Sick Leave:
Definition, Uses, Calculation & Comparison

Sick leave is paid time off from work that employees use to address health-related needs without losing pay. Employees earn sick leave hours based on hours worked, typically one hour of paid sick leave for every 40 hours worked, and can use these hours for personal illness, injury, medical appointments, or to care for sick family members.

Sick leave differs from paid vacation time because it serves health-related purposes specifically. At least 145 countries require paid sick leave for short- or long-term illnesses, with 127 providing a week or more annually. In the United States, there is no federal requirement for paid sick leave, though the Family and Medical Leave Act (FMLA) mandates unpaid sick leave for eligible employees.

Related terms: paid sick days, sick pay, medical leave, FMLA, sickness benefit

Local regulations determine the amount of sick leave employees are entitled to take each year. In Washington State, employees earn at least one hour of paid sick leave for every 40 hours worked, with unused balances of 40 hours or less carrying over to the next year. Federal employees under the Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS) have no limitation on the amount of sick leave they can accumulate.

The length of paid sick leave varies significantly across countries. Luxembourg allows over a year of paid sick leave, while some jurisdictions provide just a few days per year. In Europe, the average worker takes approximately 14 sick days per year, with Norway reporting the highest rate at 27.5 days annually, followed by Finland at 26.6 days.

Eligibility criteria for sick leave differ across jurisdictions and typically cover factors such as employee type, job tenure, contributions to social security, length of sickness, and reason for sick leave. In Washington State, employees become eligible to use earned paid sick leave 90 calendar days after their first day of work.

Federal employees under FMLA are eligible if they have worked for their employer for at least 12 months, worked at least 1,250 hours over the previous 12 months, and work at a location where at least 50 employees are employed within 75 miles. Some countries impose waiting periods before sick pay begins, France has a three-day waiting period, meaning employees receive pay only if they remain off work for four days or more.

Employees can take sick leave for 5 primary health-related reasons:

• Personal mental or physical illness, injury, or health condition requiring medical diagnosis or preventative medical care
• Care for a family member with a mental or physical illness, injury, health condition, or need for medical diagnosis or preventative care
• Workplace, child's school, or place of care closed for health-related reasons by order of a public official or after emergency declaration
• Domestic violence, sexual assault, or stalking situations covered under the Domestic Violence Leave Act
• Preparing for or participating in a judicial or administrative immigration proceeding involving the employee or family member (added in Washington State in 2025)

Federal employees are entitled to use sick leave for exposure to communicable diseases where health authorities determine the employee's presence would jeopardize others' health. This applies to serious communicable diseases such as cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, SARS, and pandemic influenza.

Sick pay amounts depend on local jurisdiction regulations. Washington State requires employers to pay earned paid sick leave hours at the employee's normal hourly compensation. Federal regulations do not mandate a specific sick pay rate, though many employers provide full pay for short-term sick leave.

Internationally, sick pay varies widely. Austria provides full pay during the first 6-8 weeks and half-pay for the following four weeks. Spain provides 60-75% of normal base salary for up to one year. The UK offers a flat-rate sum of £116.75 per week for up to 28 weeks. The most generous countries for sick pay include Austria, Germany, Iceland, Luxembourg, Norway, and Switzerland.

Sick pay is paid by the employer, the government through social security, or a combination of both. In Washington State and most U.S. jurisdictions with paid sick leave laws, employers pay sick leave directly to employees. Federal employees receive sick pay from their employing agency.

Internationally, payment responsibility varies. Employers in Bulgaria pay 70% of salary for the first three days, then the National Security Institute pays 80-90%. Netherlands employers pay 70% of wages for up to two years. Spain requires employers to make payments for the first 4-20 days but reimburses them through social security. In some jurisdictions, employers can claim back sick pay from the government.

The definition of family member for sick leave purposes covers a wide range of relationships. In Washington State, family members include a child, grandchild, grandparent, parent, sibling, spouse, any individual who regularly resides in the employee's home where the relationship creates an expectation that the employee care for the person, and any individual who depends on the employee for care.

Federal regulations define family members to include spouse, parents, parents-in-law, children, brothers, sisters, grandparents, grandchildren, step parents, step children, foster parents, foster children, guardianship relationships, same-sex and opposite-sex domestic partners, and spouses or domestic partners of the aforementioned. Agencies may require employees to document their relationship with the family member when requesting sick leave for family care or bereavement purposes.

Federal employees can use up to 13 days (104 hours) of sick leave for general family care and bereavement each leave year. They can use up to 12 weeks (480 hours) of sick leave to care for a family member with a serious health condition each leave year. If an employee has used any portion of the 13 days for general family care or bereavement, that amount must be subtracted from the 12-week entitlement.

Employees are entitled to no more than a combined total of 12 weeks of sick leave each leave year for all family care purposes. Part-time employees and employees with uncommon tours of duty receive sick leave prorated in proportion to the average number of hours worked in their scheduled tour of duty each week.

Pregnant employees who must be absent from work before giving birth for their own health or that of their unborn child are entitled to use sick leave. Employees can also use sick leave to care for a family member incapacitated because of pregnancy or childbirth, or to accompany her to prenatal care appointments.

