Estimating Alleged Sick Leave Misuse Accounting for Social Desirability Afflicted Responding

Sickness absence has become a focal issue in labour market debate across high income economies- Specifically, accessible telemedical sick leave procedure is politically cited as a driver of opportunistic absenteeism. However, empirical evidence on the prevalence of such behaviours and their underlying mechanisms remains limited as traditional questionnaires on sensitive behaviours are prone to social desirability bias (SDB). We estimate the prevalence and predictors of voluntary absenteeism in this large, population-based pre-registered study (N = 1964) with an indirect questioning technique designed to circumvent SDB responding. We find that self-reported voluntary absenteeism doubles when measured indirectly (34.6%) compared to directly (18.6%). Psychosocial workplace factors - burnout, role conflict, and low work engagement - emerge as consistent predictors along with injunctive social norms (p’s < 0.05). Uncertainty about telemedical access was associated with reduced odds of voluntary absenteeism compared to having access (OR = 0.58, p = .003), while no effect was found for no access. Findings challenge dominant narratives attributing telemedical-sick leave to opportunistic misuse. Rather voluntary absenteeism is better understood as a function of workplace conditions and employee well-being rather than procedural access to certification. Policy efforts should focus on improving workplace conditions over simplistic reforms of sick leave certification procedures.