No Doctor, No Sick Pay: Germany Outlaws Online-Only Medical Certificates

Employees who submit a sick note obtained purely through an online questionnaire without any direct contact with a physician could be dismissed without notice, a German labour court has ruled. The decision by the Hamm State Labour Court on 5 September 2025 strips such digital documents of any evidentiary value, leaving workers exposed to immediate termination.

The ruling arrives as Health Minister Nina Warken pushes ahead with legislation that will outlaw the practice altogether. Under the planned reform, a certificate of incapacity for work will only be valid if it follows an in-person appointment or a video consultation. The so-called "questionnaire route"—where patients answer a few questions on a commercial platform and receive a sick note without ever seeing a doctor—will be legally prohibited.

"Video consultations remain a modern and acceptable tool," Warken said, noting that roughly 20% of medical practices in Germany already offer them. The move responds to pressure from the German Association of General Practitioners, which has long argued that commercial platforms without medical examination undermine both patient safety and the integrity of sick-leave certification.

Reform package goes beyond sick notes

The crackdown on online certificates is part of a broader legislative package. Another element is the planned abolition of the telephone sick note, which has been allowed as a pandemic-era measure. To help finance these and other health-system changes, the government is introducing a levy on sugary drinks. The new tax is expected to generate around €650 million annually, which will flow into the federal budget. In return, the state will increase its subsidies to statutory health insurers, aiming to put the system on a more stable financial footing.

The health ministry is also coordinating with Labour Minister Bärbel Bas. One idea under discussion is a requirement for employees to provide proof of illness from the very first day of absence. The goal, according to officials, is to strike a balance: protecting employers' legitimate interests without overburdening doctor's surgeries or damaging the trust-based relationship between employers and staff.

Long-term illness drives most absences

The push for tighter rules reflects a stark reality: although long-term conditions such as depression or cancer account for only 3.3% of all illness cases, they are responsible for roughly 40% of all days lost to sick leave, according to AOK statistics. Policymakers hope that clearer documentation and reduced abuse of digital shortcuts will help contain rising absence rates while preserving the right to proper medical care.

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