Paid sick leave was a wartime benefit designed to keep factories running, not workers healthy.
For most of industrial history, missing work due to illness meant losing pay. No law or custom required employers to compensate workers who could not report to the factory or the office. The concept of the paid sick day emerged not from concern for worker welfare but from labor market competition during World War II.1
With millions of men serving overseas, employers competed fiercely for the remaining civilian workforce. The War Labor Board, which regulated wages to control wartime inflation, permitted employers to offer benefits, including sick leave, as a way to attract workers without raising wages.2
After the war, employer-provided sick leave expanded through collective bargaining agreements between unions and major employers. By the 1960s, paid sick days had become a standard feature of white-collar and unionized blue-collar employment in the United States, though they were never codified as a federal right.3
The United States remains the only wealthy democracy without a national paid sick leave law. The Bureau of Labor Statistics reported in 2023 that roughly 77 percent of civilian workers had access to paid sick leave, but the figure dropped to 57 percent among the lowest-paid quartile of workers.4 The workers least likely to afford unpaid time off are the workers least likely to receive paid time off.
Other countries chose different paths. Germany’s Entgeltfortzahlungsgesetz (Continued Remuneration Act) of 1994 codified an employer obligation to pay full wages for up to six weeks of illness, following a tradition that predated World War I.5 In the United States, the paid sick day remains a benefit, not a right, a distinction rooted in the wartime labor market that produced it.