Belgium's One-Day Sick Note Experiment: A 54% Jump That Nobody Can Agree On

Belgian workers are calling in sick for a single day far more often than they used to. Since the country dropped the requirement for a doctor's note to cover one day of absence, one-day sick reports have climbed 54% between 2021 and 2024, according to a joint study by HR services firm Securex, KU Leuven and the Université libre de Bruxelles (ULB).

The researchers read the shift mainly as a change in behaviour: people who feel unwell take a day to rest instead of dragging themselves into work. They found no evidence of systematic abuse.

What the numbers show

Under a reform introduced by the De Croo government at the end of 2022, staff at Belgian companies with more than 50 employees may stay home without a medical certificate. Since 1 January, this is allowed up to twice a year; the previous cap was three times.

Securex's impact analysis, which involved Philip Verwimp and KU Leuven's HIVA research institute among others, puts hard figures on the trend. At workplaces with at least 50 staff, one-day absences per employee rose from 0.22 in 2021 to 0.42 in 2024. The increase began in 2023 and grew more pronounced last year.

Smaller firms, still bound by the certificate requirement, saw the figure edge up only from 0.17 to 0.25. Sick leave lasting two to five days stayed flat over the same period.

Overall short-term absenteeism of up to one month showed no statistically significant change, even though employers report extra organisational costs and administrative burden.

Employer groups push back

Heidi Verlinden of Securex stressed that the statistical rise does not necessarily point to abuse. Timely rest during acute fatigue or strain could, over the longer term, help prevent more serious long-term illness.

Business and political circles remain sharply critical of the model. Labour economist Stijn Baert of Ghent University suspects the absences are largely unjustified, and like Frank Beckx, head of the Flemish employers' association Voka, he wants the exemption scrapped. Axel Ronse, parliamentary group leader for N-VA, has already tabled a proposal to that effect.

Germany weighs the opposite move

While Belgium debates bringing back the certificate for single days, Germany is considering tightening its rules. Federal Labour Minister Bärbel Bas spoke out in substance against a general obligation to obtain a sick note from day one, yet agreed to such a plan in coalition negotiations in order to head off further demands from the Union for waiting days and cuts to continued pay.

The minister voiced concern that doctor visits for mild infections on the first day of illness could more often lead to full-week sick notes. The new rule forms part of a wider package including appointment guarantees and stroke prevention, with implementation planned by the end of the year.

Current German law on continued pay allows up to three calendar days of absence without a certificate, provided the employer has not agreed otherwise. An estimated 45 to 55 percent of German companies already require a certificate from the first day of absence. Separately, the Bundestag decided on 15 October 2026 to postpone the introduction of staggered partial incapacity for work to 1 July 2028.