The financial burden of sick leave payments has more than doubled over the past fifteen years, rising from €81.2 billion in 2024. This total includes €72.5 billion in gross wages reported by the Federal Ministry of Labor and an estimated €13.1 billion in employer contributions to social security. The IW attributes this increase to higher wages, increased employment, and a statistically significant rise in the sickness rate since the introduction of electronic sick leave notifications in 2022. This digital system has reduced the loss of sick leave notifications, potentially inflating reported sick days. However, it remains unclear whether actual absenteeism has increased. The IW expresses caution regarding the proposed mandatory medical certificates from the first day of illness, citing potential administrative burdens and impacts on employer-employee relations as barriers to widespread implementation.