What is continued pay during illness?
Continued remuneration during illness means employees keep receiving their salary for a limited period during sickness-related incapacity, even though they do not work. The legal basis is the German Continued Remuneration Act (§3 EFZG).
Duration: the 6-week rule
For non-self-inflicted incapacity the employer continues full pay for up to six weeks (42 calendar days). Only afterwards does the statutory health fund take over with sick pay.
Conditions
- Waiting period: the employment has existed for at least four weeks.
- Not self-inflicted: the incapacity must not be the employee's own fault.
- Notification & proof (§5 EFZG): illness must be reported immediately. If incapacity lasts longer than three calendar days, it must be established by a doctor by the next working day at the latest; the employer may require this earlier.
Important for employees in the statutory health insurance: they no longer have to submit a certificate to the employer (§ 5 (1a) sentence 1 EFZG). They only have to have the incapacity established by a doctor and be handed a certificate; the employer retrieves the electronic certificate (eAU) from the health fund. The duty to submit still applies to privately insured employees and to mini-jobbers in private households. Asking statutorily insured staff to submit a certificate, or warning them for not doing so, relies on a duty that does not apply to the majority of the workforce.
Amount and what applies after 6 weeks
During the six weeks employees receive 100% of their regular pay (§ 4 (1) EFZG). Afterwards the health fund pays sick pay: 70% of the reference pay, meaning the contributory earnings up to the contribution ceiling, capped at 90% of net earnings (§ 47 (1) SGB V). Employee contributions to pension, unemployment and long-term care insurance are deducted from sick pay.
The "same illness" rule
A different illness creates a fresh six-week entitlement only if the first incapacity had already ended. If the second illness is added while the first still continues, German case law treats it as a single case of prevention: the six-week period simply runs on and no new entitlement arises. For the same illness a new entitlement arises only if the employee was free of it for at least six months, or twelve months have passed since the first incapacity began.
Mental illness and continued-pay costs
Mental illnesses cause the longest absences per case: 28.5 days of incapacity per case in 2024, against an average of 10.5 days across all diagnoses (WIdO, Fehlzeiten-Report 2025, reference: employed AOK members). By total volume of absence days, musculoskeletal disorders rank first, so no claim about the highest continued-pay costs follows from this. Long individual cases do tie up continued pay for an unusually long time, which is where prevention pays off. The legally required psychological risk assessment under §5 ArbSchG uncovers the stressors behind long absences before they arise. Learn more →
