Overview

• An AOK analysis reports persistently high sickness absence this year, driven chiefly by respiratory infections.
• Respiratory cases hit a new high in February 2025, then settled below 2024 levels from April before trending up again from September.
• In the previous year, AOK members averaged 2.3 sick notes, with 228 cases per 100 insured, surpassing the 2023 record and far above 2014–2021 levels.
• Mental health conditions contribute significantly to lost work time, with sick days up 43 percent over a decade and an average of 28.5 days per case.
• Electronic sick notes have improved the recording of absences, while phone certifications accounted for about 1.5 percent of 2024 respiratory cases and do not explain the increase.