Labor and Employment

Time Off Work for an Illness or Medical Condition

By Sachi Barreiro, Attorney, University of San Francisco School of Law
Whether you have a temporary or chronic illness, you might need time off from work.

At some point in time, many employees will need to take time off due to an illness. It might be something minor—like a cold or the flu—or it might be a more serious medical condition, such as cancer, diabetes, or mental illness. Fortunately, there are federal and state laws that protect your right to time off for illness.

Paid Sick Leave

In a growing trend, a handful of states (and several cities) have passed paid sick leave laws in recent years. These laws require employers to provide employees with a certain number of paid sick days each year, typically three to five. Some state laws apply to all employers; others apply only to employers of a certain size. If you’re lucky enough to live in a state or city with paid sick leave, you will have at least a few days for short-term illnesses.

Many employers also have a paid sick leave or paid time off (PTO) policy that provide time off for illness, even if they aren’t required to by law. These policies vary in the details, but it’s not uncommon for employers to offer at least a week of sick pay for established full-time employees. However, many employers don’t offer any paid sick leave at all. (To learn more, see our article on vacation, holiday, and sick pay.)

FMLA Leave

For serious medical conditions, you might be entitled to additional time off under the federal Family and Medical Leave Act (FMLA). The FMLA provides up to 12 weeks of leave in a year for various reasons, including for an employee to recover from a “serious health condition.” However, the FMLA does not apply to all employers, and the time off is unpaid.

The FMLA applies to employers with 50 or more employees. Employees are eligible to take leave as long as they:

  • have worked for a covered employer for at least 12 months total
  • have worked at least 1,250 hours in the 12 months preceding the leave, and
  • work within a 75-mile radius of at least 50 other employees of the employer.

A “serious health condition” is defined relatively broadly and includes, among other things, any mental or physical impairment that:

  • requires inpatient care (such as an overnight stay at a hospital)
  • causes more than three days of missed work and requires ongoing medical treatment, or
  • requires multiple treatments ordered by a health care provider and that would likely cause incapacity of more than three days if left untreated (for example, chemotherapy for cancer).

A serious health condition also includes incapacity caused by pregnancy (or prenatal care), a chronic health condition (for example, diabetes), or other long-term condition (for example, Alzheimer’s). To learn more, see our article on taking FMLA leave.

Leave Under the Americans With Disabilities Act

If you’re not entitled to paid sick leave or FMLA leave—or if you’ve used up all of your leave—you might be entitled to leave under the federal Americans With Disabilities Act (ADA). The ADA, which applies to employers with 15 or more employees, requires employers to provide reasonable accommodation to employees with disabilities unless it would cause undue hardship.

A disability is a physical or mental impairment that substantially limits a major life activity (such as walking, thinking, talking, or grooming oneself) or a major bodily function (such as the proper functioning of the bowels or immune system). Examples that usually qualify as disabilities include cancer, HIV, diabetes, epilepsy, multiple sclerosis, paralysis, bipolar disorder, and schizophrenia. However, many other conditions may also qualify. Notably, pregnancy is not considered a disability under the ADA. However, a pregnancy-related health condition could qualify if it substantially limits a major life activity or bodily function (such as gestational diabetes).

Employers must provide reasonable accommodations to employees with disabilities. One form of reasonable accommodation is an unpaid leave of absence. For example, if you have diabetes and need a few weeks off for a related surgery, your employer might be required to give you the time off under the ADA. (For more details, see our article on reasonable accommodation under the ADA.)

Other State Leave Laws

Some states have laws similar to the FMLA that apply to smaller employers or have different eligibility requirements. You might be entitled to time off for your illness under one of these laws, even if the FMLA doesn’t apply to your situation. Likewise, some states have laws similar to the ADA, which apply to smaller employers or cover a larger spectrum of conditions (including pregnancy).
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