Can a private doctor backdate a sickness note?

When a backdated sickness note is legally possible

The sickness note is not a free stamp but a regulated medical finding. The German Arbeitsunfähigkeits-Richtlinie explicitly states that an AU usually applies from the day of examination. Backdating is allowed only in justified exceptions and limited to a maximum of three calendar days. Exceptional grounds can be: the patient could not have reached a doctor earlier for medically understandable reasons (weekend with no reachable doctor, marked bed-rest, no practice availability) and the illness at examination is in a state that makes a start three days earlier plausible. Pure 'wish backdating' without this clinical correlate is a false certification and a violation of professional law — serious doctors do not do this.

In practice: if you book a Monday house call with us for a flu-like illness existing since Friday and you were bedridden over the weekend — in that case we can realistically write the AU from Friday or Saturday, depending on the findings. If by contrast you have had mild symptoms for three weeks and now need an AU for a past week because your employer is asking, backdating is neither legal nor medically justifiable. We discuss the matter openly on the phone or on site and in most cases find a way that is medically and legally correct. It is not in our interest to issue invalid notes — they get rejected by employers or insurers and harm you more than they help.

Employer validity: a private-issued AU is accepted by employers just like a statutory one — the Federal Labour Court has confirmed this repeatedly. However, statutorily insured patients have a parallel obligation to inform their statutory fund about the sickness. Since 2022 the electronic eAU is the standard, transmitted by statutory contract doctors directly. For a private AU you have to trigger the process manually as a statutory member: submit the private AU to your fund for recognition; the fund will then notify the employer separately. This double track is a typical administrative effort of private medicine for GKV-insured patients.

Example: gastroenteritis since Saturday, call on Monday

A patient in Wedding calls Monday morning — since Saturday afternoon gastroenteritis with vomiting and diarrhoea, bedridden Saturday and Sunday, no doctor contact possible. We come Monday at 11. History plausible, clinically still significant residual symptoms with mild dehydration, exam fits. We write the AU backdated from Saturday to Wednesday (4 days). Legally this is within the permitted 3-day backdating window (Saturday to Monday) plus expected AU from the exam day (Monday to Wednesday). Patient submits the AU manually to his statutory fund on Tuesday, in parallel to the employer.

What applies to a backdated sickness note

• Backdating only in exceptions — standard is: AU from day of examination.
• Maximum three calendar days backdating — more is not permissible.
• The reason must be plausible: medical constellation, bed-rest, no reachable practice.
• Findings at examination must match an illness that started earlier.
• Wish-backdating without medical basis: NOT possible, would be false certification.
• A private AU is valid for employers — not worth less than a statutory one.
• GKV-insured: must submit private AU manually to the fund — no automatic eAU transmission.
• Delayed reporting to the employer can risk continued-pay entitlement — submit promptly.