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- Review The status and implications of paid sick leave and sickness benefits in OECD countries
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Jaehoon Lee1, Jinwoo Lee2,*
, Sang Baek Koh3,* -
Annals of Occupational and Environmental Medicine 2025;37:e21.
DOI: https://doi.org/10.35371/aoem.2025.37.e21
Published online: July 28, 2025
1Public Policy Institute for People, Seoul, Korea
2Center for Occupational and Environmental Medicine, Hanil General Hospital, Seoul, Korea
3Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- *Corresponding author: Jinwoo Lee Center for Occupational and Environmental Medicine, Hanil General Hospital, 308 Uicheon-ro, Dobong-gu, Seoul 01450, Korea E-mail: uzhamjinbo@gmail.com
- Sang Baek Koh Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea E-mail: kohhj@yonsei.ac.kr
• Received: May 13, 2025 • Revised: May 23, 2025 • Accepted: May 23, 2025
© 2025 Korean Society of Occupational & Environmental Medicine
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Abstract
- The experience of the coronavirus disease 2019 pandemic has highlighted the importance of paid sick leave and sickness benefits, and is creating an international movement to introduce or improve real-world systems. The Organisation for Economic Co-operation and Development (OECD) countries except Korea and the United States already have statutory paid sick leave or sickness benefits, with the United Kingdom extending statutory paid sick leave to low-income workers in 2025, and Ireland introducing statutory paid sick leave in 2023. In the United States, 19 states, including Minnesota in 2024 and Alaska and Missouri in 2025, as well as the Washington, D.C., have introduced statutory paid sick leave (as of December 2024). Furthermore, an analysis of 33 OECD countries with statutory paid sick leave or sickness benefits suggests that 21 countries comply with the International Labour Organization (ILO) Convention standards for adequacy of benefits and comprehensiveness of coverage, while six countries with social assistance have high comprehensiveness of coverage but low adequacy of benefits. There was not a single country with a program that had low levels of both benefit adequacy and coverage. In Korea, the pilot sickness benefit program has been extended until 2027, and the system has been delayed. The principles of benefit adequacy and coverage comprehensiveness must be upheld for the purpose and intent of the program to ensure adequate care and rest. Consequently, in addition to adhering to the standards outlined in the ILO Convention, the implementation of paid sick leave should be codified in legislation to enhance employer accountability.
BACKGROUND
Paid sick leave and sickness benefits are programs that ensure workers receive treatment and rest to recover from an illness or injury. It is a key element in promoting the right to health and social protection, supporting public health and poverty prevention, while addressing the loss of income and risk of poverty, poor health, and reduced productivity due to disease. The International Labour Organization (ILO) has long recognized the need for and provided international standards for sickness benefits through the Social Security (Minimum Standards) Convention (1952, No. 102), Medical Care and Sickness Benefit Convention and Recommendation (1969, Convention No. 130 and Recommendation No. 134), and Recommendation on Minimum Social Protection (2012, No. 202). In fact, the majority of countries worldwide (91%) have established legal provisions for paid sick leave or sickness benefits, and 62% of the global labor force (39% of the working-age population) is covered by social insurance or social assistance, employer-provided statutory paid sick leave, or a combination of the two programs.1
In particular, the coronavirus disease 2019 (COVID-19) pandemic has fueled an international effort to improve or introduce new paid sick leave and sickness benefits. In Korea, a social consensus for the introduction of the program has been built through demands from the labor and civil society, a proposal to amend the law in the National Assembly, and a recommendation by the National Human Rights Commission to introduce public sickness benefits (2022). The government has also launched a phased pilot program to introduce sickness benefits starting in July 2022. Notably, the implementation of the pilot program was initially scheduled for 2025; however, the extension of the program by 2 years has resulted in the institutionalization of the program being postponed to 2027 for review. Key issues in the design of the program, such as the level and duration of benefits, waiting periods, charging of premiums, eligibility for benefits, financing, and the relationship with other programs, remain unresolved.
