Paid Sick Leave FAQs (Rollover, Payout, State Sick Leave Laws)

Andrew Buck's avatar Andrew Buck January 15, 2024

We’re going to answer all your questions about sick leave, and clear up anything you’re unsure about when it comes to sick leave.

This article has answers to all the most common questions people ask about sick leave, from which states have mandatory sick leave laws, to small procedural questions, like whether sick leave rolls over, and what happens to it when you quit.

Which States Require Employers to Provide Paid Sick Leave?

19 states currently have laws mandating paid sick leave for employees:

This list is steadily increasing, with Illinois and Minnesota passing sick leave laws that came into effect on January 1st of 2024.

Each state’s sick leave laws have their own nuances, regarding who is eligible for sick leave, how much sick leave an employee should earn, and more.

Also, some of the states above have general laws regarding paid leave, where though the law doesn’t specifically provide sick leave, it does entitle employees to paid leave that can be used for sickness.

For example, Illinois’ Paid Leave for All Workers Act lets workers earn up to five days of paid leave per year (one hour for every 40 hours worked). This leave can be used for any reason, so can cover sick leave as well as other types of leave.

Learn More: Our Leave Laws HQ has a rundown on how vacation time, sick leave and more works in all US states.

What Can Sick Leave Be Used For?

Generally, sick leave can be used for illness, injury and medical or dental appointments.

In some cases, employees may be able to use sick leave if they need to take time off work to care for their sick child, family member or someone else close to them.

Some national or state laws spell out specific reasons sick leave can be used. This means employees in these locales are legally entitled to take sick leave for those reasons, while any other reasons are up to the discretion of their employer whether to allow it or not.

Do You Get Paid for Sick Days?

Usually, yes, you get paid for sick days.

The amount you get paid for sick leave varies. The default is to get your regular pay; what you would have earned if you came in and worked a normal day.

In some areas with paid sick leave laws (including many European countries) sick leave pay is a percentage of your regular pay (e.g. 75%). This is more common where sick leave is paid out by a national social security/social insurance scheme.

In places where paid sick leave is not required, the law may still require businesses to provide unpaid sick leave.

One of the best examples is the Family and Medical Leave Act (FMLA) in the US. This nationwide law provides unpaid leave for certain circumstances, including serious health conditions that prevent an employee from working.

Even if a state does not provide sick leave by law, the FMLA still applies (as long as the business and employee are both covered by the act).

How Does Unpaid Sick Leave Work?

Though employees don’t get compensated on unpaid sick leave (such as FMLA leave), there’s still a difference between taking an unpaid sick day and simply being off work.

Unpaid sick leave means the employee’s absence is excused and allowed, so generally they will not be punished for their absence as they would if they just did not turn up.

Unpaid sick leave is usually a job-protected absence, meaning the employee is entitled to return to their same position, with the same benefits, after their sick leave is over.

This is the case with FMLA leave; though it doesn’t entitle the employee to paid leave, it does allow them to return to their job after the leave, and prevents employers from firing the employee when on FMLA leave.

What’s the Difference Between Sick Days vs PTO?

Paid Time Off (PTO) is a blanket term for any kind of excused absence from work, where the employee is compensated despite being away from work. Sick leave or sick days are a specific type of paid time off.

However, it should be noted that PTO is often used to mean vacation time or annual leave. Vacation/annual leave is different from sick leave in that it is a planned absence, taken for whatever reason the employee chooses.

Sick leave is (in most cases) not planned, and taken specifically for an illness or injury that makes the employee unable to attend their regular shift.

Do Employers Need to Provide Sick Leave if They Already Provide PTO?

This will differ depending on the state’s (or country’s) laws, and how they regulate minimum requirements for sick leave and PTO.

As long as the business provides enough PTO/vacation time AND sick leave, they may be able to offer all types of paid leave under one heading.

For example; let’s say the state your company is located in requires five days of sick leave per year, but doesn’t require you to offer vacation time.

You offer 10 days of vacation time for your employees anyway. In this case, you may not have to offer sick leave as well, as long as you allow vacation time to be used for illness and injury too.

