Sick note for a cold online: from which day, for how long and how it works by video

A cold and the sick note: what German law requires

A cold is the most common reason for short absences in Germany, yet many people are unsure when a certificate is needed. The Continued Remuneration Act (Entgeltfortzahlungsgesetz, EntgFG) sets two duties. You must inform your employer of your incapacity without delay, meaning on the first day before work starts. And you must present a medical certificate by the fourth calendar day at the latest if the illness lasts longer than three days (section 5(1) EntgFG).

Your employer may demand the certificate earlier, even from the first day of illness. This is often written into employment or collective agreements or ordered after repeated short absences. If in doubt, ask your HR department or read your contract. Many employees therefore get a sick note from day one as a precaution, even though the law only requires it from day four.

Important: a sick note (Arbeitsunfähigkeitsbescheinigung, AU) is a medical prognosis, not a ban on working. If you feel fit again before it expires you may return to work and simply inform your employer. German law has no concept of being signed back on.

As of October 2026: the federal government has announced a reform of the notification rules, including a certificate from the first day. No draft bill existed when this article was published. We will update this section as soon as the legal position changes.

How long does a cold last, and how long are you unfit for work?

A cold, medically an acute viral rhinopharyngitis, follows a typical pattern. After one to three days of incubation it begins with a scratchy throat and sneezing, followed by a runny and blocked nose, cough and often a mild fever. Symptoms peak after two to three days and subside within seven to ten days. A dry cough can linger for up to three weeks without being a sign of anything serious.

You are not unfit for work for the whole infection, only for as long as fever, exhaustion, headache, muscle pain or heavy coughing make work impossible or you would infect others. In practice that is usually two to five days. Anyone doing physical work, handling food or working in care needs longer than someone in an office or working from home.

Phase	Timing	Typical symptoms	Fit for work?
Onset	Day 1	Scratchy throat, sneezing, chills	often yes, not with fever
Peak	Days 2 to 3	Runny nose, cough, head pressure, mild fever, exhaustion	usually no
Subsiding	Days 4 to 7	Thicker nasal discharge, cough loosens	increasingly yes
Tail	Up to day 10, cough up to 3 weeks	Dry cough, tiredness	yes

These are reference values from the literature on the course of the common cold. Your personal duration depends on the virus, your condition and your job. That is why the length of the sick note is set not by a calendar but by the doctor’s assessment in the consultation.

Sick note for a cold by video: how it works at OpenClinic24

A cold is well suited to a video consultation. The doctor sees you, hears your cough and asks about fever, duration, pre-existing conditions and your job. A physical examination rarely adds information for an uncomplicated infection, while skipping the waiting room avoids infecting others.

1. Describe your concern. Choose “sick note” and answer a few questions about symptoms, onset, fever and pre-existing conditions. This is possible around the clock.
2. Account and reservation. Create a patient account and add a payment method. €10.72 is reserved, the consultation fee under GOÄ no. 1 at factor 2.3. Nothing is charged until after the consultation.
3. Video consultation. As soon as a doctor is online, the consultation starts. Have your thermometer, medication list and questions ready.
4. Certificate as PDF. If you are unfit for work, the private certificate appears in your account: one copy for your employer without diagnosis and one for you, plus the GOÄ invoice listing every item.

The limits are clear. The certificate covers at most three calendar days and usually starts on the day of the video consultation. Backdating is possible only exceptionally after medical assessment, an extension by video is not. It is a private medical certificate as a PDF, not an electronic sick note (eAU); nothing is sent to your health insurer. Whether it is issued is decided solely by the treating doctor. There is no entitlement to a sick note, not even for a cold.

Cold, flu or something else: what the doctor looks for

Not every airway infection is a harmless cold. In the video consultation the doctor therefore clarifies three questions: does the picture fit a cold, are there signs of influenza or a bacterial complication, and are there warning signs that require an in-person examination?

Cold: gradual onset, runny nose and sore throat dominate, fever usually below 38.5 °C, general condition only moderately affected.

Influenza: sudden onset within a few hours, high fever from 38.5 °C, chills, severe headache and muscle pain, dry cough, marked weakness. Flu lasts longer and incapacity often five to seven days. For risk groups antiviral treatment can be useful if started within 48 hours; a practice is usually the right place for that.

Bacterial complications: sinusitis, tonsillitis with pus or bronchitis with a second fever peak can follow a cold. The typical sign is worsening after initial improvement. An examination of the throat, ears and lungs is then indicated.

Allergy: watery, itchy eyes, sneezing fits, clear nasal discharge without fever or muscle pain point to hay fever or a dust mite allergy rather than an infection.

What helps with a cold and what does not

There is no medicine against the viruses themselves; the body clears the cold. Treatment targets the symptoms so that you can sleep, drink and breathe. Rest, plenty of fluids, steam inhalation, decongestant nasal sprays for no more than seven days, lozenges or gargling for a sore throat and, if needed, fever-reducing painkillers such as paracetamol or ibuprofen according to the leaflet are well established.

Antibiotics do not help with a viral cold and, according to the guideline of the German College of General Practitioners, are only useful for a proven bacterial infection. Cough suppressants and expectorants have limited benefit according to the acute cough guideline; if you want to try them, do not combine them. Vitamin C and zinc shorten a cold by less than a day at most.

If you take regular medication, for example for blood pressure, blood thinning or diabetes, discuss interactions with over-the-counter cold remedies in the consultation. That is one more reason to use the video consultation not only for the certificate but also to ask what you can safely take.

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

The video consultation does not replace an in-person examination when findings need to be gathered. Go to a practice if fever lasts more than three days, with purulent sputum and breathlessness, earache with hearing loss, difficulty swallowing with pus on the tonsils, symptoms lasting longer than ten days or worsening after improvement. Pregnant women, people over 65 and people with chronic heart or lung disease, diabetes or a weakened immune system should be examined early when feverish.

Call 112 for shortness of breath, chest pain, impaired consciousness, seizures or fever with a stiff neck and rash. The medical on-call service is available nationwide on 116 117, including at night and at weekends.

Practical tips for when you are ill

Report sick on the first day before work starts, by phone or e-mail as your company requires. Note when symptoms began, your temperature readings and the medication you have taken; this makes the video consultation shorter and the assessment more accurate. Submit the employer copy of the certificate immediately. If you are still ill on the last certified day, have yourself reassessed by the next working day at the latest so that no gap arises; after a video certificate a practice is usually responsible for this.

And stay at home as long as you have a fever or a heavy cough. That protects colleagues and shortens your own illness.