Germany will require employees to provide a medical certificate on the first day of illness under a new government reform plan.

The policy change aims to tighten sick-leave rules and reduce the abuse of the healthcare system. By eliminating the possibility of telephone sick-notes, the government intends to ensure that medical certificates are based on verified consultations.

Three coalition partners, including the CDU, CSU, and SPD, have agreed to the reform [1]. The move is part of a broader effort to modernize health-care administration through increased digitalization. Health Minister Karl Lauterbach said, "Wir setzen auf Digitalisierung" (We are relying on digitalization) [1].

While the coalition has reached an agreement, the exact start date for the mandatory first-day certificate remains unconfirmed [2, 4]. The reform is planned for the near future, though specific timelines have not been fixed [2, 4].

SPD leader Lars Klingbeil said, "Wir wollen eine „vernünftige Umsetzung“" (We want a reasonable implementation) [1]. The shift toward a first-day requirement represents a significant change in how German workers interact with their employers, and physicians, during short-term illness.

Representatives from the Kassenärztliche Bundesvereinigung, including Andreas Gassen, are involved in the discussions regarding the rollout. The government believes the change will improve the integrity of the sick-leave process by removing the gaps that allowed for unverified absences [1, 3].

Critics and some physicians have raised concerns regarding the potential increase in administrative burdens on general practitioners. However, the coalition maintains that the digital transition will offset these pressures by streamlining how certificates are issued and transmitted to employers [1, 3].

“Germany will require employees to provide a medical certificate on the first day of illness”

This reform signals a shift toward stricter labor oversight in Germany, prioritizing the prevention of sick-leave fraud over the convenience of short-term self-certification. By mandating an official 'Attest' from day one, the government is leveraging digitalization to create a more transparent audit trail for employee absences, which may increase the workload for primary care physicians while reducing the flexibility previously enjoyed by the workforce.