However, another state requires businesses to provide 10 vacation days and five sick days. Again, the business provides 10 vacation days for their employees. In this case, they would need to provide five sick days as well (or increase their overall PTO allowance to 15 days, to cover both the vacation and sick time requirements).

Disclaimer; be sure to check with an employment law professional in your area for full and complete advice.

What Happens at the End of the Year? Does Sick Leave Roll Over?

Each state or country treats this differently. The most common practice is that sick leave doesn’t roll over at the end of the year, or at least it’s not as likely as it is for unused PTO to roll over.

15 states prohibit “Use It or Lose It” for sick leave; meaning any unused sick leave at the end of the year must carry over to the following year. There may be a cap on how much can be accrued and held at one time, but businesses in these states cannot strip away unused sick days at the end of the year.

These states are:

If not required by law, it’s up to the employer’s discretion whether to roll over unused sick days or not.

Do You Get Paid For Unused Sick Days When You Quit?

This, too, is dependent on state or national laws, plus the employer’s own company policy.

Currently, no US states require businesses to pay out unused sick days when an employee leaves their job (though some states’ laws are a little ambiguous on this matter, or require a written policy stating that unused sick leave will not be paid out).

This is the most common practice around the world too. While unused PTO tends to be paid out upon termination, unused sick days are usually not.

What Happens if You Run Out of Sick Days?

If an employee is ill and doesn’t have any sick days left, the business has a few ways to handle it.

They could be allowed to take unpaid sick leave. In this case, their absence will be excused, but they won’t be paid for it.

The employee could have the option of taking vacation days to cover sick leave (though this practice is banned in some countries). They may also be allowed by their employer to dip into their sick leave quota from the following year.

There’s also the possibility that the business may not approve any absence if all the employee’s sick leave has been used up. In a case such as this, the employee may be faced with the option of coming to work while unwell, or face disciplinary action (extending potentially to dismissal).

This would not be a healthy (in both the physical and psychological sense) way to run a business, and local labor laws may prohibit a company from firing or disciplining someone for being unwell.

Ultimately, outside of what the law says in their location, it’s up to the business to decide how to handle this situation.

Can You Cash Out Sick Time?

In most companies and locations, employees cannot exchange their sick days for cash.

Sick leave is not meant to be a financial benefit, like vacation time, an end of year bonus or stock options. It’s meant to cover for when an employee is unwell and unable to work.

Some companies may allow employees to cash out their unused sick leave, though this is definitely not the norm.

How Much Sick Leave is Normal?

The average sick time allowance (as well as the average number of sick days taken) differs from location to location.

In the US, workers receive approximately eight sick days per year, on average.

This is higher for union workers (10 days on average) vs non-union (seven days).

48% of workers with access to paid sick leave receive between five and nine days per year.

Americans, however, average just two to three days of sick leave taken per year. Around a quarter of Americans didn’t even take one sick day in the last 12 months.

In Europe, the average number of sick days is generally higher, with most countries averaging 10 or more sick days per year.

Learn more in this article.

Final Thoughts: How to Track Sick Days in Your Business

If you’re running a business, and you offer sick leave to employees in your business, you need an efficient way to track sick leave usage, in order to:

Flamingo is the sick leave tracking tool you need. It’s easy to use and understand, allowing employees to notify their managers that they’re sick in just a couple of clicks, and storing the information about the employee’s sick leave request for scheduling and follow up purposes.

Flamingo lets you set each employee/team/location’s limit on yearly sick days (or go unlimited), so both employees and managers know at all times how many sick days they’ve taken and how many they have left.

You can also track vacation days, public holidays and any other leave types you need, and managers can pull up detailed reports in seconds.

Flamingo is free to try; add it to your Slack organization now and see how much easier it makes tracking sick leave in your business.

Andrew Buck's avatar

Andrew Buck

Andrew is the content manager at Flamingo. He has managed teams in multiple industries, for both physical and remote businesses, and has experience dealing with the ins and outs of HR and leave management on a daily basis.

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