Telephone Sick Notes in Germany: Rules for 2026

A telephone sick note is a certificate of incapacity for work issued after a doctor takes your medical history and assesses your symptoms over the telephone. The German term is “telefonische Krankschreibung”; the certificate itself is an Arbeitsunfähigkeitsbescheinigung, usually shortened to AU.

You do not necessarily have to attend the practice in person. However, the telephone conversation must give the doctor enough information to make an appropriate medical assessment. A request for a certificate is not, by itself, a medical consultation.

On 7 December 2023, the Federal Joint Committee, known as the G-BA, introduced telephone certification as a regular option within its incapacity-for-work rules. The aim was to reduce unnecessary practice visits, ease pressure on medical practices and avoid bringing people with mild infections into waiting rooms. [1]

“Permanent” did not mean that every patient could automatically obtain a sick note by telephone for every illness. The decision remains a medical one. If the doctor considers an in-person examination necessary, a telephone conversation will not be sufficient.

A mild cold or an uncomplicated infection may be suitable for assessment by telephone. Severe symptoms, or symptoms that require a physical examination, need a different approach. The doctor decides whether your individual circumstances meet the conditions. [1]

The requirements for telephone certification are more restrictive than those for a video consultation. Three main conditions must be met:

• You must already be personally known to the medical practice.
• You must not have severe symptoms.
• A video consultation must not be possible or cannot be carried out.

Being “known to the practice” does not simply mean that the receptionist has saved your name or telephone number. You must be known to the doctor or practice through previous personal treatment. A new patient cannot usually call an unfamiliar practice and request a standard telephone AU. [2]

The telephone assessment must also provide enough information for a medical decision. The doctor may ask about your symptoms, how long they have lasted, their intensity, changes in your condition and any other relevant health issues.

Even when the formal requirements are met, you do not have an automatic right to a telephone certificate. If there is medical uncertainty, the practice may ask you to attend in person or arrange another appropriate form of consultation. [1]

The practical first step is therefore to contact your usual practice and explain your situation. The practice can tell you whether telephone assessment is suitable and how the consultation will be organised.

The process is usually straightforward, but it involves more than calling reception and saying that you are ill. A doctor must assess whether your illness makes you unable to carry out your work.

First, contact a practice that already knows you and explain why you are calling. The practice checks whether a telephone assessment may be appropriate. The doctor then takes the necessary medical history during a telephone consultation.

During the conversation, you may be asked:

• What symptoms do you have?
• When did the symptoms begin?
• Do you have a fever?
• Are you experiencing breathlessness or severe pain?
• What medicines are you taking?
• Do you have any relevant pre-existing conditions?
• Can you perform your usual work with your current symptoms?

Your answers help the doctor assess your condition and its effect on your ability to work. Describe your symptoms honestly and clearly. There is no special phrase that guarantees a sick note, and the doctor may decide that an examination in the practice is needed.

If the doctor finds that you are unfit for work, a certificate can be issued. For patients with statutory health insurance, the practice normally sends the electronic certificate, known as the eAU, to the health insurer. The employer can then retrieve the relevant information electronically from the insurer. [2]

This replaces the traditional paper certificate in most standard cases. However, it does not replace your own responsibility to tell your employer that you are ill and how long you expect to be absent.

An initial certificate issued after a telephone assessment can cover a maximum of five calendar days. This is a specific limit for telephone certification and differs from the limits that apply to video consultations or an in-person examination. [1]

Five days is a maximum, not an automatic entitlement. The doctor may certify a shorter period if that is the medically appropriate estimate of how long you will be unable to work.

Calendar days include weekends and public holidays. They are not the same as the individual days on which you would normally work. The certificate records the medically assessed period of incapacity for work.

An extension by telephone is not always possible. If the illness was initially assessed exclusively over the telephone and you remain unfit for work, an in-person examination is generally necessary for a follow-up certificate.

The situation can be different if the initial certificate was issued following an in-person examination. Under the relevant conditions, a subsequent follow-up certificate may then be issued by telephone. [1]

Telephone certification should therefore not be understood as a way to keep extending an absence without an appropriate medical assessment. If you have not recovered by the end of the certified period, contact the practice to clarify the next step.

Telephone sick notes and video consultations are often confused, but they are subject to different requirements. A telephone call provides no visual information: the doctor cannot see you or assess visible signs of illness.

For that reason, telephone certification is restricted to patients who are already personally known to the practice. It is also intended for situations in which a video consultation is not possible.

