How is a sick note for migraine assessed by video?

How can you describe your headache accurately?

The Federal health portal (gesund.bund.de) describes migraine as often involving a one-sided headache with a throbbing or pulsating quality. Nausea, vomiting and particular sensitivity to light or sound can accompany the headache as well. This general description alone is not enough to establish that your symptoms are definitely migraine. Begin by describing your own symptoms before offering any possible explanation you have considered for them.

Note when the pain began, where it occurs and how it has changed since first appearing. Compare the current episode with previous symptoms only where you actually have relevant earlier experience. Say explicitly if this headache is new to you or feels different from your usual experience. Mention previous examinations and keep any existing information about them available for questions during the consultation.

Describe limitations using specific situations, such as reading or taking part in a longer conversation. Distinguish the intensity of pain from any additional symptoms you notice at the same time. If timing is difficult to recall, give an approximate period and clearly describe it as approximate. This preparation supports a clear account and cannot replace medical decisions about the cause or next steps.

Which demands of your job should you mention?

For statutory insurance care, § 2 paragraph 1 Arbeitsunfähigkeits-Richtlinie takes account of the work you most recently carried out. Assessment considers whether illness prevents that work or whether doing it could worsen your condition. Describe the actual tasks awaiting you at work and those which are currently causing difficulty. Examples include screen work, changing conversational situations or duties that require a high level of attention.

Explain which particular task is difficult at present, as well as how unwell you feel overall. Mention whether you have already tried working and what difficulties arose during that attempt. This is not an invitation to test yourself by forcing activity despite your current symptoms. Use only observations you have already made naturally and can usefully share during the consultation.

The guideline dated 14 November 2013 applies from 21 February 2024 with the amendment of 7 December 2023. Its scope is statutory insurance care; our service is instead a private medical video consultation. Here, the doctor decides about a possible certificate within the limited period offered by the service. A familiar pattern of symptoms therefore does not automatically guarantee a sick note before the personal consultation.

What should you clarify before the consultation ends?

Ask whether video allowed an adequate assessment of your symptoms or whether further examinations seem necessary. Have the doctor explain whom to contact if your symptoms continue or change after the consultation. Note the answer specifically enough to understand the recommended next step when you refer to it later. If you could not take in information during the conversation, ask immediately for another explanation.

Our service excludes extensions and limits a certificate to no more than three calendar days. If symptoms last longer, arrange another examination at a local practice in good time for reassessment. Bring details of the course so far and, where relevant, the certificate already issued to you. An earlier assessment describes the previous position and cannot replace a fresh evaluation of changed symptoms.

Choose a place where you can speak with the doctor without interruption when preparing for the consultation. Keep important documents within reach so you spend as little time as possible searching for them. Say openly if the screen, conversation or concentration is especially difficult for you at present. This feedback describes your current situation and helps the doctor adjust how the conversation proceeds.

When should you seek help without waiting for video care?

medical on-call service on 116117 lists acute, persistent, extremely severe pain and seriously impaired consciousness as examples requiring a call to 112. In this situation, do not wait for a video appointment, whether already booked or still being sought. For urgent, non-life-threatening symptoms outside normal consultation hours, the medical on-call service on 116117 provides assistance.

What do you need to tell your employer?

Notify your employer without delay that you cannot work and how long you expect the absence to last. This legal duty to notify follows from § 5 paragraph 1 continued remuneration law (Entgeltfortzahlungsgesetz, EFZG), the German continued remuneration law (Entgeltfortzahlungsgesetz, EFZG). Where possible, send your notification before waiting for the video consultation to finish. If unsure, ask which reporting channel to use and who handles sickness notifications at work.

Keep your sickness notification separate from the medical evidence covering the period certified by the doctor. With this service, you receive a PDF for your employer after the doctor establishes incapacity for work. You submit it yourself; there is no electronic transmission to your health insurance fund here. Our terms of service explain this service limit alongside the procedure for the private medical consultation.

Before sending the certificate, check the recipient, your name and the period stated on it. Store your own copy and confirmation of submission somewhere protected for your personal records. If questions arise, you can then find and identify the documents you actually submitted more easily.

What are the limits and fees of this service?

Our service is for adults aged 18 and over whose symptoms can be assessed adequately by video. Generally accepted professional standards must allow your treatment without an in-person medical consultation. The certificate usually starts on the day of your video consultation. After careful medical assessment, the doctor may exceptionally backdate its start by up to three days. The doctor must also be able to establish your incapacity for work during that earlier period. There is no entitlement to backdating. The certificate still covers no more than three calendar days, including any backdated days. This service does not extend an existing certificate by video. Contact us on your first day of illness whenever possible. Further details are set out in our terms of service.

According to our service, a base consultation fee of €10.72 is reserved before the appointment. If a medically necessary visual examination is actually performed, the fee totals €21.44 plus applicable surcharges. The fee remains payable even if the medical assessment does not result in a certificate. Before booking, read the full pricing information carefully, including details of any possible surcharges.

People with statutory health insurance pay themselves; reimbursement by private insurance depends on their policy terms. Our terms of service do not guarantee reimbursement or acceptance of the certificate by your employer. Have your identity document and a device with a camera and microphone ready for the consultation. Check your internet connection and choose somewhere you can speak without being disturbed by others.

Where can you find further answers?

These related guides provide further information about the next steps in reporting your sickness absence:

• Is a sick note issued by video valid in Germany?
• How do you get an online sick note in Germany?
• How should you notify your employer about sick leave?
• What does a private video consultation for a sick note cost?

Editorial team Krankschreibung per Video, Drylabs GmbH

Updated: 26 October 2026