Paid sick leave laws: State-by-state guide

Paid sick leave lets employees rest and recover when they're unwell, helps prevent illness from spreading at work, and keeps your business compliant with the law.

But here’s the tricky part: the rules aren’t the same everywhere. What applies in Texas might not in California. Some states have set requirements for sick days, while others have specific rules on accrual or carrying over unused days. Staying compliant means knowing the rules for each state you operate in. Getting it wrong can cost you in fines and frustration.

In this guide, we break down paid sick leave laws by state, so you can stay ahead, remain compliant, and keep your team covered.

What does paid sick leave mean?

Paid sick leave means giving employees time off, with pay, when they’re too sick to work. It allows them to recover without worrying about losing income for the ordinary hours worked they miss.

For employers, paid sick time goes beyond a legal checkbox. It’s an investment in your business. Here’s why it matters:

• Boosts morale: Employees know you’ve got their back, which builds trust and loyalty.
• Supports productivity: Sick employees at work can lead to more mistakes and more illness spreading. Letting them take paid leave helps everyone stay healthier and more productive.
• Promotes public health: Encouraging sick employees to stay home helps stop the spread of illness. That’s good for your workplace and your community.
• Ensures compliance: In many states, paid sick leave is the law. Staying compliant helps you avoid fines, legal headaches, and reputational damage.

Common uses for paid sick leave

When it comes to paid sick leave, knowing what counts as acceptable use is key. A clear sick leave policy ensures employers stay compliant and employees know when they can take time off. Here are some common situations where paid sick time applies:

• Caring for personal illness or injury: Whether it’s the flu, a cold, or a more serious condition, employees can use paid sick leave to recover without sacrificing income.
• Caring for a sick family member: Paid sick time often covers caring for an ill child, spouse, or other immediate family members. This helps employees balance family needs without needing to take unpaid medical leave.
• Attending medical appointments: Routine check-ups, specialist visits, or follow-up care are all valid reasons for using sick days. Including these in your sick days policy supports preventive healthcare and keeps your workforce healthier.
• Addressing mental health needs: Mental health is just as important as physical health. Paid sick leave can cover therapy sessions, mental health days, or treatment for conditions like anxiety or depression.
• Recovering from surgery or medical procedures: If employees need time off after surgery, they can rely on medical leave through your sick leave policy to ensure they fully recover before returning to work.

Legal complexities and best practices for paid sick leave

Managing paid sick leave policies can get tricky with federal, state, and local laws all in the mix. To stay compliant, you need to understand the legal requirements and have clear policies in place. Here’s a breakdown of key legal considerations and best practices to help you navigate the nuances.

1. Stay updated on federal, state, and local regulations

While many employees can take unpaid medical leave under the Family and Medical Leave Act (FMLA), there’s no federal law guaranteeing paid sick leave for private-sector workers. However, some states have stepped up with their own paid leave programs and requirements. This means your business needs to stay on top of varying regulations depending on where you operate. For example:

• California: Employees earn paid sick time at a rate of 1 hour per 30 hours worked, with the ability to carry over unused leave.
• New York: Employers with 100 or more employees must provide up to 56 hours of paid sick leave per year, while smaller businesses have different requirements.
• Washington, D.C.: The Accrued Sick and Safe Leave Act requires businesses to offer varying amounts of leave based on company size, with a minimum of 1 hour of leave for every 37 hours worked.
• Illinois: The Paid Leave for All Workers Act (PLAWA) requires employers to provide employees with up to 40 hours of paid leave per year, which they can use for any reason, including illness.

At the federal level, the FMLA provides up to 12 weeks of unpaid medical leave for serious health conditions or caregiving responsibilities. While the FMLA doesn’t mandate paid sick leave, it does protect employees' jobs during extended absences. Pairing a strong paid sick leave policy with FMLA protections helps cover both short-term illnesses and longer-term needs.

Additionally, the Americans with Disabilities Act (ADA) may require accommodations for employees with qualifying medical conditions. For example, if an employee’s disability or chronic illness means they need frequent time off for medical appointments or recovery, you might need to offer flexible paid sick time or additional unpaid medical leave to stay compliant.

2. Communicate policies to employees

Make sure your paid sick leave policy is clear, accessible, and easy to understand. Clearly outline:

• How paid sick time is accrued (e.g., 1 hour per 30 hours worked)
• Who qualifies for leave under the FMLA and when unpaid medical leave applies
• The process for requesting paid time off for illness or extended medical leave
• Any requirements for documentation, like a doctor’s note

Regularly remind employees where to find this information and make sure new hires receive it during onboarding. Good communication can help you reduce confusion, avoid disputes, and maintain compliance.

