What is sick leave? 

Sick leave is time an employee can take off work due to illness, injury or certain medical needs. Depending on the applicable regulations, employees may also be entitled to leave to care for a sick family member. 

There are two main types: paid and unpaid sick leave. Paid sick leave allows eligible employees to receive wages while taking qualifying time off, while unpaid sick leave provides time away from work without pay. 

Sick Leave Regulations in the U.S. 

If you recruit in the US, it’s important to understand that employment regulations can differ significantly from one state to another. 

Sick leave is no exception. Federal, state and local laws can all influence an employee’s entitlement, meaning recruitment agencies must consider where their workers are based when managing placements. 

Federal Sick Leave Laws 

Unlike the UK, the U.S. does not have a general federal law requiring private-sector employers to provide paid sick leave. 

However, the Family and Medical Leave Act (FMLA) provides eligible employees of covered employers with up to 12 weeks of unpaid, job-protected leave in a 12-month period for certain medical and family circumstances. 

This includes qualifying serious health conditions affecting the employee or certain family members. 

Eligibility requirements apply, including conditions relating to length of employment, hours worked and employer coverage. The FMLA is therefore not a universal sick leave entitlement. 

Which States Require Paid Sick Leave? 

As of 2026, the following 17 states have statewide paid sick leave requirements for covered employers and eligible employees: 

Alaska, Arizona, California, Colorado, Connecticut, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont and Washington. 

Washington, D.C. also has mandatory paid sick leave requirements. 

In addition, Illinois, Maine and Nevada have broader earned paid leave laws, allowing eligible employees to use their leave for various purposes, including illness. 

These laws do not necessarily apply to every employer or employee in each state. Eligibility, accrual rates and annual leave allowances can vary. 

Source: Congressional Research Service – Paid Sick Leave in the United States, April 2026. 

Local Sick Leave Regulations 

State legislation isn’t the only consideration. Some cities and municipalities have their own paid sick leave requirements. 

For example, San Francisco has a Paid Sick Leave Ordinance that covers eligible employees working in the city, including part-time and temporary employees. 

This means recruitment agencies placing workers in different locations may need to account for local requirements alongside state legislation. 

What Does This Mean for UK Recruitment Agencies? 

For UK recruitment agencies expanding into the U.S., sick leave is one of several employment requirements that work differently across the two markets. 

In the UK, eligible employees are entitled to Statutory Sick Pay (SSP) for up to 28 weeks. As of April 2026, SSP is payable from the first full day of sickness absence, at 80% of average weekly earnings or £123.25 per week, whichever is lower. Some employers also offer more generous contractual sick pay. 

In contrast, the U.S. has no equivalent nationwide statutory paid sick leave entitlement for private-sector employees. Instead, requirements depend on the state, local jurisdiction and applicable employer policies. 

For UK recruitment agencies placing workers across multiple U.S. states, these differences can affect employment costs, payroll calculations and the ongoing management of placements. 

Understanding the requirements before making a placement helps agencies account for sick leave obligations when pricing contracts and managing their U.S. workforce. 

Managing Sick Leave Across the U.S. 

At Lead & Gain, we help recruitment agencies manage the employment, payroll and compliance requirements behind their U.S. contract placements, including sick leave accrual and tracking. 

Contact our team to learn how we can support your U.S. recruitment operations. 

Disclaimer: This article is provided for general informational purposes only and does not constitute legal advice. Employment regulations may change and requirements vary by jurisdiction and individual circumstances.