Sick Leave

Paid or unpaid time off for illness or medical appointments — required by law in many states and cities, but with no federal mandate outside of FMLA.

Sick leave is paid or unpaid time off granted to employees when they are ill, injured, or attending medical appointments. Unlike vacation or PTO, sick leave is specifically designated for health-related absences. The United States has no federal law requiring private employers to provide paid sick leave — but more than 20 states and dozens of cities have enacted their own mandates. This patchwork means your sick leave entitlement depends heavily on where you work, not just who you work for.

States with paid sick leave mandates include California, New York, Massachusetts, Washington, Oregon, Colorado, Connecticut, New Jersey, Maryland, Illinois, and others. Most mandate at least 1 hour of paid sick leave per 30–40 hours worked, up to 40–56 hours per year. Some laws are narrow — covering the employee only; others extend to caring for a sick family member. New York City's law is among the broadest, covering employers with 5+ employees and allowing leave for both illness and 'safe leave' (related to domestic violence, sexual assault, or stalking).

Many employers offer sick leave as part of a broader PTO pool, making the distinction academic — employees draw from the same bank regardless of reason. Others maintain separate sick and vacation banks. The distinction matters at termination: vacation/PTO is treated as earned wages and must be paid out at termination in some states (California, Colorado), but sick leave generally is not — even in those states. Understanding your company's policy and state law is important for both day-to-day use and end-of-employment financial planning.

State Sick Leave Laws at a Glance

  • California: 5 days (40 hours) paid sick leave per year for most employees; can accrue up to 80 hours.
  • New York State: 56 hours per year for employers with 100+ employees; 40 hours for smaller employers.
  • Massachusetts: 40 hours per year (1 hour per 30 hours worked).
  • No federal mandate: employees in states without laws may have zero paid sick leave if their employer doesn't provide it.
  • If your city is in a state without a law, check local ordinances — many cities (Seattle, Chicago, Philadelphia, Denver) have their own mandates.

Sick Leave vs. FMLA vs. PTO

These leave types are related but distinct. Sick leave is the baseline — short-term, typically paid, for illness or medical appointments, state-mandated in 20+ states but not federally required. PTO is a combined pool that folds sick leave, vacation, and personal days into one bank — flexible, but it doesn't give you more time than the total. FMLA is the federal safety net for serious health conditions: 12 weeks of unpaid, job-protected leave that can run concurrently with sick leave or PTO, converting your paid leave balance from unpaid time off into pay you're drawing while FMLA protects the job. Short-term disability insurance picks up where sick leave ends for extended illnesses — typically 60–80% pay for conditions lasting beyond a few days, up to the STD benefit period. Understanding how these stack is most important when facing a serious illness: the right combination can mean months of protected, partially paid leave rather than a forced resignation.

Example

A full-time employee in California works 40 hours/week and accrues 1 hour of sick leave per 30 hours worked. After about 5 months they've accrued the 5-day (40-hour) minimum required by state law — which they can use for their own illness, a doctor's appointment, or caring for a sick child.