Sick note online: by video, private, as a PDF

An online sick note is a certificate of incapacity for work (Arbeitsunfähigkeitsbescheinigung, AU) issued after a medical video consultation. The legal basis is the incapacity directive (AU-Richtlinie) of the Federal Joint Committee (G-BA): doctors may determine incapacity for work by video if the symptoms can be assessed with sufficient certainty during the call.

At OpenClinic24 the sick note is private (privatärztlich). You receive a medical certificate as a PDF that you present to your employer. No electronic certificate (eAU) is sent to your health insurer. The certificate is valid for at most three calendar days and usually starts on the day of the video consultation; backdating by up to three days is possible only exceptionally after medical assessment, and it cannot be extended by video.

There is no sick note without a conversation, by questionnaire only, at OpenClinic24. In 2025 the Hamm regional labour court held that a summary dismissal after a questionnaire-only certificate was justified. The video call protects you.

The video sick note suits acute, mild complaints that can be assessed in conversation and do not require a physical examination. Typical examples:

• Common cold, cough, sore throat, runny nose
• Gastrointestinal infection with nausea, vomiting or diarrhoea
• Migraine and tension headache
• Acute back pain and muscle tension
• Fever and general exhaustion
• Severe period pain

The video sick note is not suitable when an in-person examination is needed, when you have already been off work for some time and need a follow-up certificate, or when warning signs are present. The doctor will then recommend a practice, the out-of-hours service 116 117 or, in an emergency, the emergency number 112.

The whole process usually takes less than half an hour when a doctor is online. You start with “Request a sick note”, answer a few questions about your symptoms and their onset, create your patient account and reserve €10.72.

If a doctor is online you go straight into the video consultation. Otherwise you join the queue and receive the link by SMS and e-mail as soon as the consultation opens. Requests are possible around the clock; we do not promise a fixed response time.

During the call the doctor checks whether your symptoms can be assessed by video and whether you are unfit for work. If so, the certificate is issued immediately and is available as a signed PDF in your patient account. If not, you receive a recommendation on where to turn.

The G-BA incapacity directive sets out how long each route can certify. The table shows the rules and which of them OpenClinic24 offers.

The certificate shows your name, the date of issue, the period of incapacity and the details of the issuing doctor. It does not show a diagnosis. Your employer therefore only learns that you are unfit for work and for how long.

Under section 5 of the Continued Remuneration Act (Entgeltfortzahlungsgesetz, EntgFG) you must present a medical certificate to your employer by the fourth day of illness at the latest; many employment contracts require it earlier. A certificate issued by a licensed doctor carries a high evidential value. The employer can only challenge it with concrete doubts (Federal Labour Court, 5 AZR 149/21).

For patients with statutory insurance (GKV): we do not send an eAU to your insurer. Continued pay in the first six weeks is the employer’s responsibility, and the employer receives your PDF. Sickness benefit from the insurer from the seventh week requires a certification reported to the insurer; the video sick note is not intended for that. Whether employer or insurer accept the certificate is their decision; we cannot guarantee it.

You reserve €10.72 (GOÄ no. 1, factor 2.3). You are charged as soon as the consultation has started, based on the actual call. With a visual examination per GOÄ no. 5 it is €21.44. The invoice under the German medical fee schedule (Gebührenordnung für Ärzte, GOÄ) is available as a PDF in your account. In the evening (8–10 pm and 6–8 am), at night (10 pm–6 am) and on Saturdays, Sundays and public holidays the statutory GOÄ surcharge is added at the single rate (€10.49, €18.65 or €12.82); the start of the consultation counts and you see the amount before reserving.

• Statutory insurance (GKV): you pay yourself; insurers usually do not reimburse a private medical service.
• Private insurance (PKV): submit the GOÄ invoice to your insurer as usual; reimbursement depends on your tariff.
• Civil-service aid (Beihilfe): submit the invoice to your Beihilfe office.

If no sick note is issued, you are only invoiced for the medical consultation. No membership, no subscription.

A video consultation does not replace a physical examination. The doctor decides case by case whether remote treatment is medically justifiable (section 7 (4) of the model professional code, Musterberufsordnung). Not possible by video: backdated certificates, extensions beyond three days, follow-up certificates without a prior in-person examination, and certificates for children.

Call 112 immediately for chest pain, acute shortness of breath, paralysis, speech disorders, impaired consciousness or heavy bleeding. Outside practice hours the out-of-hours medical service is available on 116 117.

• G-BA incapacity directive (AU-Richtlinie): determination by video for patients not known to the practice up to 3 calendar days, for known patients up to 7; by phone for known patients up to 5; follow-up certificate by video only after a prior in-person examination; no entitlement to a certificate.
• Section 7 (4) of the model professional code (Musterberufsordnung) of the German Medical Association: exclusive remote treatment is permitted in individual cases if medically justifiable and the patient has been informed.
• Section 9 of the Health Advertising Act (Heilmittelwerbegesetz, HWG): advertising remote treatment only where recognised professional standards do not require personal contact. That is why we state for each complaint what is possible by video and what is not.
• Section 5 EntgFG and Federal Labour Court 5 AZR 149/21: duty to provide proof and evidential value of the medical certificate.
• Hamm regional labour court, 14 SLa 145/25: a questionnaire-only certificate without a conversation justified a summary dismissal.
• Sick-note reform: in 2026 the federal government announced changes (proof from the first day, end of telephone certificates). As of 22 October 2026 there is no draft bill. This page will be updated when the law changes.