Paid sick leave- who gets what?
For an employee, taking sickness absence is a result of a number of variables, including health status and symptoms, impact on function and how this matches to the role, and the overall psychosocial context.
Employer flexibility around adaptations to a role to meet functional changes, even for short term sickness absence (such as allowing somebody to work remotely during a period of reduced mobility) can help provide the leverage necessary to keep the individual working and productive.
Where this leverage does not exist or is not enough to keep people working during a period of ill health, working conditions around employment security during sickness absence also have a bearing on employees attitude towards taking time off work. How does taking a paycut, or receiving zero pay impact willingness to take sickness absence? There is a balance between presenteeism (showing up to work when not well enough) and absenteeism (taking sickness absence without adequate reason). Neither of these are good for the individual, nor the organisation (or customers/ service users).
In the UK, some employers offer occupational sick pay for a period of time (which may be close to full pay, or start at full pay then taper down over time), while all are mandated to offer statutory sick pay. This is £109.40 per week, from day four to week 28 of sickness absence. There are grey areas around what constitutes an employee, such as for agency workers and people on zero hours contracts which means that not everybody is entitled to some form of sick pay. In fact, people in insecure employment who are lowest down the socioeconomic ladder may be least likely to be entitled to any form of sick pay, which feeds back into the social determinants of health.
In contrast to the UK, the US has less regulation around paid sick leave. Currently, there are no federal legal requirements for paid sick leave. Different state regulations also lead to different working conditions in different parts of the country. In California, the law around paid sick leave is changing from January 2024, increasing the requirement for employers to pay for five full days or 40 hours sickness absence (whichever is more), compared to three full days or 24 hours. In other parts of the US, employees accrue paid sick leave entitlement per number of hours worked, which may be capped. Across the US, there is additional variation in how regulations apply to employers of different sizes.
Less regulated environments, such as the US vs the UK, hand more autonomy to employers regarding how to curate their own sickness absence policies. This is worth thinking about where recruitment and retention costs feed into productivity alongside the benefits of attracting and retaining a diverse workforce, which must be balanced with policies that keep both absenteeism and presenteeism to a minimum.