Sick note online: how to get a German Arbeitsunfähigkeitsbescheinigung by video

Is a sick note issued by video legally valid?

Yes. German law does not know an “online sick note” as a separate category, only the medical certificate of incapacity for work, the Arbeitsunfähigkeitsbescheinigung. Section 5(1) of the Continued Remuneration Act (Entgeltfortzahlungsgesetz) requires you to notify your employer of your incapacity without delay and to submit a medical certificate by the fourth calendar day at the latest. How the doctor arrives at the assessment is not regulated by the law.

The medical framework is set by the professional code. Since 2018, section 7(4) of the (Model) Professional Code has allowed treatment exclusively via communication media if this is medically justifiable, the required care is maintained and you have been informed about it. Section 25 obliges doctors to issue certificates only with the necessary care and to the best of their knowledge. A video consultation in which the doctor asks about your symptoms, sees you and documents the assessment meets these requirements.

For people with statutory health insurance, the incapacity guideline of the Federal Joint Committee has specified since 2020 that contract doctors may establish incapacity for work by video consultation. This guideline binds practices in the statutory system; private providers such as OpenClinic24 follow the professional code and apply the same standards of care.

In short: a certificate is not valid or invalid because it was created online. What matters is that a licensed doctor issued it after a genuine medical contact.

How a sick note by video works at OpenClinic24

1. Describe your concern. You answer questions online about your symptoms, how long they have lasted and which pre-existing conditions or medicines are relevant. This takes a few minutes and is possible around the clock.
2. Account and reservation. You create an account and add a card. €10.72 is reserved, which corresponds to the consultation under GOÄ no. 1. Nothing is charged until after the consultation.
3. Video consultation. A doctor joins you by video, asks follow-up questions and assesses whether and for how long you are unfit for work. Have your symptoms, a thermometer and your list of medicines ready.
4. Receive the certificate. If incapacity for work is medically justified, you will find the certificate as a PDF in your patient account: one copy for the employer without diagnosis, one for you and, for statutorily insured patients, one for the health insurer. The GOÄ invoice with all items is included.
5. Forward it. You send the employer copy to your HR department, just as you would with a paper certificate.

For how many days can you be signed off by video?

There is no statutory maximum duration for a sick note, but there are medical standards of care. The incapacity guideline specifies for statutory practices: for patients not known to the practice, incapacity should be established by video for up to three calendar days, for known patients up to seven. A follow-up certificate by video is only foreseen there if the previous certificate was issued after an in-person examination. In private practice these limits do not apply literally, but they describe well what is medically justifiable: short, clearly limited periods for mild, self-limiting illnesses.

What this means in practice:

Situation	Usual duration by video	What you can expect
Cold, mild infection, stomach upset at first contact	1 to 3 calendar days	Certificate if the symptoms justify incapacity
Extension after a first video certificate	New assessment required	Often a recommendation to be examined in person if symptoms persist
Prolonged or unclear symptoms	Not by video alone	Recommendation for examination, laboratory tests or a specialist
Psychological strain, exhaustion	Individual decision, usually short	Conversation, assessment, guidance on further care

The guideline also states that incapacity should not be certified for more than two weeks in advance, or up to one month only if the course is foreseeable. How many days you are certified depends solely on the medical assessment. There is no “requested duration”.

What the employer sees and what they may demand

The employer copy shows your name, the date of issue, the start of the incapacity, its expected duration and whether it is a first or follow-up certificate. The diagnosis is not on it. Nor are you obliged to tell your employer what you are suffering from.

The employer may require you to submit the certificate earlier than the fourth day, in extreme cases from the first day of illness (section 5(1) sentence 3 EntgFG). They may question the evidential value of a certificate, but need concrete grounds. In 2021 the Federal Labour Court ruled that the evidential value can be shaken if a sick note covers exactly the notice period after a resignation (5 AZR 149/21). In such cases you must be able to prove in a dispute that you were actually unfit for work. A carefully documented video consultation with a clear history helps.

