Germany prepares sweeping overhaul of sick-leave certificates
Published on 07/17/2026 at 07:24 | Redaktion boerse-global.de
A doctor’s visit would become mandatory from the first day of illness under plans unveiled by Germany’s black-red coalition, which wants to curb the use of online sick notes and end telephone-based certificates for ordinary cases.
Bundesgesundheitsministerin Nina Warken (CDU) presented the proposals in mid-July. The aim is to regulate the issuing of sick notes more strictly and to remove dubious online platforms from the market.
Video consultations with a family doctor would still be allowed. But only around 20 percent of practices currently offer such digital appointments, according to data from the Kassenärztliche Bundesvereinigung (KBV) and the IGES-Institut.
The biggest change would be the end of telephone sick notes. Until now, they were possible for mild illnesses for up to five days, provided the practice already knew the patient. Under the new rules, a medical certificate would be required nationwide from the first day of illness. So far, employees have only had to present one from the fourth day, unless their employment contract set different rules.
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A retrospective sick note would still be permitted for up to three days. The doctor’s office would transmit the data to the employer digitally, and as before, the employer would not receive a diagnosis.
For parents of sick children, telephone-based exemption from work would initially remain in place. A final new rule has not yet been decided.
The push for tighter rules follows a decision by the Landesarbeitsgericht Hamm on 5. September 2025 (Az. 14 SLa 145/25). The court ruled that sick notes issued without personal contact have no evidential value. Affected workers could lose entitlement to continued pay or even face summary dismissal.
Economic considerations are also part of the package, with the government looking to relieve pressure on health insurers. A separate savings plan includes a sugar tax on sweet drinks. It is expected to raise around 650 million euros a year.
Those funds would first go into the federal budget. In return, statutory health insurers are to receive more tax money.
AOK statistics underline how much long-term illness weighs on the system. Just 3.3 percent of cases involve conditions such as depression, exhaustion, cancer or spinal disorders, yet they account for around 40 percent of all days of incapacity for work.
In 2025, the average sick leave rate in Germany stood at 19 days.
The new rules could play out differently depending on employment status. While the Entgeltfortzahlungsgesetz provides the legal basis for employees, civil servants are subject to different rules.
In July, the Bundesinnenministerium pointed out that federal civil servants already have to prove their incapacity for duty on request. Data from 2023 show clear differences: federal civil servants recorded an average of 20.9 sick days, compared with 15.3 days for employees.
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In the pharmacy sector, workers covered by collective agreements may be exempt from the stricter certificate requirement. The trade union Adexa criticised the plans, arguing that compulsory visits to a doctor’s practice could prolong rather than reduce sickness absence.
Doctors’ representatives and the Deutsche Beamtenbund (dbb) also voiced strong criticism. The KBV said the proposals would add a major burden at a time of overcrowded surgeries and growing bureaucracy.
A survey by the Civey institute in June 2026 points to the pressure people feel at work: around 72 percent of those questioned said they had to justify a sick report. More than 95 percent said they had already worked while ill.
Employers’ associations welcomed the plans, while parts of the CDU-Arbeitnehmerflügel called for the new tightening measures to be dropped.
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