Germany’s governing coalition is moving to tighten sick-leave rules, requiring a medical certificate from day one of illness and scrapping the option for phone-based sick notes, as part of a broader push to curb absenteeism.

The reform also permanently ends pandemic-era telephone certificates and eliminates week-long certificates issued via phone consultations.

Chancellor Friedrich Merz and the CDU/SPD coalition argue the changes are needed to address high sick days and post-pandemic absences, framing them as a health-policy tightening to boost competitiveness.

The policy debate includes perspectives from pediatricians, patient groups, and politicians, highlighting concerns about family impact and healthcare capacity.

Opponents warn the plan could raise patient contacts, overburden general practices, and delay care for vulnerable groups like children, with calls for alternatives such as guaranteed days.

Industry reactions are mixed: employer associations support tightening to improve productivity, while health experts warn it could worsen wait times and strain medical resources.

Implementation will be through a government framework in law, with local adaptations via individual contracts, works agreements, or collective bargaining, and changes to the Entgeltfortzahlungsgesetz or guidelines are needed.

Green party critics say the reform ignores broader health and care policy issues and would worsen the burden on practices amid ongoing system reforms.

Critics warn the package could increase bureaucracy and overwhelm doctors, challenging the government’s aim to reduce burdens.

Statistics show variation in sick days across insurers, reflecting longer-term illnesses and prior shifts to electronic AU documentation.

Timeline remains unclear; changes touch Entgeltfortzahlungsgesetz and possibly require action by the G-BA, with no firm start date yet.

Experts propose alternatives like a digital child illness certificate or partial certifications to balance accessibility with record-keeping.