Sick leave
Sick leave is paid time off from work that workers can use to stay home to address their health needs without losing pay. It differs from paid vacation time or time off work to deal with personal matters, because sick leave is intended for health-related purposes. Sick leave can include a mental health day and taking time away from work to go to a scheduled doctor's appointment. Some policies also allow paid sick time to be used to care for sick family members, or to address health and safety needs related to domestic violence or sexual assault. Menstrual leave is another type of time off work for a health-related reason, but it is not always paid.
In most nations, some or all employers are required to pay their employees for some time away from work when they are ill. Most European, many Latin American, a few African and a few Asian countries have legal requirements for paid sick leave for employees. In nations without laws mandating paid sick leave, some employers offer it voluntarily or as the result of a collective bargaining agreement. Even where sick leave is normally required for all employees, the business owner may not be considered an employee or have access to paid sick leave, especially in a microbusiness that is operated by the owners.
Paid sick leave can reduce employee turnover, increase productivity, and reduce the spread of disease in the workplace and in the community. Naturally, paying workers when they are not working due to illness costs money that could be used for other purposes, such as higher profits or other benefits.
Health benefits of paid sick leave
Paid sick leave is believed to reduce the spread of infectious diseases, such as flu-like illnesses and foodborne illnesses, in the workplace and in the community.Workers without access to paid sick leave will go to work while sick, which spreads the infections to other workers. Nearly seven in ten U.S. workers report they have gone to work with the stomach flu or other contagious disease. Nearly half reported that they went to work sick because they could not afford to lose the pay. Thirty percent of workers report they contracted the flu from a colleague. According to a 2020 study, requiring paid sick leave in Washington state led to a reduction in the number of workers who reported working while sick.
Paid sick leave can also reduce the risk of occupational injuries, especially in high-risk industries such as construction, manufacturing, agriculture and health care. One study found that workers with access to paid sick leave were 28% less likely than those without to experience workplace injuries.
In addition to infecting their colleagues, workers who choose to go to work sick may worsen public health and pass infectious diseases to customers. Nearly half of outbreaks of stomach flu are linked to food-service workers who go to work while sick. In 2008, a sick employee at a Chipotle restaurant in Kent, Ohio likely caused an outbreak that resulted in over 500 people becoming ill. The outbreak cost that community between $130,233 and $305,337 in lost wages, lost productivity, and health care costs.
During the 2009 H1N1 influenza outbreak, the U.S. Centers for Disease Control recommended that anyone with flu-like symptoms remain at home. According to a report from the Institute for Women's Policy Research, more than eight million workers went to their jobs while sick during the H1N1 pandemic.
Parents who have access to paid sick leave are more likely to take time away from work to care for their sick kids. Working parents without paid sick days may feel compelled to send their sick children to school, where the children spread infections to other students and school staff, and additionally experience negative short- and long-term health outcomes themselves.
Opposition to a paid sick day mandate
Opponents of a workplace mandate assert that employers should offer paid sick days at their own discretion. They say employers best understand the benefit preferences of their employees and must maintain flexibility to meet the unique needs of their workforce.Cost of paid sick leave
The cost of paid sick leave depends upon the amount the employee is paid and how much time can be taken. Sick leave costs less for a low-wage worker than for a high-cost worker, and paying sick leave for a few days costs less than sick leave for a month.A 2008 paper found that the costs incurred by a paid sick leave policy would include "lost wages for new users of paid sick leave policies and administration expenses incurred to operate sick leave accountability systems". The study concluded that a paid sick leave mandate would have been harmful to the state's employees and employers by imposing a net cost on the state and resulting in lost jobs.
In 2010, a non-random survey of some New York City employers by the Partnership for New York City estimated that introducing a new paid sick leave mandate, in which employees of small businesses would get a minimum of five days paid sick leave per year and employees of large businesses would get a minimum of nine days paid sick leave per year, would increase total payroll expenses in the city by 0.3%, with the burden largely falling on the fraction of businesses that did not already pay for any sick leave, or that offered sick leave only to long-time employees. The total cost of providing paid sick leave in that high-cost market was estimated to be around 40 or 50 cents per hour worked.