A range of international precedents can offer valuable insights and implications for the design and implementation of the sickness benefit program in South Korea. This study aims to review the structure, characteristics, and recent reform trends of paid sick leave and sickness benefit programs in different countries, focusing on the benefits, coverage, and financing that have been controversial in Korea. It also compares and categorizes countries based on the ILO Medical Care and Sickness Benefit Convention and Recommendation (1969, Convention No. 130) to determine the adequacy of benefits and the comprehensiveness of coverage, in order to examine whether the system is operating in accordance with its intended purpose and objectives.
METHODS
This study analyzed the status of programs by country, focusing on data from the International Social Security Association, the literature that analyzes them, and information from the social security agencies in each country. In order to analyze the adequacy of benefits and the comprehensiveness of coverage, 37 countries from the Organisation for Economic Co-operation and Development (OECD) were categorized based on the ILO Convention (1969, No. 130). The data used in this study are primarily based on “Social Security Programs Throughout the World” (2018, 2019), jointly published by the International Social Security Association (ISSA) and the U.S. Social Security Administration.2 For OECD countries, more recent information was updated using ISSA’s Country Profiles database.3 In addition, selected reform cases were supplemented with official sources from relevant government ministries in each country.
Statutory sick leave: A legally mandated period of paid leave from work granted to employees who are unable to work due to illness or injury. The employer typically provides full or partial wage compensation during this period.
Sickness benefit: A form of income support provided through social insurance or public welfare systems when an employee is unable to work due to illness or injury for an extended period.
Waiting period: A mandatory period during which no sickness benefits are paid. The employee bears this unpaid or partially paid time before benefits commence.
Replacement rate: The proportion of an employee’s usual earnings that is paid as a benefit during the sick leave period.
RESULTS
Of the 37 OECD countries, only four do not have statutory sickness benefits: Korea, the United States, Switzerland, and Israel. Korea and the United States also do not have statutory paid sick leave. Of the 33 OECD countries with sickness benefits, five countries, including Australia, Denmark, Iceland, New Zealand, and the United Kingdom, have social assistance programs funded by taxation. With the exception of Australia, which targets only the low-income groups based on means tests, eligibility does not require a contribution history and is primarily based on residency and age (≥18 years); thus, it is broadly inclusive of non-regular workers and the self-employed. However, there are exception criteria. The United Kingdom only applied it to workers earning more than 123 pounds (£) per week (as of 2024). Given that the minimum wage is £11.44, minimum wage workers would not qualify unless they work at least 11 hours per week. In Australia and New Zealand, workers must be enrolled in a job or school that they expect to return to after they recover. The benefits are paid on a flat rate, except in Australia, New Zealand, and Ireland, where they are paid on a sliding scale based on the number of dependent children (age and number).
The remaining 27 countries have a social insurance system that is primarily funded by premiums, and while some countries do not have minimum contribution requirements (Finland, Germany, Italy, Slovenia, Japan, etc.), they usually require a certain amount of contribution (enrollment) history for eligibility. For premium contributions, seven countries, including the Czech Republic, Estonia, Italy, France, the Netherlands, Lithuania, and Turkestan, have only employer contributions; four countries, including Germany, Japan, Luxembourg, and Slovakia, have the same contribution rate for employers and employees; and 13 countries have a higher contribution rate for employers than for employees. Finland and Greece have slightly higher contribution rates for workers, and in Chile, with its private insurance system, only workers pay premiums. Benefits are paid on a regular basis based on an average daily wage over a period of time (3 months, 6 months, 12 months, etc.). The level of benefits depends on the income replacement rate and the upper and lower wage limits, and the income replacement rate is differentiated by the income level, occupation, and employment type (white-collar workers, blue-collar workers, the self-employed, voluntary subscribers, etc.). It replaces a percentage of wages and can cover a greater portion of wage loss than flat-rate social assistance benefits.
In order for sickness benefits to fulfill their intended purpose, adequate mechanisms are needed to protect workers in all forms of employment.4 Austria, Italy, and Switzerland only partially cover atypical workers, such as temporary and part-time workers, with gaps in coverage, while the other 32 countries provide coverage regardless of the employment type.
