Heute KrankGuide
Online Sick Notes in Germany: How They Work, Cost, Validity
In short: you can get a sick note online in Germany if a doctor sees you and asks you questions in a video consultation. The certificate counts with your employer just like one from any doctor’s practice. Certificates based solely on an online questionnaire are not accepted. This page covers the process, the costs, the route to your health insurer and the limits.
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How Do I Get a Sick Note Online?
Through a video consultation. You need a phone or a computer with camera and microphone; the consultation runs in your browser, without an app.
Select your symptoms and book a time. Appointments are available daily until 10 pm, usually within 30 minutes.
Give a few details before the consultation. A short form asks about your symptoms and about warning signs, so the doctor is prepared.
Video consultation. The doctor sees you, asks questions and takes time for your symptoms.
Receive your documents. The certificate arrives as a PDF by email, usually ten minutes after the consultation, together with the doctor’s letter and the invoice.
Important: regardless of this, report sick to your employer on the first day, before work starts. Reporting sick and the doctor’s certificate are two separate steps.
Is an Online Sick Note Legal and Valid?
Yes. In Germany a certificate of incapacity for work (Arbeitsunfähigkeitsbescheinigung, AU), usually just called a sick note or doctor’s note, may only be issued by a doctor. Whether that happens after an examination in a practice or after a video consultation makes no difference to its validity, as long as genuine contact with a doctor took place.
Courts have confirmed this: the Arbeitsgericht Erfurt (labour court) gave a sick note from a video consultation full evidential value because the doctor had seen the patient in the video consultation and had watched her take her temperature (judgment of 19 July 2023, case no. 4 Ca 32/23).
The line is drawn at contact with a doctor, not at the screen: a certificate based only on a completed online questionnaire has no evidential value in court. More on this in the section on reputable offers.
Will My Employer Accept an Online Sick Note?
Yes. The doctor’s certificate is the proof required by section 5 (1) of the German Continued Remuneration Act, and it is as valid as one from any doctor’s practice. You receive it as a PDF and submit it to your employer yourself. It states the start and the expected duration, but no diagnosis.
One difference from a GP practice is worth knowing: panel doctors report the sick note electronically to the health insurer, and the employer retrieves it there. The doctors working for Heute Krank are private doctors, and this electronic route is not open to them. What counts is therefore the document you submit. If your HR department finds nothing in the electronic retrieval, that is not a flaw in the certificate.
How Does the Sick Note Reach My Health Insurer?
People with statutory insurance receive a second copy for their health insurer. Submit it within one week, most easily via your insurer’s app or online portal. The insurer then confirms to your employer that proof has been provided.
For continued pay during the first six weeks, only the proof to your employer matters. The health insurer becomes relevant once you are ill for longer and draw sick pay; for longer illnesses you belong in ongoing medical care anyway.
Privately insured patients only submit the invoice to their insurer.
What Does an Online Sick Note Cost, and Does Insurance Pay?
With Heute Krank the consultation usually costs €49.99, including the certificate and the doctor’s letter. Billing follows the German scale of fees for doctors (GOÄ); you receive an invoice listing the individual fee items.
The doctors working for Heute Krank are private doctors, so you pay for the consultation yourself; statutory health insurance does not reimburse. Privately insured patients and civil servants with Beihilfe submit the invoice and are usually reimbursed.
For people with statutory insurance a video consultation is free only with panel doctors, for example via their insurer’s app. For that you usually need an account and your health card.
How Long Can I Be Signed Off Online, and Can It Be Backdated?
The doctor sets the duration individually with you in the consultation, depending on what is medically justified.
A backdated start is possible too: if you have already been ill, for example since the weekend, the certificate can run from the actual start. The German incapacity guideline generally provides for up to three days.
If you are still ill afterwards, simply book another appointment. The doctor reassesses the course in the consultation and, if it is medically justified, issues a further certificate.
For Which Symptoms Is a Video Consultation the Right Route?
