Germany plans in-person sick notes, doctors call move madness

Germany’s coalition government agreed to end phone sick notes and require workers to see a doctor in person on the first day of illness from January next year. The move has set off a sharp backlash from doctors.

Under the current rules, a sick note is generally needed only after more than three days off work, although employers can already ask for one earlier. Since December 2023, patients have been able to phone their GP for a sick note for up to five days, a pandemic-era arrangement that the new plan would roll back.

Chancellor Friedrich Merz said Germany’s sick days were “too high” and argued that long absences were hurting the economy and creating a competitive disadvantage. The government is also returning to pre-pandemic arrangements, while allowing individual businesses to agree different rules if they want them.

IGES Institute research published in January found that German workers averaged 19.5 working days of sick leave per year, up from about 13 in 2018. The Federal Statistical Office put the 2023 average at 15.1 sick days. Germany allows workers to receive full pay for up to six weeks, paid by employers, and then about 70% of gross pay through statutory sickness insurance for up to 78 weeks within three years for the same illness.

The KBV, the umbrella body of Germany’s medical profession, said it bordered on madness to force thousands of ill people into surgeries just to complete paperwork. It warned that people with coughs or gastrointestinal infections should stay in bed rather than sit in crowded waiting rooms. The Association of General Practitioners said the rule would flood doctors’ offices with patients who only needed one or two days off.

SPD vice-chancellor Lars Klingbeil said he was looking for “workable solutions,” while Labour Minister Bärbel Bas said she would examine whether the change would have any real effect or simply create difficulties. The proposal sits inside a broader package on health and social security.