German Coalition's Sick-Note Overhaul Sparks Fury Among Doctors, Raises Infection Fears
Published on 07/14/2026 at 19:37 | Redaktion boerse-global.de
A decision by Germany's federal government to require employees to produce a medical certificate from the first day of illness has drawn sharp condemnation from physicians and statutory health insurers. The Hausärzteverband, which represents family doctors, called the plan "fatal" for primary care, warning that practices would be inundated with patients seeking only a note for minor ailments. That, they say, could endanger treatment for the chronically ill.
The change, approved by the coalition committee in early July 2026, would scrap the current rule that lets workers stay home for up to three days without a doctor's certificate unless their employer demands one earlier. Instead, every sick day would require a medical certificate of incapacity for work (AU-Bescheinigung) from day one. Alongside that, the coalition wants to abolish entirely the option of telephone-based sick notes, which had been introduced during the pandemic.
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The initiative is part of a broader 34-point reform package that also tightens criminal law. The government plans to amend § 278 of the penal code (StGB) to impose tougher penalties on doctors who issue false health certificates. The new regulations are not yet in force. However, companies can already demand a day-one sick note based on a 2012 ruling by the Federal Labour Court—without needing to provide a special reason. The pending law would make that individual option the universal standard.
Mixed Signals from Industry
Business reactions are divided. Some large companies in southern Germany welcome the move as a way to reduce absenteeism. Others see no need for change or prefer to keep existing trust-based arrangements. In the financial sector, scepticism dominates: companies say they favour a culture of mutual trust over tighter control.
Certain sectors may be exempted. Pharmacy employees covered by the federal collective bargaining agreement (Bundesrahmentarifvertrag) are currently required to present a note only from day four. The coalition has indicated that deviating collective agreements should remain permissible.
Special Rules for Civil Servants
The reforms under the salary continuation law (Entgeltfortzahlungsgesetz) do not directly affect federal civil servants. According to the Federal Ministry of the Interior, officials still only have to prove incapacity for work when asked. But an employer may already demand a day-one certificate under current law. In Bavaria, the threshold for state civil servants currently stands at day four; the state finance ministry is examining whether to adopt the new federal standard.
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Statistics from 2023 show why absenteeism is a sensitive issue. Federal civil servants averaged 20.9 sick days per person that year, compared with 15.3 for private-sector employees. In Bavaria, the figure was notably lower at 11.6 days.
Legal Risks and Tax Relief as Flanking Measures
Beyond tightening sick-note rules, the package includes economic stimulus worth roughly €10 billion annually in tax relief for low and middle incomes, as well as greater flexibility in fixed-term contracts. Experts warn that false sick reports already carry legal risks: apart from the planned § 278 reform, employees can face prosecution for fraud or using false documents. For civil servants, such offences can lead to dismissal and loss of pension rights. According to estimates, nearly 10 percent of employees stay away from work each year without a valid medical reason.
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