Economists Cast Doubt on Germany’s Plan to Scrap Phone Sick Notes and Require Doctor’s Visit from Day One
Published on 07/04/2026 at 11:33 | Redaktion boerse-global.de
The German government wants employees to produce a doctor’s certificate from their very first day of illness, eliminating the phone-based sick notes that became routine during the pandemic. But experts warn the reform may backfire.
A coalition committee sealed the decision on 2 July 2026. Under the new rules, the current grace period—which allowed workers to stay off for up to three days without paperwork—will vanish. Anyone calling in sick will need a physical or virtual medical consultation. Chancellor Merz justified the move in early July by citing high absenteeism rates, calling it a return to pre-corona standards. Companies can still negotiate individual agreements with staff, he added.
Union faction leader Spahn defended the tightening as a measure of fairness toward colleagues who do turn up. The government hopes to reduce the average sick days per insured person, which stood at 19.5 in 2025, according to DAK data.
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But economists immediately pushed back. Daniel Graeber, an economist at the DIW, warned on 3 July that requiring a doctor’s visit from day one could actually raise absence levels. His reasoning: extra practice visits increase the risk of infection in waiting rooms, and the medical infrastructure risks becoming overwhelmed.
Doctor associations reacted sharply. Andreas Gassen, chair of the National Association of Statutory Health Insurance Physicians (KBV), called it misguided to push a surge of additional patients into surgeries. The German Association of General Practitioners described the plan as a looming catastrophe for care provision, adding that many of the extra appointments would be medically unnecessary.
KBV data show roughly one-third of all sick notes currently cover three days or fewer.
The phone-based sick note that the government is scrapping accounts for only 0.8 to 1.2 percent of all certificates, according to analyses by the Central Research Institute for Ambulatory Health Care (Zi) and the Barmer health insurance fund. Graeber therefore sees no causal link between that option and overall absence rates. A large chunk of sick leave is driven by other factors anyway: long-term illnesses lasting more than six weeks caused about 40 percent of all lost workdays in 2024.
Public opinion also leans against the change. A YouGov poll found 59 percent of respondents oppose the day-one certificate rule, and 58 percent reject abolishing phone sick notes. Unions such as ver.di and the DGB warned of rising presenteeism—workers showing up despite being ill.
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Inside the coalition, details are still being hammered out. SPD leader Klingbeil argued on 3 July for a practical implementation. A government spokesperson clarified that the proof requirement from day one does not necessarily mean the document must physically reach the employer on the first day.
Health Minister Warken is promoting video consultations as a digital alternative that could ease pressure on practices and partly compensate for the loss of phone-based certificates. Policymakers are also discussing partial sick leave modeled on Scandinavian systems, where employees can be certified as unfit for 25, 50, or 75 percent of their working hours. Labour Minister Bas said she would commission a thorough assessment of the potential effects of the new rules.
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