Who Has Paid Sick Leave in the United States?

For the 24% of workers who don’t, illness can force difficult decisions

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Who Has Paid Sick Leave in the United States?

When Natalie’s* husband woke up one morning in March 2020 with a cough, she knew she had to call in sick. Natalie didn’t make the decision lightly — she doesn’t have paid sick leave, so over her seven years of working in the catering industry she’s pushed through innumerable colds to avoid losing income. But the COVID-19 pandemic was different, and she had no choice but to stay home in case her husband had the virus.

Natalie, 31, says her experience isn’t uncommon, adding that “people don’t realize that there are going to be people who are sick but keep serving your food or your groceries because they can’t afford to miss a paycheck.”

Around the world, 179 of 193 countries have some form of paid sick leave, although details vary. The United States does not, with approximately 33.6 million people — almost a quarter of the civilian workforce — who are not guaranteed pay when they have to take time off work due to illness (according to 2019 data from the Bureau of Labor Statistics).

24 percent of the civilian workforce in the U.S. don't have paid sick leave

However, paid sick leave is becoming somewhat more common in the United States. According to the federal Bureau of Labor Statistics’ (BLS) 2019 National Compensation Survey, 76% of U.S. civilian workers were offered paid sick leave in 2019, up from 65% in 2014.

The availability of paid sick leave varies greatly based on occupation, employer, and geography. Lower-income workers are far less likely to have it because, like health insurance, it is considered a benefit. According to the BLS, as of 2019, 49% of the lowest-earning quarter of civilian workers have no paid sick leave. For those whose wages are $10.80 an hour or less (the lowest-earning tenth of civilian workers), 69% have no paid sick leave.

For many Americans, a pandemic brings the issue of paid sick leave into sharp relief, but for many others, it’s nothing new.

Judy, a 72-year-old grocery store worker in Wichita, Kansas, had to dissolve her retirement funds two years ago when knee surgery meant she couldn’t work for six weeks. She worries what she’d do now if she got sick, saying that she’d probably juggle which bills to pay: the electric company would give her a couple months before it switched her off, but her phone would probably be cut right away. She guesses she’d rack up daily late fees on her rent, compounding her financial problems. 

"Getting paid sick leave might be harder than getting out of a sickbed and going to work."


The Families First Coronavirus Response Act (FFCRA), which was passed by Congress in March 2020, provides tax credits to certain public employers and private employers with fewer than 500 employees to cover the cost of providing paid sick leave to those with COVID-19 symptoms who are seeking a diagnosis, or who are caring for family members who have been ordered to quarantine. However, those provisions may not extend to workers such as Judy or Natalie because, like millions of Americans, they work for companies with over 500 employees that are not subject to the new law.

That leaves many employees with a difficult decision should they or a loved one get sick. As Judy noted, “Getting paid sick leave might be harder than getting out of a sickbed and going to work.”

* We have used only first names in this article to protect the privacy of the people interviewed.