Short answer
A backdated sick note is only allowed as an exception in Germany: the incapacity guideline lets a doctor in a practice backdate by usually no more than three days after careful assessment. By video, OpenClinic24 applies the same standard: the private certificate usually starts on the day of the consultation; backdating by up to three days is possible only exceptionally after careful assessment and with a documented reason. Anyone who gets in touch on the first day of illness avoids any gap.
Key facts
Section 5(3) of the incapacity guideline (AU-RL): certifying incapacity for a period before the doctor contact is permitted only exceptionally and usually for up to three days.
By video, OpenClinic24 usually certifies from the day of the video consultation, for at most three calendar days; backdating by up to three days is possible only exceptionally after medical assessment, and backdated days count towards the limit.
The medical certificate must be presented by the fourth calendar day of illness at the latest (section 5 EntgFG); notifying the employer is due on day one.
A follow-up certificate should be issued by the next working day after the previous one expires, otherwise a gap in sick pay or continued remuneration may arise.
A certificate without doctor contact or with a false date is a false health certificate (section 278 StGB) and can justify dismissal.
What “backdated” means for a sick note
Backdated means the doctor certifies incapacity for days before the contact took place. A typical case: you fall ill on Saturday, stay home on Monday and only sit in the consultation on Tuesday. The question is whether the certificate (Arbeitsunfähigkeitsbescheinigung, AU) applies from Saturday, from Monday or only from Tuesday.
The legal answer is clearly regulated and narrower than many think. The incapacity guideline of the Federal Joint Committee (Arbeitsunfähigkeits-Richtlinie, AU-RL), which applies to all statutory practices, says in section 5(3): incapacity should as a rule not be certified for a period before the doctor’s visit. Backdating is permitted only exceptionally and after careful assessment, usually for up to three days. The guideline does not apply literally to private certificates, but it describes the standard of care that private doctors also follow, because the professional code demands the same diligence.
The key word is “exceptionally”. Backdating is not an entitlement you can claim but a medical decision in the individual case. The doctor must be convinced from your account, the course and the current findings that you were already unable to work on the previous days.
The three-day rule: what it allows and what it does not
The guideline names three days as the upper limit “as a rule”. These are calendar days, not working days. If you fall ill on Friday and visit a practice on Monday, you are within the limit. If you fall ill on Monday and come on Friday, you are not. Counting starts with the first day of illness and ends on the day before the doctor contact.
| Fell ill on | Doctor contact on | Backdating possible in a practice? |
|---|---|---|
| Saturday | Monday | yes, two days, after assessment |
| Friday | Monday | yes, three days, after assessment |
| Thursday | Monday | only for three days, so from Friday; Thursday remains open |
| Monday | the following Monday | no, backdating beyond three days is not provided for |
Two things are worth knowing. First, even within the three days backdating is not automatic. The doctor can refuse if the findings do not support earlier incapacity. Second, the duty of proof under section 5 of the Continued Remuneration Act (Entgeltfortzahlungsgesetz, EntgFG) only begins on the fourth calendar day anyway. For up to three days without a certificate you need no proof by law, unless your employer has ordered presentation from the first day.
Avoid gaps: get in touch on day one
Describe your symptoms as soon as they start. A doctor assesses them by video and issues the certificate from the day of the consultation if you are unfit for work.
Request a sick note onlineBackdating by video: when OpenClinic24 does it and when not
In a video consultation the doctor usually sees you for the first time, has no previous findings and cannot make up for a missed examination. That is why OpenClinic24 applies the same standard as a practice, only more strictly: the private certificate usually starts on the day of the video consultation and covers at most three calendar days. Backdating by up to three days is possible only exceptionally, when the doctor is convinced after careful assessment of your account, the course and the findings that incapacity already existed; the reason is documented, and backdated days count towards the maximum of three calendar days. There is no entitlement to it. The certificate is not extended by video.
This is not red tape but protection for both sides. A correctly dated certificate has full evidential value towards your employer. The Federal Labour Court clarified in 2021 that the evidential value can be undermined when circumstances raise doubts, for example a certificate that exactly covers a notice period. A certificate whose date does not match the medical finding would be such a reason for doubt and, in the worst case, a false health certificate under section 278 of the Criminal Code.
