German Workers Now Must Provide a Doctor’s Note on Day One of Illness
Published on 07/22/2026 at 21:10 | Redaktion boerse-global.de
Germany’s coalition government has pushed through a major overhaul of labour rules, introducing a requirement that employees obtain a medical certificate from the very first day they call in sick. The change, part of a broader “Programme for Upturn and Employment,” was approved in early July and replaces the previous system where a doctor’s note was only needed after the fourth day of absence.
The pandemic-era practice of phone-based sick notes has been scrapped entirely. Video consultations remain an option, though the impact is likely minimal—statistics show telephone sick notes accounted for just 0.8 to 1.2 percent of all medical certifications. Employers have welcomed the move, hoping it will curb rising absenteeism. The German Trade Union Confederation, however, warned of “impending capacity problems in doctors’ surgeries.”
Separate from the legislative changes, courts are tightening the screws on how companies handle illness-related dismissals. The Lower Saxony Regional Labour Court ruled that if an employer prematurely ends the mandatory Return-to-Work Management process—known in Germany as BEM—any subsequent termination is disproportionate. Agreed measures, such as digital health courses or appointments with company doctors, must actually take place; merely starting the procedure is not enough.
When employers suspect fraudulent sick leave, they can turn to the Medical Service for verification. Private investigators may also be used, but within strict limits. The DĂĽsseldorf Regional Labour Court cautioned that excessive surveillance could lead to compensation claims for damages.
High earners face a looser regime starting January 2027. Companies will be able to terminate employment contracts for workers earning more than €177,450 in annual gross salary by paying a severance package, without needing to provide a specific reason. Fixed-term contracts are also being made more flexible: employers can now offer up to 48 months of fixed-term employment without a specific justification, with up to six extensions. This rule is temporary, running until the end of 2030. The requirement for written form in fixed-term contracts will be dropped in early 2027.
Health data paints a mixed picture. The DAK-Gesundheit insurer reported an average of 9.6 sick days per insured person in the first half of 2026, down from 9.9 days a year earlier. The Techniker Krankenkasse recorded 18.6 days for all of 2025. But the headline improvement masks a troubling shift: mental illness has become the leading cause of work incapacity for the first time, with 184 sick days per 100 insured individuals. Respiratory illnesses, by contrast, fell by 21 percent.
A survey conducted in mid-June highlights the pressure workers feel. 72 percent of employees said they feel compelled to justify themselves when reporting sick. More than 90 percent admitted they had worked despite being ill.
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