Can your employer require a sick note from the first day?

Why does the three-day rule have exceptions?

§ 5 paragraph 1 EFZG first sets out the general threshold of incapacity lasting more than three calendar days. Immediately afterwards, it expressly allows employers to require the medical certificate at an earlier point. Looking only at the general threshold therefore overlooks an essential part of the same legal rule. Before arranging your appointment, check whether an earlier evidence requirement already applies to you.

Consult the information your employer has given you about the procedure for reporting sickness absence. If anything is unclear, ask which deadline and submission method are expected in your case. Note the answer, date and responsible contact person for your own records and future reference. This helps you prepare the medical consultation and the subsequent submission of your certificate more precisely.

What should you do first on your first sick day?

Tell your employer that you cannot work and how long you expect this to last as soon as possible. § 5 paragraph 1 EFZG requires prompt notification regardless of any earlier requirement to provide a medical certificate. If relevant, explain that you are arranging the required examination and the subsequent medical evidence. This message does not replace a certificate, but already informs your employer about your expected absence.

Then arrange a medical consultation suited to your symptoms and the examination that may be necessary. Our service is only suitable for adults with symptoms that can be assessed adequately by video. An urgent workplace deadline does not guarantee that a video consultation will be medically sufficient. Tell the doctor honestly when your symptoms started and what work you currently carry out.

Is electronic notification enough or do you need a PDF?

Subject to its conditions, § 5 paragraph 1a EFZG simplifies submission of evidence for people with statutory health insurance. Timely medical assessment and your own notification to your employer remain necessary under these arrangements. The paragraph also contains exceptions, including assessments by doctors outside the statutory insurance care system. The type of care therefore also affects how you actually pass on your medical evidence.

With our service, you receive a PDF in your patient account after incapacity for work is established. Electronic certification (elektronische Arbeitsunfähigkeitsbescheinigung, eAU) and transmission to your health insurance fund are expressly excluded. Ask the responsible department at work in good time who should receive the PDF file. Check its dates before sending it to avoid questions caused by selecting the wrong period.

What if you can only get a later appointment?

Our service allows exceptional backdating after medical assessment but does not guarantee appointment availability. The start may exceptionally be backdated by up to three days if the medical assessment supports this. Tell your employer about appointment difficulties early and agree how you should proceed from there. Keep records of your contact attempts without assuming they automatically release you from evidence requirements.

For statutory insurance care, § 5 paragraph 3 Arbeitsunfähigkeits-Richtlinie provides a narrowly defined exception allowing backdating after careful assessment. It generally permits no more than three days and does not create an entitlement to backdating. For our private medical treatment, this backdating rule serves as guidance for the individual medical decision. The relevant guideline is dated 14 November 2013, amended 7 December 2023, effective since 21 February 2024.

For urgent symptoms outside normal opening hours, the medical on-call service on 116117 helps you access appropriate medical care. Use this route according to medical urgency and describe your symptoms as accurately as possible. A general article cannot resolve an employment dispute concerning deadlines you may have missed. For a specific disagreement, seek support that takes your records and the actual sequence of events into account.

What do you need to tell your employer?

Notify your employer without delay that you cannot work and how long you expect the absence to last. This legal duty to notify follows from § 5 paragraph 1 EFZG, the German continued remuneration law (Entgeltfortzahlungsgesetz, EFZG). Where possible, send your notification before waiting for the video consultation to finish. If unsure, ask which reporting channel to use and who handles sickness notifications at work.

Keep your sickness notification separate from the medical evidence covering the period certified by the doctor. With this service, you receive a PDF for your employer after the doctor establishes incapacity for work. You submit it yourself; there is no electronic transmission to your health insurance fund here. Our terms of service explain this service limit alongside the procedure for the private medical consultation.

Before sending the certificate, check the recipient, your name and the period stated on it. Store your own copy and confirmation of submission somewhere protected for your personal records. If questions arise, you can then find and identify the documents you actually submitted more easily.

What are the limits and fees of this service?

Our service is for adults aged 18 and over whose symptoms can be assessed adequately by video. Generally accepted professional standards must allow your treatment without an in-person medical consultation. The certificate usually starts on the day of your video consultation. After careful medical assessment, the doctor may exceptionally backdate its start by up to three days. The doctor must also be able to establish your incapacity for work during that earlier period. There is no entitlement to backdating. The certificate still covers no more than three calendar days, including any backdated days. This service does not extend an existing certificate by video. Contact us on your first day of illness whenever possible. Further details are set out in our terms of service.

According to our service, a base consultation fee of €10.72 is reserved before the appointment. If a medically necessary visual examination is actually performed, the fee totals €21.44 plus applicable surcharges. The fee remains payable even if the medical assessment does not result in a certificate. Before booking, read the full pricing information carefully, including details of any possible surcharges.

People with statutory health insurance pay themselves; reimbursement by private insurance depends on their policy terms. Our terms of service do not guarantee reimbursement or acceptance of the certificate by your employer. Have your identity document and a device with a camera and microphone ready for the consultation. Check your internet connection and choose somewhere you can speak without being disturbed by others.

Where can you find further answers?

These related guides provide further information about the next steps in reporting your sickness absence:

• How should you notify your employer about sick leave?
• How can you get a sick note at weekends or on holidays?
• When is a backdated sick note possible in Germany?
• What is the difference between eAU and a PDF sick note?

Editorial team Krankschreibung per Video, Drylabs GmbH

Updated: 26 October 2026