Germany Plans to End Phone Sick Notes, Require Doctor’s Certificate From Day One
Published on 07/28/2026 at 10:24 | Redaktion boerse-global.de
Germany’s coalition government is moving to scrap the option for workers to call in sick without a doctor’s note, replacing it with a mandatory medical certificate starting on the first day of illness. The proposed change has drawn sharp opposition from physicians and unions, while employers argue it is a necessary check on rising absenteeism.
Doctors Warn of Overwhelmed Practices
The backlash has been swift. “The phone-based sick note has massively relieved our practices and reduced infection risks in waiting rooms,” said Dr. Alexander Jakob, head of the Hesse Association of General Practitioners. His colleague Dr. Jana Husemann in Hamburg added: “Seriously ill patients will have to wait even longer because we’ll be dealing with minor cases.”
Unions are also pushing back. The German Trade Union Federation (DGB) in Hesse and Thuringia pointed to studies showing that phone sick notes did not significantly affect overall sick leave rates. Instead, they warn the new rule could fuel “presenteeism,” where employees drag themselves to work ill rather than staying home.
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Sick Leave Surges—But Root Causes May Be Deeper
The debate comes amid alarming statistics. The DAK health insurance fund reported a 38 percent jump in lost workdays in 2024 compared to the previous year. According to the BKK association, workers were on sick leave an average of 22 days.
But the reasons are more complex. Mental health conditions are playing an expanding role: while they accounted for just 4.8 percent of cases at the AOK fund, they caused an average of 28 missed days per case. Since 2014, sick days due to psychological issues have risen 47 percent.
Employer consultant Georg Soller criticized the approach: “The planned controls treat symptoms, not causes. Long waits for specialist appointments, poor working conditions in nursing and teaching—none of this is being addressed.”
Parallel Health Insurance Overhaul Adds Pressure
Alongside the sick-note changes, the Bundestag passed a major financial reform of the statutory health insurance system in July 2026. Key adjustments include:
- Medication: Co-payments rise to between €7.50 and €15
- Dental prosthetics: Fixed subsidy drops to 50 percent
- Homeopathy: Coverage is eliminated
A new partial sick-note option allows graded work incapacity at 25, 50, or 75 percent. In family insurance, a 2.5 percentage point surcharge for certain spouses will take effect in 2028.
The GKV Contribution Rate Stabilization Act, passed on July 10, restricts contribution-free co-insurance. Estimates suggest roughly 2.46 million households would be affected.
Tighter Rules for Welfare Recipients and Pensioners
Since spring 2026, stricter rules have applied to recipients of basic income support. A new regulation in the Social Code II allows job centers to raise justified doubts about work incapacity after repeated sick notes.
Critics see this as a blanket suspicion. “It stigmatizes people in need,” said Harald Thomé from the advocacy group Tacheles. Green Party politician Timon Dzienus also voiced strong criticism.
For partial pension recipients, a change takes effect on January 1, 2027: those drawing a partial pension exceeding two-thirds of a full pension will lose their entitlement to sick pay. The rule targets the so-called 99.99-percent partial pension model and is expected to generate savings in the millions.
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Cabinet Reshuffle Adds Political Turmoil
These health and labor market reforms are unfolding amid a government shakeup. Chancellor Merz has restructured his cabinet: Carsten Linnemann takes over the health ministry. Transport Minister Patrick Schnieder was dismissed, with Steffen Bilger widely seen as his successor.
The reshuffle follows the resignation of parliamentary group leader Jens Spahn in recent months. While the government defends the reforms as necessary to relieve social security systems, business representatives are calling for more sweeping action.
“High labor costs and excessive bureaucracy are endangering the competitiveness of small and medium-sized enterprises,” warned Sven Polifka, head of the AVW business association. The debate, he added, is far from over.
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