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Sickness benefit in general

What is the sickness benefit?

The sickness benefit is an income compensation benefit that is paid by the statutory health insurer. It compensates for loss of income if you are unable to work or during a hospital stay. Payment begins after the 42 calendar day continued remuneration payments have expired.

The sickness benefit is calculated based on the regular salary. This is transmitted via the EEL procedure and based on the last payroll period before the incapacity to work.

Who is eligible for the sickness benefit?

According to Section 44 (1) SGB V, all statutory insured employees are entitled to the sickness benefit if they:

• are unable due to sickness.
• are treated, at the expense of the health insurer, in a hospital, a preventive care or rehabilitation center.

The entitlement to the benefit starts on the first day of a medically determined incapacity to work. However, this entitlement is suspended for the first 42 calendar days, as employers are obliged to pay continued remuneration during this time. The health insurer therefore only pays the sickness benefit from the seventh week. An exception to this are employees who fall under the waiting time regulation for the first four weeks of their employment.

Note
Persons who are unable to work due to an organ, tissue, blood, or blood cell donation are also eligible for the sickness benefit. In this case, the EEL procedure won't apply. The application for the benefit needs to be submitted on paper.

Duration and benefit amount 

The sickness benefit amount is 70% of the regular gross remuneration that is subject to contributions, but not more than 90% of the most recent net salary. Regular one-off payments such as Christmas or vacation bonuses are also taken into account. The sickness benefit itself is limited to a maximum of €128.63 per day (2025 value). 

The health insurer calculates the benefit based on the data transmitted by the employer through the EEL procedure. 

The payment period is limited to a maximum of 78 weeks within any three-year period if the illness is the same. If another illness occurs while the benefit is being received, this duration is not extended. 

The benefit period also includes the continued remuneration period. 

Time of EEL notification for the sickness benefit 

The employer must submit an EEL notification immediately as soon as it becomes apparent that the employee will exceed the sick leave period of 42 calendar days and thus lose their entitlement to continued payment of remuneration. 

Note
An EEL form is created in Personio Payroll as soon as a time off is set to Sick without salary (unpaid time off) under the Reporting and time off periods tab.

Create EEL notification 01 for sickness benefits

Review prerequisites

Ensure that the entries for the following attributes are correct. 

• Type of health insurance = Public
• Consider in German payroll = Yes

If necessary, also check the history and make any necessary adjustments.

Record time off

To record the time off, follow these steps:

1. Go to the Time off tab in the employee's profile.
2. Enter the start and end dates of the time off. The period must exceed 42 calendar days or be connected with other sick leave periods (prior illness request).
3. Answer these questions:
   • Did you still work on the first day of your time off?
   • Does your sick leave relate to an organ, tissue, or stem cell donation?
4. You can add further information about the sick leave in a comment if you wish.
5. Save your entry.

Note
Make sure that time off types have been created correctly. An EEL notification can only be created for time off with the category Sick leave. 

Review time off periods

In order to create an EEL notification, you now have to confirm the unpaid sick leave time off. Proceed as follows:

1. Go to Payroll > Compliance.
2. Click on Review time off periods.
3. Confirm that the employee is sick without continued payment of remuneration (unpaid time off).
4. Save your entry.

The employee's salary will be reduced automatically based on the stored partial salary payment method, and an EEL form will be created in the Reporting tab. 

Complete and send EEL notification

In the last step, you need to fill in, review and send the EEL notification. This involves the following steps:

1. Go to Payroll > Compliance.
2. For the relevant employee, click on Request EEL certificate. Tip: You can access this via the filter function and the category Income certificate.
3. Check the automatically created template for the EEL notification. We explain what to look out for in the dedicated section below.
4. Submit the EEL notification.

You can also reject an EEL notification. For example, if you have switched to Personio Payroll and one was already created by the previous provider. 

If you accidentally reject an EEL notification, you can create a new one by deleting and recreating the relevant time off in the employee profile.

