Online sick note and your employer in Germany: what they see, what they must accept

What the law requires of the employer

The legal basis is short. Section 5(1) of the Continued Remuneration Act (Entgeltfortzahlungsgesetz, EntgFG) obliges employees to report incapacity without delay and, if it lasts longer than three days, to present a medical certificate by the fourth calendar day at the latest. The employer may demand it earlier. The law says nothing more: no requirement for a form of examination, no exclusion of video consultations, no distinction between statutory and private certificates.

How the doctor reaches the finding is governed by medical professional law. Since 2018, section 7(4) of the (Model) Professional Code has allowed treatment exclusively at a distance in individual cases if it is medically justifiable and due care is maintained. Section 25 requires certificates to be issued with the necessary care and to the best of the doctor’s knowledge. For statutory practices the incapacity guideline has specified since 2020 that incapacity may be established by video consultation.

So the employer has no choice. They must accept a properly issued medical certificate as proof, whether it was issued in a practice, by telephone or by video. What they may do is undermine its evidential value in the individual case with concrete reasons. That is the subject of the next section.

What the employer sees and what they do not

The certificate of incapacity (Arbeitsunfähigkeitsbescheinigung, AU) consists of several copies. The employer copy contains: name and date of birth, date of issue, the day from which incapacity was established, the expected duration, whether it is a first or follow-up certificate, and the name and address of the issuing practice or institution. It does not contain the diagnosis. That appears only on your copy and, for statutorily insured patients, on the copy for the health insurer.

The form of the doctor contact is not included either. That the finding was made by video is not noted on the certificate. The employer therefore does not recognise an online sick note from the certificate itself, at most from the issuing institution. Neither entitles them to reject it.

Item	Employer copy	Your copy
Name, date of birth	yes	yes
Start and expected duration	yes	yes
First or follow-up certificate	yes	yes
Issuing doctor	yes	yes
Diagnosis (ICD code)	no	yes
Form of contact (practice, telephone, video)	no	no

You are not obliged to tell your employer the diagnosis. If they ask, you may refuse to answer. The only exception is when the illness is relevant to occupational safety, for example an infectious disease in food processing; then the Infection Protection Act applies, not the employer’s right to ask.

Evidential value: when the employer may doubt

Under established case law a proper medical certificate has high evidential value. An employer who wants to refuse continued pay must undermine that value. Suspicion is not enough; they need actual circumstances that give rise to serious doubt about the illness.

In 2021 the Federal Labour Court (5 AZR 149/21) recognised such a circumstance: an employee had resigned and on the same day presented a certificate covering exactly the notice period. This congruence undermined the evidential value. The consequence was not that the certificate was invalid, but that the employee now had to prove the incapacity herself, for example through testimony of the treating doctor after release from confidentiality.

Other examples from the regional labour courts: a sick note announced during a dispute, leisure activities obviously incompatible with the certified illness, an unusual accumulation of certificates around bridging days, or a certificate issued without any doctor contact. The last point is decisive for online providers.

For you this means: a video sick note is no more vulnerable than one from a practice as long as the consultation took place and is documented. At OpenClinic24 every certificate is linked to a documented video consultation; in a dispute the doctor could, after your release from confidentiality, confirm that an assessment took place.

The LAG Hamm judgment of 2025: a questionnaire is not a consultation

In September 2025 the Regional Labour Court of Hamm upheld the summary dismissal of an employee (14 SLa 145/25). He had bought a sick note from a website where he merely filled in a questionnaire with preset answers. No doctor had seen or spoken to him. The court saw this as deliberate deception: the employee had created the impression of a medical contact that never took place. Such a certificate does not comply with the incapacity guideline, under which incapacity may only be established on the basis of a medical examination, in person, by telephone or by video.

The judgment is often cited as a ruling against “online sick notes”. That is imprecise. It is directed against certificates without doctor contact. The video consultation, in which a doctor sees, questions and assesses you, is exactly the contact the guideline expressly allows. The difference between the two models is the decisive point for employers and courts.

Private and as a PDF: procedural particularities

Since 2023 sick notes for statutorily insured employees have been reported electronically: the statutory practice sends the data to the health insurer and the employer retrieves it there (section 5(1a) EntgFG). This eAU procedure applies only to contracted doctors. OpenClinic24 works privately. You receive the certificate as a PDF in your patient account and submit the employer copy yourself, as privately insured people have always done and as is also intended for statutorily insured people receiving private treatment.

The employer may not reject the PDF on the grounds that it is not an eAU. The eAU is a transmission channel, not a mark of validity. What matters remains section 5(1) EntgFG: a medical certificate of incapacity and its expected duration.

We state two limits openly. First: the private certificate at OpenClinic24 covers at most three calendar days, usually starts on the day of the video consultation, is backdated only exceptionally after medical assessment and is not extended by video. Second: sick pay from statutory health insurance after six weeks requires uninterrupted findings from contracted doctors; anyone foreseeably ill for longer belongs in a practice. This plays no role for continued remuneration in the first six weeks (section 3 EntgFG), which the employer pays.

Deadlines and duties at a glance

Duty	Deadline	Legal basis
Notifying the employer	on the first day, before work starts	section 5(1) sentence 1 EntgFG
Medical certificate	by the fourth calendar day at the latest; earlier if the employer demands it	section 5(1) sentences 2 and 3 EntgFG
Follow-up certificate	before the previous one expires, by the next working day at the latest	section 5(1) sentence 4 EntgFG, Federal Social Court case law
Continued remuneration	up to six weeks per illness	section 3 EntgFG
Sick pay (statutory insurance)	from the seventh week, uninterrupted findings	sections 44 ff. SGB V

As of October 2026: the federal government has announced that it will bring the duty of proof forward to the first day and restrict sick notes by telephone; no draft bill existed at publication. We will update this table as soon as the deadlines change.

If the employer still rejects the certificate

Stay factual. Point to section 5 EntgFG and to the fact that the certificate was issued by a licensed doctor after a video consultation. Offer to present the invoice with GOÄ codes; it documents the doctor contact without stating the diagnosis. If requested, give the practice address of the doctor.

If the employer refuses continued pay, they bear the risk: in court they must undermine the evidential value. Seek advice from the works council, a trade union or a specialist employment lawyer. This article is medically reviewed information on the legal position, not legal advice in an individual case.

When to go to a practice, when to call emergency services

The video consultation is intended for short, clearly defined incapacities: a cold, gastroenteritis, a migraine attack, back pain without warning signs, an acute stress reaction. You belong in a practice if an examination is needed, if symptoms last longer than a week, if a follow-up certificate is due or if sick pay foreseeably becomes relevant. The medical on-call service is available on 116 117.

Call 112 for shortness of breath, chest pain, impaired consciousness, sudden paralysis or speech disorder, heavy bleeding or an acute mental crisis with danger to yourself or others.