Slight Decline in Employee Sick Days in Germany, But Long-Term Illnesses Remain a Concern

Employee sick days in Germany saw a slight decrease in 2025, but high absence rates continue to be driven by long-term illnesses, according to a recent analysis by the AOK Scientific Institute (WIdO). On average, employees insured by AOK were absent due to illness for 23.3 days in 2025, a slight dip from 23.9 days in the previous year.

The Impact of Electronic Sick Notes

The current level of absenteeism remains slightly above the peak recorded in 2022, which saw 24.5 sick days. WIdO attributes the sustained high levels, since 2022, to the introduction of the electronic certificate of incapacity for operate (eAU) in 2022. The eAU system has led to more complete recording of short-term illnesses, which previously were often unreported due to the responsibility falling on the employee to submit paper certificates.

WIdO’s modeling suggests that without the eAU, the increase in sick days would have been less pronounced. A calculation based on data from 2016-2019 indicates an expected 20.8 sick days for 2025, more than 10 percent – or 2.5 days – lower than the actual recorded figure. “The introduction of electronic sick notes in 2022 has led to a remarkable shift in the level of occupational absences,” emphasizes WIdO Managing Director Helmut Schröder.

Short-Term vs. Long-Term Illnesses

The analysis reveals a significant increase in short-term illness-related absences. Since 2022, there has been a marked rise in sick days due to illnesses lasting up to 14 days. In 2016, these short illnesses accounted for 6.7 sick days, compared to 10.1 days in 2022 and an average of 9.1 days in 2025.

Conversely, no comparable shifts were observed in longer-term illnesses – those lasting more than six weeks. While these longer illnesses represent only 3.3 percent of all absences, they account for over 40 percent of total absence time.

Mental Health and Musculoskeletal Issues Dominate Long-Term Absences

Musculoskeletal diseases have consistently been a major contributor to long-term absences. However, mental illnesses are now the biggest driver of increased long-term sick leave, averaging 28.5 days of incapacity for work per case.

About WIdO

The AOK Scientific Institute (WIdO) is part of the Federal Association of AOK in Berlin. Established in 1976, WIdO focuses on research related to the health care system and its financing. Learn more about WIdO.