A video consultation provides additional information and can be used in a wider range of circumstances, provided that the illness can be assessed adequately through this format.

For patients who are already known to the practice, an initial sick note following a video consultation can cover up to seven calendar days. For patients who are not previously known to the practice, the maximum is three calendar days. There is no automatic entitlement to a certificate through either route. [1]

The appropriate consultation method depends on the symptoms and the information the doctor needs. A video call is not a substitute for a physical examination when such an examination is medically necessary.

The political discussion about ending telephone certification should also be distinguished from video consultations. These are separate routes, and proposals concerning one do not automatically describe the rules for the other.

Many employees still expect to receive a paper certificate to hand to their employer after speaking to a doctor. For people with statutory health insurance, the standard process is now largely electronic.

The medical practice creates the eAU and sends it to the health insurer through the healthcare system's digital infrastructure. The employer then retrieves the relevant absence information electronically from the insurer. [2]

The employer does not automatically receive the medical diagnosis or the details discussed during your consultation. Information needed to document an absence is separate from confidential medical information.

However, the eAU does not replace your notification of sickness. You must still inform your employer without delay that you are unable to work and how long the absence is expected to last. Follow the reporting procedure used by your workplace. [3]

If there are technical problems, the practice can provide paper documentation. Paper may also remain relevant for certain employment or insurance arrangements that are not covered by the usual electronic procedure.

If you are unsure whether your employer has the information it needs, clarify the administrative process with the practice and your employer. Receiving an eAU does not mean you can simply remain absent without notifying anyone.

Reporting that you are ill and obtaining a medical certificate are two different steps. They are carried out by different people and serve different purposes.

You make the sickness notification yourself. Depending on your workplace, this may be done by telephone, email or an internal absence-reporting system. You tell the employer that you cannot work and give the expected duration of your absence.

The doctor separately assesses your incapacity for work. If a certificate is issued, the practice normally transmits it electronically to the statutory health insurer. Since 2023, the employer-side eAU process has largely replaced the previous exchange of paper copies. [2]

The insurer makes the relevant AU information available for the employer to retrieve. In standard cases, employees therefore do not have to submit a traditional paper certificate themselves.

An employer may require medical certification earlier than the usual statutory deadline. This existing possibility must be distinguished from political proposals for a general requirement to obtain a certificate from the first day of illness.

The government has announced changes concerning first-day certification and telephone sick notes. Until a change is implemented, an announcement alone does not replace the existing rules. Employees should also check their workplace's current reporting requirements. [3]

It is important to distinguish between the rule currently in force and proposals to change it. Telephone certification became a regular option under the G-BA rules in December 2023, rather than remaining only a temporary pandemic measure. [1]

In that sense, the arrangement was described as permanent. This does not prevent the relevant rules from being amended later, and it does not create an unconditional right to a telephone sick note.

In 2026, the governing coalition announced plans to abolish telephone certification. The Federal Government's information page explicitly states that the existing arrangements continue until the planned measures are implemented. [3]

For patients, this distinction is practical: a political agreement or announcement does not, by itself, tell you that a practice can no longer issue a telephone certificate. The applicable rules and the doctor's assessment still determine what is possible.

The debate includes different views about how sickness absence should be managed. Critics of telephone certification raise concerns about misuse or insufficient assessment. Supporters emphasise the reduction in unnecessary visits and the benefit of keeping people with mild infections out of waiting rooms.

These arguments should not be confused with a description of the current legal position. When reading headlines about abolition, check whether they describe a proposal, an adopted measure or a change that has actually entered into force.

Under certain conditions, parents can also obtain a medical certificate by telephone when their child is ill. This is a separate certificate connected with caring for a sick child, rather than a sick note declaring the parent personally unfit for work.

According to the Federal Government's information, a telephone certificate for a child's illness can cover up to five working days. The child must already be known to the practice, the illness must not be severe, and the doctor must consider a telephone assessment sufficient. [3]

The certificate may be relevant to a claim for children's sickness benefit, known as Kinderkrankengeld. Eligibility for the benefit depends on the applicable insurance and social-security conditions, so parents should clarify their individual entitlement with their health insurer.

For privately insured patients, the administrative process may differ from the statutory eAU procedure. Depending on the practice, insurance arrangement and employer, a paper certificate or another form of documentation may still be needed.

Privately insured patients should therefore check in advance what documentation their employer requires. An electronic process used for statutory insurance should not automatically be assumed to apply in exactly the same way to every patient.