Germans Reject Day-One Sick-Note Rule as Doctors and Economists Warn of Collateral Damage

A YouGov poll finds 59 percent of respondents opposed to the planned obligation to present a medical certificate from the very first day of illness. That disapproval rises to 58 percent when voters are asked about scrapping the option to obtain a sick note by phone — a practice that coalition parties agreed to eliminate in a recent breakthrough deal. The deep unpopularity underscores the tensions surrounding one of the most debated workplace reforms in Germany.

The blueprint, hammered out by the Union and SPD coalition committee, replaces the current system under which an employer can demand a doctor's note only after the fourth day of absence. Under the new rules, a physician’s certificate will be mandatory from day one. The measure is intended to curb rising absenteeism, but critics say it will backfire.

Coalition rift widens as Merz defends hard line

Chancellor Friedrich Merz has stood firmly behind the plan, describing it as a return to the standards applied in the 1990s. “This step is necessary,” Merz argued. Union parliamentary leader Jens Spahn added that the day-one requirement is fairer toward colleagues who cover for absent workers. But the stance has not united the government.

SPD Secretary-General Tim Klüssendorf conceded that the decision has caused irritation within his party, calling it the “lesser evil” compared to a debated unpaid waiting day. The Greens — not formally part of the coalition but often consulted — escalated their criticism. Munich’s mayor Dominik Krause accused the government of placing all employees under blanket suspicion.

Medical associations predict massive practice overload

The German Association of General Practitioners reacted with blunt rejection. Chairwoman Nicola Buhlinger-Göpfarth labelled the reform “pure symbolic politics” and warned that it would generate at least 30 million extra consultations per year. Instead of targeting patients and doctors, she said, the government should curb the proliferation of commercial video-consultation platforms that bypass traditional care structures.

The head of DAK-Gesundheit, Andreas Storm, echoed the warning of overcrowded waiting rooms. He proposed adopting the Scandinavian model of partial sick leave — allowing employees to work reduced hours while recovering. Federal Patient Advocate Stefan Schwartze (SPD) highlighted an additional health risk: mildly ill people would have to sit in crowded waiting rooms to obtain a paper, increasing the spread of infections.

Economists question whether the rule will actually cut sick leave

Daniel Graeber of the German Institute for Economic Research (DIW) poured cold water on the reform’s core premise. According to him, telephone sick notes account for only 0.8 to 1.2 percent of all medical certificates of incapacity — far too small a share to explain the rise in absence rates.

Data show that the increase in average sick days — from 18 days in 2016 to 22 days — is largely a statistical artifact. The introduction of the electronic certificate of incapacity (eAU) in 2022 enabled comprehensive recording for the first time. Moreover, long-term illnesses lasting more than six weeks cause roughly 40 percent of all missed days. Graeber also warned of “presenteeism”: workers afraid of the bureaucratic hassle may show up while contagious, infecting colleagues and reducing overall productivity.

Existing contracts and legal safeguards

Labour law experts pointed out that many current employment contracts already stipulate a three-day grace period before a doctor’s note is required. Under the principle of favour (Günstigkeitsprinzip), those individual agreements would likely remain valid, allowing employers and employees to opt out of the tighter rule. The reform thus applies only where no such arrangement exists.

Employers’ President Rainer Dulger welcomed the change, arguing that it would reduce abuse. The German Trade Union Confederation (DGB), however, warned of an unnecessary burden on staff and on the medical infrastructure. With public opinion squarely against the plan, the coalition faces a tough sell — both in parliament and at the ballot box.

en | boerse | 69700643 |