The German Sick Note

What is a certificate of incapacity for work?

The Arbeitsunfaehigkeitsbescheinigung, AU for short, is the medical proof that illness prevents you from doing your work. It is not a verdict on your health in general but a statement about your particular job: the same illness can be unproblematic in an office and a reason to stay away on a building site.

In everyday German it is called Krankschreibung, gelber Schein or Krankenschein. Legally it is the evidence with which you show your employer that you are entitled to continued pay (section 5 of the Continued Remuneration Act).

What does the certificate say?

Every certificate of incapacity for work carries your name and date of birth, the day on which the incapacity was established, when it began, how long it is expected to last, and whether it is a first or a follow-up certificate. Added to that are the issuing doctor with address, the date, and a signature or stamp.

The issuer is the decisive part. What matters for the evidential value is not which form was used but that it is clear which doctor established the incapacity for work, and when.

Does my employer see the diagnosis?

No. The copy intended for the employer carries no diagnosis and no diagnostic code. Your employer only learns that incapacity for work exists and how long it is expected to last. What you are ill with is none of their business, and you do not have to tell them even if asked.

The diagnosis appears only on the copy for your health insurer, which is covered by the relationship of trust with the fund and by medical confidentiality. Anyone telling you otherwise is confusing the copies.

Who receives which copy?

For people with statutory insurance this has been largely digital since January 2023: the practice transmits the finding electronically to your health insurer, and your employer retrieves the data there. That is the electronic certificate of incapacity for work, eAU for short. You additionally receive a printout for your own records.

Important: retrieval does not release you from reporting in. You have to tell your employer without delay that you are unable to work and how long it is likely to last. Only the proof runs through the insurer; the notification still runs through you.

Privately insured patients and patients of a private practice, by contrast, receive the certificate directly on paper or as a PDF and submit it themselves. There is no electronic retrieval procedure there.

Can a private doctor sign off someone with statutory insurance? What applies then →

From when do you need it?

By law the certificate has to be presented at the latest on the working day following the third day of illness. Your employer may, however, require it earlier, even from the first day, and needs no particular reason for that (section 5 (1) sentence 3 of the Continued Remuneration Act). Many employment contracts and works agreements provide for this expressly, so it is worth looking at your own contract.

On 2 July 2026 the coalition committee agreed to require the proof from the first day of illness in general in future. There is no law on it yet, so for now the existing rules stand.

Can it be issued retrospectively?

As a rule, no. A doctor may only certify what has actually been established, and what can be established is today's condition, not the day before yesterday's. Backdated certificates are provided for only exceptionally and only for a few days, and they require that the condition can be traced medically.

Anyone promising a certificate for a past period without having seen the patient is operating outside what is medically defensible. That is not an advantage for you but a risk: such a certificate is open to attack in a dispute.

Can you get one without visiting a practice?

Yes, if a genuine medical consultation takes place. The video consultation is the recognised route for that: the doctor sees you, can assess your general condition, ask targeted questions and, for example, have you show a temperature reading. The Arbeitsgericht Erfurt gave a private certificate issued this way full evidential value (judgment of 19 July 2023, case no. 4 Ca 32/23).

With us, a doctor licensed in Germany holds this consultation, daily from 9 am to 10 pm. If incapacity for work is medically justifiable, you receive the certificate as a PDF; the doctor sets the duration individually, and a backdated start is possible. The consultation usually costs €49.99 and is billed privately under the German scale of fees for doctors.