A certificate issued without any medical conversation, for instance after merely ticking symptoms, is worthless and can have criminal consequences (sections 278 and 279 of the Criminal Code, false health certificates). You recognise reputable providers by the fact that a doctor always speaks to you and makes the decision.

Online sick notes and health insurance: eAU, private patients, sickness benefit

Since 2023, notification to the employer for statutorily insured people has been electronic: the statutory practice transmits the data to the health insurer and the employer retrieves it there (section 5(1a) EntgFG). This eAU procedure applies only to contract doctors. Private certificates, including those from OpenClinic24, are not transmitted electronically. You receive the certificate as a PDF and submit the employer copy yourself. For your entitlement to continued pay this makes no difference: the employer continues to pay your salary for the first six weeks of incapacity (section 3 EntgFG), regardless of how the certificate reaches them.

Privately insured people and civil servants were never part of the eAU procedure; nothing changes for them.

If an illness lasts longer than six weeks, the statutory health insurer pays sickness benefit (Krankengeld). For this the insurer needs uninterrupted medical certificates. Anyone who is foreseeably ill for longer is better placed with their GP or the relevant specialist; the video consultation is intended for short, clearly defined periods of incapacity.

Backdating, weekends, extensions: the most common special cases

Backdating. The incapacity guideline allows backdating only exceptionally, after careful assessment and usually for no more than three days. Typical case: you fall ill on Saturday and speak to the doctor on Monday. Incapacity can then be certified from Saturday if your account supports it. Anyone who comes a week later will not receive a certificate for the past days.

Weekends and public holidays. Requests at OpenClinic24 are possible at any time; the consultation takes place as soon as a doctor is online. Weekend days count as calendar days towards the duration. If you are signed off on Friday and still ill on Monday, you need a follow-up certificate, which should be issued by the next working day after expiry at the latest so that no gap arises.

Extension. A follow-up certificate requires a new medical assessment. If symptoms persist after a first video certificate, the doctor will often recommend an in-person examination because the course has changed or findings are needed.

Children. A certificate for caring for a sick child (child sickness benefit under section 45 SGB V) is issued by paediatricians; it is not part of the adult video consultation at OpenClinic24.

Which complaints are suitable for a video sick note, and which are not

Well suited are illnesses that can be assessed from conversation and observation and usually resolve on their own: colds and flu-like infections, cough and sore throat, gastroenteritis, headache or migraine attacks, back pain without warning signs, period pain, acute stress reactions. In these cases a trip to the practice adds little information but exposes others to infection.

The video consultation is not suitable when a physical examination, a swab, a blood test or imaging is needed to clarify the cause: abdominal pain with guarding, shortness of breath, chest pain, injuries, high or persistent fever, neurological deficits, pregnancy complaints. The doctor will then refer you to a practice, the out-of-hours service or emergency services. This limit is not a shortcoming of telemedicine but part of medical care.

International evidence supports this approach: systematic reviews show comparable outcomes for video consultations and in-person contacts for clearly defined concerns, while the benefit for complex or unclear complaints depends on the possibility of examination.

What does an online sick note cost?

OpenClinic24 works as a private medical service. Billing follows the German fee schedule for doctors (GOÄ), each service with code, factor and amount on the invoice. At booking, €10.72 is reserved; this is the consultation under GOÄ no. 1 at the 2.3-fold rate. The certificate of incapacity is a short certificate under GOÄ no. 70. You see the total before confirming. Statutory health insurers generally do not reimburse private invoices; privately insured people and civil servants can submit them depending on their tariff.

A medical sick note is free of charge only within the statutory system, that is, at your GP practice. Offers promising a “sick note without a doctor’s consultation” for a flat fee do not meet medical requirements.

Recognising reputable providers

Look for four things: a doctor always speaks to you, the person is named and licensed in Germany. The decision on the certificate is made individually and can also be negative. The invoice lists GOÄ codes. And the platform names a responsible entity in Germany in its legal notice. OpenClinic24 is operated by Drylabs GmbH in Ludwigsfelde; the treating doctors are members of their regional medical chamber.