Austria, Canada, Italy, Japan, Mexico, the Netherlands, Spain, and Switzerland exclude the self-employed, while Poland and Portugal offer voluntary subscription. The remaining 25 OECD countries include the self-employed, with some requiring a certain annual income (Slovakia) or a minimum number of years or hours of coverage. Notably, there exist discrepancies in terms of the benefits, insurance premiums, coverage periods, and waiting periods. For example, in Belgium and Estonia, the insurance premiums are paid at a flat rate. Even in countries where insurance premiums are elevated relative to those applicable to workers, or where workers do not contribute, a specified proportion of reported income must be remitted. In Norway, unlike workers who are guaranteed 100% of their wages for up to 52 weeks, the self-employed are guaranteed 75% of their wages for up to 248 days. In Portugal, the waiting period for the self-employed is 30 days (3 days for workers), and the guarantee period is 1,950 days for workers, but only 365 days for the self-employed. Slovakia provides 25% of income for the first 3 days to the self-employed and voluntary subscribers, but then guarantees 55% of income replacement, as for workers, for up to 52 weeks. In Finland, workers are entitled to paid sick leave for a period of 10 days, which is considered a waiting period, while the self-employed are entitled to receive sickness benefits after a waiting period of 1 day. Overall, a significant number of countries cover the self-employed. Although there are differences from workers in terms of the benefits and coverage periods, the level of benefits is higher than that of the pilot program in Korea (60% of the minimum wage for 150 days).
An adequate coverage period is essential for the treatment and recovery from illness and injury. The ILO Convention (130) also stipulates that, in principle, the entire period of sickness should be covered, with a minimum of 52 weeks as a substandard. In fact, 23 OECD countries provide benefits for ≥52 weeks. Germany guarantees benefits up to 78 weeks, Greece for 720 days, the Netherlands for 104 weeks, and Portugal for 1,950 days. In addition, some countries have provisions that allow for extensions in cases of specific illnesses (chronic diseases, long-term treatment, rehabilitation, or recurrence) or medical reassessment. There are no nominal limits in Slovenia, Turkey, and other countries. On the other hand, nine countries guarantee <52 weeks. However, with the exception of Canada (26 weeks), these countries, including Australia (9 months), Colombia (180 days), Costa Rica (26 weeks), Denmark (22 weeks), Italy and Estonia (180 days), Poland (182 days), and the United Kingdom (28 weeks), all have longer periods than the 150 days set as the pilot program standard in Korea.
The waiting period also varies from country to country. Countries that provide a combination of paid sick leave and sickness benefits consider the statutory paid sick leave period to be the waiting period for sickness benefits, and sickness benefits are paid after that period if continued coverage is necessary. For example, Finland guarantees sickness benefits from the 11th to the 300th day, after employers cover 100% of the wages until the 10th day. In Estonia, after a 3-day waiting period, employers cover the wage from the fourth to the eighth day, and from the ninth day onwards, the sickness benefits are guaranteed at 70% of the standard wage for up to 182 days. France also has a 3-day waiting period; however, the cost is borne by the employers. Countries without statutory paid sick leave tend to have relatively short waiting periods. Greece, Italy, Japan, Mexico, and Portugal have a waiting period of 3 days for sickness benefits, while Costa Rica has no waiting period (Table 1).5,6
The ILO Recommendation on Minimum Social Protection (2012, No. 202) suggests that expanding social security should be based on two main strategies: adequate benefits in the vertical dimension and comprehensive coverage in the horizontal dimension. Based on criteria, such as the period (minimum 52 weeks) and level of benefit (minimum 45% of previous income, lower limit 60% or more) specified in the ILO Convention, and the coverage of the self-employed, temporary workers, and part-time workers, the sickness benefit systems in OECD countries can be classified as follows. While 21 OECD countries comply with both the adequacy of benefits and comprehensiveness of coverage (Ⅰ), six social assistance-type countries, including Australia, Iceland, and Ireland, have high comprehensiveness of coverage, but low adequacy of benefits (Ⅳ). Six countries, including Austria, Japan, Canada, and Mexico, demonstrate adequacy of benefits, but do not cover the self-employed (Ⅱ). Among countries that have introduced paid sick leave or sickness benefits, there are no countries with both low adequacy of benefits and low comprehensiveness of coverage (Ⅲ) (Table 2).