A 2013 study by the Employment Policies Institute found that many businesses responded to a paid sick leave mandate in Connecticut by reducing paid leave, scaling back employee benefits, cutting back on hours, reducing wages, or raising prices. About 24% of employers that responded to the survey said they'd hire fewer employees as a consequence of the law and 10% admitted that the law had caused them to limit or restrict their expansion within the state.
Economic considerations
Some studies show that the cost of losing an employee is often greater than the cost of providing sick days to retain existing employees. One brief suggests the average cost of turnover is 25 percent of an employee's total annual compensation.Presenteeism costs the U.S. economy $180 billion annually in lost productivity. For employers, this costs an average of $255 per employee per year and exceeds the cost of absenteeism and medical and disability benefits. For workers in the foodservice industry, one analysis found that foodborne illness outbreak for a chain restaurantincluding negative public opinion, which affects other operations in a metropolitan areacan be up to $7million.
The United States Bureau of Labor Statistics has said that the average cost of sick leave per employee hour worked is 23 cents and the cost per service worker is eight cents. Additional research by advocates for a policy has suggested that paid sick days could lead to savings of $1.17 per worker per week for employers.
Many studies have looked at the economic well-being of the city of San Francisco after they passed their sick leave policy in 2004. The research finds that San Francisco outperformed its neighboring counties in terms of job growth in the years after its sick leave program went into effecteven during the recent recession.
Existing provisions
At least 145 countries require paid sick leave for short- or long-term illnesses, with 127 providing a week or more annually.United States
The United States does not require that employees have access to paid sick days to address their own short-term illnesses or the short-term illness of a family member, though some states and local jurisdictions do.A 2009 analysis from the Bureau of Labor Statistics found that around 39 percent of American workers in the private sector do not have paid sick leave. Around 79 percent of workers in low-wage industries do not have paid sick time. Most food service and hotel workers lack paid sick days.
A 2008 survey reported that 77 percent of Americans believe that having paid sick days is "very important" for workers. Some workers report that they or a family member have been fired or suspended for missing work due to illness.
A 2020 paper found that requiring paid sick leave in the U.S. likely increased overall well-being. When paid sick leave is required by law, workers tended to take two more days off work each year.
The U.S. requires unpaid leave for serious illnesses through the Family and Medical Leave Act. This law requires most medium-sized and larger employers to comply and, within those businesses, covers employees who have worked for their employer for at least 12 months prior to taking the leave.
State and local laws
Since 2006 and as of 2018 ten states, Washington D.C., and an increasing number of other cities have implemented some form of paid sick leave.| State | Date of taking effect | Legalization method |
| Connecticut | January 1, 2012 | Public Act No. 11-52 signed into law by Governor Dannel Malloy on July 1, 2011. |
| California | January 1, 2015 / July 1, 2015 | Legislation signed into law by Governor Jerry Brown in 2014. |
| Massachusetts | July 1, 2015 | Question 4 passed by voters in November 2014. |
| Oregon | January 1, 2016 | Legislation signed into law by Governor Kate Brown in 2015. |
| Vermont | January 1, 2017 | HB 187 signed into law by Governor Peter Shumlin on March 9, 2016. |
| Arizona | July 1, 2017 | Proposition 206 passed by voters in November 2016. |
| Washington | January 1, 2018 | Initiative 1433 passed by voters in November 2016. |
| Rhode Island | July 1, 2018 | Legislation signed into law by Governor Gina Raimondo in 2017. |
| Maryland | February 11, 2018 | In January 2018, the State Legislature overrode a veto of Governor Larry Hogan. |
| New Jersey | October 29, 2018 | Legislation signed by Governor Phil Murphy on May 2, 2018 |
In November 2006, the voters of San Francisco passed a ballot initiative making the city the first in the country to guarantee paid sick days to all workers.
In March 2008, the Washington, D.C. Council voted unanimously to pass legislation guaranteeing workers paid sick time. The law does not cover tipped restaurant workers or workers in the first year of employment. The D.C. law was also the first in the United States to include paid "safe" days for victims of domestic violence, sexual assault, or stalking.
On July 1, 2011, Connecticut Governor Dannel P. Malloy signed into law Public Act No. 11-52 which made Connecticut the first state to mandate paid sick leave. The Act, which only narrowly passed through Connecticut's Senate and House of Representatives, took effect on January 1, 2012, and requires employers to allow their "service workers" to earn one hour of paid sick leave for every 40 hours worked, capped at a maximum of 40 hours per year. The Act applies to the "service workers" of employers with 50 or more employees in Connecticut during any single quarter in the previous year.
