Germany’s Push for Stricter Sick Notes Collides with Rising Mental Health Absences
Published on 07/21/2026 at 14:04 | Redaktion boerse-global.de
Germany’s governing coalition is facing renewed scrutiny as it moves to require a doctor’s note from the first day of illness — a policy shift that critics say threatens access to care precisely when mental disorders have overtaken respiratory infections as the leading cause of workplace absence.
The proposal, which would also scrap the pandemic-era phone-in sick note, lands against a backdrop of fresh data from the DAK health insurance group. The company’s annual health report, released Monday, shows that while the overall sick?leave rate edged down to 5.3 percent, the share of absences linked to mental illness jumped nine percent year on year.
Mental illness now accounts for 184 sickness days per 100 insured members — up sharply and ahead of respiratory infections (175 days, down 21 percent) and musculoskeletal conditions (174 days). The analysis, conducted by the IGES Institute, covers roughly 2.2 million DAK-insured employees.
The average length of a sickness spell held steady at 9.6 to 9.7 days, but the report reveals a clear generational split. Workers under 55 took fewer days off overall, while those over 60 saw their sick?leave rate rise by 0.3 percentage points. Older employees tend to be absent for longer stretches.
DAK chief executive Andreas Storm welcomed the overall decline but warned that long?term illness remains a pressing concern. He repeated his call for models that allow partial sick notes — enabling employees to work reduced hours rather than staying home entirely. Storm said rising performance pressure, staff shortages and general uncertainty are driving the increase in mental health diagnoses.
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The coalition’s plan to reintroduce mandatory medical certificates from the first day off has drawn sharp criticism from therapists and patient advocates. They argue bureaucratic hurdles will delay people from seeking help, especially for psychological complaints that often require swift intervention. Experts in occupational health are instead urging a beefed?up prevention strategy, citing the new DAK figures as evidence that the system needs more — not fewer — low?barrier entry points for treatment.
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