automatically

With the eAU system, your doctor sends the certificate directly to your Krankenkasse electronically. You don’t need to do anything, this happens automatically.

How Long Can You Be on Sick Leave?

• Up to 6 weeks: Your employer pays your full salary (Lohnfortzahlung).
• From week 7 onwards: Your Krankenkasse takes over and pays Krankengeld, approximately 70% of your gross salary (capped at around €130/day in 2026). You must apply for this from your Krankenkasse.
• Maximum duration: Krankengeld is paid for up to 78 weeks for the same illness within 3 years.

Can You Be Fired for Being Sick?

In Germany, being sick does not automatically put your job at risk. German employment law is strongly protective. However, if you have an unusually high rate of sick days over several years and it demonstrably disrupts operations, a dismissal can (in rare cases) be legally challenged. For normal illness, you are fully protected.

Tips for Expats

• Always save the name and phone number of your Hausarzt: you’ll need it fast when sick.
• If you don’t have a Hausarzt yet, register with one before you need one. Practices fill up and many have waiting lists.
• Telemedical apps work well for mild illnesses: keep one installed as a backup.
• If your German is limited, write a simple template message to your employer in German for the first sick day notification.
• Track your sick days per illness: the 6-week clock resets if you’ve been healthy for at least 6 months between episodes of the same illness.