Germany is currently debating potential reforms to sick leave certification rules, with proposals suggesting employees only need to submit a medical certificate after the fourth or fifth day of illness, instead of the existing requirement after three days.

This proposal has been criticized by KBV chief Andreas Gassen, who argues that the current law leads to unnecessary doctor visits, and that extending the period before a sick note is required could help reduce these visits.

The discussion is part of broader efforts by Germany's Health Minister Nina Warken to cut healthcare costs, with calls for medical organizations to cooperate constructively rather than oppose reforms.

Healthcare experts and employers emphasize the need for better patient management to ensure a sustainable and efficient healthcare system, with Steffen Kampeter criticizing the proposal as a short-term fix that does not address structural issues.

Employers, represented by the BDA and led by Kampeter, oppose the proposal, arguing that extending the sick note requirement would increase their burden without solving underlying healthcare system problems.

The debate occurs amid ongoing challenges such as workforce shortages, high workloads, and burnout among German doctors, many of whom are considering leaving the profession, further straining the healthcare system.

Friedrich Merz, CDU leader, criticizes Germany's high number of doctor visits—around one billion annually—and calls for better social incentives to manage healthcare resources more effectively.

There are proposals to extend quarantine periods from three to four or five days and to eliminate sick notes for short-term illnesses, especially in children, to reduce the burden on pediatric practices during infectious outbreaks.

Some suggest that even children should require sick leave certification from the first day of illness to help reduce infections and ease healthcare strain.

Currently, German law mandates employees to submit a medical certificate if unable to work for more than three days, though employers can request it earlier if desired.