3. Maintain accurate and secure records

Accurate record-keeping is essential for managing paid sick leave and staying compliant. Track:

• Accrual rates for each employee
• How much paid sick time has been used and how much is left
• Requests for paid time off for illness or unpaid medical leave
• Documentation related to the FMLA or ADA accommodations

Store these records securely and ensure only authorized personnel can access them. Well-maintained records protect employers in case of audits or disputes and help you demonstrate compliance with federal, state, and local laws.

4. Incorporate flexibility and inclusivity

A good sick leave policy supports all employees, regardless of their needs and if they work on site or remotely. Consider offering:

• Paid sick days that cover mental health days, not just physical illness
• Flexible options for using paid sick time in smaller increments (e.g., hours instead of full days)
• Clear provisions for FMLA and ADA accommodations, like extending unpaid medical leave when necessary

This flexibility helps your business stay compliant while showing employees that their wellbeing matters. Inclusive paid sick leave policies reduce absenteeism, boost morale, and create a more supportive work environment.

How many sick days do employees get? Paid sick leave laws by state 

17 states and Washington, D.C., have enacted laws mandating paid sick leave for employees. However, with upcoming implementations like Nebraska's, you can expect this number to increase. These paid sick leave laws vary in terms of accrual rates, maximum usage, carryover policies, and coverage for part-time employees. Below is a general overview of these regulations:

Simplify sick leave management with Rippling

Managing paid sick leave compliance across various jurisdictions can be complex. Rippling, built on a single source of truth, simplifies this process with a full suite of HR tools designed to automate tracking, customize policies, and ensure adherence to regulations.

Rippling Time & Attendance automates the tracking of hours worked. It facilitates precise accrual of paid sick time, with approved hours seamlessly syncing to payroll, eliminating manual data entry and reducing errors. Compliance management features automate tax calculations and filings, helping you stay up-to-date with the latest regulations. This gives you total peace of mind, knowing you’re administering paid leave correctly and meeting all legal requirements.

With Rippling headcount planning, you can forecast staffing needs to keep your team covered, even when employees take sick days. The platform allows you to tailor paid sick leave policies to align with your specific company needs and comply with local laws. It even allows for the creation of custom pay types, job codes, and the configuration of overtime and break policies, making sure that all paid time off policies are compliant and reflective of your specific organizational practices.

With Rippling, you can do so much more than just manage paid sick leave. You can maintain compliance, streamline operations, and support your team with a single, unified platform.

FAQs on paid sick leave laws by state

Are sick days paid?

Yes, in states with paid sick leave laws, employees have a right to take paid sick time if they meet the eligibility criteria. Employees typically earn sick leave through an accrual system, such as one hour of paid sick time for every 30 hours worked. Some states also allow employers to front load the full amount of paid sick leave at the start of the year instead of using the accrual method.

Can employers require a doctor’s note for sick leave?

Yes, employers can often require a doctor’s note or other documentation for paid sick leave or paid time off for illness, especially if the absence lasts more than a few consecutive days. However, state laws differ on what is reasonable. Some states prevent employers from demanding a doctor’s note for short absences to avoid burdening employees. For unpaid sick days, documentation requirements may still apply, particularly under the FMLA.

How many sick days per year do you get in the US?

The number of paid sick leave days varies depending on state and local laws. Many states mandate up to 40 hours (five days) of paid sick leave per year, though some states allow for more. For instance, New York requires up to 56 hours. If no state or local law mandates paid sick leave, employers aren’t required to offer it, but employees may still have a right to take unpaid sick time under the FMLA.

What happens if an employee exhausts their sick leave?

If an employee uses up all their paid sick leave, they typically have a few options depending on company policy and state law. They may use other forms of leave, such as vacation or unpaid sick time. If the absence qualifies under the FMLA, employees may be eligible for job-protected, unpaid leave. In some cases, employers may allow additional paid sick time at their discretion.

Are employers required to notify employees about their sick leave balance?

Yes, many states with paid sick leave laws require employers to inform employees of their available paid sick time balance. You can include notification on pay stubs or through an electronic portal. For example, California and New York mandate that employers provide this information regularly. Staying informed helps employees understand their rights and usage under the associated paid sick leave policy.

This blog is based on information available to Rippling as of December 13, 2024.

Disclaimer: Rippling and its affiliates do not provide tax, accounting, or legal advice. This material has been prepared for informational purposes only, and is not intended to provide or be relied on for tax, accounting, or legal advice. You should consult your own tax, accounting, and legal advisors before engaging in any related activities or transactions.