FRANKFURT, Germany – Germany’s plans to tighten sick-note rules may be mistaking the symptoms of rising absenteeism for the underlying illness, researchers say, pointing to mental health strains and deteriorating working conditions in sectors such as healthcare and education.

Workers in Germany took an average of about 22 days of sick leave in 2024, among the highest levels internationally. That figure, from the association of company health insurers BKK, jumped sharply in 2022 after the introduction of electronic sick-note reporting, which improved the recording of short-term absences. Under plans agreed by Chancellor Friedrich Merz’s coalition, telephone sick notes would be scrapped and employers could require medical certificates from the first day of absence, part of a broader push to raise productivity in an economy grappling with an aging population and years of weak growth.

But researchers studying sickness, mental health and labor markets increasingly point to deeper problems in professions where absenteeism is high, such as nursing, care work and teaching.