Sick note (AU) online

The certificate of incapacity for work (AU) confirms that you are temporarily unable to work for health reasons. For many acute complaints such as a common cold, gastrointestinal infection or migraine, the medical assessment can take place via video consultation. Following the doctor's assessment, the sick note can be issued online.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

A certificate of incapacity for work (AU), colloquially known as a sick note, confirms that you are temporarily unable to carry out your work for health reasons. Remote medical treatment is generally permitted in Germany; following the doctor's assessment, an AU can therefore also be issued during a video consultation. The prerequisite is that your complaints can be assessed with sufficient certainty via video. During the video consultation, the doctor takes your medical history, asks specifically about the nature, onset and course of your symptoms, and then decides whether incapacity for work exists and for what period it can be certified. There is no entitlement to a sick note; the decision always lies within the doctor's discretion. OpenClinic24 is aimed at privately insured patients and self-payers; billing is carried out as a private service in accordance with the German medical fee schedule for physicians (GOÄ). After the appointment, you receive the certificate as a document that you can present to your employer.

Common causes

The most common reasons for a sick note are acute illnesses that usually resolve on their own. These include respiratory infections such as common colds with cough, runny nose, sore throat and fever, as well as flu-like infections. Gastrointestinal infections with nausea, vomiting or diarrhoea are also frequent and can justify short-term incapacity for work. Headaches and migraine attacks often considerably impair concentration and the ability to work. Acute back pain and muscle tension, for example after physical strain, are also among the common reasons. In addition, pronounced exhaustion, sleep disturbances or acute stress reactions can make a temporary break from work medically advisable. Whether and for how long incapacity for work exists depends not only on the diagnosis but also on your occupation: a febrile infection affects physical work differently than office work.

When to see a doctor

Visit a practice promptly if a fever above 39 °C lasts longer than three days, if complaints worsen despite rest, or if there is no improvement after one week. A physical examination should also take place in the case of severe, clearly localised pain, bloody sputum, bloody diarrhoea, signs of dehydration (for example markedly reduced urine output) or recurring infections. In these cases, a video consultation does not replace an in-person examination. Call the emergency number 112 immediately if warning signs occur such as chest pain or tightness in the chest, acute shortness of breath, high fever with neck stiffness, sudden paralysis, speech or vision disturbances, very severe headaches unlike any experienced before, or impaired consciousness. These symptoms can indicate life-threatening conditions and belong in emergency care, not in a video consultation.

Symptoms & Indications

Cold symptoms with cough and runny nose Fever and general fatigue Sore throat and difficulty swallowing Gastrointestinal complaints with nausea, vomiting or diarrhoea Headaches or migraine attacks Acute back pain or muscle tension Pronounced exhaustion and acute stress Severe menstrual pain

Treatment Options

Medical video consultation to assess incapacity for work
Physical rest and sufficient sleep
Adequate fluid intake, especially with fever or diarrhoea
Symptomatic measures such as inhalation, gargling or heat application
Following the doctor's assessment: over-the-counter pain and fever medication (analgesics, antipyretics)
If needed, a private prescription following the doctor's assessment
Medical follow-up if there is no improvement

Important Notes

A sick note via video is only possible if your complaints can be assessed with sufficient certainty during the consultation. If a physical examination is required, you will be advised to visit a practice.
There is no entitlement to a sick note; the decision always lies within the doctor's discretion.
Backdated certificates are only possible in narrowly defined exceptional cases. Please book a consultation on the first day of illness if possible.
In the event of warning signs such as chest pain, acute shortness of breath, paralysis, speech disturbances or impaired consciousness, call the emergency number 112 immediately.

HOW IT WORKS

How OpenClinic24 works

STEP 01

Complete the questionnaire

Brief details about your symptoms

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STEP 02

Doctor connects with you

Video consultation within minutes

STEP 03

Receive your documents

Prescription, sick note or referral, digitally

Estimated wait

…

Online consultation

Video consultation with licensed doctors.

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Is a sick note issued online valid?

Yes. A certificate of incapacity for work issued during a video consultation is a regular medical certificate. The prerequisite is that the doctor can assess your complaints with sufficient certainty via video. There is no entitlement to a sick note; the decision is always made following the doctor's assessment.

For how many days can I be signed off sick online?

The duration depends on the nature and severity of your complaints and is usually a few days for an initial video assessment. If an extension is necessary, a follow-up certificate can be issued after a renewed medical assessment. If complaints persist or worsen, you may be advised to have an in-person examination.

How much does the online sick note cost and will my insurance cover it?

The video consultation is billed as a private service in accordance with the German medical fee schedule for physicians (GOÄ). You receive a transparent invoice, which you can usually submit to a private health insurer for reimbursement; your individual tariff is decisive. Self-payers bear the costs themselves. The issuing of the certificate is also billed according to the GOÄ.

Can a sick note be issued retroactively?

A backdated certificate is only possible in narrowly defined exceptional cases and lies within the doctor's discretion. Therefore, please book a video consultation on the first day of illness if possible. This allows the incapacity for work to be documented from the day of the medical assessment.

What happens if my complaints cannot be assessed via video?

If your complaints cannot be assessed with sufficient certainty via video, or if a physical examination is required, the doctor will advise you to visit a practice. In the event of warning signs such as chest pain, acute shortness of breath or impaired consciousness, call the emergency number 112 immediately.