The experience of the COVID-19 pandemic has highlighted the importance of ensuring the “right to rest and recover when ill,” not only in terms of health security and prevention, but also at the socio-economic level, and has led to institutional reforms. During the pandemic, countries, such as Finland, Norway, Sweden, and Canada changed their paid sick leave for COVID-19–related illnesses to be provided from the first day, and expanded the coverage to the self-employed and freelancers.7 Germany has relaxed its rules to allow sick leave without a doctor’s note from the first day of sick leave and has simplified the sick leave application process by introducing electronic medical certificates. With the average number of sick days expected to increase to 15.1 in 2023, there are discussions about strengthening the certification process.
The United Kingdom amended the Sick Leave Act 2022 to extend eligibility for Statutory Sick Pay to low-income workers earning less than £123 per week starting in 2025. An estimated 1.3 million people, primarily parents who juggle cleaning, caregiving, and childcare, are expected to benefit from paid sick leave. The amount of sickness benefits has also been increased to £118.75 per week (£3 per hour) from April 2025.8
Ireland introduced statutory paid sick leave in 2023. With a doctor's note, up to 5 days of paid sick leave per year are provided with no waiting period. The benefits are 70% of the daily wage, capped at a maximum of 110 euros (€) per day. All workers who have worked at least 13 consecutive weeks are eligible to the claim, and the full amount is paid by the employers. The original plan was to expand the period to 7 days per year starting in January 2025, with a goal of expanding it to 10 days per year in 2026; however, this has been temporarily put on hold.9
At the federal level, the United States has the Family and Medical Leave Act, which guarantees 12 weeks of sick leave; however, it is unpaid and only applies to businesses with 50 or more employees and workers who have worked at least 1,250 hours over a 12-month period. The administrative order also requires federal contractors to provide up to 7 days of paid sick leave per year to employees of federal contractors beginning in 2017 (Executive Order 13706). However, there has been a recent trend of states adopting statutory paid sick leave programs. Eighteen states, including Minnesota in 2024 and Alaska and Missouri in 2025, as well as the District of Columbia, have introduced statutory paid sick leave (as of December 2024) (Fig. 1).10 Notably, 10 other states operate voluntary subscriptions that provide paid family leave through private insurance. The percentage of private sector workers covered by paid sick leave is expected to grow from 63% in 2010 to 79% in 2024.11,12 With more than 300 bills filed to institutionalize paid sick leave, this trend is only expected to grow.
CONCLUSIONS
Paid sick leave and sickness benefits vary across OECD countries. However, in order to ensure the “right to rest and recover when ill,” the fundamental principles of adequate benefits and comprehensive coverage must be met. In fact, the vast majority of OECD countries guarantee at least some level of income replacement, while also covering temporary and part-time workers and the self-employed. Even when Korea introduces paid sick leave and sickness benefits, it is necessary to ensure that the law specifies adequate benefits, comprehensive coverage, workers’ rights to sick leave, and employers’ responsibilities. In particular, the adequacy of sickness benefits should be evaluated not only by the level of income replacement, but also by the scope of medical conditions covered. Comprehensive inclusion of common conditions such as mental health disorders and musculoskeletal diseases is essential. Advanced welfare states—including Sweden, Norway, France, Finland, and Germany—already provide such coverage, recognizing that these categories account for a significant share of sickness benefit claims and reflect high medical demand.
The financial resources needed for the introduction of sickness benefits should be raised through a socially shared method, and the government should also provide financial support. The OECD average expenditure on cash benefits is approximately 0.5% of the gross domestic product, and even in countries with higher expenditures, it is below 1% (Slovenia 1.0%, Sweden 0.9%, and Norway 0.8%, etc.). Considering the size of Korea's economy and the socio-economic effects of the introduction of sickness benefits, it is affordable.
Abbreviations
COVID-19
coronavirus disease 2019
ILO
International Labour Organization
ISSA
International Social Security Association
OECD
Organisation for Economic Co-operation and Development
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Competing interests
Sang Baek Koh, contributing editor of the Annals of Occupational and Environmental Medicine, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.
