Photo by Bianca Ackermann on Unsplash
A **Krankschreibung**, or sick note, is essential for expats in Germany to prove illness and secure paid sick leave. This guide explains every step, from notification to extensions, helping you navigate German rules confidently.
Why Every Expat Needs to Master the Krankschreibung Process
Germany’s strict sick leave rules protect workers but confuse newcomers. A **Krankschreibung** (Arbeitsunfähigkeitsbescheinigung, or AU) certifies you cannot work due to illness. Without it, you risk unpaid days or job issues[1][2].
Expats often panic over language barriers or appointment waits. However, digital options make it simple. This guide covers timelines, costs, and pitfalls for professionals[5].
Know your rights: Employers pay full salary for six weeks via Lohnfortzahlung. After that, health insurance steps in with Krankengeld[3][6].
When Do You Need a Krankschreibung? The 3- or 4-Day Rule Explained
Most employers require a **Krankschreibung** from the third or fourth day of illness. Weekends count, so Friday sickness through Monday needs a note by Tuesday[1][5].
German law allows employers to demand it from day one. Check your contract—probation periods often require it immediately[1][7]. For example, if sick Friday to Monday, get it for Monday.
Without a note, pay stops after the grace period. Common mistake: Assuming two days suffice. Always confirm your company’s policy to avoid disputes[2].
How to Inform Your Employer Immediately: First Step to Paid Leave
Notify your employer as soon as possible, ideally same day. Use email, phone, or app—written proof is best[1][6].
Say: “I’m ill and unable to work today. Expected return: tomorrow.” No diagnosis needed, just absence notice (Krankmeldung)[6].
Freelancers notify insurers after six weeks. Expats: Save emails as proof. Failure to notify can lead to warnings or pay deduction[5].
Step-by-Step: Booking a Doctor When You’re Already Sick
Call your Hausarzt (GP) first. Bring your eGK (electronic health card). Wait times average 1-2 days, but urgent slots exist[2].
Remote options speed it up: Apps like TeleClinic or Doktor.de offer video calls in 4 minutes, English available[1][4][5]. Costs: Free for statutory insurance.
Steps: 1) Register online/phone. 2) Video consult. 3) Doctor issues eAU digitally. In-person? Go during Sprechstunde (office hours)[2]. Edge case: If office closed, doctors issue retroactive notes rarely[7].
What is an AU-Bescheinigung? Decoding Your Sick Note
AU-Bescheinigung is the **Krankschreibung**—it lists your name, diagnosis code, start date, and expected duration[2][6].
Since 2023, it’s electronic (eAU). Doctors send it to your insurer, who forwards to employer—no paper needed[1][2]. Privately insured? Submit manually[1].
Get a patient copy (“Ausfertigung für Versicherte”) for records. Check codes on WHO site[3]. Hospital stay? Request Liegebescheinigung[3].
Lohnfortzahlung: Your Salary During the First 6 Weeks of Sickness
**Lohnfortzahlung** means employer-paid salary for up to six weeks. It’s 100% of net pay, no gaps[3][6].
After week six, apply for Krankengeld from insurer—about 70-90% of gross[6]. Notify employer daily if over three days in some firms[1].
Expats: Statutory insurance mandatory for employees. Private? Similar rules apply. Track weeks to switch seamlessly[1].
Can Doctors Extend a Krankschreibung Remotely? Yes, Here’s How
Doctors extend via phone, video, or app without visits. Re-consult before expiry[1][4].
For example, initial three-day note extends to seven via TeleClinic. eAU updates automatically[2]. Limit: Prolonged illness needs in-person checks[7].
Mistake: Letting it lapse. Set reminders. Maximum? No fixed limit, but over six weeks triggers Krankengeld assessment[3].
Maximum Sick Days Without a Doctor Note: Know Your Limits
Up to three days without note in most cases, but contracts vary—one day possible[1][5][6]. Probation: Always day one[1].
No legal maximum sick leave with notes—paid six weeks, then Krankengeld up to 78 weeks in three years[6].
Edge case: Chronic illness. Insurer reviews after six weeks. Always get notes early to cover extensions[7].
Can Your Employer Fire You for Being Sick? Protection Rules
No, frequent sickness alone cannot justify firing. Protection kicks in after four weeks continuous or frequent short leaves[6].
However, probation (first 6 months) has less protection. Long-term: Employer proves inability to perform duties[5].
Expats: Document everything. Unions or BMAS help disputes. Rest fully—working on sick note risks invalidation[6].
Related: See [INTERNAL: Health Insurance in Germany] for coverage details and [INTERNAL: Employment Contracts Guide] for probation tips.
Common Expat Mistakes with Krankschreibung and How to Avoid Them
Mistake 1: No immediate notice—leads to pay loss. Solution: Email template ready[1].
Mistake 2: Delaying doctor—notes rarely retroactive. Use apps[7]. Mistake 3: Sharing diagnosis—unnecessary, privacy protected[6].
Costs: Free with insurance. Timelines: Notify day 1, note by day 3. For kids: Parent note same rules[2]. Check TK or Barmer portals[2][3].
