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Every employer has faced it: an employee needs to take the day off due to a child’s fever, a sudden illness or a medical appointment. And whether you're running a small business or managing HR for a multi-state organization, a common question arises: Are we required to offer paid sick leave?
The answer depends on multiple factors—including your location, company size and internal policies. With a growing number of paid sick leave laws at the state and local levels, keeping up with compliance is more important than ever.
This guide explains the current landscape of paid sick leave laws, including state and local requirements, federal protections and recent legislative changes. It also outlines practical steps employers can take to maintain compliant paid sick leave policies in 2026.
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As of 2026, there is no federal law requiring private employers to provide paid sick leave to employees.
However, the Family and Medical Leave Act (FMLA) does require certain employers to provide unpaid, job-protected leave in specific circumstances:
FMLA generally applies to private-sector employers with 50 or more employees for at least 20 workweeks in the current or preceding calendar year. To qualify, employees generally must have worked for their employer for at least 12 months, completed at least 1,250 hours of service during the preceding 12 months and work at a location where the employer has at least 50 employees within 75 miles.
Although FMLA leave is generally unpaid, employees may use accrued paid leave during an FMLA absence when permitted under the applicable policy. Employers may also require employees to use qualifying accrued paid leave concurrently with FMLA leave.
⚠️ Note: Some federal contractors are subject to Executive Order 13706, which mandates paid sick leave under specific contract types.
As of November 2026, 20 states and Washington, D.C., require covered employers to provide paid sick leave or broader paid leave that can be used for illness and other qualifying reasons.
States with paid sick leave requirements include:
Three additional states require broader paid leave that employees may use for any reason, including illness:
Virginia: Paid sick leave requirements currently apply to certain home health workers. Legislation enacted in 2026 will expand paid sick leave protections to additional employers beginning July 1, 2027, with coverage phased in based on employer size.
Missouri: The state's earned paid sick time law was repealed effective August 28, 2025. Missouri no longer has a general statewide paid sick leave requirement for private employers.
Each law establishes its own rules for employer coverage, employee eligibility, accrual, permitted uses, carryover and documentation. Employers operating in multiple states should evaluate the requirements applicable to each employee's work location.
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Across jurisdictions, common permissible uses include:
Some states also allow use for mental health care or to seek legal help in response to domestic violence.
In addition to statewide requirements, some cities and counties have their own paid sick leave ordinances. Examples include:
Local laws may establish different accrual requirements, broader definitions of family members, additional permitted uses or specific documentation and notice requirements.
Some states restrict local governments from establishing separate leave requirements, while others allow local ordinances to provide additional employee protections.
Employers should review both state and local requirements for every location where employees work to determine which provisions apply.
Some states regulate how employers provide or allow employees to use sick leave, even when the requirements differ from traditional paid sick leave mandates.
Employers with 25 or more employees that offer paid sick leave generally must allow eligible employees working at least 30 hours per week to use up to five days of earned sick leave annually to care for immediate family members. Certain exceptions apply. Georgia does not generally require employers to establish paid sick leave benefits.
The Paid Leave for All Workers Act (PLAWA) generally requires covered employers to provide up to 40 hours of paid leave annually that employees may use for any reason.
Separately, the Illinois Employee Sick Leave Act requires employers that provide personal sick leave benefits to allow employees to use at least a portion of those benefits to care for covered family members. Chicago and Cook County also maintain separate paid leave requirements.
These distinctions demonstrate why employers should examine not only whether paid sick leave is required, but also how existing leave benefits must be administered.
Missouri's earned paid sick time law took effect May 1, 2025, but was repealed less than four months later.
Governor Mike Kehoe signed House Bill 567 on July 10, 2025, eliminating the statewide paid sick time mandate effective August 28, 2025.
Missouri employers are no longer required under the repealed state law to accrue or provide paid sick leave. However, employers that voluntarily offer paid sick leave must continue to follow their applicable policies, contracts and other legal obligations.
Employers should ensure their employee handbooks and leave policies reflect current requirements. Any outstanding questions involving leave accrued before the repeal should be evaluated in light of employer policies, agreements and applicable legal guidance.
RELATED: Missouri Paid Sick Leave Law Repealed – What Employers Need to Know >>
To reduce risk and manage leave effectively:
Managing compliance with overlapping paid sick leave laws can be complex—especially for small businesses with lean HR teams.
Axcet HR Solutions, a Kansas City-based certified Professional Employer Organization (PEO), helps:
Let us simplify your leave management and support your workforce.
Explore Axcet’s HR Support Services »
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