-
Author contributions
Conceptualization: Lee J (Jaehoon Lee). Data curation: Lee J (Jaehoon Lee). Methodology/Formal analysis: Lee J (Jaehoon Lee). Project administration: Lee J (Jinwoo Lee). Funding acquisition: Koh SB. Writing - original draft: Lee J (Jaehoon Lee). Writing - review & editing: Lee J (Jaehoon Lee).
NOTES
SUPPLEMENTARY MATERIAL
Supplementary Data 1.
The status and implications of paid sick leave and sickness benefits in OECD countries (Korean).
Fig. 1.
Washington, D.C. and 18 other states that have adopted statutory paid sick leave. Source: U.S. Department of Labor (December 2024).10
Table 1.
Comparison of statutory paid sick leave and sickness benefits in OECD countries
| Country | Statutory paid sick leave | Sickness benefit | ||||||
|---|---|---|---|---|---|---|---|---|
| Benefit | Coverage | Waiting period | Benefit period (max) | Financial resources (worker/employer) | Expenditure (% GDP)a | |||
| Non-regular workers | Self-employed | |||||||
| Australia | 10 days/regular workers | Flat-rate | ○ | ○ | 7 days | 9 months | Taxes | N/A |
| Austria | 16 weeks | 50%–75% | △ | × | N/A | 52 weeks | Worker < Employer | N/A |
| Belgium | 30 days | 60% | ○ | ○ | 15–30 days | 1 year | Worker < Employer | N/A |
| Canada | Varies by province | 55% | ○ | × | 7 days | 26 weeks | Worker < Employer | 0.1 |
| Chile (Private) | 3 days | 100% | ○ | ○ | 3 days | Worker | 0.1 | |
| Colombia | 2 days | 50%–66.6% | ○ | ○ | 2 days | 180 days | Worker < Employer | N/A |
| Costa Rica | × | 60% | ○ | ○ | N/A | 26 weeks | Worker < Employer | N/A |
| Czech Republic | 14 days | 60%–72% | ○ | ○ | 3 days | 380 days | Employer | 0.8 |
| Denmark | 30 days | Flat-rate | ○ | △ | Self-employed (2 weeks) | 22 weeks | Taxes | 0.8 |
| Estonia | Days 4–8 | 70% | ○ | ○ | 9 days | 182 days | Employer | 0.5 |
| Finland | 10 days | 70% | ○ | ○ | 10 days | 300 days | Worker > Employer | 0.4 |
| France | 3 days | 50% | ○ | ○ | 3 days | 12 months (3 years) | Employer | 0.7 |
| Germany | 6 weeks | 70% | ○ | ○ | 6 weeks | 78 weeks | Worker = Employer | 0.4 |
| Greece | × | 50% | ○ | ○ | 3 days | 720 days | Worker > Employer | 0.2 |
| Hungary | 15 days | 50% | ○ | ○ | N/A | 1 year | Worker < Employer | 0.5 |
| Iceland | 14 days | Flat-rate | ○ | ○ | 14 days | 52 weeks | Taxes | 0.0 |
| Ireland | 5 days (introduced in 2023) | Flat-rate | ○ | ○ | 6 days | 52 weeks (2 years) | Worker < Employer | 0.3 |
| Israel | 90 days | × | × | × | × | × | × | N/A |
| Italy | × | 50%–66.6% | △ | × | 3 days | 180 days | Employer | 0.2 |
| Japan | × | 66.67% | × | × | 3 days | 18 months | Worker = Employer | 0.1 |
| Korea | × | × | × | × | × | × | × | N/A |
| Latvia | Days 2–10 | 80% | ○ | ○ | 10 days | 52 weeks | Worker < Employer | 1.0 |
| Lithuania | 2 days | 80% | ○ | ○ | 2 days | 1 year | Employer | 0.8 |
| Luxembourg | 77 days | 100% | ○ | ○ | 77 days | 52 weeks | Worker = Employer | 0.4 |
| Mexico | × | 60% | ○ | × | 3 days | 52 weeks (78 weeks) | Worker < Employer | N/A |
| Netherlands | 104 weeks | 70%–100% | ○ | × | N/A | 104 weeks | Employer | 0.3 |
| New Zealand | 5 days | Flat-rate | ○ | ○ | 2 weeks | 52 weeks reassessment | Taxes | |
| Norway | 16 days | 100%/75% (workplace/region) | ○ | ○ | 16 days | 52 weeks/248 days (workplace/region) | Worker < Employer | 1.0 |
| Poland | 33 days/14 days (under 50/50 or older) | 80%/70% (under 50/50 or older) | ○ | △ | 33 days/15 days | 182 days | Worker | 0.9 |