How to check the EEL form

To ensure that all data in the EEL notification is correctly transmitted to the health insurer, we recommend checking each EEL form. This article explains what you should pay attention to in each of the individual sections. 

Employee and company data

Check the employee's and the company's data.

Incorrect information cannot be adjusted directly in the template. To correct the employee data, adjust the relevant attributes in the employee profile. You can edit the company master data in the settings.

Feedback on compensation for reduced income

Under Feedback, you can tick two checkboxes: 

• Compensation amount: Activate this checkbox if you wish to receive feedback on the compensation from the social insurance provider. This will allow you to determine whether a continued remuneration that you pay is subject to contributions, e.g. for a company car during the employee's incapacity to work.
• End date for the compensation payment: Activate this checkbox if you would like the social insurance provider to inform you about the end date for the compensation. This request helps to avoid overpayments.

Time off

Under Time off, check the periods of the sick leave time off. This information is taken automatically from the previously created time off in the employee profile.

Additional remuneration

After the continued remuneration has ended, further remuneration payments can be made, e.g. benefits in kind or subsidies to the sickness benefit. These must be stated as additional remuneration if, together with the sickness benefit, they exceed the reference net salary by more than €50.00. Payments are taken over from the Salary tab of the employee profile.

Termination of employment

If the employment has already been terminated, check the following in the Termination section:

• Date of the last working day
• Termination reason
• Date the termination was received

In the case of a fixed-term employment, the date field for employment termination remains empty.

Kurzarbeitergeld* 

These fields are automatically populated with data in the employee and company profiles. 

Incorrect information cannot be adjusted directly in the template. To correct the employee data, adjust the relevant attributes in the employee profile. You can edit the company master data in the settings.

Long-term care insurance and work schedule 

Check this section for the status of the long-term care insurance bonus for people without children. The relevant month is the month in which the compensation benefit begins. The number of children under 25 is taken automatically from the employee profile. 

If the employee was initially employed on a work schedule pursuant to Section 7 (1a) SGB IV (e.g. value credit), this field is marked as Yes.

Last payroll periods before the start of the incapacity to work 

Note
Payroll periods are taken directly from Personio Payroll, if available. If you change systems, you will need to fill these fields manually for the first few months after the change.

The last month before the start date of the incapacity to work is always the basis for calculating the sickness benefit. 

• If remuneration remains the same: Completing the fields under Last settled payroll period (period 1) is sufficient.
• For different remuneration: If in the last three months prior to the incapacity to work there were deviations in the salary (e.g. due to regular overtime or fluctuation in piece wages), all three payroll periods must be certified.

The fields under Last settled payroll period (period 1) must always be filled out.

Tip
Also read our Best practices on this topic. 

The following table explains individual fields and which information needs to be entered: 

Working hours

The working hours section in the EEL form is only displayed and filled in if the relevant employee has compensation type 1 = Hourly salary.

The following table explains individual fields and which information needs to be entered: 

Best practices for the section Last completed payroll periods before the start of the incapacity to work

The following examples indicate which fields in this section need to be completed.

 

Case 1: Salary recipients without any particularities

Starting situation:

• Employees with a fixed monthly salary of €3,000.00 gross (net: €2,018.70)
• Start of the incapacity to work on 03/05.
• Continued payment of remuneration ends on 13/06.
• There were no unpaid working days in the last month before the start date of the incapacity to work 

 

Case 2: Salary recipients with a variable gross salary 

Starting situation:

• Employees with a fixed monthly salary of €3,000.00 gross (net: €2,018.70)
• Start of the incapacity to work on 03/05.
• Continued payment of remuneration ends on 13/06.
• There were no unpaid working days in the last month before the start date of the incapacity to work 

In addition, the employee has an hourly basic salary of €17.31 and was compensated for the following overtime hours: 

Month	Overtime	Gross total
April	10 hours * €17.31 = €173.10	€3,173.10
March	25 hours * €17.31 = €432.75	€3,432.75
February	5 hours * €17.31 = €86.55	€3,086.55