How long does the employer pay during illness?

Up to six weeks, that is 42 calendar days, where the incapacity is through no fault of the employee and after four weeks of service. After that the health insurer pays sick pay.

What happens if I am off sick repeatedly for the same reason?

A fresh six-week entitlement only arises once there has been no incapacity due to this illness for six months, or twelve months have passed since the first incapacity. Otherwise the health insurer pays from day one.

Do I lose my leave if I fall ill during it?

No. Certified days of illness are not counted against the annual leave under section 9 BUrlG. They come back onto the account, but they do not automatically extend the current holiday.

From when do I need a medical certificate?

By law from the fourth calendar day (section 5(1) EFZG). The employer may, however, require proof from the first day without having to justify it. Many businesses settle this in the employment contract or in a works agreement.

Do days of illness count as working time in the hours account?

No working hours accrue. So that the days do not accumulate as negative hours, the target time for those days has to be dropped. In a time tracking system, illness therefore belongs in as an absence type and not as a zero-hour day.

Continued pay in case of illness

Six weeks of pay in case of illness, and what comes after

In shortIn case of incapacity for work through no fault of the employee, the business continues to pay the full remuneration for up to six weeks under section 3 EFZG, that is 42 calendar days. After that the health insurer pays sick pay. For the same illness, a fresh entitlement only arises after six months without incapacity or twelve months after the first one.

As of: September 20262 min readSections 3, 4 and 5 EFZG · Section 9 BUrlG

Contents

Six weeks, and in calendar days
The same illness a second time
Sick pay from week seven
Ill during leave, proof, child sick

Six weeks, and in calendar days

The entitlement exists under section 3(1) EFZG where the incapacity is through no fault of the employee and is the sole cause of the loss of work. 42 calendar days are counted, including weekends and public holidays, not 42 working days.

It requires an uninterrupted employment relationship of four weeks (section 3(3) EFZG). Anyone falling ill before that receives sick pay from the outset.

What has to be paid on is the remuneration that would have accrued without the loss of work (section 4(1) EFZG), including premiums for work that would actually have arisen. Pay for overtime is left out of account.

The same illness a second time

This is where the mistake most commonly made in payroll lies. A fresh entitlement to six weeks arises for the same illness only under one of two conditions, and the two periods start from different events.

Period	Expires	Meaning
Six months	the end of the last incapacity due to this illness	During those six months there must have been no incapacity due to the same illness.
Twelve months	the start of the first incapacity due to this illness	Once it has elapsed, a fresh entitlement arises, even if there was incapacity in between.
A new, unrelated illness	sofort	Its own entitlement of six weeks, even immediately afterwards. Where they occur at the same time, there is still only one period.

As of 15/09/2026, section 3(1) sentence 2 EFZG. Whether two illnesses are the same one is a medical question and not one for the HR department.

Six months
Expires
the end of the last incapacity due to this illness
Meaning
During those six months there must have been no incapacity due to the same illness.
Twelve months
Expires
the start of the first incapacity due to this illness
Meaning
Once it has elapsed, a fresh entitlement arises, even if there was incapacity in between.
A new, unrelated illness
Expires
sofort
Meaning
Its own entitlement of six weeks, even immediately afterwards. Where they occur at the same time, there is still only one period.

As of 15/09/2026, section 3(1) sentence 2 EFZG. Whether two illnesses are the same one is a medical question and not one for the HR department.

Sick pay from week seven

After the six weeks, the statutory health insurer pays sick pay: 70 percent of gross pay, at most 90 percent of net pay, capped by the contribution assessment ceiling. Contributions to pension, unemployment and long-term care insurance come off that.

For the same illness, the entitlement runs for up to 78 weeks within three years, including the six weeks of continued pay.

Ill during leave, proof, child sick

Anyone falling ill during leave gets the certified days of illness back on the leave account under section 9 BUrlG. A medical certificate is required; the leave is not automatically extended, and the days have to be requested anew.

Incapacity for work has to be reported without delay. Under section 5 EFZG, proof is due from the fourth calendar day, but the business can require it from the first day. Since 2023 people with statutory health insurance report electronically, and the business retrieves the certificate from the insurer.

For caring for a sick child it is not the EFZG that applies but section 45 SGB V: child sickness benefit from the insurer, with its own number of days per child and parent.

Further reading:Sections 3, 4 and 5 EFZGSection 9 BUrlGSections 45 and 48 SGB V

This is not legal advice; for a specific case at your workplace you are better off asking someone qualified to give it.

Published by: AMNAU GmbH

Editorial responsibility: Ugur Aydogan, Product development.

Last reviewed: 15 September 2026

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