| Portugal | × | 55%–75% | ○ | △ | 3 days/10 days | 1,950 days/1 year (workplace/region) | Worker < Employer | 0.6 |
| Slovakia | 11 days | 55% | ○ | ○ | 11 days | 52 weeks | Worker = Employer | 0.8 |
| Slovenia | 30 days | 70%–80% | ○ | ○ | 30 days | No limits | Worker < Employer | 1.2 |
| Spain | Days 4–15 | 75% | ○ | × | 4 days | 12 months | Worker < Employer | N/A |
| Switzerland | 3 weeks–1 year | × | × | × | × | × | × | 0.9 |
| Türkiye | 7 days | 66.7% | ○ | ○ | 2 days | No limits | Employer | 0.8 |
| United Kingdom | Day 4–week 28 | Flat-rate | ○ | ○ | 3 days | 28 weeks | Taxes | 0.1 |
| United States | Varies by state government | × | × | × | × | × | × | N/A |
The data were primarily based on the “Social Security Programs throughout the World” published by Social Security Administration (SSA) and International Social Security Association (ISSA) (https://www.ssa.gov/policy/docs/progdesc/ssptw/)2, and were supplemented by Lee5 and Lim et al.6 OECD countries, more recent information was updated using ISSA’s Country Profiles database (https://www.issa.int/databases/country-profiles)3. In addition, selected reform cases were supplemented with official sources from relevant government ministries in each country.
OECD: Organisation for Economic Co-operation and Development; GDP: Gross Domestic Product; N/A: not available; ×: Enrollment restricted; ○: Enrollment allowed; △: Optional enrollment.
aPublic cash expenditure on sickness benefits as a percentage of GDP is from OECD SOCX (visited on April 19, 2025).
Table 2.
Classification of the comprehensiveness of coverage and adequacy of benefits of statutory paid sick leave and sickness benefits in OECD countries
| Comprehensiveness of coverage (low) | Comprehensiveness of coverage (high) | Classification |
|---|---|---|
| (Ⅱ) Austria, Japan, Canada, Mexico, Netherlands, Spain | (Ⅰ) Belgium, Colombia, Costa Rica, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Slovakia, Slovenia, Türkiye | Adequacy of benefits (high) |
| (Ⅲ) (United States, Korea)a | (Ⅳ) Australia, Iceland, Ireland, New Zealand, Denmark, United Kingdom | Adequacy of benefits (low) |
- 1. International Labour Organization. Sickness Benefits during Sick Leave and Quarantine: Country Responses and Policy Considerations in the Context of COVID-19. Geneva, Switzerland: International Labour Organization; 2020.
- 2. International Social Security Association (ISSA); U.S. Social Security Administration (SSA). Social Security Programs throughout the World: Asia and the Pacific, 2018. SSA Publication No. 13-11802. Washington, DC: U.S. Social Security Administration; 2019.
- 3. International Social Security Association (ISSA). Country profiles database. Geneva, Switzerland: International Social Security Association; updated continuously. https://www.issa.int/databases/country-profiles/. Updated 2025. Accessed May 13, 2025.
- 4. International Labour Organization. Towards Universal Health Coverage: Social Health Protection Principles. Geneva, Switzerland: International Labour Organization; 2020.
- 5. Lee JH. Paid Sick Leave and Sickness Benefits Abroad and the Introduction Direction for Korea: Ensuring the Right to Rest and Recover When Ill. Issue Paper 2020-02. Seoul, Korea: Public Policy Institute for People, Korean Public Service and Transport Workers' Union; 2020.
