German coalition proposes mandatory first-day sick notes to curb absenteeism

Germany’s governing coalition, led by the Christian Democrats (CDU), the CSU and the Social Democrats (SPD), is proposing to require employees to submit a medical certificate on the first day of sick leave. The plan also includes abolishing telephone sick notes and increasing penalties for the fraudulent issuing of medical certificates.

Under current regulations, workers must notify their employer on the first day of illness but only need a doctor’s note from the fourth day onward. Since 2023, patients with mild symptoms known to their practice have been able to obtain these certificates over the phone, a system trialled during the pandemic.

The overhaul is driven by concerns over Germany’s high rate of workplace absenteeism and its impact on national economic output. Chancellor Friedrich Merz argued that the country can no longer afford the competitive disadvantage caused by long absences at work, framing the policy as a necessary productivity measure.

Statistical comparisons highlight the scale of the issue, though methodologies vary across borders. Data compiled by the IGES institute and health insurer DAK-Gesundheit showed German employees took an average of 25 paid sick days in 2022, while public insurer AOK reported an average of 23.9 sick days in 2024.

Backlash and practical concerns

The proposal has drawn sharp criticism from medical and social welfare groups, who warn it will overwhelm general practitioner surgeries. Michaela Engelmeier, chair of the German Social Welfare Association, stated the regulation could force employees to attend work while ill and further exacerbate the strained situation in doctors’ offices.

Dr Paula Piechotta, health budget spokesperson for the Greens’ parliamentary group, called the plan a mistake in health policy. She argued that harsher penalties and mandatory first-day notes mean doctors will no longer dare to issue sick notes, adding that the government hates workers and doctors.

Experts question whether the measures will actually reduce sickness absence. A study published in early October 2025 by the Central Institute for Statutory Health Insurance Medical Care suggested that higher recording rates stem from the pandemic and the electronic sick note system, not telephone certifications.

Similarly, the DAK health insurance organisation found no systematic abuse of the telephone sick note system. The Federation of German Consumer Organisations has praised the existing phone system as a model of success for cutting red tape.

Practical details remain vague until draft legislation is published, including how the rules will interact with the existing electronic sick note system. Ministers must now draft laws for coalition agreement before seeking approval in the Bundestag and Bundesrat.