Germany Proposes Stricter Sick Leave Rules; Researchers Highlight Deeper Work Issues
German Chancellor Friedrich Merz plans to end telephone sick notes and require doctor's certificates from day one to boost productivity, but researchers argue that high sick leave rates, especially in healthcare and education, reflect poor working conditions and mental health strain rather than abuse of the system.
Germany's government is pushing to tighten sick leave regulations as part of efforts to increase economic productivity amid an aging population and years of weak growth. Chancellor Friedrich Merz's proposal would abolish the option to report sick by phone and mandate a doctor's certificate from the first day of absence.
Researchers, however, caution that the plan confuses a symptom—frequent absenteeism—with the underlying ailment. They point to Germany's average of 22 sick days per worker in 2024, one of the highest globally, which surged after the introduction of an electronic sick note system in 2022 that improved short-term absence tracking.
The highest absenteeism is concentrated in professions with heavy emotional and physical demands. According to insurer association BKK, women in healthcare and social care averaged 27 sick days in 2024, while teachers averaged 24 days. In contrast, finance and communication sectors saw 18 and 16 days respectively.
Emeritus Professor Johannes Siegrist of the University of Düsseldorf emphasizes that the issue is not just depression but also exhaustion and burnout driven by difficult work conditions. Data from health insurer AOK shows mental health issues account for only 4.8% of sick cases, but when they occur, average absence lasts 28 days. Since 2014, mental health-related sick days have risen 47%, making them the second most common reason after respiratory illnesses.
Siegrist notes that workers in healthcare, education, and social care face high responsibility, the need to combine performance with communication, emotional challenges, and physical stressors including violence. Low pay and low socioeconomic status contribute to an effort-reward imbalance.
A 2024 study in German schools found nearly half of teachers reported psychological or physical violence from students, and over a third felt emotionally exhausted several times a week. The healthcare sector faces similar strains, with surprisingly low wage increases despite acute staff shortages.
The Verdi trade union criticized the proposal, saying it fosters a culture of mistrust. Medical associations warned it would burden an already overloaded healthcare system. The government responded that companies could decide whether to adopt the new rules, which also require a medical certificate from the fourth day of illness.
Researchers and OECD experts argue that international comparisons are difficult. Germany's sick pay system is among the most generous globally—100% wage replacement from day one for up to six weeks. Seven other OECD countries report more sick days. OECD researcher Sofia Malinai Domagk says rules are just one factor, and direct comparisons should be avoided. Multiple studies have found no evidence of systematic abuse.
