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BERLIN: Germany is considering tougher rules for workers taking sick leave, but researchers warn that stricter requirements may not address the deeper reasons behind the country’s high absenteeism. German employees took an average of around 22 sick days in 2024. The figure is among the highest reported internationally. The government’s proposed changes are part of a wider effort to improve productivity. Germany is dealing with an ageing population and years of weak economic growth. Under the proposed changes, employers could require workers to provide a medical certificate from the first day of absence. Telephone-based sick notes could also be scrapped. However, researchers say the debate should focus on why workers are becoming ill rather than simply making it harder to take sick leave. Healthcare, education and social services are among the sectors reporting the highest levels of absenteeism. Workers in these fields often face heavy workloads. They also deal with staff shortages, emotional pressure and difficult working conditions. BKK data shows that women working in healthcare and social work took an average of 27 sick days in 2024. Teachers recorded around 24 days. The figures were lower in several other sectors. Workers in finance averaged about 18 days, while employees in communications recorded around 16 days. Researchers say mental health is an important part of the problem. Mental health-related cases represent a relatively small share of total sickness cases. However, they often result in much longer absences. Data from AOK shows that sick-leave days linked to mental health problems have increased by 47% since 2014. Mental health conditions are now one of the biggest causes of prolonged absence after respiratory illnesses. Experts say burnout and exhaustion can develop without reaching the level of a diagnosed mental disorder. Healthcare workers and teachers are particularly exposed to these pressures. They carry significant responsibilities while dealing with emotional and sometimes physical challenges. Teachers have reported violence and aggressive behaviour in schools. A 2024 survey found that almost half had experienced psychological or physical violence among pupils at their schools. More than one-third also reported feeling emotionally exhausted several times a week. Nursing faces similar difficulties. Germany has a shortage of healthcare workers, but studies indicate that wage growth has remained limited in some hospitals and public institutions. Researchers describe the situation as an imbalance between effort and reward. Workers face high demands but may receive relatively low pay, limited career opportunities and insufficient recognition. Studies have linked such conditions to mental health problems and long-term sickness absence. However, experts caution against blaming Germany’s absenteeism solely on workplace stress. Sick leave is affected by many factors. These include the age of the workforce, working conditions, social attitudes and differences in healthcare systems. Germany also has generous sick-pay provisions. Workers can generally receive full wages during the initial period of illness. Several other European countries, however, report even higher levels of sick leave among full-time employees. Researchers have also found little evidence of widespread abuse of sick-note rules. A study by DAK and the IGES Institute found that the sharp rise in recorded absences in 2022 was largely linked to improved electronic reporting and unusually high levels of respiratory infections and Covid-19. Sick-leave levels have since stabilised. Researchers also found no clear evidence that telephone sick notes introduced during the pandemic caused the increase. The government’s proposal has faced opposition from labour representatives. The Verdi services union has described the plan as creating a culture of distrust towards employees. Doctors have also warned that tougher certification requirements could put additional pressure on already busy medical practices. The government has defended its approach. It says employers would have the option of requiring certificates from the first day of illness while allowing companies to retain existing arrangements. The debate is therefore moving beyond the question of whether German workers take too many sick days. Researchers argue that reducing absenteeism in the long term may require better staffing, improved working conditions, stronger career prospects and greater support for workers facing emotional pressure.