Germany’s federal government is preparing to reassess the rules for telephone-based sick notes, as concerns grow over rising absenteeism levels. Federal Health Minister Nina Warken (CDU) announced that the existing regulations will undergo a thorough review, citing commitments in the coalition agreement to prevent misuse. Speaking to the Tagesspiegel, she said the government intends to “put the current rules to the test.”
Warken echoed warnings previously raised by Chancellor Friedrich Merz, who has repeatedly pointed to what he views as an excessively high level of sick leave in Germany. She stressed that highlighting the issue is not a criticism of individuals who are genuinely unfit for work.
However, she noted that the low-barrier option of obtaining a sick note by phone could be vulnerable to abuse. According to Warken, a comparison with other countries shows that Germany’s sick leave levels are high by international standards.
Merz intensified the debate during a campaign event in Bad Rappenau, where he cited an average of 14.5 sick days per German employee. He later emphasized that this figure excludes short-term absences of one or two days, which would push the average even higher. Both private companies and the public sector, he said, are experiencing sick leave rates that he considers too high. One contributing factor, he argued, is the ease of obtaining a sick note via telephone.
The ability to receive a sick note by phone was introduced in 2021 during the COVID-19 pandemic and later made permanent by then–Health Minister Karl Lauterbach (SPD). Merz questioned whether the measure remains justified today, saying it had been appropriate during the pandemic but should now be reconsidered. He also announced plans to discuss the issue with the SPD, stressing that Germany must work collectively to improve its overall economic performance.
Support for Merz’s concerns came from Andreas Gassen, head of the National Association of Statutory Health Insurance Physicians, who argued that telephone assessments cannot reliably determine whether someone is truly unable to work. He said the system naturally encourages misuse. Warken said the government would now evaluate both the benefits and the risks of the current rules and examine whether changes are necessary.
Employees insured with DAK were on sick leave for an average of 19.5 days in 2025, only slightly below the 19.7 days recorded in 2024, indicating that Germany’s sickness rate remains at a consistently high level. DAK CEO Andreas Storm welcomed Chancellor Friedrich Merz’s debate on the issue and called for a national sickness-rate summit bringing together employers, trade unions, doctors, and health insurers to identify causes and solutions.
Storm proposed the introduction of partial sick leave for certain illnesses, describing it as a proven approach in Scandinavian countries that could help reduce overall work absences. An analysis by the IGES Institute of data from 2.4 million insured employees showed that respiratory illnesses, mental health conditions, and musculoskeletal disorders together accounted for about half of all sick-leave days.
Mental health-related absences rose by 6.9% year on year, while days lost to respiratory and musculoskeletal problems remained largely unchanged. Storm warned that psychological illnesses often lead to long periods away from work and stressed that prevention must be a priority, not only for companies but also for the wider economy.
The German Trade Union Confederation (DGB) strongly rejected the current debate about alleged misuse of telephone-based sick notes. DGB chair Yasmin Fahimi called it “highly indecent” that employees who report sick are being placed under general suspicion “as if they were shirkers and idlers.” She said the accusation that simple phone sick notes encourage abuse is not only directed at workers but also reflects “a great sign of mistrust toward the doctors in our country.”
Fahimi argued that the rise in recorded sick notes has a statistical explanation: with the introduction of electronic sick notes, every illness day is now counted, which does not mean more people are calling in sick. She added that the real issue is the opposite, too many people are going to work while sick. She also criticized Chancellor Friedrich Merz’s comments on the matter, saying anyone trying to gain political advantage from this debate “will achieve the opposite.”
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