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Procedure descriptions

Apply for sickness benefit for people with statutory health insurance

In the event of illness, employees continue to receive pay for six weeks in most cases (continued payment of remuneration in the event of illness). After this period, legally insured persons may be entitled to sickness benefit in the event of:

  • permanent incapacity for work or
  • in-patient treatment in a hospital or rehabilitation centre


  • 70 per cent of gross pay, up to a maximum of 90 per cent of net pay
  • One-off payments such as Christmas bonuses are taken into account
  • Sickness benefit is limited to a statutory maximum of 116.38 euros per day (value for the year 2023).

You can make up the difference between sick pay and net pay. To do this, you can take out individual insurance with a private insurance company Insurance company.


  • You can receive sickness benefit for the same illness for a maximum of 78 weeks within each three-year period.

After the three years, you can only receive sickness benefit for the same illness if you have been fit for work for at least six months in the meantime and

  • you have not been incapacitated for work because of this illness and have worked, orr
  • have been available to the employment service.

Attention: The entitlement to sickness benefit ends if you

  • a pension due to full reduction in earning capacity or incapacity for work,
  • an old-age pension,
  • a retirement pension or
  • an early retirement pension.

Payment begins on the day when the income ceases - i.e. in most cases after the end of the six-week period of continued remuneration.

Responsible department

Your health insurance



  • There must be health insurance with entitlement to sickness benefits. For most employees and unemployed persons, this entitlement is included in the statutory health insurance.
  • The period for continued payment of wages has expired.
  • You must be undergoing in-patient treatment at the expense of the health insurance fund and
  • report the incapacity for work to the health insurance fund immediately.

Voluntarily insured self-employed persons are not entitled to sickness benefits. By submitting a declaration of choice, you can opt to receive sickness benefit during the period of incapacity for worksickness benefit during incapacity for work. Your health insurance fund will advise you on the optional sickness benefit tariffs. Alternatively, you can take out private daily sickness benefit insurance with an insurance company.

Recipients of unemployment benefit are also entitled to sickness benefit.

Unemployment benefit II is also paid after the six weeks.


You must send a copy of the certificate of incapacity for work to the health insurance fund during the period of continued payment. After the continued payment of remuneration has expired, your doctor will confirm your continued incapacity for work on a so-called payment slip. If the incapacity for work continues, you must submit the further payment slips to the health insurance fund regularly and without interruption.

In addition, most health insurance funds require you to fill out a declaration for the payment of sickness benefits. In this declaration

  • give your bank details and
  • inform them whether or not you have applied for a pension and
  • which rehabilitation measures you may be taking or have applied for.

These benefits affect your further sickness benefit entitlement.

. The health insurance fund canthe health insurance fund can arrange for an assessment by the Medical Service (MD) at any time after the onset of incapacity for work. This is to ensure the success of the treatment. If necessary, it can initiate measures to restore the ability to work Ability to work. The assessment may also include a physical examination.

Sickness benefit will be transferred to the account you have specified for the past period of incapacity for work. Sickness benefit is calculatedsickness benefit is calculated per calendar day. If you are entitled to sickness benefit for a whole calendar month, this will be calculated as 30 days. If you are only partially entitled to sickness benefit in a month, payment will be made for the days actually accrued.

Sickness benefit is subject to compulsory contributions to pension, unemployment and long-term care insurance. The contributions are deducted before payment.


You must submit the follow-up certificate without any gaps. Retroactive sick leave is not possible.

Required documents

  • Payment slip (AU certificate new)
  • Declaration of payment of sickness benefit

Note: Also check with your health insurance fund which documents you need to submit.





Release note

02.10.2023; Sozialministerium Baden-Württemberg

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