Germany Tightens Sick Leave Rules: Medical Certificates Required From Day One, Telephone Sick Leave Ended

The German coalition government, composed of the Union and SPD, has announced a significant tightening of sick leave regulations set to take effect in 2026. Following a meeting of the coalition committee, the government decided that employees will now be required to present a medical certificate from the very first day of illness, replacing the previous standard which allowed certification only after four days of absence.

Alongside this, the telephone-based sick leave option, introduced at the end of 2023 to relieve medical practices during the COVID-19 pandemic, will be abolished. This change is expected to increase patient visits during cold and flu seasons, potentially exacerbating waiting times and burdens on healthcare providers.

Federal Chancellor Friedrich Merz described the decision as a "hard decision," emphasizing the need to reduce the economic impact caused by prolonged employee absences. However, the policy shift has sparked intense debate. Critics, including some within the SPD and opposition parties, warn of heightened bureaucracy and the risk of pressuring employees to attend work while ill, possibly compromising patient care.

The Federal Chamber of Physicians and several health ministers have voiced strong opposition, concerned about the influx of patients with minor ailments straining medical practices.

Defending the reforms, Federal Health Minister Nina Warken (CDU) acknowledged that the telephone sick leave system, although effective during the pandemic's exceptional conditions, lowered the threshold for declaring incapacity to work. She stated it is appropriate to revert to the former system but affirmed that no one should work when unwell.

The coalition also plans broader health sector reforms, including guaranteeing specialist appointment availability and addressing issues in the statutory health insurance system. These measures collectively aim to enhance economic competitiveness by reducing the current high number of sick days.

Overall, while the government argues that the stricter regulations are necessary to curb absenteeism and protect economic productivity, opposition voices fear increased bureaucracy and the potential negative impact on healthcare delivery in Germany.