Germany Ends First-Day Sick Notes Without Doctor's Visit

German workers will no longer be able to call in sick to work without a certificate on the first day of their illness.

The reform aims to crack down on "extraordinarily high" numbers of sick days in the country's workforce, German Chancellor Friedrich Merz said.

Currently, Germans are allowed three sick days without a medical certificate, although employers can request a certificate earlier.

The move has drawn criticism from the medical sector and workplace experts, who say it will blow out waiting times at doctor's clinics and force genuinely sick people out of bed.

Here's why the changes are being made.

How will it work?

During the COVID-19 pandemic "sick notes via telephone" were introduced to stop the spread of infection and were made a permanent option by the German health minister in 2023.

It meant employees could call their GP and describe symptoms to obtain a medical certificate over the phone which would then be sent to the employer.

This change was introduced by the previous government.

The doctor's note had to be obtained after the employee was away for more than three days.

That will now be abolished and a patient will be required to see a doctor in person on day one of sick leave.

Why is there a crackdown on sick leave?

A new report by Berlin-based research institute IGES, commissioned by DAK Gesundheit, one of Germany's largest health providers, found that in 2025, the average German employee took 19.5 sick days.

There was also a 6.9 per cent increase in mental health-related absences.

It has become easier to record absences due to the country's new electronic sick note system (eAU), which took full effect in 2023.

Doctors send certificates directly to the health insurer and employers can retrieve them digitally, making tracking more accurate.

IGES argued that many short absences that previously went unrecorded on paper were now captured in the data.

It also said the COVID-19 pandemic may have made workers more aware of the spread of germs in the workplace, leading to higher rates of absences.

DAK chief executive Andreas Storm used the study to push for a federal government-run summit to find a solution for the increase.

"Sick leave due to mental health issues is often associated with extended periods of absence," Mr Storm said.

"Companies are facing the challenge of having to compensate for a high number of lost workdays due to these illnesses.

"From an economic perspective, prevention is paramount."

Respiratory problems, mental health issues and musculoskeletal disorders together accounted for roughly half of all days of absence.

Mr Merz announced the change as part of a package of productivity reforms aimed at addressing German economic stagnation.

In April, the government halved its growth forecast for 2026 to 0.5 per cent and also cut its growth prediction for 2027 to 0.9 per cent.

In June, Germany's central bank projected calendar-adjusted GDP to grow by 0.5 per cent this year, and 0.8 per cent in 2027.

"This is a tough decision," the chancellor said about the sick leave change.

"But we can no longer afford this competitive disadvantage caused by long periods of absence from work."

Fierce criticism from health peak bodies

Medical peak bodies in Germany say the move will put a strain on the health system.

Germany's Association of General Practitioners told Reuters the requirement for workers to obtain written confirmation of illness would be "absolutely disastrous" for already overburdened medical practices.

The association's Markus Blumenthal-Beier told the RND media group the proposed sick note changes were "absolutely catastrophic" and it would clog up the health system.

Trade union Verdi said they exemplified a "culture of mistrust" against workers.

Bond University's Dr Libby Sander, a workplace wellbeing and productivity expert, said the policy change was "impractical".

"If you think about the burden it will leave on the health system, you can imagine it would be quite overwhelming if every single person who needed to call in sick went to the doctor on the first day," she said.

"We know [in Australia] that half of workers are reporting burnout, and flexible working arrangements have been shown to be very helpful for people struggling with mental health issues, so that is a great thing to look at.

"Looking at that to support productivity as well as wellbeing, rather than looking at a blanket policy like this, which I just can't see how that can practically be implemented, let alone the cost."

German leave entitlements some of the highest in the world

In Germany, workers are entitled to 100 per cent of their salary for up to six weeks of sick leave, paid by their employer.

After six weeks of sick leave, statutory health insurance takes over, paying about 70 per cent of gross pay for up to 78 weeks within three years for the same illness.

Until the Merz reform, Germany was ranked highly for a large sick leave allowance.

It is often ranked alongside Switzerland, which allows up to two years' sick leave at 100 per cent salary, and Norway, which pays 100 per cent salary for up to a year.

On the other end of the spectrum, the US has no federal law requiring employers to pay sick leave.

Neither does India or Japan.

Could Australia crack down on sick days?

Australia does have a mandated sick leave allowance of 10 days per year for full-time workers.

In cases where an employee needs to take a longer period of time off due to illness, they may be able to make an arrangement with an employer.

Most will allow them to take up to three months.

If an employee takes more than three months of leave per year, they may not be protected from dismissal.

It is important for each individual to check the protocol for calling in sick for their workplace.

Dr Sander said it was unlikely a policy like this would need to be implemented in Australia.

She said most Australians did not actually take their federally mandated 10 days of sick leave anyway.

"I think some of that's because people are now having that ability to do hybrid of work from home," she said.

"And so on the days they are sick, they might be able to keep working without worrying about spreading sickness to people in the office."