German sick leave stays near record as mental health absences climb 50% since 2016

Mental health problems have fueled a sharp rise in workplace absences across Germany. Since 2016, the share of sick days attributed to psychological conditions has jumped by more than half, according to data from the BKK Dachverband. This surge is reshaping how employers approach absenteeism, with some introducing tougher controls while the care sector struggles with the highest rates of all.

Musculoskeletal disorders still account for the largest share of sick leave, but the trend in mental illness is accelerating. National absence rates remain elevated: the BKK figures show a 2025 rate of 5.83 percent, down only marginally from 5.90 percent in the previous year. Between January and November 2025, employees missed an average of 17 working days.

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Tesla has taken one of the hardest lines in response. At its German plant, the company has stopped paying wages during long-term illness and systematically questions the validity of medical certificates. The automaker says each day of absence costs between €300 and €600. Company documentation reviewed by the DAK health insurer shows that sick leave at the site rose 38 percent in 2024 compared with the year before.

The care sector is hit particularly hard. Figures from the Techniker Krankenkasse for 2024 show that nurses were on sick leave for an average of 28.5 days per year. In elderly care, that figure reached 33.1 days – far above the cross-sector average of 18.2 days. Respiratory infections, mental strain and musculoskeletal problems were the main drivers.

To counter the trend, new prevention strategies are emerging. The AOK Bayern and the University of Applied Sciences Allensbach plan to launch a pilot project in 2026 called “Gesundes Onboarding in der Pflege” (Healthy Onboarding in Nursing). The aim is to integrate new staff into the profession in a way that protects their long-term health. A nationwide rollout is slated for 2027.

Employer skepticism about doctor’s notes is not limited to Germany. In Switzerland, Martin Lörtscher, CEO of logistics firm Hugelshofer Logistik, complained in early June about what he called overly lax practices in issuing medical certificates. His company lost more than three million francs from 26,000 hours of absence – each day out costs roughly 1,000 francs. The Swiss National Council has already voted for stricter rules on medical certificates.

Meanwhile, a study published in June by Pronova BKK sheds light on employee behavior. It found that 60 percent of workers have called in sick when they actually felt able to work. Seven percent said they do so frequently.

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The Institute of the German Economy (IW) points to a different lever: companies that pay better tend to have higher productivity. But economists caution that higher wages alone do not automatically lift output.

Germany’s business environment faces additional pressures. Labour costs are now burdened by a 48 percent tax wedge. The country has also been in breach of EU law since early June, having missed the transposition deadline for the EU Pay Transparency Directive. That could impose new regulatory demands on human-resources departments in the months ahead.

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