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October 21, 2026 · 5 min read
Sick notes by video or phone: what is allowed in Germany
Up to three days for new patients, up to seven for known ones: the rules for getting signed off sick without visiting a practice, why an online questionnaire is not enough, and what you need to tell your employer.
In short
A doctor may sign you off sick by video consultation if your illness allows it: for up to 3 calendar days if you are new to the practice, and up to 7 days if you have been treated there in person before [1]. By phone, a sick note of up to 5 days is possible, but only for known patients with mild symptoms [1]. A certificate based only on an online questionnaire, without contact with a doctor, is not permitted.
Travelling to a busy practice with a fever and a sore throat just to get a sick note is not necessary. For some years now, doctors in Germany have been allowed to certify incapacity for work by video or phone. The rules are set out in the incapacity for work guideline (Arbeitsunfähigkeits-Richtlinie) of the Federal Joint Committee (G-BA).
What are the ways to get a sick note?
You can get a sick note (Krankschreibung) at a practice visit, by video consultation or, under certain conditions, by phone. In every case, a doctor must examine you, either in person at the practice or remotely by video or after a phone conversation [1]. The options differ mainly in how long the first sick note may last.
| Criterion | Practice visit | Video consultation | Phone | Online questionnaire |
|---|---|---|---|---|
| Who for | everyone | everyone, if the illness allows it | known patients with mild symptoms only | not permitted |
| First sick note | at the doctor's discretion | up to 3 days (new), up to 7 days (known) | up to 5 days | none |
| Extension | yes | only after a previous examination at the practice | only after a previous examination at the practice | none |
There is no entitlement to a sick note by video or phone [1]. If the doctor cannot assess your symptoms reliably this way, they will ask you to come to the practice.
How long can a sick note by video last?
How long a sick note by video may last depends on whether the practice already knows you. If you are new, the first certificate may cover a maximum of 3 calendar days. If you have been treated in person before by the practice or by another doctor in the same group practice (Berufsausübungsgemeinschaft), up to 7 calendar days are possible [1].
At avi, you count as a known patient if you have been treated in person at an avi practice in the same city within the last three quarters.
An extension by video, known as a follow-up certificate (Folgebescheinigung), is only possible if you have already been examined in person and signed off sick at the practice for the same illness [1] [2]. If you are new and remain ill for longer, you will need to come to the practice for the extension.
Before the consultation, the practice must confirm your identity [1]. Have your health insurance card ready. The doctor will also explain that an examination by video is only possible to a limited extent.
How a sick note by video works
Book an appointment
Book a video consultation online, ideally on the first day of your illness.
Prepare
Have your health insurance card ready and note briefly which symptoms you have had since when and which medication you take.
Video consultation
The doctor asks about your symptoms, sees you on camera and decides whether a sick note by video is possible.
Receive your certificate
The practice sends the sick note electronically to your health insurer. Your employer retrieves it from there.
When is a sick note by phone possible?
A doctor may only sign you off sick by phone if the practice already knows you, your symptoms are not severe and a video consultation is not possible. The first certificate then lasts a maximum of 5 calendar days [1] [3]. For an extension, you usually have to come to the practice. Only if the first sick note was based on an examination in person can the extension also be done by phone [3].
The German government plans to abolish sick notes by phone and to make a sick note mandatory from the first day of illness. The coalition committee decided this in July 2026 [4]. There is no law on this yet, so the current rules still apply. According to current plans, sick notes by video are not affected.
Is a sick note from an online questionnaire valid?
No. A sick note requires a doctor to examine you, in person, by video or by phone [1]. Certificates based only on a completed online questionnaire do not meet this requirement.
Submitting such a certificate to your employer is risky. In 2025, the Regional Labour Court of Hamm upheld the dismissal without notice of an employee who had bought a sick note online for a fee, issued solely on the basis of a questionnaire [5]. If you use an online service, make sure that you actually speak to a doctor.
What do you need to tell your employer?
You must tell your employer without delay that you are ill and how long you expect to be off work. This applies whether you are signed off sick at the practice, by video or by phone [6].
If your incapacity for work lasts longer than three calendar days, you must have it certified by a doctor by the following working day at the latest. Your employer may also ask for this earlier [6]. If your employment contract requires a certificate from the first day, that applies.
If you have statutory health insurance, you no longer need to submit the certificate yourself. Since 2023, the practice has sent the electronic certificate of incapacity for work (eAU) to your health insurer, and your employer retrieves it from there [2] [7]. You can get a printout for your records on request. For people with private insurance, mini-jobs in private households and sick notes from abroad, the paper certificate still applies [7].
When not to wait for a video consultation
If someone is unconscious or has severe shortness of breath, severe chest pain, heavy bleeding or signs of a stroke, call 112 immediately [8]. If you need medical help outside practice hours that cannot wait until the next day, the medical on-call service is available around the clock on 116117 (in German) [8].
Frequently asked questions
Yes. A sick note from a video consultation is a regular medical certificate and is transmitted in exactly the same way as after a practice visit [1] [2].
For people with statutory health insurance, video consultations are covered by their insurer. People with private insurance receive an invoice under the medical fee schedule (GOÄ).
Only in exceptional cases and usually for a maximum of 3 days [1]. So get in touch on the first day of your illness if possible.
Yes. The certificate that parents need for child sickness benefit (Kinderkrankengeld) is permanently available by video or phone if the practice knows the child [9]. Child sickness benefit applies to children under 12 [10].
Mainly mild symptoms that are easy to assess, such as a cold, a stomach bug or a migraine. The doctor decides in each case whether an examination by video is sufficient.
Sources
- Federal Joint Committee (G-BA): Arbeitsunfähigkeits-Richtlinie, § 4 (5) and (5a), § 5 (3) (in force since 21.02.2024). (accessed 19.10.2026)
- National Association of Statutory Health Insurance Physicians (KBV): Arbeitsunfähigkeit (as of 29.07.2026). (accessed 19.10.2026)
- Federal Joint Committee (G-BA): Sick notes by phone possible again to relieve practices and patients (07.12.2023). (accessed 19.10.2026)
- German Federal Government: Ein Programm für Aufschwung und Beschäftigung, results of the coalition committee (02.07.2026), item 11. (accessed 19.10.2026)
- Regional Labour Court of Hamm: judgment of 05.09.2025, 14 SLa 145/25. (accessed 19.10.2026)
- Federal Ministry of Justice: § 5 Entgeltfortzahlungsgesetz, notification and evidence obligations. (accessed 19.10.2026)
- National Association of Statutory Health Insurance Physicians (KBV): PraxisInfo electronic certificate of incapacity for work (January 2025). (accessed 19.10.2026)
- National Association of Statutory Health Insurance Physicians (KBV): The medical on-call service. (accessed 19.10.2026)
- Association of Statutory Health Insurance Physicians Baden-Württemberg: Child sick notes permanently possible by video and phone (25.07.2024). (accessed 19.10.2026)
- Federal Ministry of Justice: § 45 SGB V, sickness benefit when a child is ill. (accessed 19.10.2026)
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