Under what circumstances am I entitled to benefits?
If you are unable to work as a dependent employee for a lengthy period of time (continued payment of wages during illness), you receive sick pay from the health insurance company.
A person who is sick and unfit to work after the employer's wage payments expire, receives sick pay from the health insurance company.
What am I entitled to and where can I apply for the benefits?
If you have been employed by your employer for at least four weeks, the employer continues paying you the wage for at most six weeks if you cannot work due to illness ("continued payment of wages during illness").
If you are still not able to work after the employer's payment of your wages during illness expires, you will receive sick pay from the health insurance company. This is between 70 and 90% of your last regular wage (regular salary).
You receive sick pay until the end of the medically certified period of unfitness for work. But for the same illness, the sick pay is paid out for a maximum of 78 weeks over a period of three years. At the end of these 3 years, under specific circumstances you can continue to receive sick pay for the same illness for a further three years.
Other social security benefits, such as disability or incapacity pensions or payments from social security funds in other countries, are offset against the sick pay.
If you are ill and therefore unable to go to the doctor, you must inform your employer of this immediately. If you are absent for longer than three days, you must provide a doctor's certificate of incapacity for work (sick note). Weekends, public holidays and vacations are counted: If you are ill on Friday, you must have written confirmation from a doctor of your inability to work on Monday.
The employer can also request earlier presentation of a doctor’s certificate regarding your incapacity to work.
You receive sick pay from the day on which a doctor has confirmed your illness, and only for as long as the doctor's note is valid. You must turn up to appointments for medical examinations. If you do not go the doctor despite having an appointment, the payment of the sick pay can be stopped.
If you receive other benefits (for instance, a pension) or if your illness arose as a result of an accident at work or an occupational disease, you must inform your health insurance company of this. While you have a doctor's note and are receiving sick pay, you may only leave Germany with the consent of your health insurance company, otherwise the payment of the sick pay can be stopped.
Your child's illness:
If you have state health insurance and a doctor writes your child (under 12) a sick note, the state health insurance will pay you sick pay if nobody else in your household can look after your child. For each child, you receive sick pay for a maximum of ten working days per year. For all children combined, there is a maximum of 25 working days per year; for insured single parents it is a maximum of 20 working days.
You apply for sick pay from your health insurance company and receive the necessary documents for it from them.
You can obtain further information about your rights and entitlements from your health insurance company.
European Commission publications:
The health insurance companies inform their members about their rights and entitlements by telephone and over the Internet. If you do not agree with a decision made by your health insurance institution, you can seek advice from independent patient advice centres. http://www.unabhaengige-patientenberatung.de/
You can find a list of the state health insurance policies and plenty of other relevant information at http://www.gkv-spitzenverband.de/ on the site of the federal association of state health insurance funds.
If you still have social security cover in one or more countries besides Germany, ask about the effects on health insurance:
Abteilung Deutsche Verbindungsstelle
Krankenversicherung - Ausland (DVKA)
Pennefeldsweg 12 c
Tel.: +49 228 95300
You can find the Federal Ministry of Health at http://www.bmg.bund.de