For acute symptoms that can be assessed in a conversation, for example:
- Cold, Flu and CoughSore throat, runny nose, cough, fatigue without shortness of breath.
- Stomach and Bowel IssuesNausea, diarrhoea, vomiting without blood and without severe pain.
- Headache and MigraineFamiliar headache or migraine following your usual pattern.
- Stress and ExhaustionOverload, sleep problems, restlessness, acute emotional strain.
- Back and Neck PainTension or lumbago without numbness and without paralysis.
- Bladder Infection, UTIBurning when passing urine, frequent urge to urinate, without fever.
- Period and Cycle PainPeriod pain within the range you know.
If your concern is not listed, raise it in the appointment; the doctor assesses every case individually.
Warning signs cannot be dealt with remotely: in case of shortness of breath, pain or pressure in the chest, paralysis, speech problems, heavy bleeding or clouded consciousness, call 112.
Online, by Phone or at the Practice: Which Routes Are There?
Anyone who needs a sick note has four routes with very different requirements. The fifth is not one.
| Route | Cost | Appointment | What you need | Proof for your employer |
|---|---|---|---|---|
| GP practice | Cost: free with statutory insurance | Appointment: depends on opening hours and free slots | What you need: health card and a trip to the practice | Proof for your employer: electronically via the health insurer |
| By phone (GP) | Cost: free with statutory insurance | Appointment: during the practice’s consulting hours | What you need: a practice that already knows you; this route is due to be abolished | Proof for your employer: electronically via the health insurer |
| Video consultation with a panel doctor | Cost: free with statutory insurance | Appointment: depends on provider and demand | What you need: usually an app and an account, plus your health card | Proof for your employer: electronically via the health insurer |
| Private video consultation (Heute Krank) | Cost: €49.99, paid by you | Appointment: usually within 30 minutes, daily until 10 pm | What you need: phone or computer with camera, no app | Proof for your employer: PDF that you submit yourself |
| Online questionnaire without a doctor | Cost: around 20 to 30 euros | Appointment: none | What you need: only a form | Proof for your employer: no evidential value in court, risk of dismissal |
On the state of the reform: on 2 July 2026 the governing coalition agreed to abolish the telephone sick note and to require the certificate from the first day of illness. There is no law yet; until then today’s rules apply. Sick notes by video are not affected by the plans.
Does It Work Without a Doctor, and How Do I Recognise a Reputable Offer?
It does not work without speaking to a doctor. Providers who issue a certificate purely on the basis of a completed online questionnaire expose you to a real risk: the Landesarbeitsgericht Hamm (regional labour court) upheld the summary dismissal of an employee who had submitted such a certificate (judgment of 5 September 2025, case no. 14 SLa 145/25). The Landgericht Köln (regional court) held that a diagnosis made purely by questionnaire does not meet the professional standard (judgment of 29 April 2026).
You can recognise a reputable offer by three points:
- A doctor sees you and asks you questions in a video consultation before anything is issued.
- The doctor is licensed in Germany, and the website carries a complete German legal notice.
- With self-pay offers, the invoice lists medical services under the German scale of fees for doctors (GOÄ).
Several medical associations now keep warning lists of names that appear on online certificates without those doctors existing.
Quick Answers
Do I Need an App?
No. The consultation runs in your browser, without an app.
Does It Work in the Evening and at the Weekend?
Yes. Appointments are available daily until 10 pm, at the weekend too.
What Happens if the Doctor Does Not Issue a Sick Note?
Whether a sick note is medically justifiable is assessed by the doctor together with you in the consultation. In rare cases this individual assessment means that no sick note can be issued. We then refund your advance payment in full; you still receive the medical advice on your symptoms together with the doctor’s letter.
Can I Cancel the Appointment?
Cancel or reschedule free of charge until the appointment starts, via the link in your confirmation. The fee goes back to your payment method in full.
This text is general information and does not replace medical advice in an individual case. In case of acute danger call112; outside consulting hours the German on-call medical service is available on 116117.