Germany to Tighten Sick Note Rules, Require Medical Certificate from Day One
Germany’s coalition will require medical certificates from the first sick day and end telephone sick notes; health ministry points to video consultations.
The governing Union and SPD have agreed to tighten sick note rules that would end blanket telephone-based certificates and make a doctor’s medical certificate required from the first day of illness rather than the fourth. Government spokespeople emphasized that the change does not automatically mean every employee must visit a clinic on day one. Officials said the practical details and legal text remain to be developed before the rule becomes law.
Coalition Agrees to New Sick Note Rules
The coalition’s leadership decided to abolish the routine of issuing sick notes by phone without a clinical assessment and to move the mandatory presentation of a medical certificate to the first day of absence. Party leaders from the Union and SPD approved the measures at a recent coalition committee meeting, positioning the change as a return to stricter documentation standards. Lawmakers and ministries will now be tasked with drafting implementing legislation and regulations.
Government Clarifies No Mandatory Clinic Visit
Government spokesman Stefan Kornelius told reporters that requiring a certificate from day one does not equate to forcing patients into a doctor’s waiting room on the first day of illness. Chancellor Friedrich Merz reiterated the point in television remarks, saying citizens must have a certificate from the first day but need not necessarily attend a practice in person that day. The administration stressed that the form of the certificate and the process for obtaining it will be clarified in subsequent guidance.
Health Ministry Highlights Video Consultations
The Federal Health Ministry pointed to existing telemedicine options as a primary route for securing a medical certificate without an in-office visit. Video consultations, the ministry noted, can be used to assess patients remotely and produce a physician-issued certificate when clinically appropriate. Health officials argued that relying on telemedicine could limit unnecessary travel, reduce exposure in waiting rooms and preserve in-person appointments for more urgent cases.
Businesses May Negotiate Different Rules
The coalition plans include a provision allowing firms and employers to agree to different internal rules on sick notes where appropriate. That could enable collective agreements or company policies to maintain current practices or set stricter standards tailored to specific operational needs. Labour representatives warned that any flexibility must protect workers from punitive measures and ensure sick employees are not pressured into unsafe attendance.
Medical Community and Practical Challenges
Medical associations and general practitioners have raised concerns about how requiring certificates from day one might affect workload and appointment capacity. Clinics already face staffing pressures and an earlier documentation requirement could increase demand for rapid assessments, whether in person or via telehealth. Physicians will need clear legal guidance about when a remote assessment suffices, and insurers will need to adapt administrative processes to handle certificates issued at an earlier point.
Legal and Administrative Steps Ahead
The measure still requires formal legislative drafting and parliamentary approval before entering law, and the government has not yet published a timetable. Officials said the basic political decision is in place, but details such as sanctions for non-compliance, verification mechanisms and rules for repeat or chronic absences remain open. Stakeholders, including employer groups, unions and medical bodies, are expected to be consulted in the coming weeks to shape the final regulatory framework.
Public health experts noted that changes to sick note rules intersect with broader objectives such as infection control, workforce stability and access to care. Advocates for patients urged safeguards to ensure those unable to secure timely medical contact — including people in rural areas or with limited digital access — will not be disadvantaged. The coalition has signalled it will strike a balance between tightening documentation and preserving practical, safe access to medical certification for ill workers.
