Unemployment insurance agencies often combat moral hazard by punishing refusals to apply to assigned vacancies. However, the possibility to report sick creates an additional moral hazard, since (at least in Germany) during sickness spells, minimum requirements on search behavior do not apply. We analyze the effects on unemployment duration and job quality, as measured by the wage and employment stability. To evaluate sanction effects and the impact of receiving vacancy referrals, we take the endogenous probability of reporting sick into account. We estimate multi-spell duration models with selection on unobserved characteristics. We find that vacancy referrals and imposed sanctions increase the exit rate to work. Jobs found after receiving a vacancy referral as well as after the imposition of a sanction are less stable and go along with a lower wage. Our results suggest that around 8.5% of sickness absence during unemployment are induced by receiving a vacancy referral. The impact of vacancy referrals on sickness absence is decreasing over time spent in unemployment.Keywords: unemployment, vacancy referrals, sanctions, sickness absence, moral hazard. JEL codes: J64, J65, C41, C21 * University of Mannheim, IFAU Uppsala, VU University Amsterdam, IZA Bonn † University of Mannheim, IAB Nuremberg ‡ University of Mannheim, IAB Nuremberg, DIW Berlin, IZA BonnWe thank John Ham, Bo Honore, Per Johannson, Johan Vikström, Nikolas Ziebarth and seminar participants at CREST, University of Dortmund, University of Munich, NIW in Hannover, and at several workshops and conferences for valuable comments.