Full Breakdown
Germany’s Sick-Note Crackdown Targets Symptoms, Not Root Causes, Researchers Warn
7/27/2026, 2:30:20 PM
Proposed Changes to Sick-Note Rules
On July 27, Chancellor Friedrich Merz’s coalition announced a plan to eliminate telephone-issued sick notes and to allow employers to demand a medical certificate from the first day of absence. The measure is part of a broader effort to boost productivity in an economy facing an ageing population and prolonged weak growth.
Rising Absenteeism and Sectoral Data
Workers in Germany recorded an average of about 22 days of sick leave in 2024, one of the highest levels among OECD nations, according to the association of company health insurers BKK. Sector-specific figures for the same year show women in healthcare and social work took 27 days, teachers 24 days, finance employees 18 days, and communication workers 16 days. Mental-health diagnoses account for 4.8 % of all sickness cases but lead to an average 28 days of absence per case, based on data from AOK, the country’s largest health insurer. AOK members’ mental-health-related sick days have risen 47 % since 2014, making it the second-biggest cause of absence after respiratory illnesses.
Underlying Causes Highlighted by Researchers
Scholars point to chronic understaffing, low pay, limited career prospects and high emotional demands as drivers of poor mental health in nursing, care work and teaching. “It doesn’t need to be a full-blown depression,” said Johannes Siegrist, emeritus professor at the University of Duesseldorf, noting that exhaustion or burnout can stem from “problematic working conditions.” He added that these jobs combine high responsibility with physical stressors, including violence.
Official and Union Reactions
The health ministry declined comment when asked about the concentration of absenteeism in high-stress sectors. The services union Verdi condemned the proposal as fostering a “culture of mistrust” toward workers. A study by health insurer DAK and the IGES institute attributed the 2022 surge in recorded absences largely to improved electronic reporting and a wave of respiratory illnesses, not to telephone sick notes.
Verbatim Quotes
- “It doesn't need to be a full-blown depression,” — Johannes Siegrist, an emeritus professor at the University of Duesseldorf
- “They have jobs with high responsibility, they need to combine task performance and social interaction and they have to deal with emotional problems, but also with physical stressors, including violence,” — Johannes Siegrist, an emeritus professor at the University of Duesseldorf
- “What we can say is that sick leave rules are one factor among many, and we would caution against reading too much into direct country comparisons of sick leave rates," said OECD researcher Sofia Malinai Domagk.” — OECD
- “The available scientific studies suggest that sick leave by phone has not led to an increase in sick leave reports," said Enzo Weber, from the Institute of Employment Research.” — Enzo Weber, from the Institute of Employment Research
