Medical Appointments: What Employers Need to Know

Leave and remuneration during doctor's appointments: What employers need to know

Employers are regularly faced with the question of whether employees should be granted time off for doctor's appointments and whether this time should be remunerated. Section 616 of the German Civil Code (Bürgerliches Gesetzbuch, “BGB”) is particularly relevant here, as it provides for paid time off for short-term, involuntary absence – but only if collective agreements, company regulations or employment contracts do not exclude this entitlement.

This article summarises the most important basics and tried-and-tested recommendations:

Legal framework: Section 616 BGB and its significance

Section 616 BGB grants employees (paid) leave if they are prevented from working for a relatively insignificant period of time through no fault of their own. Doctor's appointments may fall under this provision – but only under strict conditions. The decisive factor is whether the appointment

• is medically necessary,
• cannot be postponed and
• cannot be attended outside normal working hours.

Routine or preventive appointments are generally not covered.

Deviating regulations

Important: Many employers exclude or modify Section 616 BGB through collective agreements, works agreements or employment contracts. In this case, there may be no entitlement to remuneration; the appointments then fall under flexible working time planning or are considered unpaid leave.

Special provisions for employees on flexitime

If employees work flexitime, this does not mean that doctor's appointments must automatically be moved to the early morning or late evening hours. The decisive factor is when the employees usually work – i.e. their individual work rhythm within the flexitime framework. Doctor's appointments should therefore generally be scheduled at times when employees do not typically work. However, if an appointment is medically necessary and cannot be rescheduled, paid leave in accordance with Section 616 BGB may be considered despite flexitime. The prerequisite here is also that rescheduling within the flexitime framework is actually unreasonable and that corresponding evidence is available.

Which doctor's appointments are eligible for remuneration?

Paid leave is particularly applicable in the following cases:

• acute treatments that are immediately necessary,
• preoperative diagnostics and consultations in connection with an operation, or
• radiation or chemotherapy within fixed medical time frames.

In such cases, the time off also includes the necessary travel time. The prerequisite is always that the appointment cannot objectively be scheduled outside of working hours.

Best practices for employers

The following are particularly recommended:

• Clear regulations in works agreements or employment contracts – in particular regarding the (partial) exclusion of Section 616 BGB;
• a clear differentiation between routine appointments and medically necessary exceptional situations;
• transparent HR guidelines for consistent handling and
• the requirement for a brief medical certificate confirming the necessity and urgency of the appointment (without diagnosis).

Recommendations for employers

From an employer's perspective, it has proven beneficial not to leave Section 616 BGB unregulated. Many companies largely exclude the standard, but open it up specifically for narrowly defined medical exceptions. This creates a clear distinction from privately arranged doctor's appointments without disadvantaging employees in stressful health situations. At the same time, this ensures uniform and legally compliant handling – also with regard to avoiding conflicts with the works council.

In this context, it is important that employers observe the distinction between the right to time off and the right to remuneration. Depending on internal regulations, employers must grant employees time off work if a doctor's appointment is medically necessary and cannot be postponed – regardless of whether the time is remunerated. In practice, this often leads to misunderstandings: time off does not automatically mean that employers have to remunerate the time lost. Clear internal communication helps to make this distinction transparent.