Procedure descriptions

Apply for sickness benefit for people with statutory insurance

In the event of illness, employees will in most cases continue to receive their pay for six weeks (continued payment of remuneration in the event of illness). After this period has expired, those with statutory insurance may be entitled to sick pay in the event of

permanent incapacity for work or
inpatient treatment in a hospital or rehabilitation centre

Amount

70 per cent of gross pay, up to a maximum of 90 per cent of net pay
One-off payments such as Christmas bonuses are taken into account
Sickness benefit is limited to a statutory maximum of EUR 128.63 per day (value for the year 2025).

You can compensate for the difference between sick pay and net pay. To do this, you can take out individual tariffs with a private insurance company Insurance company.

Duration

You can receive sickness benefit for a maximum of 78 weeks within a three-year period for the same illness.

After the three years have expired, you can only receive sickness benefit for the same illness if you have been able to work for at least six months in the meantime and

have not been unfit for work due to this illness and have worked orr
were available to the job centre.

Please note: The entitlement to sickness benefit ends if you

a pension due to full reduction in earning capacity or disability,
an old-age pension,
a retirement pension or
an early retirement pension.

Payment begins on the day on which the income ceases - i.e. in most cases after the six-week period of continued remuneration has expired.

Responsible department

Your health insurance company

Details

Prerequisite

You must have health insurance with an entitlement to sickness benefit. For most employees and unemployed persons, this entitlement is included in the statutory health insurance.
The period for continued payment of wages has expired.
You must be undergoing inpatient treatment at the expense of the health insurance company
Proof of incapacity for work since January 2023: If the attending doctor determines that you are unable to work, he or she reports the data directly to the relevant health insurance fund electronically using the so-called electronic certificate of incapacity for work (eAU). This ensures that the sick note is available to the health insurance fund from the very first day. If electronic transmission cannot be guaranteed for technical reasons, you must submit the printout of the sick note issued by the doctor's surgery with the note "For submission to the health insurance fund" to your health insurance fund yourself without delay.

Self-employed persons with voluntary insurance are not entitled to sickness benefit. By submitting a declaration of choice, you can choose to be entitled to sickness benefit duringsickness benefit during the period of incapacity for work. Your health insurance fund will advise you on the optional sickness benefit tariffs. Alternatively, you can take out private daily sickness allowance insurance with an insurance company.

Recipients of unemployment benefit are also entitled to sickness benefit. Since 1 January 2024, the Federal Employment Agency has also been participating in the eAU procedure. As of this date, recipients of unemployment benefit no longer have to submit a paper certificate. However, nothing will change for recipients of citizen's allowance. They continue to submit the paper copy for the employer to the job centre.

Unemployment benefit II is also paid out after the six weeks have expired.

Procedure

At the end of your continued remuneration, you will automatically receive a questionnaire on sick pay. You should then submit the completed questionnaire to your health insurance fund. Most health insurance companies allow you to complete and submit this online.

If you apply for a pension during your incapacity for work or take advantage of rehabilitation measures, you must inform your health insurance fund of this in advance. These benefits will affect your continued entitlement to sickness benefit.

The health insurance fund cancan arrange for an assessment by the Medical Service (MD) at any time after the start of your incapacity for work. This is intended to ensure the success of the treatment. If necessary, it can initiate measures to restore the Ability to work. The assessment may also include a physical examination.

Sickness benefit will be transferred to the account you have specified for the past period of incapacity for work. The sickness benefit is calculatedper calendar day. If you are entitled to sickness benefit for an entire calendar month, this will be calculated as 30 days. If you are only partially entitled to sickness benefit in a month, payment will be made for the days actually accrued.

Sickness benefit is subject to compulsory contributions to pension, unemployment and long-term care insurance. The contributions are deducted before payment.

Deadlines

Please note: If you are unfit for work, you must still report sick to work immediately, for example by telephone. The switch to the digital certificate does not change this. Only the obligation to submit a certificate to the employer on the fourth day of incapacity for work at the latest no longer applies.

Required documents

Questionnaire on the payment of sick pay at the end of continued remuneration

Costs

none

Miscellaneous