On September 8, 2014, California Governor Jerry Brown announced that he would sign the Healthy Workplaces, Healthy Families Act of 2014 to require employers to offer paid sick leave to employees. California would become the second state after Connecticut to require paid days off for ill employees.
On November 4, 2014, Massachusetts voters approved "Question 4", a ballot measure mandating sick pay for all part-time and full-time workers at firms with more than 11 employees. The law was passed 59–41 and came into effect July 1, 2015.
On June 12, 2015, the Oregon legislature passed OL 537, 2015 mandating sick pay for all workers at businesses with at least ten employees effective January 1, 2016.
Australia
Sick leave has its origins in trade union campaigns for its inclusion in industrial agreements. In Australia, it was introduced into "industrial awards" in 1922Under the Federal Government's industrial relations legislation eligible employees are entitled to 10 days of paid personal leave per year, which also carries over to subsequent years if not used.
In addition, Australian workers may be entitled to two days of compassionate leave for each permissible occasion where a member of their family or household contracts or develops a personal illness or sustains a personal injury that poses a threat to his or her life, or dies.
United Kingdom
The UK has sick leave, paid at £89.35 per week, with the first three days unpaid.Sweden
has paid sick leave. Prior to 2019 the first sick day was unpaid, whereas since 2019 a deduction of 20% of a worker's average weekly pay is made, which is intended to make the system fairer for non-salaried workers. After that day a minimum of 80% of the income is paid for 364 days and 75% for a further maximum 550 days. Collective employment contracts may specify a higher payment. A medical doctor must certify the illness no later than one week after the first sick day. The parent of a sick child can get paid leave to care for the child. In that case the first day is also paid. The state pays all these benefits, except for the first two weeks of sick leave for employees, which is paid by the employer.China
According to Chinese Labor Law, the sick leave system is established for employees who are suffering from illness or non-work-related injuries. During the medical treatment period, an employer cannot terminate the labor contract and must pay the sick-leave wage. Generally, an employee is compensated at 60 to 100 percent of their regular wage during the sick leave period, depending on the employee's seniority. The minimum sick leave is three months long for employees with less than a ten-year cumulative work history and less than five years' seniority with their current employer. Sick leave for workers with 20 years of work history and 15 years with their current employer are entitled to unlimited paid sick leave.France
In France paid sick leave is paid partly by social security and partly by the employer. It requires a medical justification no later than 48 hours after the first sick day. Social security pays only one part of the treatment, starting at the fourth day, and can make controls. The employer pays an additional part depending on collective agreement and legislation. Basic legislation requires that an employee working for more than one year, starting at eighth sick day social security and employer together provides 90% of salary for at least 30 days. Ratio and number of days are computed according to the number of years worked in the company.Other legislation and agreements are applicable in other contexts such as sick child, pregnancy, paternity leave.
Since 2011, civil servants are not paid for the first day of a sick leave. This rule was abolished in 2014, and then reinstated again since January 2018.
Germany
In Germany, employers are legally required to provide at least six weeks of sick leave per illness at full salary if the employee can present a medical certificate of being ill. The salary paid during sick leave is partially refunded to employers.After these six weeks, an employee who is insured in the statutory health insurance receives about 70% of their last salary, paid by the insurance. According to § 48 SGB V the health insurance pays for a maximum of 78 weeks in case of a specific illness within a period of three years. In case another illness appears during the time when the employee is already on sick leave then the new illness will have no effect on the maximum duration of the payment. Only if the patient returns to work and falls sick again with a new diagnosis will the payment be extended.
Fathers and mothers who are insured in the statutory health insurance and are raising a child younger than 12 years also have the right to paid leave if the child is sick. The insurance pays for a maximum of 10 days per parent and per child, limited to 25 days per year per parent.
For patients with a private health insurance, payments beyond the legally mandated first six weeks depend on the insurance contract.
Other countries
At least 145 countries provide paid sick days for short- or long-term illnesses, with 127 providing a week or more annually. 98 countries guarantee one month or more of paid sick days.Many high-income economies require employers to provide paid sick days upwards of 10 days, including: the Netherlands, Switzerland, Sweden, Denmark, Finland, and Singapore.