Germany Sick Leave Reform 2025: Doctor's Note Required from Day One

Introduction

If you work in Germany, you need to know about this. The CDU/CSU-SPD coalition government is set to pass a significant reform to Germany's sick leave rules — one that will require employees to obtain a doctor's certificate (Arbeitsunfähigkeitsbescheinigung, or AU) from the very first day they are too ill to work. This removes the well-known existing rule that allowed workers to self-certify for the first three days of illness without visiting a GP. For expats who rely on Germany's strong workers' rights framework, understanding this change — and how to navigate the healthcare system quickly — is now essential.

What Is Changing and Why

Under the current system, German employees can stay home sick for up to three consecutive days without providing a doctor's certificate. From day four, they need an AU signed by a doctor. Many employers already had the option to require a certificate from day one under individual employment contracts, but the new reform appears to set this as the legislative standard, giving employers the right to demand proof of illness immediately.

The CDU/CSU-SPD coalition has framed the reform as a measure to reduce absenteeism. Germany has one of the highest sick-day rates in Europe — a statistic that has been a point of political debate for several years. Critics of the reform, including trade unions, argue that it will discourage genuinely ill workers from resting, leading to longer illnesses and increased spread of contagious conditions in workplaces.

For employees, the practical impact is clear: if you wake up sick and cannot go to work, you will need to contact a doctor the same day — or at the very latest, secure documentation that covers your absence from the start.

How This Affects Expats Specifically

For expats in Germany, this reform introduces a layer of practical complexity that goes beyond what many are used to in their home countries.

Getting a same-day appointment: Germany's GP system can be difficult to navigate, especially when you are new to the country and don't yet have an established relationship with a Hausarzt. Many practices have limited same-day slots. It's worth registering with a Hausarzt before you need one urgently — don't wait until you're ill.

Online and telephone options: Since the COVID-19 pandemic, Germany has expanded access to remote medical certificates. Many doctors now offer telemedical AU certificates via video or phone consultation, and there are platforms (such as AU-Schein services online) that can issue a certificate for mild illnesses without an in-person visit. However, policies vary by insurer and employer, so check in advance whether your employer accepts remotely issued AUs.

Language barriers: If you are not yet confident in German, look for a GP who offers consultations in English or your language. Many urban practices, particularly in Berlin, Hamburg, Munich, Frankfurt, and Cologne, accommodate English-speaking patients. Your Krankenversicherung can often provide a list of multilingual doctors.

Sick pay is not affected: Germany's Entgeltfortzahlung (continued salary payment during sick leave) remains in place. Employers are still legally required to pay your full salary for up to six weeks of illness. After six weeks, your Krankenversicherung takes over with Krankengeld (sick pay at approximately 70% of your gross salary). The reform changes the documentation requirement — not your entitlement to pay.

What You Need to Do Before You Get Sick

The best time to prepare for this change is now, not when you're running a fever.

1. Register with a Hausarzt if you haven't already. Ask your colleagues, neighbours, or expat community groups for a recommendation. Many practices have waiting lists for new patients, so start early.
2. Check whether your GP offers phone or video consultations. This is especially useful for mild illnesses where you cannot physically travel to the practice.
3. Research telemedical AU platforms. Services like Doktor.de or similar platforms can issue digital AU certificates quickly. Check whether your employer's contract or your collective bargaining agreement (Tarifvertrag) specifies acceptable formats.
4. Read your employment contract. Some contracts already require a certificate from day one — check your specific obligations before the new law takes effect.
5. Inform yourself about the exact implementation date. As of the time of writing, the reform is moving through the legislative process. Follow reliable sources (BAMF, official government channels, or your employer's HR department) for the confirmed start date.

Frequently Asked Questions

Does this mean I can be fired for being sick without a certificate?

No. German employment law provides strong protection against dismissal due to illness. However, failing to provide a required AU certificate could be treated as unauthorised absence, which is a different matter and could have disciplinary consequences. The reform changes when documentation is needed — not your fundamental right to sick leave. If you have concerns about your specific situation, consult a Fachanwalt für Arbeitsrecht (employment law specialist).

What if I can't get a doctor's appointment on the first day?

This is a genuine concern with the new rules. Document your attempts to reach a doctor (phone logs, online booking confirmations) in case you need to demonstrate good faith to your employer. Telemedical platforms may offer a faster route for less severe illnesses. If you use an emergency walk-in clinic (Notaufnahme), note that these are intended for urgent cases and may involve long waits. In the meantime, notify your employer immediately when you are sick — regardless of documentation.

Does this apply to all workers in Germany, including those on work visas?

Yes. German labour law applies to all employees working in Germany, regardless of nationality or visa type. If you have a work permit — whether a standard work visa, EU Blue Card, or any other Aufenthaltstitel that permits employment — these sick leave rules apply to you.

Does this affect my Krankenversicherung coverage?

No. The reform is about documentation requirements between employees and employers. Your Krankenversicherung coverage — including access to doctors, hospitals, and Krankengeld after six weeks — remains unchanged.

Conclusion and Next Steps

Germany's sick leave reform is one of the most practically significant changes to workers' rights in recent years, and every employed expat needs to be aware of it. The core message is simple: from the moment this law takes effect, staying home sick without a doctor's certificate could have consequences. Prepare now — register with a Hausarzt, explore telemedical options, and review your employment contract. Your right to sick pay remains fully protected; it's the paperwork process that is changing. Stay updated on the official implementation date through your employer's HR department or reliable news sources.

Source: IamExpat