Any period of incapacity due to pregnancy or childbirth, or for prenatal care, is considered a serious health condition, even if the employee or family member does not receive active treatment from a health care provider during the period of incapacity or the period does not last more than three consecutive calendar days. Sick leave may be used for medical examinations and during the period of incapacitation for delivery and recuperation. Once the period of incapacitation is over, there is no entitlement to use sick leave. There is no provision in law or regulation that permits the use of sick leave to care for a healthy newborn, bond with a healthy child, or for other child care responsibilities.

Employers can require administratively acceptable evidence for sick leave absences. For absences exceeding three days, or for a lesser period when determined necessary, employers may require a medical certificate or other administratively acceptable evidence. An employer may consider an employee's self-certification as to the reason for absence as administratively acceptable evidence, regardless of the duration.

In Washington State, employers must have a written policy if they require verification for absences. In the UK, employees need to provide a sick note (or "fit note") signed by a doctor if they are off work for more than seven days. Employees must provide administratively acceptable evidence or medical certification within 15 days of the employer's request. If unable to provide evidence despite diligent, good faith efforts, employees must provide it within a reasonable period, but no later than 30 calendar days after the request.

Sick leave abuse occurs when an employee takes sick leave without having a valid reason outlined within the law or their employment contract. It is often associated with frequent use of sick leave, referred to as absenteeism. If an employee repeatedly abuses sick leave, the employer may have the right to use disciplinary measures, including dismissal.

Employers should speak to the employee first to confirm if and why they are misusing sick leave to identify the root cause. Before taking disciplinary actions, employers must refer to local laws and regulations to ensure compliance. However, employers are prohibited from disciplining employees who use paid sick leave for any reason allowed by law.

Unused sick leave is used in calculating an employee's or survivor's annuity based on retirement with an immediate annuity or on death in service. For employees covered by the Civil Service Retirement System (CSRS), credit toward the annuity computation is based on the full sick leave balance at retirement or death.

For employees covered by the Federal Employees Retirement System (FERS), credit is based on a percentage of the sick leave balance depending on separation date. Employees who separated between October 28, 2009, and December 31, 2013, receive 50 percent credit. Employees who separated on or after January 1, 2014, receive 100 percent credit. For reemployed annuitants, sick leave used in the annuity computation is charged against the employee's sick leave account and cannot be used, transferred, or recredited in the future.

Employees who have a break in service and return to work for the Federal Government are entitled to recredit their sick leave, regardless of the length of the break. For FERS employees who retired between October 28, 2009, and December 31, 2013, 50 percent of sick leave was credited toward the FERS annuity computation. If the employee returns to federal service as a reemployed annuitant, they are entitled to recredit the remaining 50 percent.

For CSRS employees or FERS employees who retire on or after January 1, 2014, 100 percent of the employee's sick leave is used in the annuity computation. Consequently, no sick leave remains for recredit should the retiree later return to federal service. Any sick leave used in the computation of the employee's annuity is charged against the employee's sick leave account and cannot be used, transferred, or recredited in the future.

Employers must maintain records of the amount of sick leave used by employees for general family care, bereavement, and care of a family member with a serious health condition. Records must be sufficient to ensure employees do not exceed the limits placed on sick leave usage per leave year.

In Washington State, employers must notify employees at least once a month with a statement (paper or electronic) explaining how much paid sick leave was earned since the last notice, how much was used since the last notice, and how much unused paid sick leave is available. Employers may use regular payroll statements to provide this notification. All Washington employers must provide an initial, one-time written notice (paper or electronic) explaining employees' legal entitlement to paid sick leave, how much they will earn, when they may use it, and that retaliation is prohibited.

Sick leave is often compared to 4 related leave types:

Sick Leave vs. Annual Leave

Sick leave is intended for health-related purposes including illness, injury, medical appointments, and care for sick family members, while annual leave is paid vacation time for rest, recreation, or personal matters. In some jurisdictions, agencies may grant sick leave to an employee on annual leave for any purpose for which sick leave may be granted, such as when an employee becomes sick while on vacation.

Sick Leave vs. FMLA Leave

The Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job-protected leave for serious medical situations, while sick leave provides paid time off for health-related absences. FMLA covers employees who have worked for their employer for at least 12 months and at least 1,250 hours over the previous 12 months. In many instances, paid sick leave may be substituted for unpaid FMLA leave.

Sick Leave vs. Compassionate Leave

Sick leave addresses health conditions and medical needs of the employee or their family members, while compassionate leave (also called bereavement leave) specifically addresses situations involving the death of a family member or urgent family emergencies. Some jurisdictions allow employees to use sick leave for bereavement purposes, federal employees can use up to 13 days of sick leave for general family care and bereavement each leave year.

Sick Leave vs. Medical Leave

Medical leave is another term for sick leave, commonly used in the United States and India. Both terms refer to paid time off from work that employees use to address health-related needs. In the U.S., federal medical leave is regulated by the Family and Medical Leave Act (FMLA), while several states have implemented Paid Family and Medical Leave (PFML) as a benefit.