- 6. Lim SJ, Lee YG, Lee JM. An international comparison of sickness benefit programs. Health Soc Welf Rev 2021;41(1):61–80.
- 7. Organisation for Economic Co-operation and Development. Paid sick leave to protect income, health and jobs through the COVID-19 crisis. https://www.oecd.org/en/publications/paid-sick-leave-to-protect-income-health-and-jobs-through-the-covid-19-crisis_a9e1a154-en.html. Updated 2020. Accessed May 13, 2025. Article
- 8. Edwards C. Low-paid workers to get 80% of salary in sick pay. https://www.bbc.com/news/articles/cx28qw46p6yo/. Updated 2025. Accessed May 13, 2025.
- 9. Department of Enterprise, Tourism and Employment. Statutory sick leave in Ireland: an assessment of the impact of public policy changes post-pandemic. https://enterprise.gov.ie/en/publications/statutory-sick-leave-in-ireland-assessment.html. Updated 2025. Accessed May 13, 2025.
- 10. Mitchell SM. U.S. State Paid Sick Leave Laws. Issue Brief. Washington, DC: U.S. Department of Labor; 2024.
- 11. U.S. Bureau of Labor Statistics. National Compensation Survey: Employee Benefits in the United States. Washington, DC: U.S. Department of Labor; 2024.
- 12. Gould E, Wething H. Access to paid sick leave continues to grow but remains highly unequal. https://www.epi.org/blog/access-to-paid-sick-leave-continues-to-grow-but-remains-highly-unequal/. Updated 2024. Accessed May 13, 2025.
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XML DownloadThe status and implications of paid sick leave and sickness benefits in OECD countries
Fig. 1. Washington, D.C. and 18 other states that have adopted statutory paid sick leave. Source: U.S. Department of Labor (December 2024).10
Fig. 1.
The status and implications of paid sick leave and sickness benefits in OECD countries
| Country | Statutory paid sick leave | Sickness benefit | ||||||
|---|---|---|---|---|---|---|---|---|
| Benefit | Coverage | Waiting period | Benefit period (max) | Financial resources (worker/employer) | Expenditure (% GDP) |
|||
| Non-regular workers | Self-employed | |||||||
| Australia | 10 days/regular workers | Flat-rate | ○ | ○ | 7 days | 9 months | Taxes | N/A |
| Austria | 16 weeks | 50%–75% | △ | × | N/A | 52 weeks | Worker < Employer | N/A |
| Belgium | 30 days | 60% | ○ | ○ | 15–30 days | 1 year | Worker < Employer | N/A |
| Canada | Varies by province | 55% | ○ | × | 7 days | 26 weeks | Worker < Employer | 0.1 |
| Chile (Private) | 3 days | 100% | ○ | ○ | 3 days | Worker | 0.1 | |
| Colombia | 2 days | 50%–66.6% | ○ | ○ | 2 days | 180 days | Worker < Employer | N/A |
| Costa Rica | × | 60% | ○ | ○ | N/A | 26 weeks | Worker < Employer | N/A |
| Czech Republic | 14 days | 60%–72% | ○ | ○ | 3 days | 380 days | Employer | 0.8 |
| Denmark | 30 days | Flat-rate | ○ | △ | Self-employed (2 weeks) | 22 weeks | Taxes | 0.8 |
| Estonia | Days 4–8 | 70% | ○ | ○ | 9 days | 182 days | Employer | 0.5 |
| Finland | 10 days | 70% | ○ | ○ | 10 days | 300 days | Worker > Employer | 0.4 |
| France | 3 days | 50% | ○ | ○ | 3 days | 12 months (3 years) | Employer | 0.7 |
| Germany | 6 weeks | 70% | ○ | ○ | 6 weeks | 78 weeks | Worker = Employer | 0.4 |
| Greece | × | 50% | ○ | ○ | 3 days | 720 days | Worker > Employer | 0.2 |
| Hungary | 15 days | 50% | ○ | ○ | N/A | 1 year | Worker < Employer | 0.5 |
