Sick pay: from when you get it and how to apply for it

On a certificate of incapacity for work from the doctor there is a ballpoint pen

As a student, on the other hand, you do not usually receive sick pay – even if you work a little while studying, without paying insurance contributions. This doesn’t turn around until you put more emphasis on work than study for a longer period of time. This means that if your job is your main occupation, you are insured and receive sickness benefits. The important question is usually: do you work more than 20 hours in a typical week?

You do not receive sick pay in the event of an accident at work or an occupational illness. In these cases, the accident insurance fund or the employers’ liability insurance association is responsible instead.

When am I entitled to sick pay as an employee??

As soon as your doctor has certified that you are unable to work, you are entitled to sickness benefit. This also applies from the first day of an inpatient stay in a hospital or in a preventive or rehabilitation facility of the health insurance company. Under certain conditions, sick pay is also paid if you are caring for a sick child.

The most Employee are, however, entitled to continued payment of wages by their employer during the first six weeks of illness. Only from the seventh week, the health insurance then steps in and pays sick pay.

The sick note from your doctor is usually called a "certificate" or "yellow slip This is called a "certificate of incapacity for work". You must

  • Inform your employer immediately that you are ill. As soon as you are ill for more than three days at a time, the medical certificate must also be submitted to the employer. This must be submitted on the fourth day at the latest. The employer may require it earlier.
  • submit it to your health insurance company within one week of the start of your incapacity for work – you are still responsible for this yourself, your employer will not do it for you.
  • also with each extension of the incapacity for work both your employer and the health insurance company by follow-up attestation prove that you are still ill.

The electronic certificate of incapacity for work (eAU) will be gradually introduced for people with statutory health insurance from 2021 onwards. The attending physician then transmits the certificate digitally to the health insurance company. For medical practices, however, electronic transmission is not required until 1. October 2021 obligatory. If you are on sick leave, check with your doctor to see if the certificate can be sent digitally. If it is not yet possible, you are responsible for sending it to the health insurance company yourself.

Attention: For privately insured persons, however, everything remains as usual.

New sick note via video

Since October 2020, doctors have also been able to issue sick notes to their patients in a video consultation session. The corresponding guideline was adapted accordingly by the Federal Joint Committee (G-BA).

Requirements of the certificate of incapacity for work by video:

  • It is only possible in the case of patients who are in the practice already known from previous treatments Are and for which an incapacity for work can be assessed with sufficient certainty via video transmission.
  • A Initial certificate can be sent by video for a maximum of seven days be issued. After that, the patient must visit the doctor’s office if he continues to be sick.
  • Follow-up certificates Can be done by video only if they have visited the practice beforehand issued by a doctor with a personal examination has determined incapacity for work due to the same illness.
  • The patient must also before the video consultation be informed about the limited possibilities for findings in this way.

Patients are not entitled to sick leave in a video consultation: the doctor decides whether to issue an AU certificate even after an online visit in certain cases.

As a general rule, if it is not possible to make a sufficiently reliable assessment of your incapacity for work by video consultation, you must be examined in person at the doctor’s office.

In addition, the incapacity for work may not be issued exclusively on the basis of, for example, an online questionnaire, a chat survey or a telephone call.

Are self-employed persons also entitled to sickness benefit??

For self-employed persons there is no legal entitlement to sick pay. However, you have three different options to ensure that you are still covered in the event of illness:

  1. make a declaration of choice to the health insurance company and pay a higher contribution in the statutory health insurance, which also includes the entitlement to payment of sick pay.
  2. You take out an optional tariff for sick pay with the statutory health insurance company.
  3. Alternatively, you can take out a private daily sickness benefit insurance policy.

How much sick pay is paid?

Sick pay is paid for each calendar day you are on sick leave. It is based on the amount of your regular income:

  • Sick pay is 70 percent of gross income, but not more than 90 percent of net income.
  • One-time payments such as Christmas bonuses are taken into account.
  • Sickness benefit is limited to a maximum statutory amount of 112.88 euros per day (value for the year 2021).

Contributions to pension, unemployment and long-term care insurance are still deducted from the sick pay. You do not have to pay health insurance contributions if you receive sick pay.

For most people, this means that you will have slightly less money available with sick pay than while you are working.

If you are unable to work for several months and have to pay a large amount for medication and aids yourself or have to modify your home because of the illness, things can get tight financially. Additional protection against this risk is offered by some occupational disability insurances, which also pay in the case of longer incapacity to work. If you are looking for an appropriate insurance, you can pay attention to this clause. The insurance company then usually steps in after six months of illness and pays a pension over a longer period of time.

How long the sick pay is paid?

Insured persons receive sickness benefit for the same illness for a maximum of 78 weeks within each three-year period. This is calculated from the day on which the incapacity for work began. The period of continued payment by the employer is included in the calculation.

You will only receive continuous sickness benefit if your doctor writes that you are incapable of work without interruption. Retroactive sick leave is not possible.

This means that you must return to your doctor no later than the working day after which the sick note expires! If the certificate of incapacity for work ends on a Friday, it is sufficient if further sick leave is taken on the following Monday.

What happens if I do not submit a certificate in time?

If you are ill for a longer period of time, you must regularly obtain new certificates from your doctor and send them to the health insurance company and your employer. If you do not do this, there may be gaps in sick pay. The insurance companies do not pay as soon as a valid certificate is no longer available.

In the event that the employment relationship ends during a sick leave, one now has one month from the end of the last certified incapacity to work to submit a follow-up certificate. Here, too, the entitlement to sick pay is suspended until a corresponding medical certificate is submitted.

If you are a few days late with a follow-up certificate, you lose some money this way. Sickness benefit entitlement is suspended for this period. If the health insurance company then receives a certificate again, it will continue the payments.

On the other hand, it can be worse if the gap is due to of the same Illness lasts longer than one month. If you take more time to submit a new medical certificate to the health insurance company, you risk your insurance coverage being!

You should therefore avoid any gaps and forward the follow-up certificate to the health insurance fund immediately after the end of the last sickness certificate.

Can I go on vacation if I receive sickness benefit?

For travel within Germany no agreement of the health insurance company is necessary. You also do not have to inform the health insurance company about such a trip. You only have to attend medical treatments and examinations. If no treatment is planned during the time of the trip, you can travel within the country without any problems.

The situation is different for trips abroad. In principle, the entitlement to sick pay is suspended abroad. You can usually avoid this by getting approval from your health insurance company before traveling abroad. We have compiled more about this in a separate article.

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