Overview
- Employers generally cover the first six weeks of absence, then statutory health insurers pay sickness benefit from day 43, while after workplace or commuting accidents the accident insurer pays injury benefit at about 80% of regular pay and potentially beyond 78 weeks if treatment continues.
- A single day back at work does not restart the six‑week employer entitlement; a new six‑week period arises only after genuine recovery and a different illness, otherwise the health insurer becomes responsible immediately.
- For the same condition, sickness benefit is limited to 78 weeks within a three‑year block counted from the first day of incapacity, and a temporary return to work does not interrupt that block.
- When sickness benefit coincides with a partial disability pension, the benefit is reduced only by the pension’s net payment and only if the pension begins after the incapacity; if the pension was already in payment beforehand, no reduction applies.
- After a work or commuting accident, notify the employer promptly, see a designated trauma specialist (Durchgangsarzt) and ensure an accident report is filed, and for all cases maintain gap‑free medical certificates with follow‑ups due by the next working day as Saturdays do not count.