Sick Leave in Berlin: How Long the Money Lasts and the Six-Month Rule Nobody Warns You About

The first time a colleague of mine went off sick in Berlin for more than a few days, he did everything right and still lost money. He told his manager, he went to the doctor, he stayed in bed. What nobody had told him was that the flu he had in February and the same chest infection that put him back in bed in May were, as far as the law was concerned, one illness. The second time round his employer stopped paying after a handful of days, because the six weeks had never started again.

That is the part of sick leave in Berlin that catches people out. The headline rule is simple and everybody knows it. Six weeks at full pay, then the Krankenkasse takes over. The rule underneath it is a calendar, and the calendar does not reset when you feel better.

An Ärztehaus on Hohenzollerndamm in Wilmersdorf. A building like this is where most of the paperwork in this article actually happens.

Sick leave in Berlin starts with a phone call, not with a doctor

Two duties, and people mix them up constantly.

The first is telling your employer. The law says unverzüglich, without undue delay, which in practice means before your shift starts. Not after. Not once the doctor has seen you. If the office opens at nine and you already know at seven that you will not be there, seven is when you send the message. That duty is yours and no doctor performs it for you.

The second is the certificate. Under the Entgeltfortzahlungsgesetz you only need one once the incapacity lasts longer than three calendar days, and then it is due on the next working day. Your employer is allowed to demand it earlier, including from day one, and a great many Berlin contracts quietly do. That single line is worth finding in your own contract before you need it.

Since 2023 you no longer carry the yellow slip to the office yourself. Your doctor sends the certificate electronically to your Krankenkasse, your employer pulls it from there, and you keep a printout for yourself. It changed the paperwork. It changed nothing about the phone call.

Berlin is, for what it is worth, a fairly sick city by German standards. The DAK's Berlin analysis, published on 5 August 2026 from 112,000 insured employees here, puts the Krankenstand at 5.0 percent for the first half of 2026, down from 5.3 the year before, and the average at 9.0 sick days per employee in six months. Across the whole of 2025 the figure was about 19 calendar days each. Respiratory illness fell hard, from 230 days per 100 employees to 185.

The two halves of the old paper certificate, one for you and one for your employer. The transmission is electronic now, but the dates printed on it still decide everything.

The day-one rule that was agreed in July and is still not law

On 2 July 2026 the coalition committee agreed to two changes: a doctor's certificate from the first day of illness, and the end of the telephone sick note. There was an Aktuelle Stunde about it in the Bundestag on 10 July. Karenztage, unpaid first days of illness, were taken off the table.

Then it stopped. As I write this, checked on 20 September 2026, no bill has passed. That means the old rules still run:

• The certificate is due once you are off for more than three calendar days, unless your contract says sooner.

• A telephone sick note is still possible for up to five calendar days, if the practice already knows you, if the illness has no severe symptoms, and if a video consultation is not the better route. A follow-up by phone only works when the first certificate was issued in person.

• Nothing about your pay changes. Six weeks is six weeks.

If the law does change, the practical effect for most people is one extra morning in a waiting room, not less money. Worth watching, not worth worrying about yet.

The plenary chamber of the Bundestag. An agreement in a coalition committee is not a law, and until a bill goes through this room the four-day rule stays.

Six weeks of full pay, and the six-month rule that stops it restarting

Your employer owes you full pay for up to six weeks, which the law counts as 42 calendar days, not 42 working days. Weekends inside a spell count. Two conditions attach to it: the incapacity must not be your own fault, and the employment must already have run four uninterrupted weeks. Start a job on the first of the month, fall ill on the tenth, and the Krankenkasse pays from the start instead.

Now the part my colleague missed. If you go off again with the same illness, you only get a fresh six weeks when one of two things is true:

• you were free of that illness for at least six months before the new incapacity, or

• twelve months have passed since the first day you were off with it.

Either one is enough, and the earlier of the two dates is the one that matters to you. Between those dates, every day off with that illness comes out of the same 42. Spend 30 in March and you have 12 left in July, and on day 13 the money steps down.

A different illness is a different account. Break an ankle while you are still signed off with something else and you do not get a second six weeks running alongside the first, but once the first is finished the new diagnosis carries its own 42 days. What decides it is the diagnosis on the certificate, not how ill you feel.

This is arithmetic nobody does in their head while running a temperature, so I built the board below for it. Put in each spell you have been off with the same illness and it lays them on one calendar, counts the days of full pay you have spent, and marks the day the six weeks open again.

The board is about time, not about your exact payslip. It uses the statutory limits and the 2026 ceilings, and your Krankenkasse is the one that works out your euro to the cent.

What Krankengeld actually pays, and the gap that ends it

When the six weeks run out, the Krankenkasse takes over with Krankengeld. The formula is 70 percent of your gross, capped at 90 percent of your net, and then capped again by the contribution ceiling.

For 2026 that ceiling is 69,750 euros a year, or 5,812.50 euros a month. Nothing above it counts. The arithmetic gives a maximum Krankengeld of 135.63 euros a day, which is 4,068.90 euros for a 30-day month before deductions. You still pay your own share of pension, unemployment and long-term care contributions out of it, roughly 12.4 percent, so the maximum that actually lands is somewhere around 3,560 euros. Health insurance contributions are not charged on Krankengeld.

