Germany’s New Sick-Note Rules Target Short-Term Absence, but Long-Term Illness Drives Most Sick Days
Published on 07/04/2026 at 18:47 | Redaktion boerse-global.de
Doctors are bracing for a flood of extra appointments under a planned overhaul of Germany’s sick-leave rules — even as data shows the policy may do little to tackle the real driver of rising absenteeism. The German Medical Association estimates that requiring a doctor’s note from the first day off work will trigger roughly 30 million additional surgery visits each year. The National Association of Statutory Health Insurance Physicians calls the plan “bureaucratic madness,” arguing it will divert resources from seriously ill patients.
The criticism landed just hours after the federal cabinet, led by Chancellor Friedrich Merz, approved the reform package. Under current law, employees generally need a medical certificate only from the fourth day of illness. The new rules scrap that grace period and go further: the telephone-based sick note, introduced as a pandemic-era emergency measure, will be abolished. Instead, the government of Health Minister Judith Warken wants to push patients toward digital consultations, including video appointments.
A third element — partial sick leave — marks a conceptual shift. Workers would be able to return to their jobs at 25, 50 or 75 percent capacity, a move designed to ease the transition back after illness.
The coalition is deeply split over the changes. Union politician Jens Spahn defends the policy as a “matter of fairness,” citing an average of 18 sick days per worker per year. Parts of the SPD, led by party chief Lars Klingbeil, are urging a workable implementation: “No one should be overwhelmed when they are ill.” Labour Minister Eva Bas announced a thorough review and made clear the proposal did not originate in her department.
The opposition Greens are demanding a complete withdrawal, accusing the government of putting all employees under general suspicion.
A closer look at the figures raises questions about the reform’s effectiveness. According to the German Institute for Economic Research (DIW), roughly 40 percent of all sick days in 2024 were linked to long-term illnesses lasting more than six weeks. An earlier doctor’s certificate for short-term absences does nothing to address that category. Overall absenteeism stood at 14.8 days per person in 2024 and rose to as much as 19.5 days in 2025.
One reason for the apparent spike, analysts note, is the electronic sick-note system (eAU), introduced in 2022. It captures short-term illnesses much more comprehensively than paper-based reporting, inflating the headline figures.
Meanwhile, the existing telephone sick note, which the government now plans to scrap, accounted for just 0.8 to 1.2 percent of all sick notifications recently. Critics call its abolition a purely symbolic gesture.
DAK chief Andreas Storm warns that packed waiting rooms — especially during waves of infection — could actually spread disease faster. Public sentiment mirrors the scepticism: surveys show that around 59 percent of Germans oppose the mandatory first-day doctor’s note, and a similar share reject the end of telephone sick leave.
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