In practice this means: use the video consultation on the first day of illness. Requests are possible around the clock and the consultation takes place as soon as a doctor is online. If you fall ill at the weekend, submit the request on Saturday and receive the certificate from the day of the consultation. For the days before, your notification to the employer applies.
Monday for Friday: the most common special case
Most questions about backdating arise at the weekend. You feel ill on Friday evening, stay in bed on Saturday and Sunday and are still not fit on Monday. Three routes are possible.
First: you see your GP on Monday. There the doctor can exceptionally certify from Friday or Saturday after assessment, because the backdating falls within three days. Second: you use the video consultation at OpenClinic24 on Monday. The certificate then usually starts on Monday; if the doctor finds earlier incapacity plausible after careful assessment, it can exceptionally start on Friday or Saturday. Saturday and Sunday are not working days for most employees anyway, and for Friday your notification applies. Third, and this is the best route: you submit the request on Friday or Saturday. Then the certificate exists from the first day and there is nothing to catch up on Monday.
For shift work, care, hospitality and retail, where Saturday and Sunday are working days, the early request counts double. Here an uncertified weekend can otherwise become a gap if the employer demands presentation from day one.
Follow-up certificate: the second gap that is often overlooked
Backdating also becomes an issue when a certificate expires and you are still ill. The follow-up certificate should be issued by the next working day after the previous one expires; the Federal Social Court has recognised this tolerance for sick pay. If your certificate ends on Friday, a new finding on Monday is sufficient. If it ends on Wednesday, you need the new certificate on Thursday.
Missing the deadline carries two risks. Statutorily insured people can lose sick pay for the gap days because the insurer requires a continuous medical finding. And the employer may withhold continued remuneration for uncertified days until proof is provided (section 5 in conjunction with section 7 EntgFG).
After a first video certificate, extension by video is not provided for at OpenClinic24. If symptoms persist, the course has changed, and the assessment then belongs in a practice where you can be examined and, if necessary, laboratory tests or imaging arranged. Plan the appointment so that it takes place by the working day after expiry at the latest.
What is not legally possible and what the consequences are
A certificate without doctor contact, for example from an online questionnaire, is not a sick note. In 2025 the Regional Labour Court of Hamm upheld the summary dismissal of an employee who had presented such a questionnaire certificate, because he created the impression of a medical contact that never took place. Incapacity may only be established on the basis of a medical examination, in person, by telephone or by video.
A certificate with a convenient date is a false health certificate (section 278 StGB). Doctors face a fine or imprisonment of up to two years and professional proceedings; employees who use such a certificate face loss of evidential value, repayment of continued remuneration and, in serious cases, dismissal.
You can recognise reputable providers by the fact that they state the limits openly: medical consultation, start usually on the day of the consultation, backdating only exceptionally after assessment and by no more than three days, no extension by video. That is exactly how OpenClinic24 works.
When to go to a practice, when to call emergency services
You belong in a practice if backdating goes beyond the medical exception by video, if a certificate has to be extended, if symptoms last longer than a week or if an examination is needed, for example with abdominal pain, fever for more than three days, airway symptoms with sputum or injuries. Outside surgery hours the medical on-call service on 116 117 refers you to a practice near you.
Call 112 for life-threatening signs: shortness of breath, chest pain, impaired consciousness, seizure, sudden paralysis or speech disorder, heavy bleeding. In these cases treatment comes first; the certificate is issued by the treating facility.
Checklist: how to avoid any gap
Notify your employer on the first day of illness before work starts. Submit the request for the video consultation the same day, even at the weekend. Hand in the employer copy of the certificate immediately. Note the last certified day and, if symptoms persist, book an appointment in a practice for the working day after at the latest. And check your employment contract: if it requires presentation from the first day, early doctor contact is not an option but an obligation.
As of October 2026: the announced reform of the proof rules may change the deadlines; we will update this article as soon as a law is passed.