| Iceland | 14 days | Flat-rate | ○ | ○ | 14 days | 52 weeks | Taxes | 0.0 |
| Ireland | 5 days (introduced in 2023) | Flat-rate | ○ | ○ | 6 days | 52 weeks (2 years) | Worker < Employer | 0.3 |
| Israel | 90 days | × | × | × | × | × | × | N/A |
| Italy | × | 50%–66.6% | △ | × | 3 days | 180 days | Employer | 0.2 |
| Japan | × | 66.67% | × | × | 3 days | 18 months | Worker = Employer | 0.1 |
| Korea | × | × | × | × | × | × | × | N/A |
| Latvia | Days 2–10 | 80% | ○ | ○ | 10 days | 52 weeks | Worker < Employer | 1.0 |
| Lithuania | 2 days | 80% | ○ | ○ | 2 days | 1 year | Employer | 0.8 |
| Luxembourg | 77 days | 100% | ○ | ○ | 77 days | 52 weeks | Worker = Employer | 0.4 |
| Mexico | × | 60% | ○ | × | 3 days | 52 weeks (78 weeks) | Worker < Employer | N/A |
| Netherlands | 104 weeks | 70%–100% | ○ | × | N/A | 104 weeks | Employer | 0.3 |
| New Zealand | 5 days | Flat-rate | ○ | ○ | 2 weeks | 52 weeks reassessment | Taxes | |
| Norway | 16 days | 100%/75% (workplace/region) | ○ | ○ | 16 days | 52 weeks/248 days (workplace/region) | Worker < Employer | 1.0 |
| Poland | 33 days/14 days (under 50/50 or older) | 80%/70% (under 50/50 or older) | ○ | △ | 33 days/15 days | 182 days | Worker | 0.9 |
| Portugal | × | 55%–75% | ○ | △ | 3 days/10 days | 1,950 days/1 year (workplace/region) | Worker < Employer | 0.6 |
| Slovakia | 11 days | 55% | ○ | ○ | 11 days | 52 weeks | Worker = Employer | 0.8 |
| Slovenia | 30 days | 70%–80% | ○ | ○ | 30 days | No limits | Worker < Employer | 1.2 |
| Spain | Days 4–15 | 75% | ○ | × | 4 days | 12 months | Worker < Employer | N/A |
| Switzerland | 3 weeks–1 year | × | × | × | × | × | × | 0.9 |
| Türkiye | 7 days | 66.7% | ○ | ○ | 2 days | No limits | Employer | 0.8 |
| United Kingdom | Day 4–week 28 | Flat-rate | ○ | ○ | 3 days | 28 weeks | Taxes | 0.1 |
| United States | Varies by state government | × | × | × | × | × | × | N/A |
| Comprehensiveness of coverage (low) | Comprehensiveness of coverage (high) | Classification |
|---|---|---|
| (Ⅱ) Austria, Japan, Canada, Mexico, Netherlands, Spain | (Ⅰ) Belgium, Colombia, Costa Rica, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Slovakia, Slovenia, Türkiye | Adequacy of benefits (high) |
| (Ⅲ) (United States, Korea) |
(Ⅳ) Australia, Iceland, Ireland, New Zealand, Denmark, United Kingdom | Adequacy of benefits (low) |
Table 1. Comparison of statutory paid sick leave and sickness benefits in OECD countries
The data were primarily based on the “Social Security Programs throughout the World” published by Social Security Administration (SSA) and International Social Security Association (ISSA) ( OECD: Organisation for Economic Co-operation and Development; GDP: Gross Domestic Product; N/A: not available; ×: Enrollment restricted; ○: Enrollment allowed; △: Optional enrollment. Public cash expenditure on sickness benefits as a percentage of GDP is from OECD SOCX (visited on April 19, 2025).
Table 2. Classification of the comprehensiveness of coverage and adequacy of benefits of statutory paid sick leave and sickness benefits in OECD countries
OECD: Organisation for Economic Co-operation and Development. The United States and Korea do not have both statutory paid sick leave and sickness benefit systems.
