Germany's sick-note crackdown may miss the real illness, researchers warn

Germany's proposed tightening of sick-note rules may be a superficial fix for a deeper problem of rising absenteeism, according to researchers. While the government plans to scrap telephone sick notes and require medical certificates from the first day of absence to boost productivity, experts point to deteriorating working conditions and mental health strains as the root causes.

Workers in Germany took an average of approximately 22 sick days in 2024, among the highest internationally. This figure saw a sharp increase in 2022, partly due to improved recording of short-term absences with the introduction of electronic sick notes. However, the underlying issues are more complex, particularly in professions like nursing, care work, and teaching.

These high-absenteeism sectors are characterized by chronic understaffing, low pay, poor career prospects, and high emotional demands. Data shows women in healthcare and social work took an average of 27 sick days in 2024, while teachers took 24, significantly more than those in finance (18 days) or communication (16 days). Johannes Siegrist, an emeritus professor at the University of Duesseldorf, noted that even states of exhaustion or burnout from problematic working conditions can lead to absence.

While mental disorders account for a smaller percentage of sickness cases (4.8%), they lead to longer absences, averaging 28 days. Germany's largest health insurer, AOK, reported a 47% rise in sickness leave days due to mental health issues since 2014, making it the second-leading cause of absence after respiratory diseases. The proposed government measures aim to address the symptom of high absenteeism, but critics argue they fail to tackle the systemic issues contributing to employee burnout and stress.

“

It doesn’t need to be a full-blown depression. It can also be a state of exhaustion or burnout as a result of problematic working conditions.