German gov’t may forbid doctors from issuing sick note by phone

The German government has said it will review a law which allows doctors to issue sick notes to their patients via phone, rather than at an in-person appointment.

Warken to review German sick note law

Federal Health Minister Nina Warken (CDU) has said that the German government will review a law which allows doctors to issue their patients sick notes by phone, instead of patients having to attend an in-person appointment.

Upon entering government in June 2025, the CDU/CSU-SPD coalition said it would work to reduce the number of sick days that employees in Germany take each year. “That is precisely what we will address and review the current regulations. We need practical solutions,” Warken told Tagesspiegel.

According to figures from the health insurance provider DAK-Gesundheit, employees in Germany were off work sick for an average of 19,5 days in 2025 and 19,7 days in 2024. 

The Federal Statistical Office (Destatis) reports that the average number of sick days taken was lower, at 14,8 days in 2024. This discrepancy is because the DAK-Gesundheit statistics are based on calendar days, while the Destatis figures are based on working days

DGB warns against mistrusting workers

While Warken and Chancellor Friedrich Merz (CDU) have both suggested that employees in Germany are exploiting the sick note via phone system, multiple organisations and politicians have reiterated that there is good reason existing rules are in place.

The policy was first introduced by the SPD-FPD-Greens coalition in the early days of the coronavirus pandemic. The rule expired in March 2023 and was re-adopted as a permanent policy in late 2023 by then-Health Minister Karl Lauterbach (SPD).

The law applies to doctors' notes for “illnesses that do not present severe symptoms”, such as a cold, according to a Federal Health Ministry press release. It is up to the doctor in question to determine whether they will issue a sick note via phone or the patient should come in for an appointment. Doctors can only issue sick notes by phone to patients who are already registered at their practice.

By late 2023 the spread of coronavirus was no longer a central concern for the government, but Lauterbach hoped adopting the law permanently could solve another problem in the German healthcare system: that doctors are struggling to meet patients’ needs amid a worker shortage.

Since the law was permanently adopted, doctors in Germany have called on the government to relax sick note rules even further to lighten their load. In October 2025, the head of the German National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung or KBV) urged the CDU/CSU-SPD coalition to extend the maximum number of days that employees can self-certify as sick from two days to four or five days, to ease existing pressure on stretched doctors practices.

Alongside doctors’ practical concerns, German Trade Union Confederation leader Anja Piel said that Merz and Warken’s recent suggestions were “a declaration of mistrust toward millions of employees who keep the business running every day”. 

“Pressuring people to work while they are sick does not bring growth, precisely the opposite. Presenteeism - working while you are sick - causes contagious illnesses to spread and results in higher costs than allowing employees to recuperate at home.”