Sick pay in the United States: what employers must provide
Reviewed by Mellow Editorial Team, HR & payroll content team
There is no federal law requiring employers to provide paid sick leave to most private-sector workers. What you must offer depends almost entirely on state and local law — and those rules vary widely.
The federal baseline
The federal government does not mandate paid sick leave for private-sector employees. The Family and Medical Leave Act (FMLA) requires covered employers (generally those with 50 or more employees) to provide up to 12 weeks of unpaid, job-protected leave per year for qualifying medical and family reasons — but that is unpaid time off, not sick pay.
The one federal paid-leave requirement that existed for private employers — the Emergency Paid Sick Leave Act passed during the COVID-19 pandemic — has expired. No equivalent permanent federal mandate has replaced it.
If you offer sick pay voluntarily, it must be administered without discrimination and in line with any promises made in an employment contract or handbook.
State and local mandates
More than a dozen states, plus Washington D.C. and many cities and counties, have their own paid sick leave laws. The rules differ on:
- Accrual rate. A common structure is one hour of paid sick leave for every 30 or 40 hours worked, but states set their own rates.
- Annual cap. Many laws cap the total hours an employee can accrue or use in a year — often 40 or 48 hours, though some states allow more.
- Waiting period. Some laws let you require a new hire to wait 90 days before using accrued leave.
- Covered employers. Thresholds vary. Some laws apply to all employers regardless of size; others exempt very small businesses.
- Qualifying reasons. Most laws cover the employee's own illness, preventive care, and caring for a family member. Several states also include safe leave — time off related to domestic violence, stalking or sexual assault.
- Carryover and payout. Some states require unused sick leave to carry over year to year. Most do not require payout of unused sick leave on termination, but a few treat it differently if your policy combines sick and vacation time into a single PTO bank.
California, New York, New Jersey, Washington, Massachusetts, Connecticut, Colorado, Oregon, Maryland, Rhode Island, and Illinois are among the states with statewide mandates. If you operate in multiple states, you need a policy for each jurisdiction — a single national policy rarely satisfies every requirement.
How accrual and usage typically work
Under a typical accrual model, an employee earns sick time as they work. A full-time employee working 40 hours a week would accrue roughly one hour per 30 hours worked, reaching 40 hours (five days) after about 30 weeks. Part-time and hourly workers accrue on the same schedule in most jurisdictions, so you cannot exclude them.
Some employers prefer a frontloading model — granting the full annual allotment on day one (or on the employee's work anniversary). Frontloading is often simpler to administer and, in many states, eliminates the obligation to track accrual and carry over unused hours, though you should verify the rules for each state where you operate.
Interaction with PTO policies
Many employers use a single paid time off (PTO) bucket that covers vacation, sick time, and personal days together. That approach is legally acceptable in most states, provided the combined balance meets or exceeds the minimum sick leave the law requires and employees can use it for any qualifying sick-leave reason without penalty. Be careful in states like California, where accrued vacation pay is treated as earned wages and cannot be forfeited — merging sick and vacation leave into one PTO pool brings that wage-protection rule to the entire balance.
Recordkeeping and notice obligations
Where state sick leave laws apply, employers are generally required to:
- Track hours accrued and used for each employee
- Provide employees with their current sick leave balance, either on each pay stub or on request
- Post a notice of employee rights, usually a state-issued poster
- Retain records for a specified period, commonly three years
Some laws also require a written sick leave policy and impose specific rules on how much advance notice you can demand from an employee before they use sick time. Requiring two weeks' notice before taking sick leave, for example, would violate most state laws — short notice or no notice is expected when an employee is genuinely ill.
Understanding your obligations at the state and local level — before you hire in a new location — is the most reliable way to stay compliant and avoid penalties. If your workforce spans multiple states, how Mellow runs payroll across six countries is worth a read for context on managing jurisdiction-by-jurisdiction complexity.
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