German Sick-Leave Reform Faces Friction: Mandatory Doctor’s Note From Day One Meets Workplace Prevention Push
Published on 07/08/2026 at 06:14 | Redaktion boerse-global.de
At the heart of the federal government’s package is a requirement for employees to present a medical certificate from the first day of illness – a move that would abolish the current practice of allowing a phone-based sick note for up to three days. Chancellor Merz has framed the change as necessary to reduce the country’s high sickness absence rate.
Yet the plans have drawn sharp criticism from medical associations. The National Association of Statutory Health Insurance Physicians expects at least 30 million extra visits to doctors’ surgeries each year if the telephone sick note is scrapped. The German Association of General Practitioners warns of a “massive surge” in practice traffic, noting that phone-based certifications currently account for only a small fraction of cases.
Beyond the sick-note rule, the reform package includes several other measures. High earners with an annual gross income above €177,500 would face eased dismissal protection. Fixed-term contracts without a specific reason could be extended to a maximum of 48 months. For 2027, adjustments to the contribution assessment ceiling and new co-payments for prescription drugs are also planned.
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The proposals have split the coalition and interest groups. The CDU’s labour wing and the SPD have voiced reservations, with the SPD calling for more flexible implementation. Business experts argue that instead of tightening sick-note rules, policymakers should focus on strengthening workplace health management to tackle the root causes of absenteeism.
Sick-Pay Bill Hits Record
Data from the BKK Federal Association underlines the financial pressure. Sick pay – Krankengeld – has become the largest single expenditure item in the statutory health insurance system, reaching €21.6 billion in 2024. That marks an increase of more than 24% over a decade. In 2025, over a quarter of all sick days were accounted for by employees receiving this benefit.
The main drivers are musculoskeletal disorders and mental health conditions. Although mental illnesses represent only 5.4% of cases, they cause average absences of more than five weeks. The overall sick rate remained stable at 6.1% in 2025. The AOK health fund recorded an average of 23.3 sick days per insured employee.
A further burden on contribution payers comes from non-insurance-related benefits. In 2024 these amounted to around €58 billion – including free co-insurance for family members and deficits in hospital investment. Government tax subsidies covered just €14.5 billion of that sum. According to estimates, contribution payers financed roughly €32 billion of these society-wide tasks.
Companies Shift to Preventive Health Strategies
A growing number of employers are moving beyond reactive measures. “Workplaces need to intervene earlier to strengthen their employees’ resilience,” says Lea Feder of JETZT Performance GmbH. Relying solely on a response after illness has set in is insufficient. Leadership culture, she adds, plays a critical role.
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Corporate health insurance (betriebliche Krankenversicherung, bKV) is gaining traction as a complement to internal health programmes. It often gives workers faster access to specialists or psychological counselling. While those in the statutory system can wait six to twelve months for a therapy slot, bKV can arrange care within weeks. German law also already requires employers to conduct psychosocial risk assessments.
Award Deadline Extended
The DAK-Gesundheit health insurance fund has pushed back the application deadline for the German BGM (Workplace Health Management) Award to 18 July 2026. Under the theme “New Paths to Healthy Work – Digital, Healthy, Human, Sustainable,” the prize honours concepts that demonstrate long-term viability. The award package is worth €60,000 in kind, split among the top three winners. The ceremony is scheduled for 29 September 2026 in Cologne. Such initiatives underscore a broader shift: workplace health is no longer seen purely as a cost but as a strategic investment in productivity and staff retention.
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