German Doctors Blast Mandatory Day-One Sick Note as Coalition Tightens Absence Rules
02.07.2026 - 21:25:16 | boerse-global.de
Germany’s coalition committee has ordered sweeping changes to sick-leave rules, requiring employees to present a medical certificate from the very first day of illness and scrapping the telephone sick-note option that was introduced only at the end of 2023. Chancellor Friedrich Merz justified the move by pointing to the country’s high sickness rate, arguing that the number of lost working days constitutes a major competitive disadvantage for the economy. The new regulations form part of a broader package aimed at reviving growth and employment.
Previously, German law obligated workers to supply a doctor’s note only from the fourth day of absence, unless their employer demanded one earlier. Under the revised rules, proof of illness becomes mandatory from day one as the default. Companies may still negotiate exceptions via collective bargaining agreements or internal company regulations.
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Medical Associations Sound the Alarm
Physicians have reacted with fury. Andreas Gassen, head of the National Association of Statutory Health Insurance Physicians (KBV), called the plan “madness,” warning that hundreds of thousands of patients would be driven into practices for nothing more than paper bureaucracy. Gassen instead proposed introducing a waiting-day system.
The German Association of General Practitioners cautioned that primary care risks being overwhelmed. The decision is “catastrophic” and would unleash a wave of red tape, the group said. It stressed that the telephone sick-note arrangement had not led to more absences; any observed rise in case numbers was a statistical artifact caused by the electronic sick-note (eAU) and more complete recording.
Green Party health expert Janosch Dahmen also voiced concerns. If people with mild cold symptoms have to visit a surgery just to get a certificate, infection risks in waiting rooms will increase. “Sick people belong at home to recover,” he said.
Culture of Mistrust or Necessary Move?
Social associations and trade unions accuse the federal government of fostering an atmosphere of distrust. Verena Bentele, president of the Social Association VdK, and Verdi chief Frank Werneke both spoke of a growing “culture of mistrust.” The AOK health insurance fund dismissed the abolition of the telephone sick-note as pure symbolic politics.
Employer bodies, however, welcomed the change. The Confederation of German Employers’ Associations (BDA) voiced its support, as did regional groups such as Metall NRW.
Additional Measures on the Horizon
Beyond the new certificate requirement and the end of telephone sick notes, the coalition is considering further adjustments. Partial sick notes covering 25, 50 or 75 percent of working capacity are under discussion. False sick-note certifications are to face stiffer penalties, with reference to Section 278 of the German Criminal Code.
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The debate is fueled by recent health insurance data. DAK reported an average of 19.5 days of absence per insured person in 2025, down slightly from 19.7 days the previous year. While business representatives and the federal government see a need for action, politicians from the Left Party and SPD-led health ministries warn of increased pressure on employees.
Whether video consultations will remain an alternative to in-person examinations is still being debated within the coalition. No concrete timeline for legislative implementation has been set.
