Full Breakdown
Germany Requires Doctor’s Certificate from Day One, Ending Telephone Sick Notes
7/2/2026, 11:10:34 PM
Doctor’s Note Rule
From 1 January 2026, German employees must present a medical certificate (Arbeitsunfähigkeitsbescheinigung) on the first day of illness. The telephone sick note for up to five days is abolished. The electronic eAU system remains, and collective agreements may still permit limited deviations.
Rationale
Chancellor Friedrich Merz framed the change as a response to high absenteeism, calling it a competitive disadvantage for German firms. The rule is part of a 34-point coalition reform that also provides €10 billion in tax relief for low- and middle-income households from 2027. Previously, a doctor’s note was required only from day four.
Data
The DAK insurer reported an average of 19.5 sick days per employee in 2025. Barmer noted regional variation, with Saarland averaging 25.4 days and psychological-related absences of 6.2 days per capita. The KBV estimates that about one-third of the 116 million annual sick notes cover absences of three days or less.
Official
Merz said the state can no longer bear the financial drain from staffing gaps. Health Minister Judith Warken announced a review of sick-leave rules and confirmed the eAU system will stay operational. The coalition argues mandatory in-person examinations will improve oversight and curb perceived abuse of the former telephone option.
Opposition
The Green Party warned the rule could overload strained general-practice offices. A spokesperson for the German Association of General Practitioners called the reform “pure cost-cutting disguised as health policy.” DAK cautioned the change might foster a “culture of distrust” toward employees. Market researchers said the telephone option previously prevented millions of unnecessary consultations and helped keep medical facilities from being swamped.
Conflicts
DAK’s national average of 19.5 sick days contrasts with Barmer’s 25.4 days in Saarland, showing geographic variation. No unified national figure is given for psychological-related absences, leaving a gap on mental-health sick leave.
Quotes
- “We can no longer accept the extraordinarily high levels of sick leave in our companies.” — Friedrich Merz, Chancellor
- “We are abolishing sick leave by telephone and introducing the requirement to submit a medical certificate from the very first day of illness.” — Friedrich Merz, Chancellor
- “We know this is a tough decision. But we can no longer afford this competitive disadvantage caused by prolonged absences from work.” — Friedrich Merz, Chancellor
- “This is pure cost-cutting disguised as health policy.” — Spokesperson, German Association of General Practitioners
Future
The rule is now enforceable, and employers must verify doctor’s notes from day one. The tax-relief component of the reform aims to deliver €10 billion in savings for low- and middle-income families from 2027. Authorities will monitor the impact on medical practices and may adjust the regulation based on feedback from health insurers and professional bodies.