Two limits to keep in view:

• 78 weeks within any three years, for one and the same illness, counted from the day the incapacity began. The six weeks of full pay count towards it. A second illness arriving during the run does not extend it.

• The next-working-day rule. This is the one that costs people real money. If you are on Krankengeld and your certificate runs out on a Friday, the further incapacity must be medically established at the latest on the next Werktag, and Saturdays do not count as Werktage. One day of gap in the chain and the entitlement can end, with the insurance behind it. Book the follow-up appointment before the current certificate expires, not on the morning after.

Some employers top Krankengeld up to something closer to your normal pay. That comes from a collective agreement or your contract, never from the law, so read yours before you count on it.

Karl-Marx-Straße 214 in Neukölln. A pharmacy can sell you something for the cough, but only a doctor can write the certificate that protects your pay.

Getting the certificate in Berlin when your practice has no slot

This is the Berlin-specific problem. Plenty of people here have no Hausarzt at all, and plenty of practices will not take a new patient on the morning they need one.

What actually works:

• 116117, the patient service of the Kassenärztliche Vereinigung Berlin, is free, round the clock, and covers both the Ärztlicher Bereitschaftsdienst and the appointment service. It is the number to call on a Sunday, on a public holiday, and at three in the morning.

• The Bereitschaftspraxen reached through that number can issue a certificate. A doctor may establish incapacity on any calendar day, weekends and holidays included. What matters is the examination, not the day of the week.

• A home visit through the Bereitschaftsdienst exists for people genuinely too ill to travel across the city.

• The telephone route, while it lasts, only works with a practice that already knows you. It is an argument for registering with a Hausarzt in a quiet week rather than a bad one.

If you are still sorting out which Krankenkasse you belong to, or you have just arrived and nothing is set up yet, that piece comes first: I went through it in health insurance in Berlin. And for the longer problem of getting a specialist appointment at all, there is the four-week rule and what it cannot give you.

Child sick days: 2026 gives you fifteen and 2027 takes five back

This one has a deadline on it, and it is the reason I would read this section twice if you have small children.

When a child under twelve is ill and needs you at home, you can take Kinderkrankengeld from your Krankenkasse and unpaid release from work from your employer. The payment is 90 percent of the net pay you lose.

For calendar year 2026 only, the entitlement is 15 working days per child per parent, capped at 35 days per parent across all children. Single parents get 30 per child, capped at 70.

From 1 January 2027 it drops back to the standing figures in the law: 10 working days per child, capped at 25, and 20 per child for single parents, capped at 50. Unless the Bundestag extends it again, a two-child household loses ten days of cover overnight.

So: if you have days left this year and a child who needs you at home, use them this year. They do not roll over, and next year's budget is smaller.

If the childcare half of that is still an open problem, the Berlin place hunt runs on its own clock and I wrote it up in finding a Kita place in Berlin.

The Charité campus seen across the Humboldthafen. For a long illness the 78-week clock, not the hospital, is the thing to keep an eye on.

Three more things people get wrong

Falling ill on holiday. If you are signed off during annual leave, the certified days do not count against your leave. You get them back. This only works with a certificate, and it is worth getting one even for a short spell, because a week of holiday is worth more than a morning in a waiting room.

Assuming you cannot be dismissed while sick. You can. Being ill is not, by itself, protection against notice in Germany. The usual employment protections apply, and nothing more.

Reading "six weeks" as a yearly allowance. It is not an allowance at all. It is a per-illness entitlement with a calendar attached, and for a condition that keeps coming back, the same 42 days can have to cover a whole year.

The dates on the certificate are the record. Keep your copies, because the six-month clock is counted from them and nobody else is counting for you.

My move

Do one thing this week while you are well, because it takes ten minutes and it is impossible to do properly on a morning when you are not.

Open your employment contract and find the sentence about the Arbeitsunfähigkeitsbescheinigung. Either it repeats the law, in which case you have until day four, or it demands a certificate from the first day, in which case your plan for a bad Monday has to include a practice that can actually see you. If you have no Hausarzt, that is the week to register with one, not the week you need them.

Then put the dates of your last long spell off work somewhere you can find them. Not for the employer, for yourself. The six-month clock is the only part of this that is genuinely invisible, and it is the part that decides whether your next illness is paid at full rate or at seventy percent.

The statutory limits in this article come from the Entgeltfortzahlungsgesetz and the fifth book of the Sozialgesetzbuch, on the 2026 figures, and they are the floor. A collective agreement or your own contract can be kinder than this, never harsher.

Image credits

Source and licence details for the 4 photographs used in this article.

The Ärztehaus on Hohenzollerndamm in Berlin: Sebastian Rittau, CC BY 4.0, via Wikimedia Commons.

The plenary chamber of the Bundestag in the Reichstag building: escpeapalumni, CC BY 2.0, via Wikimedia Commons.

The Charité Mitte campus seen across the Humboldthafen: Flocci Nivis, CC BY 4.0, via Wikimedia Commons.

A German sick note on self-copying paper: Rergeshhheim, CC BY 4.0, via Wikimedia Commons.