When you need help immediately
- Chest pain, shortness of breath or impaired consciousness: call 112, the certificate is secondary
- High fever above 39.5 °C with a stiff neck or rash
- Sudden paralysis, speech disorder or the worst headache of your life
- Persistent vomiting or diarrhoea with signs of dehydration
With these warning signs call the emergency number 112. Outside office hours the medical on-call service is available on 116 117. In these situations a video consultation does not replace an in-person examination.
Sources
- Arbeitsunfähigkeits-Richtlinie (incapacity guideline) of the Federal Joint Committee, section 5(3) (retroactive certification). Gemeinsamer Bundesausschuss (G-BA), 2024. Guideline
- Section 5 Entgeltfortzahlungsgesetz (EntgFG): duties to notify and to provide evidence. Federal Ministry of Justice, gesetze-im-internet.de, 2026. Law
- Section 3 Entgeltfortzahlungsgesetz (EntgFG): entitlement to continued remuneration in case of illness. Federal Ministry of Justice, gesetze-im-internet.de, 2026. Law
- Section 278 Criminal Code (StGB): issuing false health certificates. Federal Ministry of Justice, gesetze-im-internet.de, 2026. Law
- Judgment 5 AZR 149/21: evidential value of a certificate of incapacity. Federal Labour Court (Bundesarbeitsgericht), 2021. Law
- (Model) Professional Code for Physicians in Germany (MBO-Ä), section 7(4) and section 25. German Medical Association (Bundesärztekammer), 2024. Guideline
- Telemedicine 2020 and the next decade. The Lancet, 2020. DOI: 10.1016/S0140-6736(20)30424-4 Review
All sources were retrieved during the medical review. Studies are linked by DOI; guidelines and laws in their current version.
Frequently Asked Questions
How many days can a sick note be backdated in Germany?
Usually no more than three days, and only exceptionally after careful medical assessment. That is what section 5(3) of the incapacity guideline of the Federal Joint Committee says. The doctor must be convinced that incapacity already existed before. Longer backdating is not provided for.
Can I get a backdated sick note online?
Only exceptionally. The private certificate by video usually starts on the day of the video consultation and covers at most three calendar days. Under section 5(3) AU-RL backdating by up to three days is possible only after careful assessment; the doctor must be convinced from your account and the findings that you were already unable to work, and documents the reason. Backdated days count towards the maximum. Get in touch on the first day of illness and no gap arises.
I was ill on Friday and can only see a doctor on Monday. What applies?
In a practice, the doctor can exceptionally certify from Friday after careful assessment, because three days fall within the guideline. By video at OpenClinic24 the certificate starts on Monday. For Friday your notification to the employer applies; a certificate is only legally required from the fourth day unless your contract says otherwise.
Do I need the sick note from the first day?
By law only if incapacity lasts longer than three calendar days; the certificate is then due on day four. Your employer may demand it from the first day, for example in the employment contract or after repeated absences. The notification itself, telling your employer you are absent, is always due on the first day.
What happens if the follow-up certificate comes too late?
A gap can arise. For sick pay from statutory insurance the insurer requires an uninterrupted medical finding; the Federal Social Court accepts a follow-up certificate on the next working day after expiry. For continued remuneration the employer may withhold payment for days without a certificate. Have yourself reassessed on the last certified day or the working day after.
May a doctor backdate a sick note on request?
No. A certificate whose date does not match the medical finding is a false health certificate under section 278 of the Criminal Code (StGB). Doctors risk professional and criminal consequences, employees the loss of evidential value and, in serious cases, dismissal. Backdating remains a justified exception after assessment, not a favour.
Do weekends and public holidays count towards the backdating limit?
Yes, the guideline speaks of days, not working days. If you fall ill on Saturday and see a doctor on Tuesday, three days are still within the exception. If you wait until Thursday, they are not. By video at OpenClinic24 the day of the consultation applies anyway.
What can I do if I have no certificate for the first days?
Explain the situation to your employer and submit the certificate from the day of the doctor contact. For up to three calendar days without a certificate there is no duty of proof under section 5 EntgFG unless your employer demands it earlier. In that case the employer decides whether to accept the absence without proof; if in doubt, a practice can apply the exception.
About the author
Note: This article provides general information and does not replace individual medical advice, diagnosis or treatment. If you have symptoms, contact a doctor; in an emergency call 112.
